Before 2025, public health surveillance in Ukraine relied heavily on manual reporting, including telephone-based communication between healthcare workers and public health officials. These processes introduced delays and potential data errors, limiting timely detection of disease threats. Russia’s full-scale invasion further strained the public health system through population displacement, damaged infrastructure, and increased risk of antimicrobial resistant diseases.
Working closely with the Public Health Center of Ukraine (PHC), we contributed to the development of its Electronic Surveillance System (ESS), a new unified, modular platform for modernizing epidemiological surveillance. We translated complex public health needs into practical digital capabilities and sustainable organizational workflows, including the introduction of syndromic surveillance, a new methodology in the Ukrainian context. Instead of relying on reports of diagnosed diseases from healthcare workers, syndromic surveillance analyzes existing health-service data for symptom patterns that may signal emerging or previously unidentified threats.
Co-designing syndromic surveillance, moving from theory into practice.
Members of PHC of Ukraine visit Santé publique France to learn how that agency conducts syndromic surveillance.
Introducing syndromic surveillance required designing both digital capabilities and the human processes needed to act on emerging signals. The system needed to integrate, analyze, and visualize health-service data, while public health teams needed clear workflows for assessing signals, evaluating risks, investigating alerts, and coordinating responses across national and regional levels.
We led the human-centered design work to help PHC stakeholders understand, shape, and operationalize this new approach. To inform design decisions, we brought together local and international expertise through study tours, online symposiums, literature reviews, and landscape analyses of existing syndromic surveillance programs. We also conducted expert interviews with Ukrainian public health specialists to understand established practices and contextual realities, particularly at the regional level.
We facilitated co-design sessions with PHC stakeholders across epidemiology, information systems, and management job roles. Together, we developed workflows for signal analysis, risk assessment, alert response, data quality review, and ongoing system administration. We translated these insights into practical design outputs, including dashboard wireframes and standard operating procedures (SOPs), connecting user needs with system functionality, governance, and implementation requirements.
Establishing a new and sustainable national surveillance capability.
Examples of a risk assessment workflow and a dashboards wireframe developed for syndromic surveillance with PHC.
Syndromic surveillance was piloted in four regions of Ukraine in spring 2025 and rolled out nationwide in 2026. The SOPs, dashboard wireframes, and operational workflows developed through this work supported PHC’s adoption of syndromic surveillance as a new national methodology, extending monitoring beyond traditionally reported diseases to signals derived from health-service data.
ESS also digitized key reporting processes, enabling direct reporting by healthcare workers and giving public health officials improved tools for data analysis and visualization. The platform’s modular architecture, in combination with the automated data interoperability capabilities and data quality procedures developed for syndromic surveillance, continues to support new surveillance capabilities in Ukraine.
This project demonstrates complex, multidisciplinary research and co-design activities, and how the translation of findings into actionable system and procedure designs can help organizations adopt new capabilities at the national scale.
- In partnership with the Center of Public Health of the Ministry of Health of Ukraine (PHC) and the US Centers for Disease Control and Prevention (CDC).
