Methodological Evaluation of Community Health Centre Systems in Uganda: A Randomized Field Trial for Cost-Effectiveness Assessment

Community health centres in Uganda face challenges in cost-effectiveness due to varying service delivery models. A randomized field trial was conducted across ten Ugandan communities, with data collected on patient outcomes and costs over six months. Statistical analysis used mixed-effects regression models to assess the impact of system variations on service delivery and efficiency. Mixed-effects regression revealed a significant difference (p < 0.05) in outpatient visits per capita between two randomly selected systems, with System A seeing an average increase of 12% compared to System B. System A demonstrated superior cost-effectiveness and service delivery metrics over System B, suggesting potential improvements in other health centres. Health authorities should prioritise the adoption of System A for future community health centre expansions in Uganda. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.