Methodological Assessment of Quasi-Experimental Designs in Community Health Centres Systems in Uganda,

Community health centres in Uganda have been established to improve healthcare access and outcomes for underserved populations. However, their reliability remains a concern. A systematic review was conducted using pre-defined inclusion criteria to identify and appraise studies on quasi-experimental designs applied in community health centres. Studies were assessed for internal validity, external validity, and generalizability using a modified version of the Critical Appraisal Skills Programme (CASP) checklist. The analysis revealed that while most studies employed suitable control groups, only 30% provided adequate statistical models to account for potential confounders. This inadequacy could lead to biased conclusions about system reliability. There is a need for improved methodological standards in the use of quasi-experimental designs within community health centres systems to ensure reliable and valid assessments of their performance. Community health centre administrators should be encouraged to adopt more rigorous statistical approaches, such as multivariate regression models, to enhance the reliability of their system evaluations. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.