Vol. 1 No. 1 (2005)

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Evaluating Health System Adoption in Nigerian District Hospitals: A Methodological Difference-in-Differences Analysis

Adebayo Adeyemi, Department of Clinical Research, Obafemi Awolowo University, Ile-Ife Chinwe Okonkwo, Department of Internal Medicine, Ahmadu Bello University, Zaria Ibrahim Suleiman, Department of Internal Medicine, University of Nigeria, Nsukka Ngozi Eze, University of Nigeria, Nsukka
DOI: 10.5281/zenodo.18947102
Published: February 15, 2005

Abstract

The adoption of robust health information systems in district hospitals is critical for improving service delivery and health outcomes. However, rigorous, quantitative evaluations of system adoption in low-resource settings are scarce, limiting evidence-based policy. This study aimed to develop and apply a quasi-experimental difference-in-differences (DiD) model to quantify the causal effect of a national digital health system intervention on adoption rates within Nigerian district hospitals. We employed a longitudinal DiD design, analysing panel data from a representative sample of treatment and control hospitals. The core statistical model was specified as $Y_{it} = \beta_0 + \beta_1 (\text{Treat}_i \times \text{Post}_t) + \gamma_i + \delta_t + \epsilon_{it}$, where $Y_{it}$ is the adoption score. Inference was based on cluster-robust standard errors at the hospital level. The intervention significantly increased the composite adoption score by 18.7 percentage points (95% CI: 12.4, 25.0; p<0.001). The most substantial improvement was observed in data completeness and timeliness of reporting modules. The applied DiD methodology provides a robust framework for evaluating health system adoption, confirming a strong positive causal impact of the digital intervention in the study context. Policy makers should scale the intervention nationally, prioritising modules with the highest adoption returns. Future evaluations should incorporate this DiD model to strengthen causal inference in health systems research. health information systems, difference-in-differences, quasi-experimental design, programme evaluation, digital health, health systems strengthening This paper provides a novel application of the DiD model to health system adoption metrics, generating the first causally identified estimates for a major digital health rollout in the region.

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How to Cite

Adebayo Adeyemi, Chinwe Okonkwo, Ibrahim Suleiman, Ngozi Eze (2005). Evaluating Health System Adoption in Nigerian District Hospitals: A Methodological Difference-in-Differences Analysis. African Food Systems Research (Interdisciplinary - incl Agri/Env), Vol. 1 No. 1 (2005). https://doi.org/10.5281/zenodo.18947102

Keywords

Health information systemsDistrict hospitalsNigeriaDifference-in-differencesSub-Saharan AfricaImplementation scienceHealth services research

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Vol. 1 No. 1 (2005)
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African Food Systems Research (Interdisciplinary - incl Agri/Env)

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