**5. Conclusions**

The main problems related to availability, affordability and acceptability of HIV/AIDS and GBV services in this rural south African setting included many *material* limitations: variations in optimal settings for public health care; limitations in quantity and scope of practice of professional personnel; lack of physical space, resources and confidentiality; and poverty as an over-riding risk factor in HIV/AIDS and GBV. Similarly, *operational* limitations included the complexity of modern health care concepts for rural people; lack of appropriate models for rural social care; acceptability of health care in the context of violence; and poorly integrated care for HIV/AIDS and GBV. These problems may arise from health professions' maintenance of traditional features, stereotypes of rural and poorly educated populations, and differing perspectives on appropriate action related to HIV/AIDS and gender based violence. Interventions for complex social health issues such as HIV/AIDS and GBV should be judged in terms of how well they contribute to the 'recreation of community' through addressing both material and operational limitations of public health systems, as opposed to simple incremental health gains for individuals.
