The healthcare system in Ethiopia faces significant challenges, particularly at district hospitals where service delivery often falls short of patient expectations. A mixed-methods approach combining quantitative panel-data estimation with qualitative insights was employed to assess system reliability across districts in Ethiopia. The study utilised data from -, collected through surveys and administrative records. Panel data analysis revealed a moderate level of variation (R² = 0. 75) in service delivery effectiveness among district hospitals, suggesting room for improvement. The findings underscore the need for targeted interventions to enhance reliability and efficiency at district-level healthcare facilities. Policy recommendations include strengthening health workforce training programmes and enhancing infrastructure maintenance. Panel data analysis, System Reliability, District Hospitals, Ethiopia Treatment effect was estimated with logit (pᵢ) =₀+^ Xᵢ, and uncertainty reported using confidence-interval based inference.
Alemayehu et al. (Sun,) studied this question.