Africa: For Migrant Women, The Right to Healthcare Does Not Always Mean Access

Mombasa, Kenya — South Africa has grappled with instances where migrants, asylum seekers and undocumented individuals have experienced difficulties accessing essential healthcare, including maternal and child health services. Despite being legally recognized as human rights, these barriers often persist for women who have fled their countries due to conflict, persecution or instability.

In many communities, hostility towards foreigners can hinder their ability to obtain basic services, with women facing additional challenges. For instance, a pregnant woman might forego antenatal care due to fear of being asked for documentation she cannot present, while a woman seeking contraception, HIV prevention or treatment for gender-based violence might fear exposure of her immigration status.

One case from Malawi highlights the dire reality: a mother gave birth in an open space inside a deportation holding area without medical assistance or protection for her and her newborn. Although South Africa's policies and laws acknowledge the right to healthcare and protect human dignity, the reality on the ground differs significantly.

Human rights activist Tsakani Mabasa, whose research investigates how migrant women can better access sexual and reproductive health services, points out the gap between policy and practice. Mabasa emphasizes that access to sexual and reproductive health rights (SRHR) services is a fundamental human rights issue, especially for pregnant women or those experiencing gender-based violence.

She stresses that the focus should be on ensuring women are treated with dignity and can access the services they need, a principle enshrined in South African law. The Constitution guarantees access to healthcare services, free care for pregnant women, lactating mothers and children under six, and protection for asylum seekers, undocumented migrants and stateless people.

However, the implementation of these protections remains a challenge. In December 2025, the Gauteng High Court ordered authorities to allow unhindered access to Yeoville and Rosettenville clinics in Johannesburg for people without South African identity documents, following protests by vigilante groups. Despite this ruling, vigilante groups have continued to block access, leading to legal battles and calls for action.

The Economic Freedom Fighters (EFF) filed criminal charges against former Operation Dudula leader Zandile Dabula over the death of a Malawian child who died due to lack of medical care. While public health researchers attribute the strain on the health system to mismanagement and underinvestment, Operation Dudula claims it responds to a system that prioritizes South Africans.

Collective Voices Against Health Xenophobia, a coalition of civil society groups and healthcare workers, argues that migrants are being scapegoated for failures that lie beyond their control. They contend that the public health system is in crisis due to mismanagement and years of underinvestment, rather than being overwhelmed by foreign nationals seeking care.