District hospitals in Nigeria often face challenges related to resource allocation and operational efficiency. A randomized field trial was conducted across five districts. Data on patient flow, resource utilization, and service delivery were collected using standardised questionnaires and electronic health records (EHR). Findings indicate that the average efficiency score of district hospitals in District X improved by 15% after implementing intervention measures. The randomized field trial demonstrated that targeted interventions can significantly enhance the operational efficiency of district hospitals in Nigeria. District health authorities should prioritise resource allocation and training for staff to ensure sustainable improvements in service delivery. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.