District hospitals in Rwanda face significant challenges in providing quality healthcare services due to resource limitations and inadequate systems. A mixed-methods approach was employed, including quantitative data analysis using logistic regression to assess the impact of system improvements. Qualitative interviews provided deeper insights into staff perceptions and operational challenges. During the study period, there was a statistically significant reduction in emergency response times (OR = 0. 67, CI: 0. 54-0. 83) following the implementation of new protocols, indicating improved system responsiveness. The quasi-experimental design proved effective in quantifying risk reduction metrics within district hospitals, offering a robust framework for future healthcare improvements. District hospital managers should prioritise continuous quality improvement initiatives and further refine their operational procedures to maintain the observed benefits. district hospitals, Rwanda, quasi-experimental design, service delivery, logistic regression
Nshuti et al. (Fri,) studied this question.
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