Methodological Evaluation of District Hospitals Systems in Nigeria: A Randomized Field Trial for Measuring Clinical Outcomes

District hospitals in Nigeria play a crucial role in providing healthcare services to rural populations. However, their effectiveness and efficiency are often questioned due to inadequate funding and resource allocation. A mixed-methods approach was employed, including a quantitative component using logistic regression models for outcome measurement and a qualitative component involving interviews and observations. Data collection occurred over two years. The analysis revealed that approximately 60% of patients received appropriate treatment as per clinical guidelines, with significant variability in the quality of care provided across different districts. While progress has been made in improving patient outcomes, there is still considerable room for improvement, particularly in resource-limited settings. Investment in training healthcare workers and infrastructure upgrades are recommended to enhance service delivery and clinical effectiveness. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.