"background": "Urban primary care networks are a key strategy for strengthening health systems in sub-Saharan Africa, yet robust evidence of their impact on clinical outcomes remains limited. There is a pressing need for rigorous methodological approaches to evaluate such complex health system interventions. ", "purpose and objectives": "This study aimed to evaluate the causal impact of Uganda's urban primary care network initiative on key clinical outcomes for hypertension and diabetes management using a quasi-experimental design. ", "methodology": "We employed a difference-in-differences design, leveraging the phased rollout of the networks across 12 urban centres. Data were extracted from longitudinal electronic medical records for patients with hypertension or diabetes. The primary analysis estimated the model Y{it = \0 + \1 (\) + \ + \ +, where Y₈ₓ is the outcome for patient i at time t, with patient and time fixed effects. Inference was based on cluster-robust standard errors at the facility level. ", "findings": "Exposure to the primary care network was associated with a statistically significant 7. 2 percentage point increase (95% CI: 2. 1, 12. 3) in the proportion of patients achieving controlled blood pressure. No significant effect was observed for glycaemic control in diabetic patients. ", "conclusion": "The urban primary care network model shows promise for improving hypertension management, but its benefits may not extend uniformly across all chronic conditions. The intervention's structural components appear more effective for cardiovascular care pathways. ", "recommendations": "Programme implementers should consider condition-specific adaptations to network design. Future research should investigate the mechanisms driving differential outcomes and the cost-effectiveness of the model. ", "key words": "primary health care, health systems, quasi-experiment, difference-in-differences, chronic disease, sub-Saharan Africa", "contribution statement": "This study provides the first application
Achieng et al. (Tue,) studied this question.