The Impact of Digital Technology on Healthcare Facilities in a South African Eastern Cape Rural Environment.

Eastern Cape Department of Health and granted permission/approval to collect data.This thesis explored the impact of DT on healthcare facilities in a rural environment in the Eastern Cape, South Africa. A dual-strategy approach that combined a systematic literature review (SLR) with empirical fieldwork was employed. The SLR followed an inductive reasoning, while the empirical investigation drew on both deductive and inductive reasonings. A qualitative method was employed, and data were collected through interviews with 19 healthcare professionals across various roles in healthcare facilities. Findings revealed that DT offers promising benefits to improve data management, processing, and transmission. Additionally, the study revealed that DT has the potential to minimise cost and time. Moreover, the study uncovered operational challenges such as system backlogs, and potential data duplication and loss, all linked to poor internet connectivity. A significance contribution of the empirical component was the emergence of the new theme: Digital Health Enablers (DHEs). These refer to both formal infrastructure solutions and informal practices to support the use of DT in rural healthcare. Examples include backup power generators, solar energy systems, facility based fibre, and W-Fi connectivity. Theoretically, this study extended the conceptual framework by showing that infrastructural conditions at the facility level are active enablers of DT. Methodologically, the study offers a replicable dual-strategy that integrates an SLR with multiple case studies. Practically, this study provides guidance for district managers to ensure that facilities have reliable power sources and connectivity to strengthen DT use in healthcare facilities in rural areas.