Methodological Evaluation of Community Health Centre Systems in Nigeria: A Randomized Field Trial for Efficiency Gains,

Community health centers (CHCs) in Nigeria are crucial for providing primary healthcare services to underserved populations. Despite their importance, there is a lack of systematic evaluation of their operational efficiency. A mixed-methods approach was employed, including both quantitative data collection (utilising a validated efficiency scoring tool) and qualitative interviews to gather insights into CHC operations. Data were analysed using a linear regression model to assess the impact of various interventions on operational outcomes. In the randomized field trial conducted in , an average improvement rate of 13% was observed in service delivery efficiency after implementing targeted intervention strategies such as improved training for staff and upgraded equipment. A significant proportion (48%) of CHCs showed a positive response to these changes. The study concludes that targeted interventions can significantly enhance the operational effectiveness of CHC systems, leading to better resource utilization and patient care outcomes. Based on the findings, recommendations include allocating more resources for staff training and facility upgrades, as well as promoting a culture of continuous improvement within CHCs. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.