Innovating Healthcare Delivery: A Study on the Viability of Home Health Care in Developing Nations, eThekwini Metro – South Africa

South Africa’s dual-tiered healthcare system continues to face escalating burdens of chronic disease, infrastructural strain and systemic inequities. Home Health Care (HHC), as a decentralised and patient-centred model of sub-acute care, presents a compelling alternative to traditional facility-based delivery in low- and middle-income contexts. This study evaluates the economic viability, operational feasibility and systemic readiness for HHC implementation in eThekwini Metro, KwaZulu-Natal, South Africa, through a multi-dimensional, evidence-based framework. A cross-sectional, quantitative design was employed, integrating descriptive and inferential statistics across five domains: public preference, technical adaptability, social determinants, political trust and financial engagement. Data were collected via a validated 40-item online questionnaire (Cronbach’s alpha = 0.825) from 388 participants and analysed using SPSS v25. ANOVA and multiple regression were applied to examine subgroup differences and predictors of HHC acceptance. Strong public support for HHC (M = 1.00 ± 0.24 SD), high technological readiness (M = 1.00 ± 0.00 SD) and positive correlation between education and financial awareness (β = 0.29, p < 0.05) were observed. Key implementation constraints include community engagement deficits (M = 0.00 ± 0.00 SD) and limited caregiver availability (M = 0.07 ± 0.00 SD). Predictive modelling projects a 20% annual uptake increase with digital infrastructure expansion and equity-driven policy interventions. HHC is a feasible, cost-effective intervention aligned with universal health coverage goals. Strategic investment in digital systems, public-private collaboration and workforce development are essential for scalable, inclusive implementation.