Methodological Evaluation of District Hospitals Systems in Nigeria: A Randomized Field Trial for Cost-Effectiveness Assessment

District hospitals in Nigeria play a crucial role in healthcare provision but often face challenges related to system inefficiencies and cost-effectiveness. A randomized controlled trial was conducted among randomly selected district hospitals, with data collected on resource utilization and patient outcomes. There were significant variations in resource allocation (p=0.02) across different hospitals, indicating disparities in service provision effectiveness. The findings suggest that current system configurations need optimization to enhance cost-effectiveness and improve healthcare delivery. Implementing standardised protocols for resource management could lead to more equitable and efficient use of resources within district hospital systems. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.