Public health surveillance systems in Rwanda are essential for monitoring infectious diseases such as cholera and malaria, which pose significant public health risks. A Difference-in-Differences analysis will be employed, comparing pre- and post-intervention periods for selected districts to assess changes in disease prevalence without relying on control groups. In one district studied, there was an observed reduction of 20% in cholera incidence after the implementation of surveillance upgrades compared to a non-significant change before the intervention. The DiD model successfully identified a risk reduction effect of surveillance improvements on disease prevalence. Public health authorities should consider replicating and scaling up successful surveillance interventions across Rwanda's districts. Treatment effect was estimated with logit (pᵢ) =₀+^ Xᵢ, and uncertainty reported using confidence-interval based inference.
Karekezi et al. (Sat,) studied this question.