Methodological Evaluation of District Hospitals Systems in Senegal: Quasi-Experimental Design for Cost-Effectiveness Assessment

District hospitals in Senegal play a crucial role in healthcare delivery, but their efficiency and cost-effectiveness are often underutilized. A mixed-method approach was employed, including surveys, interviews, and cost-benefit analysis. Data were analysed using regression models to estimate cost-effectiveness ratios (CER). The analysis revealed that the average CER for patient care efficiency in district hospitals is $0.8 per unit of input. Despite financial constraints, there are opportunities for improving resource allocation and service delivery within these systems. District health authorities should prioritise training programmes and infrastructure improvements to enhance system performance. Senegal, district hospitals, cost-effectiveness, regression analysis, healthcare efficiency Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.