Technology is fundamentally reshaping healthcare, accelerating the shift towards digital innovation, patient-centred care and increasingly complex medical systems. Countries that fail to recognise and respond to this transformation risk falling behind. As healthcare evolves, tertiary education providers face growing pressure to equip future professionals with the skills needed to remain competitive.
Healthcare is changing through digital technologies, new models of care and shifting population needs. Artificial intelligence (AI), telehealth and electronic health records are changing how information is gathered and care is delivered. At the same time, South Africa faces persistent infectious diseases, rising non-communicable diseases, unequal access to services and pressure on the health workforce.
Raeesa Khan, Academic Programme Leader at the MANCOSA School of Healthcare, says that the divide between public and private healthcare is part of this context. "In 2024, about 84% of South Africans relied on public health facilities, while around 16% were covered by medical schemes that enable access to private healthcare." As a result, key priorities must govern the future of healthcare development in South Africa and must be incorporated into the NHI.
Key Priorities and Education Gaps
The World Health Organization (WHO) has identified fragmentation between public and private financing as a constraint on more equitable access to quality care (WHO, 2025a). The National Health Insurance Act sets out an ambition of more equitable access, but legislation alone cannot deliver it. Workforce capacity, effective institutions, adequate resources and public trust matter too.
"Education should prepare students for this changing environment, while helping them understand that new tools and policies operate within real service conditions. South Africa has made important gains, including through its HIV treatment programme and the continuing contribution of primary healthcare workers. However, patients may still face long waits, service interruptions, referral delays or limited access to specialists, depending on where they live and which services they can reach," says Khan.
She points out that five connected capabilities should guide healthcare education:
- Critical reasoning and evidence-informed decision-making to assess information, recognise uncertainty and justify decisions;
- Responsible digital practice to use AI, telehealth and electronic records safely, critically and equitably;
- Human-centred communication to listen, show empathy, explain care clearly and build trust;
- Interdisciplinary collaboration to coordinate care across professions and services; and
- Prevention-focused practice grounded in local realities to respond to community needs and South Africa’s changing disease burden.
"These capabilities align with the WHO’s framework for health workers, which includes decision-making, evidence-informed practice, communication, collaboration and people-centredness. Graduates also need to understand how health services are organised and resourced so they can use available resources responsibly and contribute to quality improvement," says Khan.
A key gap is the distance between knowing concepts and applying them in unpredictable situations. Graduates may need to communicate under pressure, make decisions with incomplete information, collaborate across roles and understand how a referral or care pathway works in practice. They may also encounter digital systems or resource constraints that differ from those used in training.
"Practical learning can help bridge this gap, but the number of placement hours alone does not guarantee readiness. Students need supervised opportunities to participate, practise, receive feedback and reflect. Without sufficient supervision and planning, placements may become observational or inconsistent experiences, shaped by the capacity of each site," says Khan.
The Evolution of Healthcare Education
As a result of key gaps that exist in the current education space, tertiary education providers need to re-evaluate the current healthcare education paradigm and adjust to address these gaps if South Africa wants to be an African leader in digital healthcare.
"Students should practise using digital tools while learning to question their outputs. They need to understand how biased or incomplete data can affect AI recommendations, protect confidential information, communicate effectively through remote channels and remain accountable for professional decisions," says Khan.
The benefits of digital tools are not automatic. Systems need reliable infrastructure, secure data practices, staff training and thoughtful implementation. Where connectivity, devices, electricity or digital confidence are limited, a digital-first approach may exclude people it is intended to help. Poorly designed systems can also add work or create risks to privacy and patient safety. WHO guidance emphasises that AI in health requires attention to ethics, human rights, equity and appropriate governance. Telehealth should support appropriate care, not replace in-person assessment when examination or urgent intervention is needed.
Prioritising digital skills will also be key as technology can supplement traditional healthcare. However, human skills cannot be ignored. Listening, empathy, clear explanation and trust-building will remain essential. Patients need to understand their options and feel that their concerns have been heard. This is especially important where experiences of healthcare may be shaped by language barriers, poverty, historical mistrust or difficulty reaching services.
"These skills are not separate from technical competence; they are part of it. Students need opportunities to practise difficult conversations, shared decision-making and culturally responsive communication. Institutions should assess how students communicate and involve patients in decisions, not only whether they can recall information," says Khan.
Preparing Students for an Unequal System
One of the biggest realities of healthcare in Africa is that a massive gap exists between the quality of healthcare, and healthcare access, between urban and rural communities. Until this is addressed, African healthcare will always be playing catchup with the rest of the world. It is therefore up to tertiary education providers to prepare future healthcare professionals for this.
"Rural and underserved communities may face long travel distances, fewer services and limited access to specialists. Students need supervised exposure to varied settings and opportunities to learn from local health teams and communities. The aim should be to prepare graduates to listen and adapt, rather than position them as outsiders arriving with ready-made solutions. Students should also examine how income, transport, housing, food security and language affect access to care. Understanding these realities can help future professionals make care plans that are professionally appropriate and more responsive to people’s circumstances," says Khan.
Tertiary education providers can co-design placements with health services and communities, use interprofessional simulation, practise telehealth and electronic record scenarios, and assess professional reasoning and communication alongside knowledge. Placements and simulation are most useful when linked to learning outcomes and followed by feedback.
These changes require time, trained educators, suitable placement sites and partnerships with employers. They cannot be achieved by changing a course outline alone. Healthcare providers and education institutions share responsibility for creating practical learning that is safe, supported and relevant.
Healthcare Education Must Keep Pace With Change
South Africa's healthcare future depends on more than adopting new technologies. It requires professionals who can combine digital competence with critical thinking, empathy and practical problem-solving.
As healthcare systems evolve, tertiary education providers must strengthen experiential learning, interdisciplinary collaboration and exposure to underserved communities. By aligning education with emerging technologies and real-world healthcare challenges, institutions such as MANCOSA can help develop a workforce capable of improving patient outcomes, addressing inequalities and supporting a more resilient, inclusive healthcare system nationwide.
