Abstract
{ "background": "Public health surveillance is critical for disease control, yet the methodological rigour of frameworks used to evaluate such systems in low-resource settings is often inconsistent. Uganda, facing diverse disease burdens, serves as a salient case study for examining evaluation methodologies and their impact on system performance.", "purpose and objectives": "This systematic review aims to critically appraise methodological frameworks employed for evaluating public health surveillance systems in Uganda, with a specific focus on evidence from randomised field trials measuring yield optimisation.", "methodology": "A systematic search of multiple electronic databases was conducted following a pre-registered protocol. Studies were screened against pre-defined eligibility criteria, with data extracted and synthesised narratively. The quality of included studies was assessed using appropriate tools. A meta-analytic random-effects model, $\\hat{\\theta} = \\frac{\\sum{i=1}^{k} wi yi}{\\sum{i=1}^{k} wi}$, where $wi = 1 / (v_i + \\tau^2)$, was specified for potential quantitative synthesis.", "findings": "Of the 18 included studies, only three were randomised field trials. A predominant theme was the reliance on cross-sectional, non-experimental designs. The single trial with sufficient data reported a 22% increase in case detection yield (95% CI: 14 to 30) following a community-based mobile health intervention, though the estimate's precision was limited by a small sample size.", "conclusion": "There is a stark paucity of high-quality, experimental evidence from randomised trials to robustly evaluate surveillance system improvements in Uganda. Existing methodological frameworks are largely descriptive and lack rigorous comparative designs.", "recommendations": "Future research must prioritise the design and implementation of cluster-randomised trials to generate causal evidence. Methodological frameworks should incorporate standardised outcome metrics for yield and timeliness to facilitate cross-study comparison and meta-analysis.", "key words": "public health surveillance, evaluation framework, randomised controlled trial, yield,