Aims:To identify virtual healthcare services and digital health technologies deployed in South Africa during coronavirus disease 2019(COVID-19)and the challenges associated with their use.Methods:To determine the status of digital health utilization during COVID-19 in South Africa,the preferred reporting items for systematic reviews and meta-analyses model was used to perform a systematic and in-depth critical analysis of previously published studies in well-known and trusted online electronic databases using specific search keywords words that are relevant to this study.We selected published peer-reviewed articles available from the onset of COVID-19 to July 2021.Results:Total of 24 articles were included into this study.This study revealed that South Africa adopted digital technologies such as SMS-based solutions,mobile health applications,telemedicine and telehealth,WhatsApp-based systems,artificial intelligence and chatbots and robotics to provide healthcare services during COVID-19 pandemic.These innovative technologies have been used for various purposes including screening infectious and non-infectious diseases,disease surveillance and monitoring,medication and treatment compliance,creating awareness and communication.The study also revealed that teleconsultation and e-prescription,telelaboratory and telepharmacy,teleeducation and teletraining,teledermatology,teleradiology,telecardiology,teleophthal-mology,teleneurology,telerehabilitation,teleoncology and telepsychiatry are among virtual healthcare services delivered through digital health technologies during COVID-19 in South Africa.However,these smart digital health technologies face several impediments such as infrastructural and technological barriers,organization and financial barriers,policy and regulatory barriers as well as cultural barriers.Conclusion:Although COVID-19 has invigorated the use of digital health technologies,there are still some short-comings.The outbreak of pandemics like COVID-19 in the future is not inevitable.Therefore,we recommend increasing community networks in rural areas to bridge the digital divide and the modification of mHealth pol-icy to advocate for the effective use of innovative technologies in healthcare and the development of sustainable strategies for resources mobilization through private-public partnerships as well as joining available international initiatives advocating for smart digital health.

Emerging digital technologies continues to evolve posing unprecedented opportunities in health systems globally to improve healthcare services delivery.There has been significant progress in healthcare.However,the lack of emotive recognition coupled with a dearth of personalized and pervasive health applications and emotive smart devices calls for the integration of intelligent sensors health systems through emerging technologies.Although there has been significant progress in smart and connected health care,more research innovation,dissemination and technologies are needed to unbundle new opportunities and move towards healthcare 5.0.Healthcare is at the dawn of a paradigm change to reach the new era of smart disease control and detection,virtual care,smart health management,smart monitoring,and decision-making.Therefore,this study discusses the roles and capacities of sensors,their capabilities and other emerging technologies such as nanotechnology,5 G technologies,drone technology,blockchain,robotics,big data,internet of things,artificial intelligence,and cloud computing.Healthcare 5.0 provides healthcare services including patient remote monitoring,tracking and virtual clinics,emotive telemedicine,ambient assisted living,smart self-management,wellness monitoring and control,smart treatment reminders,compliance and adherence,and personalized and connected health care.However,building resilience and robust healthcare 5.0 is not immune to challenges.Organizational challenges,technological and infrastructural barriers,lack of legal and regulatory frameworks and e-health policies,individual perceptions,misalignment with hospitals' strategy,lack of funding,religious and cultural barriers are identified as potential barriers to the successful implementation of healthcare 5.0.Therefore,there is a need for building resilient technology-driven healthcare systems.To achieve this,there is a need for expanding technological infrastructure,provision of budgetary support based on sustainable business models,develop appropriate legal and e-health policies,standardization and synchronization of protocols,improving stakeholders' engagement and involvement and establishment of private and public partnerships and investments.