South Africa grapples with overlapping HIV/NCD burden and eHealth rollout challenges

A cross‑sectional study of 18,041 residents in KwaZulu‑Natal mapped the spatial overlap of HIV, diabetes and hypertension unmet health needs. The analysis showed that people living with HIV who were undiagnosed or uncontrolled clustered in the southern urban and peri‑urban zones, while high unmet needs for diabetes and hypertension were more common in the rural central, northern and southern parts of the surveillance area. Multivariate clustering revealed a significant overlap of all three conditions among individuals with undiagnosed and uncontrolled disease in the southern catchment area, highlighting geographic pockets where HIV and non‑communicable disease burdens converge.

A separate qualitative investigation in the City of Johannesburg examined the implementation of electronic health (eHealth) systems in public primary‑care clinics. Interviews with health‑care workers and managers indicated that eHealth adoption remains limited, with low awareness of pilot projects. Key barriers identified were inadequate network infrastructure, uneven digital literacy, and insufficient management support, while facilitators included willingness of staff to use digital tools and access to reference guidelines. The findings point to both organisational and technological factors that must be addressed to improve eHealth rollout in the district.