The evaluation of district hospitals systems in Ethiopia has been a subject of interest for researchers aiming to understand healthcare delivery and service provision. The review employs rigorous methodologies including a comprehensive search strategy for relevant studies published between and . Studies are critically appraised using predefined inclusion criteria based on their methodological rigor and relevance to the study objectives. Panel data estimation techniques were applied in various studies, with adoption rates ranging from 40% to 65%, indicating moderate levels of service uptake across different districts. The review highlights inconsistencies in the application of panel data methods among studies and proposes a standardised framework for future research. Future researchers are advised to adopt robust statistical models, enhance transparency in data collection processes, and consider contextual factors influencing healthcare adoption rates. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.