Methodological Evaluation of Emergency Care Units Systems in Nigeria: A Randomized Field Trial for Measuring Clinical Outcomes

Emergency care units (ECUs) in Nigeria are underutilized due to resource constraints and inefficiencies. A quasi-experimental design was employed with cluster randomization at the state level. A total of 50 ECU sites were selected for intervention and control groups, with data collected over one year. Initial analysis suggests a significant reduction in patient mortality rates by 23% (95% CI: -18%, -28%) in the intervention group compared to controls. Average length of stay decreased by 14 hours (95% CI: -7, -19) among patients. The randomized field trial demonstrated promising improvements in clinical outcomes with ECUs, validating its potential for resource allocation and policy formulation. Immediate implementation of standardised protocols and training programmes should be prioritised to enhance ECU performance and patient care. Emergency Care Units, Clinical Outcomes, Randomized Field Trial, Nigeria Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.