District hospitals in Nigeria face challenges in cost-effectiveness due to limited resources and variable patient volumes. A Bayesian hierarchical model was employed to analyse data from district hospitals across Nigeria. The model accounts for spatial and temporal variability in service provision and patient demographics. The analysis revealed significant differences in cost-effectiveness between regions with substantial proportions of under-resourced facilities (30% in the North-Central region). Bayesian hierarchical models provide a robust framework to assess district hospital systems, revealing disparities that can inform targeted interventions. Targeted resource allocation and additional training programmes are recommended for underperforming districts identified through this model. Treatment effect was estimated with logit (pᵢ) =₀+^ Xᵢ, and uncertainty reported using confidence-interval based inference.
Owojobi et al. (2005) studied this question.