Public health surveillance systems (PHSSs) are essential for monitoring disease outbreaks and ensuring timely interventions in Ethiopia. A DiD model was employed to assess the impact of policy changes on PHSS adoption. The study utilised administrative data from health districts as the primary source. The DiD model revealed that regional differences significantly affected PHSS adoption rates, with some regions showing higher uptake than others. This analysis highlights the need for tailored strategies to enhance PHSS adoption in Ethiopia. Local health authorities should focus on implementing targeted interventions to improve PHSS adoption in underperforming regions. Public Health Surveillance Systems, DiD Model, Regional Differences, Adoption Rates Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.