The Southern African Development Community (SADC), a regional bloc of 16 Member States stretching from Angola to South Africa, recently unveiled its 2025 Scorecard on Sexual and Reproductive Health and Rights (SRHR), a biennial assessment that tracks progress against the Sustainable Development Goals (SDGs) and the region’s own SRHR Strategy (2019–2030). While the latest data reveal substantial strides in some health indicators, they also expose persistent and deep-seated challenges that threaten the health, dignity and economic potential of millions across the region.
This scorecard emerges at a pivotal moment in global health. With only five years left until the 2030 SDG deadline, SADC’s findings offer both encouragement and urgency, and underscore the ongoing imperative for sustained leadership, investment, and accountability.
READ ALSO: Africa CDC Strengthens Continental Health Security and Regulatory Ties
At its core, the SADC scorecard functions as a regional barometer, employing a “traffic light” system to gauge progress across 20 key indicators that encompass adolescent birth rates, maternal mortality, HIV infection trends, family planning, and health financing, among others.
The scorecard’s most reassuring findings lie in measurable declines in some of the region’s most entrenched health challenges.
For the first time, the majority of SADC Member States reported a decline in adolescent birth rates, a testament to expanded life skills education and comprehensive sexuality education in schools.
Progress has also been registered in the battle against HIV. Twelve Member States are on track to meet the SDG target for eliminating vertical transmission, the passing of HIV from mother to child — by 2030, and five had already achieved this milestone by 2025. Simultaneously, overall new HIV infections are decreasing, signalling that integrated prevention and treatment strategies are yielding tangible results.
Maternal mortality, long a stubbornly high statistic across much of Southern Africa, showed meaningful reductions in six countries, a reflection of targeted health service improvements and enhanced clinical care during childbirth.
Taken together, these shifts point to the power of coordinated policy frameworks and multi-sectoral engagement. They align with broader global trends in women’s health improvements, including increasing access to skilled birth attendance and family planning services in other parts of sub-Saharan Africa.
Despite these gains, the scorecard paints a sobering picture of uneven progress. Across key metrics, serious gaps persist, gaps that have profound implications for gender equality, health outcomes, and long-term economic development.
One of the most alarming trends is the rise in sexually transmitted infections (STIs) and declining condom use among adolescents and young adults. While overall HIV infections continue to fall, the rate of reduction among girls and young women aged 15–24 has slowed in seven Member States, suggesting that gains in prevention are fragile and uneven.
Access to family planning services remains a striking challenge. Eight countries within the region are failing to meet the contraceptive needs of women and adolescent girls. This unmet need is more than a health statistic, it is a driver of teenage pregnancies, preventable maternal deaths, and lost opportunities for young women to participate fully in education, employment and civic life.
Gender-based violence (GBV) continues to plague communities across Southern Africa. Despite progressive laws and policies in all Member States, the prevalence of sexual and intimate partner violence shows little sign of abating. The scorecard emphasises that legal frameworks must be paired with robust systems for implementation, support services for survivors, and integration of SRHR and GBV programming at every level of care.
Perhaps most strikingly, no SADC Member State has achieved the Abuja Declaration target of allocating 15 per cent of national budgets to health. Only four countries have exceeded 10 per cent. In an era of declining donor financing, this shortfall in domestic investment threatens to erode the hard-won gains of the past decade and imperils the region’s long-term social and economic prospects.
These SADC findings resonate with broader global health discourses which frame SRHR as a linchpin of sustainable development. Across Africa, recent WHO African Region data show that maternal mortality, while declining overall, remains disproportionately high, accounting for more than 70 per cent of global maternal deaths. Access to modern contraception and adolescent birth rates have improved, yet structural barriers and socio-economic inequalities persist.
At the international level, organisations including UNAIDS, UNFPA, UNICEF and WHO continue to advocate for integrated, community-led health strategies, recognising that progress in SRHR is foundational to economic growth, gender equality, and inclusive human development.
Turning Insight Into Action: Strategic Recommendations
The scorecard’s insights offer a roadmap for action that extends beyond rhetoric to measurable policy action.
First, Southern African governments must prioritise domestic health financing. Meeting or exceeding the Abuja target will provide SADC Member States with fiscal space to sustain and scale up essential health services, reduce out-of-pocket costs, and build resilient health systems that can withstand future shocks.
Second, expanding access to comprehensive family planning services, particularly for adolescents, must be central to national health strategies. Investing in affordable, accessible contraception and reproductive health education will reduce unintended pregnancies and contribute to lower maternal mortality.
Third, addressing gender-based violence requires an integrated response that goes beyond legislation to robust enforcement, survivor support infrastructures, and community-level interventions that challenge harmful norms and provide protection and redress.
Finally, the region must intensify its focus on youth-centred health innovations, including digital health platforms and school-based education programmes, to reach adolescents with accurate information and services. These measures will lastingly improve SRHR outcomes and empower a generation poised to drive the region’s demographic dividend forward.
Strengthening the Foundations of Regional Well-Being
The SADC 2025 Scorecard on Health and Gender Equality underscores a crucial truth: progress in sexual and reproductive health is possible, but it is neither automatic nor assured. Gains in reducing adolescent births, controlling vertical HIV transmission, and lowering maternal mortality demonstrate that strategic policies and collaborative leadership produce results.
Yet, without urgent scaling of domestic financing, expanded access to family planning, and robust responses to gender-based violence, these achievements remain vulnerable. In the final stretch to 2030, SADC Member States must translate commitment into action, anchored in evidence, guided by accountability, and driven by the shared imperative of leaving no one behind.
