Background:
South Africa faces a quadruple burden of disease and women are affected disproportionately. Understanding the epidemiological trends and burden of disease profile of women compared to men is important for targeted implementation of public health programs. This study describes the trends and burden of disease of communicable, maternal, neonatal, nutritional diseases (CMNNDs), non-communicable diseases (NCDs), and injuries of women in South Africa between 1990 and 2019.

Methods:
In this descriptive cross-sectional study we used open-access secondary data from the Institute for Health Metrics and Evaluation (IHME) from 1990 to 2019. We measured population health as per the world health organization standards using disability-adjusted life years (DALYs), years of life lost (YLLs), years lived with disability (YLDs) and age-specific death rate (ASD). Level 1 and 2 causes and risk factors for all ages and sexes. were clustered into CMNNs, NCDs and injuries; and behavioural, environmental or occupational and metabolic respectively.

Results:
Findings for women over the 29-year period revealed that leading causes of death, DALYs and YLLs were HIV/AIDS and sexually transmitted infections (STIs), and cardiovascular disease. The leading cause of YLDs in women was other non-communicable diseases. Trend analysis showed an increase of 13,17% in CMNNDs with a decline of NCDs and injuries by 8,99% and 45,5% respectively. In 1990 the Gauteng province had the highest mortality rates whilst the Limpopo province had the lowest, however, in 2019, the Free-State province had the highest mortality rates and the Western Cape province the least.

Conclusion:
HIV/AIDS and STIs as well as cardiovascular disease are the leading causes of death, DALYs and YLLs among women in South Africa. Strengthening national policies and implementing public health programs with a gender lens is recommended to address the burden of disease among women.