Probing sexual and reproductiveh health (SRH) services: experiences of women at Umkhambathini eNkanyezini, KZN-South Africa.

Abstract

This qualitative study contributes to feminist anthropology, specifically the anthropology of women, by exploring the sexual and reproductive health (SRH) experiences of rural women in uMkhambathini, eNkanyezini, KwaZulu-Natal, South Africa. The study problematizes the higher mortality rates of rural women compared to men in this village, highlighting significant health disparities. Feminist anthropology addresses the interconnected challenges women face in accessing healthcare and proposes meaningful solutions. The study is framed by three theoretical perspectives: Social Constructivism, Critical Medical Anthropology, and Gender Theory. Purposive and snowball sampling methods were used to select thirty (30) participants, with data collected through five focus groups, each comprising six women. The findings underscore the continued marginalisation of rural women in uMkhambathini, impeding the realisation of South Africa's National Development Plan Vision 2030. These women remain unable to fully access Basic Human Rights as enshrined in the South African Constitution (No.108 of 1996) and international frameworks such as the Sustainable Development Goals (SDGs), which advocate for sexual and reproductive rights. Data analysis reveals that structural barriers, including education levels and family size, significantly hinder their ability to access and utilise SRH services. Furthermore, rural healthcare facilities in uMkhambathini are underresourced and geographically isolated, exacerbating healthcare exclusion due to inadequate resources and limited government intervention. The study introduces the Framework for Localised Reproductive Health and Support Structures (FLRHSS), which aims to accelerate the provision of SRH services for the benefit of rural women in uMkhambathini. The findings also reveal inconsistencies and a lack of clarity regarding the age of consent for HIV and SRH services in high-burden areas like eNkanyezini, particularly concerning oral PrEP. The study recommends prioritising rural women in SRH programs and expediting the implementation of the National Health Insurance (NHI) system to address structural, economic, and geographic barriers. Ensuring the availability of essential medical technologies and products is crucial for enabling healthcare workers to deliver effective services. Additionally, community-based education programs targeting women and mothers are vital for dismantling systemic barriers to SRH access. This research underscores the need for a more inclusive and equitable approach to SRH services that addresses the unique challenges faced by rural women in South Africa. It also calls for future research to explore the SRH needs of women with disabilities, further advancing a comprehensive understanding of reproductive health disparities in rural contexts.