"background": "The adoption of community health centre (CHC) systems is a critical component of public health infrastructure development in sub-Saharan Africa. However, longitudinal assessments of adoption rates, which are essential for strategic planning and resource allocation, have been hampered by methodological limitations in existing forecasting approaches. ", "purpose and objectives": "This study aimed to methodologically evaluate longitudinal data on CHC systems and to develop a robust time-series forecasting model for predicting future adoption rates. The objective was to generate reliable, long-term projections to inform health policy and infrastructure investment. ", "methodology": "A longitudinal study design was employed, analysing national-level panel data on operational CHCs. The core forecasting model was an autoregressive integrated moving average (ARIMA) model with exogenous variables (ARIMAX), specified as \ᵈ yt = c + =1^{p\ \ᵈ yt-i + =1^q\ -i + =1^m\ Xj, t + \, where Xj represents socioeconomic covariates. Model parameters were estimated using maximum likelihood, with robust standard errors to account for heteroskedasticity. ", "findings": "The methodological evaluation revealed significant autocorrelation in annual adoption rates, which the ARIMAX (1, 1, 1) model effectively captured. The forecast indicates a continued positive trajectory in system adoption, with a projected increase of approximately 22% (95% prediction interval: 18% to 26%) over the next forecast horizon. The inclusion of health workforce density as an exogenous variable significantly improved model fit. ", "conclusion": "The developed ARIMAX model provides a methodologically sound framework for forecasting CHC adoption, demonstrating the utility of time-series analysis in health systems research. The projections offer a credible evidence base for anticipating future infrastructure needs. ", "recommendations": "Health policymakers should integrate formal forecasting models into strategic planning
Mensah et al. (Thu,) studied this question.