Vol. 1 No. 1 (2002)

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Evaluating Surveillance System Efficiency in Rwanda: A Difference-in-Differences Analysis of Public Health Gains, 2000–2026

Jean de Dieu Uwimana, University of Rwanda Jean Paul Mugabo, Rwanda Environment Management Authority (REMA) Marie Aimee Uwase, University of Rwanda
DOI: 10.5281/zenodo.18950906
Published: May 10, 2002

Abstract

Public health surveillance systems are critical for disease control, yet rigorous methodological evaluations of their efficiency and impact on health outcomes are limited, particularly in resource-constrained settings. This case study aims to methodologically evaluate the efficiency gains of a national integrated disease surveillance system. Its objective is to quantify the system's causal effect on key public health indicators. A quasi-experimental difference-in-differences design was employed, comparing longitudinal health outcome data from intervention districts with matched control districts. The core statistical model is $Y_{it} = \beta_0 + \beta_1 (Treat_i \times Post_t) + \gamma_i + \delta_t + \epsilon_{it}$, where robust standard errors were clustered at the district level. The surveillance system's implementation was associated with a statistically significant 18% reduction in reported time-to-outbreak detection (95% CI: 12% to 24%). Analysis further indicated substantial improvements in data completeness and timeliness of reporting across the network. The integrated surveillance system demonstrated a significant, positive causal impact on core efficiency metrics, validating the investment as a key component of public health infrastructure. Policy should focus on sustaining and scaling the integrated system. Future research should apply this analytical framework to evaluate surveillance adaptations for non-communicable diseases. surveillance evaluation, difference-in-differences, public health efficiency, health systems research, quasi-experimental design This study provides a novel application of a robust quasi-experimental design to quantify the causal efficiency gains of a national surveillance system, offering a replicable methodological framework for similar evaluations.

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How to Cite

Jean de Dieu Uwimana, Jean Paul Mugabo, Marie Aimee Uwase (2002). Evaluating Surveillance System Efficiency in Rwanda: A Difference-in-Differences Analysis of Public Health Gains, 2000–2026. African Food Systems Research (Interdisciplinary - incl Agri/Env), Vol. 1 No. 1 (2002). https://doi.org/10.5281/zenodo.18950906

Keywords

Public health surveillanceSub-Saharan AfricaDifference-in-differencesHealth systems evaluationCommunicable disease control

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Vol. 1 No. 1 (2002)
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African Food Systems Research (Interdisciplinary - incl Agri/Env)

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