The effectiveness of district hospital systems in Tanzania has been a subject of interest due to their role in providing essential healthcare services across rural and underserved areas. A comprehensive search was conducted using databases such as PubMed, Cochrane Library, and Google Scholar. Studies published between and were included if they met the inclusion criteria of randomized field trials that evaluated district hospital systems in Tanzania. Findings from the reviewed studies indicated a moderate proportion (45%) of hospitals showed efficiency gains after implementing new management strategies, with varying levels of improvement across different regions. The review highlights the need for standardization and continuous evaluation of district hospital operations to ensure consistent performance and patient outcomes. Specific recommendations include the implementation of standardised quality control measures and regular audits to monitor hospital efficiency and identify areas for improvement. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.