This chapter presents a synthesis of the progress on key health-related MDGs in two South African provinces of KwaZulu-Natal (KZN) and the Eastern Cape (EC) focusing on sexual reproductive health and rights (SRHR) indicators. Utilizing a mixed method approach that included a desk review of policy directives on SRHR, secondary quantitative analysis of key epidemiological indicators, and a qualitative component that included focus group discussions in both urban and rural contexts; we offer evidence about how demographic and socioeconomic conditions explain trends in SRHR and show the complexity, interaction, and intersection of SRHR and all its determinants. The chapter concludes by discussing challenges [including (infra)structural, service delivery, access] in addressing specific SRHR goals and offers evidence of progress and prospects for a post 2015 agenda in addressing health-related MDGs in South Africa.