African Rheumatology Journal | 04 January 2001
Methodological Assessment of Quasi-Experimental Designs in Ethiopian District Hospitals Systems: A Systematic Literature Review
S, e, r, e, s, i, g, n, e, w, B, e, f, e, k, a, d, u, ,, T, s, e, g, a, y, e, W, o, l, d, e, g, i, o, r, g, i, s
Abstract
Ethiopia has implemented district hospitals as a primary health care system to improve access to healthcare services, particularly for underserved rural areas. However, the effectiveness of these systems in reducing healthcare risks is not well understood. A comprehensive search strategy was employed using electronic databases such as PubMed, Cochrane Library, and Google Scholar. Studies were identified based on predefined inclusion criteria related to quasi-experimental design methodologies applied in Ethiopian district hospital systems. The review identified a proportion of 60% of studies employing intention-to-treat analysis (ITT) for estimating risk reduction outcomes, which is considered robust but not universally adopted across all reviewed studies. While the majority of quasi-experimental designs in this context use ITT, there remains variability in methodological approach and reporting standards. There is a need to promote standardisation of methodology for consistent evaluation of district hospitals' performance metrics in Ethiopia. Treatment effect was estimated with $\text{logit}(p<em>i)=\beta</em>0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.