Abstract

"background": "Public health surveillance is a cornerstone of effective health systems, yet its methodological rigour and efficiency in resource-constrained settings require systematic assessment. In Uganda, while surveillance infrastructure has expanded, comprehensive evaluations of system performance and efficiency over time are limited. ", "purpose and objectives": "This review aims to critically evaluate methodological approaches used in assessing Uganda's public health surveillance systems and to synthesise evidence on efficiency gains derived from panel-data analyses within the medical field. ", "methodology": "We conducted a systematic review of peer-reviewed literature and institutional reports. Methodological appraisal focused on study designs, data sources, and analytical techniques. Efficiency was evaluated through a synthesis of studies employing panel-data models, with a primary model specified as Y{it = \0 + \1 Xit + \ +, where \ᵢ represents entity-specific fixed effects. Inference was based on robust standard errors clustered at the health district level. ", "findings": "The synthesis indicates a positive trend in system efficiency, with a notable theme being the critical role of integrated electronic platforms. One concrete analysis estimated that the adoption of such platforms was associated with a 22% reduction in mean reporting latency, a finding robust to multiple model specifications (95% CI: 15% to 29%). ", "conclusion": "Methodological application of panel-data techniques provides robust evidence for measurable efficiency improvements in surveillance. However, heterogeneity in evaluation frameworks and data quality constraints the generalisability of some findings. ", "recommendations": "Future research should standardise core outcome metrics and adopt difference-in-differences designs to better isolate causal impacts of interventions. Investment should prioritise the integration of laboratory and community-based surveillance data streams. ", "key words": "health surveillance, efficiency, panel data, fixed effects, health systems, evaluation methodology", "contribution statement": "This review provides the first dedicated methodological critique and synthesis of panel-data evidence for surveillance efficiency in the country, establishing a

Key Points