African Perioperative Nursing | 18 April 2009
Methodological Evaluation of Community Health Centre Systems in Rwanda Using Difference-in-Differences Model for Cost-Effectiveness Analysis
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Abstract
Community health centres in Rwanda have been established to improve access to healthcare services, particularly for underserved rural populations. A systematic literature review was conducted using electronic databases such as PubMed, Embase, and Cochrane Library. Studies published between and were included if they utilised a difference-in-differences approach to assess the impact of community health centres on healthcare outcomes. A total of 45 studies met the inclusion criteria. The average cost-effectiveness ratio for community health centres was $5 per capita, indicating significant potential savings in healthcare costs compared to traditional models. The difference-in-differences model demonstrated robust results across various outcomes, including reduced mortality rates and improved patient satisfaction. Given the positive findings, further research should focus on scaling up community health centre systems and exploring cost-sharing mechanisms to ensure sustainability. Treatment effect was estimated with $\text{logit}(p<em>i)=\beta</em>0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.