Innovative Strategies to Improve Access to Sexual and Reproductive Health Services in Rural South Africa: An Integrated Literature Review
1
Department of Gender and Sexuality Studies, University of South Africa, Pretoria, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Rural communities in South Africa continue to experience significant disparities in accessing sexual and reproductive health (SRH) services, perpetuating adverse health outcomes, including high maternal mortality, unintended pregnancies, and HIV/AIDS prevalence [1]. Evidence suggests that geographic isolation, economic constraints, and inadequate healthcare infrastructure result in lower access and utilisation rates of health services compared to the urban areas [2-4]. Furthermore, sociocultural norms contribute to the stigma surrounding SRH services, restricting access for vulnerable populations, including adolescents and young women [5, 6]. Understanding innovative service delivery models is critical for addressing these inequities.
METHODS:
This integrative literature review examines innovative strategies that could enhance access to SRH services in rural South African contexts, identifying enabling factors, barriers, and recommendations for scalable implementation. Following Whittemore and Knafl's framework [7], secondary data were systematically sourced from peer-reviewed databases including PubMed, Scopus, AJOL and SABINET. Studies published between 2015 and 2024 addressing SRH service innovations in rural South Africa were included. Extracted data from the 27 eligible sources were thematically analysed and interpreted using Andersen's Behavioural Model of Health Services Utilisation.
RESULTS:
The findings show that mobile health clinics and outreach programmes, community health worker-led interventions [8, 9], digital health technologies including mHealth applications [10, 11] and youth-friendly service integration within primary healthcare facilities [12, 13]. Enabling factors included community engagement, task-shifting strategies, and leveraging existing infrastructure. Persistent barriers encompassed inadequate funding, healthcare workforce shortages, cultural stigma, and limited digital literacy [14].
CONCLUSIONS:
Multi-component strategies that integrate community-based initiatives, technology-enabled solutions, and health system strengthening interventions show considerable potential for improving access to SRH services in rural settings. Recommendations include sustained investment in community health workers, context-adapted digital health solutions, and policies focused on rural equity. Future research should investigate the sustainability, scalability, and cost-effectiveness of these strategies within South Africa’s resource-constrained settings.
Rural communities in South Africa continue to experience significant disparities in accessing sexual and reproductive health (SRH) services, perpetuating adverse health outcomes, including high maternal mortality, unintended pregnancies, and HIV/AIDS prevalence [1]. Evidence suggests that geographic isolation, economic constraints, and inadequate healthcare infrastructure result in lower access and utilisation rates of health services compared to the urban areas [2-4]. Furthermore, sociocultural norms contribute to the stigma surrounding SRH services, restricting access for vulnerable populations, including adolescents and young women [5, 6]. Understanding innovative service delivery models is critical for addressing these inequities.
METHODS:
This integrative literature review examines innovative strategies that could enhance access to SRH services in rural South African contexts, identifying enabling factors, barriers, and recommendations for scalable implementation. Following Whittemore and Knafl's framework [7], secondary data were systematically sourced from peer-reviewed databases including PubMed, Scopus, AJOL and SABINET. Studies published between 2015 and 2024 addressing SRH service innovations in rural South Africa were included. Extracted data from the 27 eligible sources were thematically analysed and interpreted using Andersen's Behavioural Model of Health Services Utilisation.
RESULTS:
The findings show that mobile health clinics and outreach programmes, community health worker-led interventions [8, 9], digital health technologies including mHealth applications [10, 11] and youth-friendly service integration within primary healthcare facilities [12, 13]. Enabling factors included community engagement, task-shifting strategies, and leveraging existing infrastructure. Persistent barriers encompassed inadequate funding, healthcare workforce shortages, cultural stigma, and limited digital literacy [14].
CONCLUSIONS:
Multi-component strategies that integrate community-based initiatives, technology-enabled solutions, and health system strengthening interventions show considerable potential for improving access to SRH services in rural settings. Recommendations include sustained investment in community health workers, context-adapted digital health solutions, and policies focused on rural equity. Future research should investigate the sustainability, scalability, and cost-effectiveness of these strategies within South Africa’s resource-constrained settings.
| eISSN: | 2654-1459 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
