Community health centres (CHCs) in Ethiopia play a crucial role in primary healthcare delivery, particularly in rural areas where access to specialized medical services is limited. A mixed-methods approach combining quantitative surveys with qualitative interviews was employed to assess clinical outcomes at participating CHCs. A random allocation design ensured fair comparison between the intervention (CHC-based care) and control groups (conventional referral). Data analysis utilised an ANOVA model for comparing means of continuous variables. In a sample of 150 patients, those receiving CHC-based care showed a statistically significant improvement in adherence to treatment protocols compared to the control group, with a mean difference favouring CHCs of 23% (95% CI: 9-37%). The study highlights the potential for community health centres to enhance clinical outcomes without compromising patient satisfaction. These findings suggest that integrating CHC systems could be an effective strategy in improving healthcare delivery in Ethiopia. Policy makers should consider scaling up CHC-based care as a viable alternative or supplement to existing referral models, particularly in underserved regions where access to specialized medical services is limited. community health centres, clinical outcomes, randomized field trial, adherence to treatment protocols, patient satisfaction Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.