Methodological Evaluation of Community Health Centres in South Africa: A Randomized Field Trial on Cost-Effectiveness Assessment

Community health centres (CHCs) in South Africa play a crucial role in providing primary healthcare services to underserved populations. However, their efficiency and cost-effectiveness remain under scrutiny. A mixed-method approach was employed, including quantitative data collection via surveys and administrative records to assess service utilization and financial metrics, along with qualitative interviews to gather insights into the implementation process and patient experiences. CHCs in this study demonstrated an average cost per consultation of $50 (95% CI: $45-$55), with significant variability observed across different CHCs. Patient satisfaction scores were positively correlated with the number of health workers available, indicating that adequate staffing is crucial for service quality. The randomized field trial provided valuable insights into the operational efficiency and cost-effectiveness of CHCs in South Africa, highlighting the importance of resource optimization and staff augmentation to enhance service delivery. Investment in training programmes for health workers and infrastructure upgrades should be prioritised to improve service quality and reduce costs further.