District hospitals in Ghana play a crucial role in healthcare delivery but face challenges in maintaining consistent quality of care. A systematic search strategy was employed across multiple databases including PubMed and Embase. Studies published between and were considered. The quality of studies was assessed using the Cochrane Risk of Bias Tool (RoB). The review identified a limited number of randomized field trials, with most focusing on pediatric services in rural areas. While the selected studies provided insights into clinical outcomes, methodological inconsistencies hindered comprehensive evaluation and generalizability. Future research should prioritise harmonizing study designs to enhance comparability and robustness of findings. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.