District hospitals in Kenya play a crucial role in providing healthcare services, particularly to underserved populations. However, their efficiency and effectiveness are not well-documented, leading to the need for methodological evaluation. The review will employ rigorous methodology, including comprehensive database searches, quality assessment of included studies, thematic analysis, and synthesis of findings. The process will adhere to PRISMA guidelines for systematic reviews. A significant proportion (60%) of the reviewed studies employed quantitative methods but lacked clear reporting on data collection procedures, which may affect the reliability of their results. Current methodologies used in assessing district hospitals in Kenya are diverse and often vary significantly between studies. This review highlights the need for standardization to enhance comparability and validity of findings. Standardised protocols should be developed and implemented, ensuring consistency across future evaluations. Additionally, transparent reporting guidelines should be adopted to improve reproducibility and transparency. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.