<p>All stakeholders are actively participating in the surveillance system. Data were regularly analyzed interpreted and use for action at zonal level but not at lower levels. There is Epidemic Preparedness and Response Plan at Zonal and woreda level but no budget allocation except Debark woreda. Rapid response team are avail at all levels but, functional only at zonal level.&nbsp; The surveillance system uses loose case definition to detect Severe Acute Malnutrition case and has case management protocol. The average and overall report completeness for Epi week 28-52 were 79.2% and 77.6% respectively but the report timelines was not recorded accurately. There are no full accesses of internet, electric power reservoir, vehicles, computer, printer, and statistical package for surveillance activities at all levels. No regular feedback and supervision at woreda and lower levels.&nbsp;</p>