Feasibility of integrating human and animal disease surveillance and reporting in Rwanda: Insights from a mobile reporting pilot and veterinarians' perspectives - a multi-method study.

The Rwandan veterinary health system lacks reliable animal disease surveillance data, hindering effective response to zoonotic diseases and other animal health events, including pathogen spillovers with pandemic potential. To address this gap, we piloted a mobile phone reporting system among veterinarians to (1) collect data on animal and human health events and (2) gather insights for future implementations, strengthening the reporting system's operationalization. A multi-method approach was employed with 14 veterinarians equipped with smartphones. We developed a real-time reporting questionnaire synchronized with a central server and trained the veterinarians to use it during regular field visits. To evaluate the pilot, 11 in-depth interviews were conducted. Quantitative data were analyzed using descriptive statistics, while thematic analysis identified key qualitative themes. Over the study period, veterinarians submitted 1,181 reports through the mobile system, documenting 1,232 cattle disease cases. Common symptoms included inappetence (56.4%) and fever (53.3%). Suspected diseases were primarily East Coast Fever (36.8%) and anaplasmosis (17.4%), with diagnostic tests performed in only 3.6% of cases. Among 3,337 cattle owners, 354 self-reported illness, with 72.6% seeking medical attention. Mobile reporting proved feasible, improving veterinarians' record-keeping, communication, and collaboration. Key implementation facilitators included training, financial allowances, and technical support, while challenges involved phone capacity and network coverage. Veterinarians leveraged community trust to gather human health data, describing the process as both educational and empowering, and strongly supported the system's continued use and enhancements. This pilot highlighted the potential of mobile reporting systems to enhance veterinary practice and zoonotic disease surveillance in remote areas. Positive experiences from veterinarians underscore its feasibility, though scaling up requires investments in training, support, incentives, and addressing technological barriers. Future research should evaluate cost-effectiveness and stakeholder readiness to optimize adoption.