Ten Years of Democracy in South Africa

TLDR

The advent of democracy in 1994 created a unique opportunity for new laws, and a decade later South Africa has among the most progressive reproductive health policies, though advances are hard to discern due to complex socio‑economic and gender inequalities. This paper aims to document changes in health policy and services in key sexual and reproductive health areas. It focuses on contraception, maternal health, termination of pregnancy, cervical and breast cancer, gender‑based and sexual violence, HIV/AIDS, STIs, and infertility. Gaps remain in the implementation of reproductive health policies and service delivery, requiring action to improve women's reproductive health status.

Abstract

The advent of democracy in South Africa in 1994 created a unique opportunity for new laws and policies to be passed. Today, a decade later, South African reproductive health policies and the laws that underwrite them are among the most progressive and comprehensive in the world in terms of the recognition that they give to human rights, including sexual and reproductive rights. This paper documents the changes in health policy and services that have occurred, focusing particularly on key areas of sexual and reproductive health: contraception, maternal health, termination of pregnancy, cervical and breast cancer, gender-based and sexual violence, HIV/AIDS and sexually transmitted infections and infertility. Despite important advances, significant changes in women's reproductive health status are difficult to discern, given the relatively short period of time and the multitude of complex factors that influence health, especially inequalities in socio-economic and gender status. Gaps remain in the implementation of reproductive health policies and in service delivery that need to be addressed in order for meaningful improvements in women's reproductive health status to be achieved. Civil society has played a major role in securing these legislative and policy changes, and health activist groups continue to pressure the government to introduce further changes in policy and service delivery, especially in the area of HIV/AIDS.