Ugandan district hospitals face significant challenges in resource allocation and operational efficiency. A randomized controlled trial design was employed to assess cost-effectiveness metrics including direct healthcare costs per patient visit and indirect costs related to staff productivity. Data collection involved standardised surveys and cost accounting records over one year. The trial revealed a $10 reduction in average daily operational expenses for hospitals implementing resource optimization strategies compared to control hospitals, with an estimated 7% improvement in patient throughput efficiency. Resource optimization strategies significantly improved the financial sustainability of district hospital systems without compromising on clinical outcomes. District health authorities should prioritise investment in technology and training programmes to enhance operational efficiencies and cost-effectiveness. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.