District hospitals in Ethiopia face challenges in risk reduction protocols due to varying system efficiencies. A randomized controlled trial was conducted with 150 hospitals, assessing their performance under standardised risk reduction protocols. Data collection included patient outcomes and administrative records over one year. In the intervention group (75 hospitals), there was a statistically significant 20% decrease in mortality rates ($p < 0.05$; 95% CI: -18%, -32%). The randomized field trial demonstrated that applying standardised risk reduction protocols can lead to measurable reductions in mortality. District hospitals should implement standardised risk assessment methods and continuous quality improvement programmes based on this study's findings. district hospitals, Ethiopia, intervention study, mortality rates, risk reduction