Strengthening value-based infectious disease surveillance in primary health care, Saudi Arabia

¹Primary Health Care Surveillance Unit, Dammam Health Network, Eastern Health Cluster, Dammam, Saudi Arabia

^&Corresponding author
Nariman Adeeb AlShakhis, Primary Health Care Surveillance Unit, Dammam Health Network, Eastern Health Cluster, Dammam, Saudi Arabia

Commentary    

Infectious disease surveillance is a cornerstone of public health systems, enabling early detection, timely response, and effective containment of outbreaks. However, conventional surveillance approaches are often compliance-driven, emphasising data collection and reporting rather than outcomes and value to patients, populations, and health systems. The global shift toward value-based healthcare highlights the need to reorient surveillance systems toward maximising health outcomes relative to the resources used. In Saudi Arabia, the Health Sector Transformation Program under Vision 2030 emphasises efficiency, patient-centred care, and measurable improvements in population health-principles that align closely with value-based care. Despite significant investments in digital health infrastructure, including Raqueem, HESN, NPHIES, and ANAT, surveillance practices remain fragmented and underutilised. This commentary presents a value-based surveillance system at the PHC level. A value-based surveillance system integrates digital platforms, governance mechanisms, and community engagement, guided by a VBSC. The VBSC enables monitoring across four domains: financial (cost-effectiveness and return on investment), patient/community (satisfaction, trust, vaccination coverage), internal processes (timeliness and completeness of reports), and learning and growth (training and digital literacy).

Policy options include: 1) adopting a value-based infectious disease surveillance framework; 2) strengthening early detection and reporting systems through integrated digital tools; 3) enhancing workforce capacity through targeted training; 4) regular monitoring and evaluation using standardized KPIs; 5) promoting inter-sectoral coordination and stakeholder engagement, and 6) addressing barriers such as fragmented systems and limited resources through targeted policy support [1-8]. Table 1 summarises the proposed policy options for implementing a value-based infectious disease surveillance framework, highlighting their advantages and the potential challenges to adoption. Strengths of this approach include bridging compliance with value generation, aligning with Vision 2030 goals, and providing a scalable model for other LMICs. Challenges include ensuring interoperability between systems, training gaps among PHC staff, and the difficulty of measuring community trust. Future steps involve pilot testing, refining outcome indicators such as detection-to-response time, and conducting economic evaluations to demonstrate cost-effectiveness.

In conclusion, adopting a value-based surveillance framework within PHC offers Saudi Arabia an opportunity to move beyond compliance-driven reporting toward a system that is efficient, outcome-oriented, and trusted by the public. By integrating PHC into national digital platforms, unifying data flows, and applying a Balanced Scorecard of KPIs, surveillance can become a strategic driver of health system resilience [3,4].

Competing interests     

The author declares no competing interests.

Authors' contributions     

Nariman Adeeb Alshakhis conceptualised the study, developed the framework, analysed the evidence, and drafted the manuscript. The author critically revised the content and is accountable for all aspects of the work. The author read and approved the final version of the manuscript.

Table     

Table 1: policy options for value-based surveillance

References