Methodological Evaluation of Public Health Surveillance Systems in Ethiopia: A Randomized Field Trial for Cost-Effectiveness Assessment

Public health surveillance systems are crucial for monitoring disease outbreaks in resource-limited settings such as Ethiopia. However, their effectiveness and cost-effectiveness remain poorly understood. A randomized field trial was conducted to assess the performance metrics of existing surveillance systems. Data collection involved both quantitative and qualitative methods, including surveys and focus group discussions. During the trial, it was observed that public health workers in rural areas faced challenges with communication barriers and limited access to digital devices, which impacted data input accuracy. The evaluation highlighted significant interoperability issues between different surveillance systems used by local authorities. These findings suggest a need for standardised protocols and improved technology integration. Standardised training programmes should be developed for public health workers regarding the use of digital tools in surveillance processes, while also advocating for greater investment in infrastructure to enhance data collection and transmission efficiency. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.