Evaluating the Impact of Urban Primary Care Networks on Clinical Outcomes in Senegal: A Quasi-Experimental Study

{ "background": "Strengthening primary healthcare is a critical policy goal in many African nations, yet robust evidence on the effectiveness of integrated urban primary care networks in improving clinical outcomes remains limited.", "purpose and objectives": "This study aimed to quantify the causal impact of Senegal's urban primary care network (Réseau de Soins Primaires Urbains) initiative on key clinical outcomes for non-communicable diseases, specifically hypertension and type 2 diabetes.", "methodology": "A quasi-experimental difference-in-differences design was employed, analysing longitudinal patient-level data from intervention and matched control facilities. The primary model estimated the intervention effect as Yit = \β0 + \β1 ( \× ) + \γ Xit + \ + \ + \εit, where Yit is the clinical outcome for patient i at time t. Inference was based on cluster-robust standard errors at the facility level.", "findings": "The intervention was associated with a statistically significant improvement in systolic blood pressure control. Patients in network facilities experienced a 12.4 percentage point increase (95% CI: 7.1 to 17.7) in the probability of achieving controlled blood pressure (<140/90 mmHg) compared to controls. No significant effect was observed for glycaemic control in diabetic patients.", "conclusion": "Urban primary care networks can enhance the management of hypertension, but their design may require adaptation to effectively address complex conditions like diabetes.", "recommendations": "Policy should support the scale-up of networked primary care models for cardiovascular health, complemented by targeted, condition-specific enhancements for integrated chronic disease management.", "key words": "primary health care, health systems, quasi-experiment, non-communicable diseases, health policy, urban health", "contribution statement": "This study provides the first quasi-experimental evidence on the clinical effectiveness