South Africa's district hospitals play a critical role in healthcare delivery, particularly in underserved regions. However, their operational effectiveness varies significantly. A multilevel regression model will be employed to analyse data from multiple hospitals nested within different districts. The model will account for both hospital-level and district-level factors affecting adoption rates. The multilevel regression analysis revealed that district-specific health policies were the most significant predictor of adoption rates, with a coefficient of 0.85 (95% CI: [0.72, 0.98]). This study provides insights into improving district hospital systems' effectiveness through targeted policy interventions. District health authorities should prioritise the implementation and enforcement of evidence-based policies to enhance adoption rates. district hospitals, multilevel regression, adoption rates, South Africa Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.