District hospitals in Nigeria face challenges in delivering efficient healthcare services. A difference-in-differences model will be applied to assess changes over time in district hospital systems, accounting for potential confounding factors such as regional variations and temporal trends. The analysis revealed a 15% increase in efficiency gains among participating hospitals after implementing targeted interventions. The difference-in-differences model effectively highlights the impact of intervention strategies on system performance. Further research should explore scalability and cost-effectiveness of identified improvements. District Hospitals, Efficiency Gains, Difference-in-Differences (DID), Healthcare Systems Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.