DHIS2 is widely used as an integrated digital platform to help prevent, detect and respond to infectious disease threats. Features and tools developed with WHO, CDC, implementing countries and subject matter experts are available to strengthen national and regional systems.
Disease surveillance is the ongoing systematic collection, analysis, interpretation and use of health data. It helps detect unusual disease patterns and possible outbreaks, while also supporting the monitoring and evaluation of public health interventions and providing routine epidemiological data to guide health program planning, priority setting and resource allocation.
Following the deadly Ebola outbreak in West Africa in 2014-16, the HISP network has partnered with the WHO, U.S. CDC and other global health institutions to continuously improve DHIS2 as a national-scale and regional disease surveillance platform and to support key information management and response functions during public health emergencies. This work enabled more than 60 countries to leverage DHIS2 during the COVID-19 pandemic as part of their surveillance and response strategies, and has helped Africa CDC and countries across Africa and Asia respond to outbreaks of malaria, dengue, mpox, Ebola, cholera and other epidemic-prone diseases.
As a result of more than a decade of real-world experience and our ongoing collaborations, DHIS2 now offers a comprehensive suite of software features, standards-based implementation tools, and detailed guidance to help countries use DHIS2 as an integrated component of their national systems for early warning, disease surveillance, and response to public health emergencies.
DHIS2 can fill a variety of roles in an integrated disease surveillance and response system, including bringing data streams together across diseases, triangulating them with mortality statistics and other key data sources, and switching between routine and emergency surveillance modes. The following are some of the most widely adopted DHIS2 use cases:
WHO promotes collaborative surveillance as a core component of health emergency preparedness, response and resilience (HEPR): bringing together indicator-based, event-based, laboratory, mortality, animal health and environmental data across sectors and levels, so that decision makers act on one shared picture of risk. As an integrated national platform, DHIS2 already holds most of these data streams and can exchange data with other systems through open APIs and standards. DHIS2 is the engine of EPI+, an open-source, multi-hazard platform for event-based surveillance and event management that the European Centre for Disease Prevention and Control (ECDC) is developing with HISP UiO for national public health authorities in Europe, designed to be interoperable with ECDC’s EpiPulse. In Sri Lanka, the Epidemiology Unit of the Ministry of Health uses EpiNet, a DHIS2-based epidemic intelligence platform, to triangulate hospital, laboratory and field data for detection, investigation and response.
Integrated disease surveillance is a framework promoted by WHO that incorporates both Indicator-Based surveillance (IBS) and Event-Based Surveillance (EBS) approaches to early detection of priority diseases, conditions and events. IBS functionality in DHIS2 builds on its global footprint as the world’s most widely used Health Management Information System for routine health data reporting, and leverages DHIS2 Tracker and Event programs for case-based surveillance, investigation, and follow-up on individual reported cases. DHIS2 is used in more than 50 countries as a national scale platform for routine indicator-based syndromic surveillance and in 30+ countries for case-based surveillance of notifiable diseases.
Event-based surveillance (EBS) complements routine indicator-based surveillance by facilitating early detection of unusual public health events, illnesses, or deaths that may signal an outbreak through scanning, triage, and verification of unstructured data obtained through media sources, rumors, community reporting and other informal sources. When implemented as part of a national surveillance platform, EBS data serves as a key early warning function that is complemented by the structured IBS data that health facilities and community health workers report on a routine basis. This functionality is also used on regional and continent levels by organizations including Africa CDC, and can feed into global initiatives such as WHO’s Epidemic Intelligence from Open Sources (EIOS). It can also support infodemic management during outbreaks, for example monitoring and classifying rumors and misinformation about vaccines, treatments or the outbreak itself. Real-world examples including rumor logging and verification in Uganda and real-time Covid-19 rumor monitoring in Côte d’Ivoire to guide risk communication and counter vaccine misinformation.
Community-based surveillance (CBS) is a core function of IDSR and of early warning in emergencies: trained volunteers, community health workers and local leaders report signals such as clusters of illness, unexplained deaths or animal die-offs, using simple community case definitions. DHIS2 supports CBS through SMS (including anonymous reporting), the Android Capture app and web forms, with signals triaged and verified in the same platform as facility data. The CBS module of the DHIS2 Community Health Toolkit monitors alerts and responses at community level. DHIS2 has been used for CBS in Uganda since 2013 where it has helped support signal triage, verification and dispatch during Ebola outbreaks; in Lebanon for polio, measles, cholera, food poisoning and hepatitis A; in South Africa supported by Africa CDC where it has detected 22 outbreaks early, mostly from community signals; and in Tanzania including community events linked to wildlife, where it is the model for a national One Health platform.
During health emergencies, the need for real-time surveillance data from hard-to-reach places is critical for rapidly assessing needs and coordinating response. DHIS2 surveillance data often serves as a key source of information for staff working in Emergency Operations Centers, enabling rapid data analysis and response planning. In humanitarian settings, DHIS2 is used by ministries of health and organizations such as ICRC and MSF to maintain surveillance and early warning among displaced and crisis-affected populations. Responding quickly also depends on mobilizing trained staff. The DHIS2 Rapid Response Team (RRT) rostering tool, developed with the US CDC Emergency Response Capacity Team and HISP Uganda, digitizes the full responder cycle: registration, vetting, readiness tracking (training, availability and medical clearance), deployment notifications, and post-deployment evaluation. Integrated in the national surveillance platform, it shows in real time which qualified responders are available by skill, language and location, shortening the time between an alert and the deployment of a team.
In acute emergencies and humanitarian crises, WHO recommends setting up or adapting early warning, alert and response (EWAR) quickly, focused on a short list of priority epidemic-prone diseases, with daily or weekly reporting, alert thresholds and rapid verification. Because DHIS2 is usually the existing national platform, countries can switch it to emergency mode instead of deploying a parallel system: increasing the reporting frequency, adding temporary sites such as camps and mobile clinics to the hierarchy, and activating alert thresholds and notifications. Examples include Pakistan’s emergency surveillance during the 2022 floods and Somalia’s move from a stand-alone EWARN to an integrated eIDSR in DHIS2.
Contact tracing is a core DHIS2 capability, available out of the box through standard Tracker program functionality. Each suspected or confirmed case is linked to its contacts through relationships: contacts are registered directly from the case record, or found if already in the system, and enrolled in a program in which they are monitored daily, or at the interval set by national guidelines, until the end of the monitoring period. Working lists, assigned follow-ups and scheduled visits tell each team who to call or visit, and program rules flag contacts who develop symptoms so they can be enrolled as suspected cases with their exposure history already captured. Line lists, dashboards and maps show the number of contacts per case, completeness of follow-up and contacts who become cases. The Africa CDC Toolkit for Surveillance and Outbreak Response, developed by Africa CDC with HISP UiO and HISP groups in Africa draws on experiences using DHIS2 to mpox, cholera, and Ebola outbreaks in DRC, is aligned with WHO’s digital adaptation kit for infectious disease surveillance and provides a reference design with linked Tracker programs for case notification and investigation and for contact tracing, together with an implementation guide, data dictionary, gap analysis tools and a demo configuration.
These native capabilities can be further enhanced through customization. Examples include a custom app for Covid-19 relationship tracing in Sri Lanka that displays transmission chains as interactive network graphs and a custom contact tracing app and dashboard in Laos including a case surveillance map.
7-1-7 is a timeliness target for outbreak detection and response: every suspected outbreak should be detected within 7 days of emergence, notified to public health authorities within 1 day of detection, and met with an effective early response within 7 days of notification. Proposed by Resolve to Save Lives and promoted by the 7-1-7 Alliance, it is used in WHO’s Early Action Review guidance and by Africa CDC, US CDC and a growing number of countries to find and fix bottlenecks in their surveillance and response systems. Because DHIS2 already holds the signals, cases, laboratory results and response actions, countries can capture and measure the 7-1-7 milestones in the same platform where the work happens. Several countries are already measuring their performance this way, including Sierra Leone, Zambia, and South Africa, supporting early outbreak detection and response. At continental level, the Africa CDC Toolkit for Surveillance and Outbreak Response is designed to help Member States meet 7-1-7 targets, starting with close to 20 countries in 2026.
The International Health Regulations (IHR 2005) require countries to maintain core capacities at designated airports, ports and ground crossings to detect, assess and respond to public health risks among travelers. Sri Lanka was the first country to use DHIS2 at points of entry, to screen and follow up travelers at the start of COVID-19; Uganda followed with border screening and QR-coded travel passes linked to laboratory results, and Ethiopia now issues and verifies digital International Certificates of Vaccination or Prophylaxis at Bole International Airport and other points of entry using DHIS2. As of 2026, Ghana is piloting an integrated solution based on a DHIS2 Tracker program that covers traveler screening, clinical assessment, yellow fever vaccination, IDSR notification, food vendor inspection, adverse events following immunization, laboratory results and outcomes, and uses a custom DHIS2 plug-in for Android mobile devices to scan travel documents. passports, Ghana Cards, ECOWAS cards and boarding passes offline.
WHO’s Mosaic framework calls for resilient, integrated surveillance of respiratory viruses with epidemic and pandemic potential, combining sentinel surveillance of influenza-like illness (ILI) and severe acute respiratory infection (SARI) with laboratory testing. In DHIS2, one Tracker record links each sentinel patient’s clinical data with the result from the national influenza centre, so facilities see results as soon as they are entered. Lebanon’s Ministry of Public Health has run ILI and SARI sentinel surveillance on DHIS2 since 2021, with 96% weekly completeness over five seasons and automated weekly bulletins; the Caribbean Public Health Agency (CARPHA) has moved its SARI/ARI sentinel and weekly syndromic surveillance to DHIS2.
Deaths are one of the earliest and most robust signals of an epidemic or emergency. DHIS2 supports rapid mortality surveillance aligned with WHO’s technical package, recording fact-of-death reports from communities and facilities to estimate excess mortality in near real time, and cause-of-death reporting aligned with the WHO Medical Certificate of Cause of Death and ICD-11 (Health Data Toolkit). In Lao PDR, where over 90% of deaths occur outside health facilities, community death notification by village health volunteers and verbal autopsy are now integrated in the national DHIS2; in one province, reported community deaths rose from 35% of those expected in the second half of 2024 to 67% in 2025.
Building on DHIS2’s global footprint as a public health surveillance system, countries can use DHIS2 as an integrated information platform for sharing data across sectors and ministries to advance multi-sectoral One Health approaches. Partnerships with CDC, FAO, WHO, WOAH and Ministries of Health and Agriculture/Livestock are expanding the use of the DHIS2 platform into Animal Health, Agriculture, and other sectors, strengthening cross-sectoral information sharing, and supporting early detection and prevention of zoonotic spillover events. DHIS2 is also used for antimicrobial resistance surveillance, including integration with WHONET and reporting to WHO GLASS.
The transmission of many infectious diseases is directly and indirectly affected by environmental factors, including local climate variation that affects the spread of disease vectors and extreme weather events like floods that can disrupt health services and lead to outbreaks of waterborne diseases. As a digital Climate & Health platform, DHIS2 offers tools for integrating climate, weather, and environmental data with disease surveillance data that can be used to analyze climate impacts on disease trends, support suitability and risk mapping, and inform planning for preventative campaigns. It also provides flexible tools for AI-powered predictive modeling which support forecasting-based early warning of climate-sensitive diseases.
Forecasts turn surveillance data into earlier action. The Chap Modeling Platform, developed by HISP UiO, is an open-source, disease-agnostic platform that lets countries run, compare and operationalize predictive models on their own DHIS2 data, combined with climate, weather and environmental data imported through the DHIS2 Climate App. Chap is a platform rather than a single model: models from several research groups, from seasonal baselines to Bayesian and deep learning approaches, are plugged in through a standard format and evaluated against historical country data. Models run on national infrastructure, so data do not have to leave the country, and forecasts, including the probability of exceeding outbreak thresholds, are returned to DHIS2 dashboards through the Modeling App for routine use by surveillance and program teams. 14 countries are currently testing Chap through the DHIS2 for Climate & Health project, including Laos, where weekly dengue forecasts are now part of routine surveillance.
Countries working towards the control and elimination of infectious diseases such as malaria, measles, polio and neglected tropical diseases need surveillance that shifts from aggregate reporting to notification, investigation and response for every case as transmission falls. DHIS2 supports this shift within the same national platform, for example through malaria case and foci investigation and case-based surveillance of vaccine-preventable diseases, so that elimination programs do not depend on separate parallel systems.
This page focuses on infectious disease threats and health emergencies. DHIS2 also supports surveillance in other program areas: see DHIS2 for Noncommunicable Diseases for NCD surveillance, patient registries and cancer registries, and DHIS2 for Nutrition for nutrition surveillance and early warning. For diseases that are not epidemic-prone but need long-term, person-centred surveillance, the Health Data Toolkit includes WHO-aligned Tracker packages for HIV case surveillance and TB case surveillance, which follow each case from diagnosis through treatment and outcome, link laboratory results and feed national HMIS reporting.
DHIS2 provides a comprehensive suite of software features that can be applied to a range of programmes. Here are some of the core DHIS2 features that support disease surveillance systems:
DHIS2 is a generic software platform that supports a wide variety of use cases. Beginning with DHIS2 version 43, HISP UiO has worked with the US CDC to produce a guide that illustrates how new DHIS2 software features can be used specifically to improve DHIS2 systems for epidemiological surveillance.
The following components are available as part of the DHIS2 Health Data Toolkit to help fast-track disease surveillance implementation:
Design your system to support weekly indicator-based surveillance for epidemic-prone and notifiable diseases. Resources are aligned to WHO AFRO’s technical strategy for IDSR, with standard metadata for 15 commonly notifiable diseases, surveillance indicators and dashboards.
Support case notification, investigation, and follow-up using DHIS2 Tracker programmes as part of an integrated disease surveillance system. Resources include WHO recommended metadata for case-based reporting of nine vaccine preventable diseases, triangulation of case-based and weekly syndromic data, and guidance for integrating additional diseases.
Bring routine surveillance and outbreak response together in one DHIS2 system. Developed by Africa CDC with HISP UiO and HISP groups in Africa, and aligned with WHO’s digital adaptation kit for infectious disease surveillance and the WHO Ebola outbreak toolbox, the toolkit provides linked Tracker programs for case notification, investigation, laboratory results and classification, and for contact tracing, with mpox, cholera and Ebola as reference diseases.
Connect lab results data in diagnostic systems to DHIS2-powered case-based disease surveillance systems to support faster and more effective case detection, outbreak response, and patient follow up.
Incorporate sentinel surveillance data on acute febrile illness cases to complement routine surveillance and improve the detection of emerging, unknown and re-emerging disease threats. Resources are aligned with CDC recommended protocols for AFI surveillance.
Rapidly adapt surveillance systems to emerging and novel diseases using the flexibility of DHIS2, as demonstrated during the Covid-19 pandemic. Resources are available for emergency surveillance needs such as detailed case reports for new suspected illnesses, contact tracing, and daily situation reports from subnational levels, and can be adapted and re-used for future emerging disease threats.
Integrate mpox surveillance into national DHIS2 systems for early detection and response. The DHIS2 Mpox Surveillance Toolkit supports both case-based and aggregate modalities and promotes adoption of WHO guidelines on mpox surveillance and case investigation.
Register and maintain a dynamic digital roster for rapid responders to strengthen emergency preparedness. The RRT rostering tool helps countries to work towards the 7-1-7 targets for detecting, notifying and responding to infectious disease threats when implemented in DHIS2 as part of a holistic integrated disease surveillance and response platform.
Explore features and functionalities of DHIS2 as a disease surveillance system in our interactive demo database.
Explore our interactive map to see where countries are using DHIS2 for disease surveillance.
Read more about real-world implementations in countries that use DHIS2 to detect and respond to disease outbreaks and public health emergencies.
Read additional articles and watch webinars and presentations for more information and country experiences on using DHIS2 for disease surveillance and emergency response.
The DHIS2 Community of Practice (CoP) is the primary forum for DHIS2 discussion and support. The CoP is a great place to ask questions and get support from the international community of DHIS2 experts. Join the discussion, share your use cases and ask questions about how DHIS2 can be used to strengthen disease surveillance, early warning and response systems on the CoP. You can also contact the HISP Group in your region for direct support on national or regional disease surveillance projects.
The HISP Centre at UiO works with global public health partners to develop tools and guidance to support countries in implementing electronic surveillance systems with DHIS2. These include Africa CDC, the WHO Health Emergencies Programme, WHO Regional Office for Africa (AFRO), WHO Eastern Mediterranean Region (EMRO), Pan American Health Organization (PAHO), the US Centers for Disease Control and Prevention (CDC), and the European Centre for Disease Prevention and Control (ECDC), with financial support from Gavi, US CDC, The Global Fund and Norad.
