"background": "Municipal infrastructure asset management systems (IAMs) are critical for sustainable development, yet evidence of their cost-effectiveness in low-resource settings remains sparse. Evaluations often lack rigorous experimental designs, limiting actionable insights for policymakers and engineers. ", "purpose and objectives": "This study aimed to conduct a methodologically robust evaluation of the cost-effectiveness of different IAM diagnostic approaches implemented by municipal authorities. The primary objective was to quantify the incremental cost per unit improvement in asset condition score attributable to a structured diagnostic protocol. ", "methodology": "A randomised field trial was conducted across multiple municipalities. Authorities were randomly assigned to either a treatment group, implementing a new structured diagnostic protocol, or a control group, using existing practice. Cost data and asset condition indices were collected over a standardised period. Cost-effectiveness was analysed using a generalised linear model: \ (-Effectiveness Ratio{i) = \0 + \1 i + \\ + \, where is a vector of covariates including baseline infrastructure quality. Inference was based on robust standard errors. ", "findings": "The structured diagnostic protocol generated a statistically significant improvement in asset condition scores. However, it increased average management costs by approximately 32% compared to existing practice. The incremental cost-effectiveness ratio was estimated at RWF 1. 2 million per 0. 1 unit improvement in the condition index (95% CI: RWF 0. 9m to RWF 1. 6m). ", "conclusion": "While the structured diagnostic protocol enhances technical assessment quality, its substantial cost increment challenges financial sustainability in typical municipal budgets. The value hinges on the long-term asset lifecycle savings, which were not captured in this trial's timeframe. ", "recommendations": "Municipalities should adopt elements of the structured protocol selectively, focusing on high-criticality assets. National infrastructure agencies should consider targeted subsidies for diagnostic
Jean de Dieu Uwimana (Sat,) studied this question.