The effectiveness of community health centres (CHCs) in South Africa has been a subject of study for decades, with varying levels of cost-effectiveness observed across different regions and over time. The study employs a multilevel regression model with robust standard errors to account for the hierarchical structure of data (CHC level and district level) over time. The model is specified as: Y₈ₓ = eta₀ + eta₁ X₈ₓ + uᵢ + vₜ + e₈ₓ, where Y₈ₓ represents health outcomes, X₈ₓ are control variables including socioeconomic indicators and healthcare resource availability, uᵢ and vₜ are random effects for CHC and district level respectively. The multilevel regression analysis reveals significant heterogeneity in the cost-effectiveness of CHCs across districts, with some showing substantial improvements in health outcomes per unit cost invested over the study period. The findings suggest that while there are variations in cost-effectiveness, overall, investments in CHCs have contributed positively to improving healthcare access and quality in South Africa. Based on these results, targeted interventions should be developed to enhance the efficiency of CHC operations, particularly focusing on resource allocation and staff training programmes.
Dlamini et al. (Fri,) studied this question.