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

Infectious diseases remain a significant public health challenge in Saudi Arabia and other low-and middle-income countries. While the Kingdom has invested in advanced digital platforms such as Raqueem, HESN, and NPHIES, surveillance practices remain largely compliance-driven, resulting in delays, inefficiencies, and limited engagement in primary health care (PHC). A value-based model can transform surveillance into a resilient, outcome-driven system aligned with Saudi Vision 2030 and International Health Regulations (IHR). This commentary proposes a framework that integrates outcome indicators, digital platforms, and community perspectives, operationalised through a value-based balanced scorecard (VBSC). Key policy options include implementing outcome-based KPIs, strengthening digital integration, enhancing workforce capacity, regular monitoring and evaluation, promoting inter-sectoral coordination, and addressing barriers through policy support. The framework bridges compliance with value generation, ensures cost-effectiveness, and enhances public trust. It provides a replicable model for other low-and middle-income countries seeking to modernise their surveillance systems while improving efficiency, resilience, and accountability.