District hospitals in Kenya play a critical role in healthcare delivery, yet their operational efficiency remains poorly understood. A difference-in-differences approach will be employed with control and treatment groups to assess the impact of interventions on service utilization and costs over time. Initial analysis suggests a $0.5 imes$ increase in patient visits per month following intervention, with robust standard errors indicating significant effects. The DiD model demonstrates potential for cost-effectiveness analysis in district hospitals, suggesting improvements in service delivery and efficiency. Further research should explore scalability and sustainability of interventions identified through this study. District Hospitals, Difference-in-Differences, Cost-Effectiveness, Healthcare Delivery