District hospitals in Kenya play a crucial role in healthcare delivery but face challenges that affect clinical outcomes. A comprehensive search strategy was employed to identify relevant studies. Studies were assessed for quality, and DiD models were applied to analyse clinical outcome data. Data from three studies indicated a significant improvement in patient recovery rates with the implementation of standardised protocols (p < 0.05, CI: [12%, 34%]). The use of DiD models provided robust evidence for evaluating district hospital systems and their impact on clinical outcomes. Future research should consider longitudinal data to enhance model validity and incorporate qualitative assessments to provide a more holistic understanding. District Hospitals, Difference-in-Differences (DiD), Clinical Outcomes, Kenya Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.