Methodological Evaluation of District Hospitals in Senegal: A Multilevel Regression Analysis for Cost-Effectiveness Measurement

District hospitals in Senegal face challenges in ensuring cost-effectiveness, necessitating a methodological evaluation to identify best practices and optimise resource allocation. A comprehensive search strategy was employed using electronic databases (PubMed, Scopus) and grey literature sources. Studies were screened based on predefined inclusion criteria and analysed using multilevel regression models to assess the impact of various factors on hospital performance. The multilevel regression analysis revealed a significant positive relationship between investment in training programmes for healthcare professionals and patient outcomes (p < 0.05). This study underscores the importance of investing in continuous professional development to enhance the cost-effectiveness of district hospitals in Senegal. Policy-makers should prioritise funding for training initiatives alongside other interventions aimed at improving hospital efficiency and patient care quality. District Hospitals, Cost-Effectiveness, Multilevel Regression Analysis, Senegal Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.