Quasi-Experimental Design for Assessing System Reliability in Ethiopian District Hospitals: A Methodological Evaluation

The healthcare landscape in Ethiopia's district hospitals is characterized by varying levels of infrastructure, resources, and personnel. A quasi-experimental design was employed with a pre-post intervention study approach in four randomly selected district hospitals across Ethiopia. System reliability was assessed using an adapted version of the Hospital Process Functioning Assessment (HPFA) questionnaire, supplemented by quantitative data on resource availability and staff training programmes. System reliability scores improved significantly from baseline to post-intervention, indicating a positive effect of system interventions in enhancing operational efficiency. The quasi-experimental design proved effective in measuring system reliability within Ethiopian district hospitals. Future research should consider broader regional variations and longer-term impact assessments. District hospital managers are advised to implement regular training programmes for staff and continuous improvement initiatives based on the HPFA questionnaire results. district hospitals, Ethiopia, system reliability, quasi-experimental design, process functioning assessment Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.