In Ethiopia, district hospitals play a crucial role in healthcare delivery, yet their operational efficiency remains under scrutiny. The review will employ rigorous meta-analysis techniques to synthesize existing studies and assess their methodologies. Key variables include resource allocation, service utilization, and operational performance indicators. Panel-data estimation revealed significant variations in efficiency across different districts, with some showing substantial gains (up to 30%) through improved management practices and technology adoption. The reviewed studies highlight the importance of consistent data collection and analysis for monitoring hospital systems' effectiveness. However, there is variability in methodology and data quality that necessitates standardization. Standardised panel-data methodologies should be promoted to ensure comparability across districts. Enhanced training programmes for healthcare managers are also recommended. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.