District hospitals in Senegal are faced with challenges related to service delivery and system reliability. A difference-in-differences model was applied to assess changes in service delivery metrics before and after implementing quality improvement initiatives. Data from two pre-defined time periods were compared: one year prior to the intervention (treatment group) and one year post-intervention (control group). There was a significant increase of 30% in patient satisfaction scores post-intervention, suggesting improved service delivery. The difference-in-differences approach demonstrated effectiveness in measuring system reliability within district hospitals in Senegal. Further research should investigate the long-term sustainability and scalability of these interventions across different regions of Senegal. District Hospitals, Difference-in-Differences, Quality Improvement, Service Delivery, Patient Satisfaction Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.