Studies have shown that daily exercise has a positive effect on the prevention of heart disease. However, many South Africans do not have a healthy lifestyle. Some forms of gamification have been applied in health-related programmes in South Africa such as Multiply’s Active Dayz™ and Discovery’s Active rewards. This study looks at the motivational aspects of gamification in healthcare. It investigates the impact of gamification on clients’ use of activity rewards programmes, and aims to identify the core motivational factors that would drive people in South Africa to improve their health through exercise. We use Yu-Kai Chou’s Octalysis framework of motivation in gamification as guide. The results show that time is a barrier for engaging in exercise, rewards programmes lead to more health check-ups, knowing the benefits of exercise not enough motivation to engage in exercise, and members of rewards programmes have different motivational factors for their behaviour than non-members.