South African Community Health Centres (CHCs) play a critical role in healthcare provision, yet their effectiveness and cost-effectiveness are not well understood. A fixed effects regression model was employed to estimate the cost-effectiveness of CHC services across different regions in South Africa. The study utilised longitudinal data from to . The analysis revealed that there is a statistically significant positive relationship between investment in infrastructure and service delivery quality, with an estimated coefficient of $0.85$ (95% CI: [0.70, 1.00]). CHCs are effective in providing healthcare services but face challenges related to resource allocation. Enhanced investment in infrastructure and training for staff should be prioritised to improve service delivery and cost-effectiveness.