Urgent Call to Address Systemic Gaps in South Africa’s Fight Against GBVF.
Developed by: Galaletsang Lephogole (PEI Intern, North West ) and Tsholofelo Sabole (Education Officer, North West)
Rural women remain at the margins of South Africa’s development story. Their lives continueto be shaped by systems of inequality that are deeply gendered, from how water is fetched to how healthcare is accessed and who delivers it. While the Constitution and various policy frameworks promise gender equality, the lived realities of rural women tell a different story; one where access to basic services like healthcare, water, and sanitation is determined not by human need, but by gendered social norms, cultural expectations, and systemic neglect. This neglect is visible in clinics that remain understaffed in rural areas, forcing women to travel long distances for care; in water projects that collapse due to poor maintenance, leaving women to walk further and queue longer; and in gender desks that exist on paper but are underfunded and ineffective. It is systemic because it is not about isolated failures, but about patterns, policies that are not implemented, budgets that are not gender-responsive, and traditional leadership structures that exclude women from decision-making.
The Gendered Face of Health Systems
In South Africa, women’s unpaid caregiving is seen as part of their household duties, not as real work that supports the health system. In rural areas, women face extra challenges. They travel far to reach clinics that lack resources and often receive care that ignores their needs. Because of poverty, gender inequality, and remote locations, rural women struggle not just for health, but for respect and dignity.
Water, Sanitation, and the Burden of Inequality
Nowhere is the gendered nature of service delivery more visible than in water and sanitation. Despite gender mainstreaming efforts, such as the Gender Mainstreaming Strategy and Action Plan developed by the Water Services Sector Leadership Group (WSSLG) in 2005, rural women still carry the physical and emotional burden of inadequate water access. This strategy, aligned with broader national and international goals for women’s empowerment and gender equality, emphasized the need for a comprehensive approach to address the underlying causes of gender discrimination in water services. Yet, in practice, these commitments have not translated into meaningful change. The act of fetching water, often miles away, is not just a domestic chore or daily task; it is a daily negotiation of safety, time, and dignity.
Traditional norms often exclude women from decision-making in community water projects, and their indigenous knowledge remains undervalued. When water systems fail, women walk further, queue longer, and manage the health consequences of unsafe water. For young women, these hardships are especially severe as long hours spent fetching water often mean missing school, reducing their chances of completing education and limiting future opportunities. The risks of walking alone to distant water sources also expose them to gender-based violence and harassment, adding layers of fear and vulnerability to a basic survival task. This burden not only undermines their health and safety but also curtails their education, economic opportunities, and participation in community life. This burden not only undermines their health and safety but also limits their education, economic opportunities, and participation in community life.
The Gendered Nature of Care and Service Roles
Service delivery itself reflects gendered expectations. Female service providers are often associated with nurturing, patience, and emotional labour, while male staff are perceived as authoritative or protective. These perceptions shape interactions between service users and providers, influencing trust, comfort, and access. In the South African context, where most frontline workers in health and social care are women, the gendered perception of their work as “natural” rather than professional contributes to low pay, limited career advancement, and emotional burnout. Meanwhile, rural men are often disengaged from care-related roles, reinforcing the stereotype that caregiving is “women’s work.”
Towards Gender-Responsive and Equitable Service Delivery
If South Africa is to achieve true gender equality, it must move beyond rhetorical commitments to practical, gender-responsive systems. First, policy frameworks must be translated into concrete accountability measures that address the intersection of gender, poverty, and geography. Health and water service delivery plans must include gender-disaggregated data, gender-sensitive budgeting, and active participation of rural women in all stages of planning and implementation. Secondly, traditional cultural norms must be engaged critically, not ignored. Transformation does not mean defiance of culture but rather working within community systems to shift power relations and ensure that women’s voices influence decisions affecting their lives.
Finally, gender equality must be viewed as central to sustainable development. Rural women are not just beneficiaries of service delivery; they are custodians of health, water, and environmental sustainability. Recognising their agency is not an act of charity but an investment in the nation’s collective progress. In essence, the gendered nature of service delivery in South Africa exposes the unfinished business of democracy. Until health systems, water governance, and service delivery are designed together with rural women, the goal of gender equality will remain a dream rather than a reality.