The Southern African Millennium Ecosystem Assessment (SAfMA) evaluated the relationships between ecosystem services and human well-being at multiple scales, ranging from local through to sub-continental. Trends in ecosystem services (fresh water, food, fuel-wood, cultural and biodiversity) over the period 1990-2000 were mixed across scales. Freshwater resources appear strained across the continent with large numbers of people not securing adequate supplies, especially of good quality water. This translates to high infant mortality patterns across the region. Keywords: Ecosystem services, Multi-scales, South African millennium ecosystem assessments.