This report is a rapid appraisal of maternal health services in South Africa. It reflects the first activity in a five-year research programme, funded by DFID. The research project is a multi-country project involving researchers from the London School of Hygiene and Tropical Medicine, (UK) Manchester University (UK) and research institutions in Uganda, Bangladesh, Russia as well as South Africa. The programme aims to develop theoretical frameworks and methodologies to better understand health system functioning in developing countries, and to apply these insights to strengthening health system development. As part of this project maternal health has been identified as a possible probe or tracer to illuminate particular features of health system functioning and performance.