Abstract

The integration of Artificial Intelligence (AI) in healthcare promises significant advancements in patient care, yet its success heavily relies on public trust and acceptance, particularly in diverse socio-economic contexts like South Africa. This study investigates South African residents’ willingness to trust AI in healthcare decisions, exploring the impact of socio-demographic factors such as age and religion on their preferences. Utilizing a cross-sectional online survey distributed via Facebook, we gathered data from 341 respondents across South Africa. The survey assessed participants’ preference for human versus AI doctors in serious health scenarios, alongside demographic information including age, gender, educational attainment, religion, and home language. Weighting adjustments were applied to align the sample with South Africa’s demographic proportions for home language and gender. Data were analysed to explore correlations between these demographics and preferences for AI in healthcare. A significant majority (73.7% weighted) expressed a preference for a human doctor over an AI doctor. Notably, the importance of religion (p <.001) and specific age groups (p =.025) significantly influenced preferences. A significant proportion of respondents for whom religion was “not too important,” as well as those in the 40–49 age group, preferred an AI doctor. This study underscores the need for innovative governance models tailored to resource-constrained settings, where traditional human-in-the-loop requirements may not always be feasible. Future research should explore how socio-cultural factors and trust dynamics influence public attitudes toward AI in healthcare and investigate models that ensure safety and accountability while addressing practical limitations in healthcare delivery systems.