A framework for the integrated digital transformation of municipal healthcare services in South Africa: The case of Gauteng

Background: This study develops a framework for the integrated digital transformation of municipal healthcare services in Gauteng, South Africa, focusing on municipal clinic systems. Objectives: To identify the factors impeding digital transformation, understand key stakeholder perspectives on a systems approach to digital change, and propose a framework for integrated digital municipal clinics. Additionally, this study examines the relationship between implementing digital transformation and quality of care, as well as how digital solutions connect various components within the municipal clinic system. Method: A positivist research paradigm was applied, using quantitative surveys to gather data from 210 healthcare staff in Gauteng municipal clinics. Data were collected using closed-ended Likert-scale questionnaires designed to measure barriers to digital transformation, stakeholder consensus, key constructs for framework development and perceptions of service quality. Quantitative data were analysed using SPSS and MS Excel, employing descriptive statistics, correlation analysis and stepwise multiple regression to examine relationships between digital transformation, stakeholder roles, barriers and service quality outcomes. Results: Findings reveal significant barriers, including infrastructural limitations, funding constraints, skill gaps and low digital service user acceptance. Despite these challenges, there is strong support for digital transformation, with the potential to enhance service integration, communication and overall care quality. Conclusion: This framework aims to improve healthcare quality, access and operational efficiency in Gauteng’s municipal clinics, ultimately leading to better health outcomes for local communities. Contribution: This study proposes a comprehensive framework that emphasises adaptable systems, continuous training and stakeholder collaboration to address these barriers and ensure successful implementation.