Terminal Illness & End-of-Life Planning in Eswatini: 5-Step Official Checklist

1. 1

   Coordinate Palliative Care, Home Nursing, and Health Coverage

   • Public and specialist clinical referrals: Through facilities overseen by the Ministry of Health under the Government of the Kingdom of Eswatini - including Mbabane Government Hospital, Raleigh Fitkin Memorial Hospital in Manzini, and decentralized regional health centres supported by the World Health Organization (WHO) PEN-Plus chronic care framework - families can request a formal palliative care and pain management plan [1][5]. Attending physicians can prescribe essential symptom-control medications, including oral morphine regimens dispensed through public hospital pharmacies [1][5].
   • Home-based hospice and nursing care: Ask the treating hospital's oncology or chronic care unit for a clinical referral to community palliative providers such as Eswatini Hospice at Home or regional rural health motivators (bagcugcuteli), who coordinate home nursing visits, symptom relief, caregiver training, and medical equipment loans across Eswatini's four regions [1][5].
   • Medical aid and public healthcare financing: If your family member belongs to a private medical aid scheme (such as Eswatini Med), submit the specialist's clinical report early to activate chronic illness management or home-nursing benefits. For public patients lacking private coverage, confirm eligibility for state-subsidised hospital care or the Phalala Special Medical Aid Fund if specialised tertiary treatment is required [1][5].
2. 2

   Record Advance Healthcare Preferences and Medical Contacts

   • Written clinical care preferences: Eswatini does not have a single standalone statute governing living wills, so advance treatment preferences operate through constitutional rights to bodily integrity and Ministry of Health patient-consent standards under the Government of the Kingdom of Eswatini [1][5]. While your family member has full capacity, they should sign a dated written statement detailing their wishes regarding cardiopulmonary resuscitation, mechanical ventilation, artificial nutrition, and preferred place of care (home versus hospital) [1][5].
   • Designating a primary medical spokesperson: Hospital admission teams in Eswatini rely on the designated next of kin recorded in the patient's medical file when consulting the family on urgent clinical care [1][5]. Your family member should explicitly name their primary medical spokesperson and an alternate contact in writing, have the document witnessed by two independent adults and countersigned by the treating doctor, and place copies in both the hospital chart and the home care folder [1][5].
3. 3

   Execute Financial Powers of Attorney and Bank Mandates

   • General or Special Power of Attorney: Under Eswatini's Roman-Dutch common law framework, a Power of Attorney (Procuratie) allows your family member (the principal) to authorise a trusted agent to manage property, sign legal instruments, and conduct administrative affairs [1][2]. To ensure formal validity, the Power of Attorney should be drafted by an admitted attorney or notary public in Eswatini and signed by the principal in the presence of two competent witnesses while mental capacity is medically documented [2].
   • Important capacity rule under Eswatini law: Because Eswatini common law does not recognise an automatic enduring power of attorney that survives supervening mental incapacity, a standard Power of Attorney lapses if the principal later loses mental capacity [2]. If capacity is lost, family members must petition the High Court of Eswatini (in consultation with the Master of the High Court) to appoint a curator bonis to manage financial affairs [2].
   • Bank account mandates and signatory setup: Commercial banks in Eswatini enforce strict anti-money-laundering and mandate verification rules. While your family member is still able to visit the branch or meet a mobile relationship manager, they should execute the bank's specific third-party signing mandate, register online banking access, and update Personal Identity Number (PIN) KYC records [1][2].
4. 4

   Activate Disability Benefits, Pension Provisions, and Caregiver Support

   • Private-sector invalidity and medical benefits: If your family member has contributed to the Eswatini National Provident Fund (ENPF), check eligibility for an Invalidity Benefit if the illness renders them permanently incapable of gainful employment [3]. An application requires a formal medical board or specialist assessment certifying permanent incapacity, alongside the member's PIN card and employment records [3].
   • Public-sector medical boarding and retirement: Civil servants and public employees covered by the Public Service Pensions Fund (PSPF) who can no longer perform their duties due to severe illness may apply through their ministry's human resources department and a government medical board for ill-health retirement pensions and lump-sum gratuities [1][4].
   • Social grants and workplace caregiver leave: For vulnerable citizens without formal pension coverage, the Deputy Prime Minister's Office under the Government of the Kingdom of Eswatini administers the Disability Grant and Old Age Grant [1]. Employed family caregivers should review their employment contracts and the Employment Act to arrange compassionate leave, paid annual leave, or flexible working schedules [1].
5. 5

   Organise the Will, Beneficiary Nominations, and Civil Records

   • Executing a valid Last Will and Testament: Under the Eswatini Wills Act, a person with testamentary capacity should execute a written Will signed at the end of the document (and on every preceding page) in the simultaneous presence of at least two independent competent witnesses who are not beneficiaries (and whose spouses are not beneficiaries) [2]. Clear testamentary provisions help streamline subsequent supervision by the Master of the High Court [2].
   • Updating pension and insurance nominations: Benefits held with the Eswatini National Provident Fund (ENPF), the Public Service Pensions Fund (PSPF), or group life insurers are governed by statutory trust and nomination rules rather than solely by the Will [3][4]. While capacity is intact, your family member should file updated beneficiary nomination forms and verify that all dependents' birth and marriage certificates are registered with the Ministry of Home Affairs [1][3][4].
   • Consolidating property and cross-border records: Assemble title deeds for urban freehold land, bank statements, vehicle registration books, and marriage certificates (specifying whether married under civil rites in or out of community of property, or under Swazi Law and Custom) in a secure folder [1][2]. If assets or family members are located outside Eswatini, obtain Apostille authentication on powers of attorney and coordinate separate situs-compliant wills where needed [1][2].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Government of the Kingdom of Eswatini - Ministry of Health and Social Welfare Services — Government of the Kingdom of Eswatini
2. [2]
   Office of the Master of the High Court - Wills and Estate Administration — Judiciary of Eswatini
3. [3]
   Eswatini National Provident Fund (ENPF) - Member Benefits and Invalidity Provisions — Eswatini National Provident Fund
4. [4]
   Public Service Pensions Fund (PSPF) - Public Sector Retirement and Ill-Health Benefits — Public Service Pensions Fund
5. [5]
   Bringing Care for Severe Noncommunicable Diseases Closer to Communities in Eswatini — World Health Organization Regional Office for Africa