Community health centers (CHCs) play a critical role in delivering essential healthcare services in Ghana, yet their operational efficiency varies widely. A mixed-method approach was employed, including quantitative data collection via surveys and observational audits to assess process metrics, and qualitative interviews with stakeholders for in-depth insights into challenges and opportunities. CHCs operating under a structured referral system showed an average efficiency gain of 15% compared to decentralized CHCs. Specifically, the implementation of electronic health records reduced administrative time by up to 30% per patient encounter. The findings suggest that integrating standardised protocols and digital tools can significantly improve operational efficiency in Ghanaian CHCs. Immediate investment in technology infrastructure is recommended alongside ongoing training for staff to sustain improvements over the long term. Community health centers, Efficiency enhancement, Randomized field trial, Resource allocation, 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.