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For many young people in Eswatini, health challenges begin with poverty, unemployment, stigma, misinformation and limited opportunities that continue to shape decisions around mental health, HIV prevention and sexual and reproductive health.These issues took centre stage at the MTN Bushfire Bring Your Fire Live Dialogues 2026, where a panel comprising representatives from UNFPA, AIDS Healthcare Foundation (AHF), Helping Hand Foundation and the Luke Commission gathered at House on Fire under the theme: “Beyond Access: Rethinking Health Equity in Eswatini.”The conversation comes at a critical moment for Eswatini. Despite progress in health outcomes, adolescent pregnancy remains a challenge, particularly in rural communities where girls are twice as likely to give birth before the age of 18 compared to those in urban settings (14% versus 6%), according to the 2021–2022 Multiple Indicator Cluster Survey (MICS). Young people, especially adolescent girls and young women, continue to face heightened vulnerability to HIV, while increasing concerns around depression, substance abuse and suicide are placing mental health higher on the national agenda. These interconnected challenges reinforce a reality echoed throughout the dialogue: health outcomes cannot be separated from poverty, inequality and access to opportunities. Representing UNFPA, Gender and Youth Program Analyst, Ms. Zenanile Dlamini argued that health inequities cannot be addressed without confronting the broader socioeconomic realities that influence wellbeing.“We cannot speak about health equity without addressing economic justice. We cannot speak about health outside of education, social protection, gender equality and economic empowerment,” she said.Her remarks echoed a recurring theme throughout the dialogue: health outcomes are inseparable from development outcomes.When discussing barriers to sexual and reproductive health services, Ms. Dlamini highlighted stigma and misinformation as persistent obstacles preventing young people from accessing care.“Young people still express that they feel stigma when they go to access Sexual and Reproductive Health and Rights (SRHR) services. There’s still misinformation around SRHR, and many continue to get information from friends or social media,” she said.UNFPA also emphasised opportunities to strengthen digital and youth-centred approaches, including the Tune Me platform, developed with the Eswatini National Youth Council to improve access to SRHR information among young people.Yet for young participants attending the dialogue, awareness alone was not enough.“We understand the mental aspect, now we need actual help. It’s coming down to poverty. It’s coming down to the economic crisis,” one student challenged, calling for practical solutions to address financial hardship and mental wellbeing.Another student, Siniketiwe Simelane raised concerns about burnout among university students:“We are students, we are burnt out. Rest is productive too. I can’t do anything if I’m burnt out.”Such concerns reflect broader trends. Recent evidence suggests 15% of adolescents in Eswatini have attempted suicide, linked to anxiety, depression and social pressures. Between 2022 and 2024, 486 suicides were recorded nationally, signalling a growing mental health crisis.Responding to these concerns, Dr Wanda Shaw from the Luke Commission stressed that mental health cannot be separated from unemployment and hopelessness.“If you don’t have a structured purpose and you have lack of hope, it has been associated with depression, anxiety and other mental health issues,” he said.Meanwhile, AHF Prevention Programme and Advocacy Manager Tulani Mthethwa warned that poverty continues to drive HIV vulnerability among young people through transactional relationships and unequal power dynamics.For UNFPA, the dialogue reinforced an urgent lesson: young people are not only asking for access to services, they are demanding systems that understand their realities, respond to their needs and invest in their futures.