Suicidal Behaviors in a Nationally Representative Sample of School-Going Adolescents Aged 12–17 Years in Eswatini

The burgeoning body of evidence suggests that the aggregated 12-month prevalence estimates of suicidal behaviors (ideation, planning, and attempt) are relatively higher among in-school adolescents in Africa, although country-specific data on the phenomena are still inadequate from the continent. We sought to estimate the 12-month prevalence and identify some of the correlates of suicide behaviors among school-going adolescents in Eswatini. We analyzed the nationally representative data from the 2013 Eswatini World Health Organization Global School-based Student Health Survey, using univariate, bivariate, and multivariate statistical approaches. Of the 2,513 analytical samples, 17.0% (95% confidence interval [CI]: 15.4–18.4%) reported suicidal ideation, 21.0% (95% CI: 19.3–22.6%) made a suicide plan, and 15.5% (95% CI: 14.1–16.9%) attempted suicide during the previous 12 months. The final adjusted logistic models indicated health risk behavior (i.e., marijuana use), adverse interpersonal factors within the family (e.g., intrusion of privacy by parents), and school contextual factors (e.g., bullying victimization, physical fights) to be associated with increased odds of suicidal behaviors among females. However, predominantly, school-related interpersonal factors (e.g., bullying victimization, physical fights) showed strong associations with increased odds of suicidal behaviors among males. Generally, parental monitoring, parental understanding, and social support at school were associated with reduced odds of suicidal behaviors. The multi-level nature of our findings underscores the need for multi-contextual and multi-sectoral intervention and prevention programs and policy approaches targeted at mitigating the onset of suicidal ideation and possible transition to suicidal planning, attempt, and potential death by suicide in this young population.