Public health surveillance systems are essential for monitoring infectious diseases in Rwanda to prevent outbreaks. A mixed-methods approach combining quantitative data from surveys with qualitative interviews to assess system performance and user satisfaction. Randomized field trials were conducted to measure adoption rates across different regions. Adoption rates varied significantly, ranging from 60% in urban areas to 40% in rural settings, indicating a need for targeted interventions to improve coverage. The randomized field trial demonstrated the variability of public health surveillance systems' effectiveness and highlighted the importance of tailored strategies to enhance adoption and performance. Develop evidence-based training programmes for healthcare workers and community leaders to increase system uptake, focusing on regions with lower 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.