The COVID-19 pandemic highlighted that cause of death information in South Africa does not serve public health needs. This is often due to delays in processing resulting from a lack of digital data collection. Furthermore, gaps exist in the cause of death information from Civil Registration and Vital Statistics (CRVS), which has limited value in determining the full burden of HIV and TB. This has highlighted the urgent need for the country to assess the role and scope of an Electronic Death Registration System (EDRS), particularly online medical certification of cause of death (MCCD) to overcome these deficiencies. To support this, Vital Wave worked with the South African Medical Research Council (SAMRC) to lay the foundation for the scoping and development of an online system for medical certification of cause of death (MCCD) in South Africa. This included an landscape of existing systems and business processes for collecting cause of death information in South Africa as well as working to obtain input and support from prospective MCCD system stakeholders on next steps for a participatory workshop and formal requirements development process.