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 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 the 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 (WHO) standards using age-standardized 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 CMNNDs, NCDs, and injuries respectively.

Results:
Findings for women over the 29-year period revealed that the leading causes of death, DALYs and YLLs were, HIV/AIDS, sexually transmitted infections (STIs) and cardiovascular disease. The leading cause of YLDs in women was other non-communicable diseases. Trend analysis showed a decline in prevalence as follows NCDs from 93 544,9 cases per 100 000 population in 1990 to 93 377,4 cases per 100 000 population in 2019 (- 0,18%); CMNCDs from 87 668,61 cases per 100 000 population in 1990 to 80 101,36 cases per 100 000 in 2019 (-8,63%); and Injuries from 15 404,4 prevalent cases per 100 000 population in 1990 to 12 225,37 prevalent cases per 100 000 population (-20,64%). Considering the provincial mortality rates among women, in 1990 the Gauteng province had the highest mortality rate at 1000,09/100 000 population whilst the Limpopo province had the lowest (697,71/100 000 population) amongst women. However, in 2019, the Free-State province had the highest mortality rate among women (1188,48/100 000 population) and the Limpopo province the least (801,60/100 000 population).

Conclusion:
HIV/AIDS, STIs and 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.