The development of the National Digital Health Strategy for South Africa, 2019 - 2024 takes place at an opportune time of the massive reorganisation of the healthcare system required for the National Health Insurance (NHI) implementation. These developments, alongside a rapidly changing technology landscape within the context of the fourth industrial revolution present great opportunities for innovation. The development of the new strategy was led by the Ministerial Advisory Committee (MAC) on eHealth, which is chaired by Director-General, Ms MP Matsoso. It builds on the lessons learnt during the implementation of the eHealth Strategy 2012-2016, which include strengthening governance structures, creating robust integrated platforms for development of information systems, the use of a common unique identifier for patients interfacing with the health system at various levels, and the enhanced mobile health ability to reach health system users through systems like MomConnect. Recommendations from the review of the previous strategy formed the basis for the development of the new strategy. The strategic thrust for the new strategy is to support the health sector priorities as articulated in the National Development Plan (NDP) and in line with the current NHI transformation imperatives towards Universal Health Coverage (UHC). The new strategy sets out a vision of ‘better health for all South Africans enabled by digital health’ because digital health is expected to be a significant driver of health system transformation, and also advance the national Department of Health’s vision of ‘A long and healthy life for all South Africans’. It is embodied in the five strategic principles of a person- centred focus, expanded access, innovation for sustainable impact, digital health workforce for economic development and a whole-of-government approach.