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

Public health surveillance systems are crucial for monitoring infectious diseases in Kenya. However, their effectiveness and cost-effectiveness remain poorly understood. A randomized field trial was conducted to assess the performance and economic impact of existing surveillance systems. Data collection included weekly reporting on disease incidence, with statistical modelling using logistic regression for estimating odds ratios. The proportion of correctly identified infectious diseases through the surveillance system was found to be 75%, indicating room for improvement in detection accuracy. While the current system is cost-effective, there is a need for further refinement and investment in training and technology to enhance its performance. Investment in personnel training and technological upgrades should be prioritised to improve surveillance effectiveness and efficiency. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.