District hospitals in Ethiopia play a critical role in healthcare delivery, but their effectiveness varies across regions. A systematic review was conducted using the difference-in-differences (DiD) model. Studies were selected based on relevance to Ethiopia's healthcare context and use of DiD methodology. The DiD analysis revealed a significant reduction in maternal mortality rates by approximately 15% in regions where hospital systems were improved over six months, although the effect varied across districts. The DiD model effectively measures risk reduction in district hospitals but requires careful selection of control and treatment groups to ensure robust results. Future research should focus on expanding the sample size and exploring additional factors influencing hospital performance. Treatment effect was estimated with logit (pᵢ) =₀+^ Xᵢ, and uncertainty reported using confidence-interval based inference.
Tadesse et al. (Sun,) studied this question.