Developing a vision for public health surveillance in Canada: An engagement and expert consensus process

OBJECTIVE: Public health surveillance (PHS) supports the detection of health threats, monitoring of population health, and coordinated public health action. While its core functions remain unchanged, Canada's last national vision for PHS was articulated in 2016, and the public health landscape has since evolved considerably. These changes have been shaped by lessons from the COVID-19 pandemic, advances in data systems and technologies, evolving data governance expectations, and increasing demand for timely, integrated public health information. We therefore sought to develop a renewed vision for PHS in Canada through broad engagement, qualitative synthesis, and expert consensus. METHODS: This work used a two-phase, multi-method approach. First, national engagement with public health interest holders was conducted between September 2023 and March 2024 through regional consultations, an expert meeting, and an online survey. Qualitative data were analyzed using reflexive thematic analysis to generate draft vision components and statements. Second, a three-round modified Delphi process with Canadian PHS experts was used to iteratively review, refine, and assess agreement on the draft statements. RESULTS: Engagement activities captured input from 1740 participants across Canada, generating 38 draft statements organized within a conceptual framework. Through the Delphi process, experts refined statements based on quantitative agreement measures and qualitative feedback, achieving consensus on a final set of 30 statements. CONCLUSIONS: The resulting vision provides a shared reference point for public health professionals and partners to align efforts to strengthen and modernize PHS systems in Canada.