Public health surveillance systems are crucial for monitoring infectious diseases and managing disease outbreaks effectively. A DiD analysis was employed to assess the impact of policy interventions on the adoption of public health surveillance systems across different regions in Tanzania. The study utilised survey data from and . The DiD model indicated a significant increase in system adoption rates by 35% (95% CI: 10-60%) after the introduction of policy incentives, with urban areas showing higher uptake compared to rural regions. Public health surveillance systems showed substantial improvements following policy interventions, particularly in urban settings. Further tailored strategies should be implemented to enhance system adoption in underserved rural areas. public health surveillance, DiD model, Tanzania, policy intervention Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.