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This meta-analysis evaluates the methodological quality of quasi-experimental designs for measuring efficiency gains in district hospital systems.

March 13, 2026Open Access

A Meta-Analysis of Quasi-Experimental Designs for Measuring Efficiency Gains in Rwandan District Hospital Systems: Methodological Evaluation, 2000–2026

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Meta-analysis evaluates efficiency gains in Rwandan hospitals using quasi-experimental designs, indicating a need for methodological consistency.

This meta-analysis evaluates the methodological quality of quasi-experimental designs for measuring efficiency gains in district hospital systems.
Systematically identified studies utilizing quasi-experimental designs.
Assessed study quality with a modified Cochrane ROBINS-I tool.
Applied random-effects meta-regression to synthesize effect sizes.
Evaluated methodological covariates and examined confidence intervals.
Only 38% of included studies addressed confounding and selection biases adequately.
Pooled effect size for efficiency gains was positive but highly heterogeneous.
Studies using propensity score matching reported more conservative and reliable estimates.

Uwimana et al. (2014) studied this question.

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Meta-analysis evaluates efficiency gains in Rwandan hospitals using quasi-experimental designs, indicating a need for methodological consistency.