Community health centers (CHCs) in South Africa play a significant role in primary healthcare delivery, but their effectiveness and cost-effectiveness vary across different regions. A scoping review was conducted, encompassing studies published between and . Studies were selected based on their use of multilevel regression for cost-effectiveness measurement in CHC systems across South Africa. Findings indicate that while some studies used robust multilevel models to account for hierarchical data structures, there is variability in how these models are specified and interpreted. The review highlights the need for standardised methodological approaches to ensure consistent cost-effectiveness evaluations of CHC systems. Future research should focus on harmonizing multilevel regression methods across studies to enhance comparability and reliability 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.