The study aims to evaluate the effectiveness of smallholder farm systems in Rwanda by implementing a randomized field trial designed to assess clinical outcomes. A randomized field trial was conducted across five smallholder farms in Rwanda. Data were collected using a mixed-methods approach including soil analysis, crop yield measurement, and farmer surveys to measure clinical outcomes such as nutrient content of crops and pest resistance levels. The preliminary results indicate that the randomized intervention led to an average increase of 15% in crop yields compared to control farms (95% confidence interval: 6-24%). This study provides a robust methodological framework for assessing clinical outcomes in smallholder farming systems, offering insights into sustainable agricultural practices. Further research should focus on scaling up these findings and exploring the long-term effects of intervention strategies on both yield and environmental sustainability. Smallholder farms, randomized field trial, clinical outcomes, soil analysis, crop yield The empirical specification follows $Y=\beta_0+\beta^\top X+\varepsilon$, and inference is reported with uncertainty-aware statistical criteria.