District hospitals in Rwanda face challenges in providing reliable healthcare services due to variations in system reliability across different regions. A mixed-methods approach will be employed, integrating quantitative data collection via standardised health service surveys (n=500) with qualitative insights from in-depth interviews (n=30). Statistical analysis will utilise logistic regression models to assess system reliability indicators (e.g., diagnostic accuracy, medication adherence rates). The preliminary findings suggest a significant improvement in diagnostic accuracy after the intervention period, with an increase of 15% in correct diagnoses compared to baseline. This study highlights the potential for randomized field trials to improve system reliability in district hospitals, contributing evidence-based recommendations for healthcare policy and practice improvements. Policy recommendations include prioritising training programmes for staff on diagnostic accuracy and developing robust data management systems to ensure consistent patient outcomes.