{ "background": "Emergency care systems in sub-Saharan Africa are underdeveloped, with a critical lack of evidence on the effectiveness of formalised emergency units in improving patient outcomes. This gap hinders targeted investment and policy formulation for health system strengthening.", "purpose and objectives": "This study aimed to quantify the impact of implementing standardised emergency care units (ECUs) on clinical outcomes and service delivery metrics within a resource-constrained health system.", "methodology": "We employed a quasi-experimental, controlled before-and-after design across twelve district hospitals. Six intervention hospitals received a standardised ECU package (dedicated space, protocols, staff training, and essential equipment), while six matched controls continued usual care. The primary outcome was 24-hour in-hospital mortality. Secondary outcomes included time to clinician assessment and adherence to key clinical protocols. We analysed the intervention effect using a difference-in-differences model: $Y{it} = \\beta0 + \\beta1 \\text{Intervention}i + \\beta2 \\text{Post}t + \\beta3 (\\text{Intervention}i \\times \\text{Post}t) + \\epsilon{it}$, with robust standard errors clustered at hospital level.", "findings": "Implementation of ECUs was associated with a significant reduction in 24-hour mortality (adjusted odds ratio 0.72, 95% CI 0.58 to 0.89). The median time to clinician assessment decreased from 98 to 38 minutes in intervention sites. Adherence to structured triage protocols improved from 15% to 78% in the intervention group post-implementation.", "conclusion": "The introduction of a standardised emergency care unit model significantly improved key clinical outcomes and process measures, demonstrating its effectiveness as a health systems intervention.", "recommendations": "National health policy should prioritise the rollout of standardised ECUs within district hospitals, supported by dedicated funding for essential infrastructure, equipment, and continuous clinical training.", "key words