Community health centres in Nigeria face challenges in delivering effective healthcare services due to resource limitations and inadequate system efficiency. A systematic literature review employing PRISMA guidelines was conducted to identify relevant studies. Studies were screened based on inclusion criteria related to methodologies, study design, and outcomes. The analysis identified a significant proportion (35%) of quasi-experimental designs that employed robust statistical models such as regression discontinuity design (RDD) or difference-in-differences (DiD), demonstrating their effectiveness in measuring cost-effectiveness with moderate uncertainty around estimated effects. This review highlights the importance of methodological rigor in evaluating healthcare systems, particularly focusing on quasi-experimental designs for assessing cost-effectiveness and operational efficiency. Future research should prioritise the replication and validation of findings through additional empirical studies to ensure robustness and generalizability. Treatment effect was estimated with logit (pᵢ) =₀+^ Xᵢ, and uncertainty reported using confidence-interval based inference.
Nwachukwu et al. (Mon,) studied this question.