title: Coming of age? Women's sexual and reproductive health after twenty-one years of democracy in South Africa.
abstract: This paper is a sequel to a 2004 article that reviewed South Africa's introduction of new sexual and reproductive health (SRH) and rights laws, policies and programmes, a decade into democracy. Similarly to the previous article, this paper focuses on key areas of women's SRH: contraception and fertility, abortion, maternal health, HIV, cervical and breast cancer and sexual violence. In the last decade, South Africa has retained and expanded its sexual and reproductive health and rights (SRHR) policies in the areas of abortion, contraception, youth and HIV treatment (with the largest antiretroviral treatment programme in the world). These are positive examples within the SRHR policy arena. These improvements include fewer unsafe abortions, AIDS deaths and vertical HIV transmission, as well as the public provision of a human papillomavirus vaccine to prevent cervical cancer. However, persistent socio-economic inequities and gender inequality continue to profoundly affect South African women's SRHR. The state shows mixed success over the past two decades in advancing measurable SRH social justice outcomes, and in confronting and ameliorating social norms that undermine SRHR.
authors.affiliation: Professor, School of Public Health, University of the Western Cape, South Africa. Electronic address: dcooper@uwc.ac.za.
authors.forename: Diane
authors.initials: D
authors.lastname: Cooper
authors.affiliation: Associate Professor and Director, Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, South Africa.
authors.forename: Jane
authors.initials: J
authors.lastname: Harries
authors.affiliation: Director Cancer Research Initiative, Faculty of Health Sciences, University of Cape Town; Associate Professor Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town; Deputy Director SAMRC/UCT Gynaecology Cancer Research Centre.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Moodley
authors.affiliation: Senior Researcher, Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, South Africa.
authors.forename: Deborah
authors.initials: D
authors.lastname: Constant
authors.affiliation: Director, AIDS and Society Research Unit, University of Cape Town, South Africa.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hodes
authors.affiliation: Scientist, Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa; Associate Professor, Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, South Africa.
authors.forename: Cathy
authors.initials: C
authors.lastname: Mathews
authors.affiliation: Senior Clinical Lecturer, EGA Institute for Women's Health/Institute for Global Health, University College London, London UK; Botswana-Upenn Partnership, Gaborone, Botswana; Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, South Africa.
authors.forename: Chelsea
authors.initials: C
authors.lastname: Morroni
authors.affiliation: Emeritus Professor, Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, South Africa.
authors.forename: Margaret
authors.initials: M
authors.lastname: Hoffman
mesh_terms: D000028:Abortion, Induced; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000517:prevention & control; D003267:Contraception; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D006291:Health Policy; D054625:Healthcare Disparities; D006801:Humans; D008427:Maternal Health Services; D011247:Pregnancy; D060728:Reproductive Health / Q000331:legislation & jurisprudence; D046269:Reproductive Rights; D012742:Sex Offenses; D012935:Social Justice; D013019:South Africa; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control; D016387:Women's Health / Q000331:legislation & jurisprudence; D014933:Women's Rights / Q000331:legislation & jurisprudence / Q000379:methods*
chemical_list: D044966:Anti-Retroviral Agents
keywords: South Africa; challenges; democracy; successes; women's sexual and reproductive health and rights