Table 2.

Input, outputs and outcomes measures for event-based surveillance in Vietnam

Main components	Inputs	Activities	Outputs	Outcomes
	1. Provision of resources 2. Formation of TWG 3. List of signals 4. Materials/equipment a. Technical guidelines b. Training materials c. Reporting tools d. Communication materials e. Computers, phone credits for VHWs 5. Technical assistance	1.1.1. Stakeholder meetings to draft signals and plan implementation 2. Completion of: a. Technical guidelines b. Training materials c. Reporting tools d. Communication materials 3. Trainings a. Training of Trainers b. Cascade trainings 4. EBS FPs identified 5. Distribution of materials/equipment 6. Monitoring visits	1.1.1. List of signals available 2. Materials completed 3. Trainings conducted as planned 4. EBS FPs designated 5. Materials/equipment distributed to all levels 6. Monitoring visits conducted by provinces	Short-term outcomes: 1. Signals detected and reported 2. Events reported and responded
				Intermediate outcomes: 1. Time of notification and response 2. High acceptance of EBS by implementers at each level 3. Increased trust among the community
				Long-term outcomes: 1. Reduction of morbidity and mortality associated with infectious diseases
Questions	Process evaluation questions			Outcomes evaluation questions
	1. Were all necessary resources available to implement EBS at each level? 2. Were EBS training and monitoring visits carried out as planned at each level? 3. Were the trainings effective? 4. What were the barriers and facilitators identified by EBS implementers at each level?			1. How many signals and events were reported and responded? 2. Were events reported and responded to in < 48 h? 3. What is the acceptance of EBS? 4. What is the understanding of EBS?
Indicators	Input indicatorsa	Output indicatorsa		Outcome indicators
	1. TWG created and functional 2. Materials and equipment available a. Technical guide b. Training c. Reporting tools d. Communication e. Computers, phone credits for VHWs	1. Number of EBS focal points assigned at each level 2. Number of notebooks distributed to VHWs 3. Number of log books distributed to EBS focal points at district level 4. Number of log books distributed to EBS focal points at commune health stations 5. Number of EBS poster distributed to commune health stations and hospitals 6. Number of EBS flyers/brochures distributed to commune health stations and hospitals 7. Number of training of trainers conducted by GDPM and regional institutes 8. Number of cascade trainings conducted at each level 9. Number of assigned EBS focal point trained in EBS in each province 10. Number of village health workers trained in EBS in each province 11. Number and percentage of districts implementing EBS in each province 12. Number and percentage of public hospitals implementing EBS in each province 13. Number and percentage of communes implementing EBS in each province 14. Number of monitoring visits conducted by each province since project was launched 15. Barriers and facilitators identified by EBS implementers at each level 16. Fidelity of EBS technical guidelines implementation at each level		a) Signals and events reportedb  1. Number of signals reported  2. Number of signals triaged  3. Number of signals verified  4. Number of events reported  5. Number of events assessed  6. Number of events responded to b) Timeliness of reporting/responsea  7. Time in hours from signal detection to event reporting to the district level  8. Time in hours from signal detection to the response c) Sensitivity and specificitya  9. Signals appropriately sensitive and specific to detect real events d) Acceptance of EBSc  10. % of survey respondents at each level who agreed that EBS is very important in the detection of events  11. % of survey respondents at each level who agreed that EBS helps detect events earlier than before implementation 12. % of survey respondents at each level who were willing to continue taking part in EBS 13. % of survey respondents at each level who agreed that EBS should be continued
Tools	For monitoring: Supervisory checklist		For evaluation: Desk review tool; key informant interview guide; focus group discussion guide; timeliness form; online acceptability survey

TWG technical working group, VHWs village health workers, EBS event-based surveillance, EBS FPs event-based surveillance focal points, GDPM The General Department of Preventive Medicine (of Vietnam)

^aover 9 calendar months for Phase 1 provinces and over 5 calendar months for Phase 2 provinces

^bone calendar month per province

^cIn June–July 2017 per province (phase 1), and in January 2018 per province (phase 2)