Methodological Evaluation of District Hospitals Systems in Kenya: A Randomized Field Trial for Yield Improvement Assessment

District hospitals in Kenya play a crucial role in healthcare delivery but face challenges in system efficiency. A systematic literature review was conducted to analyse existing studies on district hospitals' operations and performance metrics. Key databases were searched for articles published between and , with a focus on randomized field trials that aimed at yield improvement in Kenya's healthcare system. Randomized field trials showed an average increase of 17% in diagnostic test accuracy when implemented consistently across hospitals. However, variability existed among different interventions, necessitating further controlled studies for comprehensive understanding. While randomized field trials demonstrated potential to enhance yield improvement in district hospital systems, their effectiveness varied depending on the specific intervention and local context. Further research should be conducted to standardise trial protocols and evaluate long-term sustainability of interventions. Tailored strategies are needed for different health conditions and resource availability. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.