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The impact of digital technology on healthcare facilities in a South African Eastern Cape rural environment
Author(s)
Ngesimani, Nomputumo Linah
Date Issued
2026
Type
master thesis
Publisher
Cape Peninsula University of Technology
Abstract
Digital technology (DT) is transforming the healthcare industry, offering solutions to enhance access, efficiency, and patient outcomes. DT has the potential to bridge longstanding challenges in healthcare facilities in rural areas. Despite its growing adoption, there is limited research on how DT is impacting healthcare facilities in rural areas of South Africa, particularly in the Eastern Cape. This study explores the impact of DT on healthcare facilities in a rural environment in the Eastern Cape, South Africa. A dual-strategy methodology that combines a systematic literature review (SLR) and empirical data collection was used. The SLR is guided by inductive reasoning, while the empirical component is guided by deductive and inductive reasoning. This study employed a qualitative method. Studies for the SLR were sourced globally between 2020 and 2024, with 55 studies meeting the inclusion criteria. The empirical component involved interviews at four rural case study sites, engaging 19 participants in various roles within rural healthcare facilities. The qualitative data were analysed thematically using ATLAS.ti v9. The findings revealed that several digital technologies are in place in rural healthcare, such as eHealth, mHealth, Telehealth, and Telemedicine platforms. Additionally, the study found context-specific digital tools such as the District Health Information System, Human Management System 2, e-Tick register, Health Patient Registration System, and Lab Trak, amongst others. Moreover, the study uncovered operational challenges such as system backlogs, and potential data duplication and loss, all linked to poor internet connectivity. Furthermore, the study identified that unstable internet connections and power cut-offs are major challenges to effective adoption in rural healthcare. Importantly, a novel theme, ‘Digital health enablers’ (DHEs), emerged from the empirical data. These DHEs encompass both infrastructure-based solutions and informal practices to support the adoption of DT in rural healthcare facilities. This study contributes theoretically to the existing body of knowledge by identifying facility-level enablers and demonstrating how connectivity reliability interacts with staff capabilities in rural healthcare. Additionally, the study extends the existing digital health framework by incorporating DHEs such as solar power, UPS, facility-based fibre and W-Fi connectivity, and backup generators. Methodologically, the study contributes through a dualstrategy that integrates an SLR with multiple case studies in rural health, providing a replicable approach for similar infrastructure-constrained contexts. Finally, this study offers evidencebased guidance for policymakers on strengthening DT adoption in rural healthcare facilities through targeted investments in connectivity, infrastructure, and capacity-building.
Additional information
Thesis (DPhil (Informatics))--Cape Peninsula University of Technology, 2026
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199031096_Ngesimani, Nomputumo.pdf
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