Methodological Evaluation of District Hospitals Systems in Rwanda: Quasi-Experimental Design for Clinical Outcomes Assessment

Rwanda's district hospitals play a crucial role in healthcare delivery but face challenges in maintaining quality clinical outcomes. A mixed-methods approach including surveys, audits, and interviews was employed to assess system performance. Data were analysed using regression analysis for statistical inference. District hospitals in Rwanda showed significant variability in patient outcomes across different regions (p < 0.05). Variance in diagnostic accuracy ranged from 12% to 34%, with an uncertainty of ±5%. The quasi-experimental design revealed notable discrepancies in clinical performance, necessitating targeted interventions aimed at enhancing diagnostic precision and patient care quality. Immediate improvements should focus on standardising diagnostic protocols and increasing staff training in high-risk areas to mitigate variability in outcomes. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.