Abstract
Background: The global shift towards digital health care presents significant challenges for municipal health systems striving for digital transformation. In Gauteng, South Africa, municipal clinics face multiple barriers including limited infrastructure and low digital competence among patients and healthcare workers, exacerbated by socio-economic disparities. This study aims to identify key obstacles to successful digital transformation in these settings.Aim: The study explores barriers such as inadequate infrastructure, financial constraints, healthcare workers’ resistance to adopting technology, and patients’ concerns about data security.Methods: A qualitative research design was employed using semi-structured interviews with healthcare staff across Gauteng clinics to gather rich, context-specific data on digital transformation challenges.Results: Findings indicate that barriers are deeply interlinked. Inadequate funding underpins many challenges, including insufficient infrastructure, poor digital skills among staff, weak data protection systems, and general resistance to technological change.Conclusion: Overcoming these obstacles requires a multifaceted strategy that includes infrastructure development, digital literacy training, change management frameworks, robust information security, and increased financial investment.Contribution: This study enhances understanding of the structural and socio-economic barriers to healthcare digitalisation. It offers practical insights for policymakers and healthcare managers aiming to implement equitable digital transformation in municipal healthcare services. Additionally, the study contributes empirical evidence to the field of electronic health records (EHRs), informing strategies to improve healthcare delivery and equity in similar developing-country contexts.