Multi-Level Regression Analysis for Evaluating Yield Improvement in Community Health Centres Systems in Ethiopia: A Longitudinal Study

Community health centers (CHCs) in Ethiopia have been established to improve access to healthcare services, but their effectiveness varies across different regions and levels of care. A longitudinal dataset spanning five years was analysed with a multi-level mixed-effects model: Yᵢⱼₜ = eta₀ + eta₁Xᵢⱼₜ + uᵢ + vⱼ + eᵢⱼₜ, where uᵢ represents the fixed effect of CHC i over time, and vⱼ captures the contextual effects at the county level. The robust standard errors account for within-cluster correlation. CHCs in rural areas showed a significant improvement in patient satisfaction scores (mean increase by 15%) compared to urban settings, suggesting geographical location as an influential factor. Multilevel regression analysis provided insights into the yield improvements and identified key drivers of performance variation between CHCs. The findings can inform policy adjustments for equitable healthcare service delivery. Enhanced training programmes should be tailored to address specific challenges in rural settings, while centralized monitoring systems are recommended to ensure consistency across all CHCs.