District hospitals in South Africa are critical for providing essential healthcare services to underserved populations. However, their effectiveness and efficiency vary across different districts. A longitudinal study employing multilevel regression analysis was conducted to assess the impact of various contextual factors on the adoption of these protocols. Data from to were analysed, capturing both district-level and hospital-specific characteristics. The analysis revealed significant variation in protocol adoption rates between districts, with some areas showing higher uptake despite similar healthcare resource availability. This study provides insights into the factors influencing protocol adoptions within district hospitals, offering a nuanced understanding of their effectiveness. Policymakers should consider these contextual differences when implementing new protocols and allocate resources accordingly to maximise impact. Treatment effect was estimated with logit (pᵢ) =₀+^ Xᵢ, and uncertainty reported using confidence-interval based inference.
Seketeña et al. (2013) studied this question.