Public health surveillance systems are critical for monitoring disease outbreaks and managing public health risks in Ethiopia. A mixed-methods approach was employed including surveys, interviews, and secondary data analysis to assess system adoption among health professionals in Ethiopia. The survey results indicated that 65% of healthcare providers adopted the public health surveillance systems, with significant variation observed between urban and rural settings (p < 0.01). Public health surveillance systems are widely adopted but vary significantly by geographical location in Ethiopia. Tailored training programmes should be developed to enhance system adoption rates among healthcare professionals in underserved areas. public health surveillance, adoption rates, quasi-experimental design, Ethiopia Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.