South Africa tells a complicated story when it comes to women’s health. It’s a country with world-class hospitals, progressive laws on reproductive rights, and a public health system that has made real gains. This alongside deep rural-urban divides, one of the world’s largest HIV epidemics, and levels of gender-based violence that remain a national crisis. Understanding women’s health means holding both realities at once. 

Progress to be proud of 

Maternal mortality (death in women before, during or after pregnancy) has come down significantly over the past two decades. Family planning access has also improved: a large majority of women of reproductive age who want modern contraception are now able to get it. 

HIV: A persistent health issue for women 

No conversation about women’s health in South Africa is complete without HIV. South Africa has the largest number of people living with HIV of any country in the world, and the burden falls disproportionately on women. National adult HIV prevalence sits around 13%, but among women of reproductive age it is roughly double that. 

This matters for more than just HIV itself. Women living with HIV face a cervical cancer risk that’s several times higher than HIV-negative women, even with good antiretroviral therapy coverage a reminder that treating HIV alone doesn’t erase its downstream health effects. Cervical cancer remains one of the most common cancers among South African women, and screening uptake is still too low, particularly in rural areas. 

Cancer screening and chronic disease 

Beyond cervical cancer, breast cancer screening rates also remain inconsistent, especially outside major cities. Studies of general-population screening behaviour consistently point to the same barriers: distance to facilities, cost of transport, fear or embarrassment around medical examination, and limited awareness campaigns reaching rural and lower-income communities. Non-communicable diseases; hypertension, diabetes, and obesity-related conditions are also rising among South African women, adding a second, quieter epidemic layered on top of the infectious disease burden. 

Gender-Based Violence as a Health Issue 

It’s impossible to separate women’s physical health from safety in South Africa. Roughly 1 in 8 women aged 15 – 49 report having experienced physical or sexual violence from a partner in the past year, and rates of sexual offenses reported to police remain among the highest in the world. This isn’t just a policing or social issue, it’s a health issue. Intimate partner violence is directly linked to lower uptake of cervical cancer screening, worse mental health outcomes, and reluctance to seek reproductive healthcare at all, since some services require pelvic exams that can be re-traumatizing for survivors. 

Reasons for optimism 

None of this erases the progress.  

The path forward looks less like inventing new solutions and more like scaling the ones that already work: educating women on physical care and well-being, integrating cervical and breast screening into routine care, and treating gender-based violence prevention as core health policy rather than a separate issue. 

Women’s health in South Africa isn’t one story, it’s several, unfolding at different speeds in different provinces. But the direction, on the whole, is forward. 

Take the opportunity during women’s month in August to visit your local GP, encourage a friend, a sister or a mother to do the same.