Methodological Evaluation of Public Health Surveillance Systems in Rwanda Using Difference-in-Differences for Cost-Effectiveness Analysis

Public health surveillance systems are essential for monitoring diseases and managing resources efficiently in Rwanda. A systematic review methodology was employed to identify relevant studies. Studies were screened based on predefined criteria and assessed for quality using the Newcastle-Ottawa Scale (NOS). The analysis revealed mixed results regarding the effectiveness of surveillance systems, with some showing cost savings compared to baseline conditions. While the difference-in-differences model demonstrated potential in measuring cost-effectiveness, further empirical studies are needed to validate these findings and identify key factors influencing system performance. Investigate specific system components that contribute to cost savings or inefficiencies and consider implementing robust monitoring practices for continuous improvement. Treatment effect was estimated with logit (pᵢ) =₀+^ Xᵢ, and uncertainty reported using confidence-interval based inference.