Frontline Surveillance Practices and Healthcare Project Performance in a Decentralized Health System: A Mixed Methods from Kayunga District, Uganda

A cross-sectional study design employing a mixed-methods approach was used. Quantitative data were obtained from frontline health workers using structured questionnaires, while qualitative insights were obtained from key informant interviews. Statistical Package for Social Sciences (SPSS) version 20 was used for descriptive statistics, correlation, and regression analyses. Qualitative data were analyzed thematically to complement quantitative findings. There was a strong positive correlation between surveillance practices and healthcare project performance (r= 0.690, p< 0.01). Regression analysis confirmed this relationship (?= 0.456, p< 0.002). Qualitative results emphasized the importance of timely reporting, data completeness, and feedback in supporting decision-making and service delivery. Barriers such as inadequate training, limited logistical support, and community mistrust were identified as key challenges for surveillance effectiveness.

Conclusion Healthcare worker surveillance practices are integral to the success of healthcare projects in Uganda. Strengthening these practices through training, enhanced resource allocation, and active community engagement can substantially enhance health system performance. These findings provide district-level health systems evidence on how routine surveillance practices shape service delivery and epidemic preparedness in decentalized settings.