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

Community health centres (CHCs) in Ethiopia face challenges in resource allocation and service delivery. A mixed-methods approach was employed, including quantitative data collection from 100 randomly selected CHCs using an efficiency scorecard model, and qualitative interviews with 20 CHC managers. Data analysis used multivariate regression for statistical significance testing. The findings indicate that the average efficiency score of the CHCs varied between 50% to 70%, with a significant difference in scores across regions (p < 0.05). CHC systems require targeted interventions, particularly in resource management and service delivery. Implementing evidence-based training programmes for CHC staff and upgrading infrastructure can enhance efficiency. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.