Methodological Evaluation of Community Health Centre Systems in South Africa Using Difference-in-Differences for Clinical Outcome Assessment

Community health centres (CHCs) in South Africa play a crucial role in delivering healthcare services to underserved populations. Despite their importance, there is limited data on the effectiveness of these systems in improving clinical outcomes. The study will utilise a DiD approach, comparing CHCs' performance before and after implementing new interventions with a control group that did not receive any changes. Data from patient records will be collected using structured questionnaires and electronic health record systems. A preliminary analysis suggests that the implementation of telemedicine services in some CHCs has led to an increase in the proportion of patients receiving timely consultations by up to 15% compared to baseline levels. This study aims to validate the effectiveness of DiD methodology for assessing clinical outcomes in community health centres and to contribute methodological guidance for policy-makers and researchers. Future research should consider longitudinal data collection methods to better understand long-term impacts and explore additional interventions that could further improve patient outcomes. Treatment effect was estimated with logit (pᵢ) =₀+^ Xᵢ, and uncertainty reported using confidence-interval based inference.