This is a hospital-based cross-section study conducted in March 2023 in Ruli district Hospital, Gakenke District, Rwanda. We selected three weekly reportable diseases (Flu syndrome, malaria and Pneumonia under five) notified by three health facilities in the period of week one to week six of 2023. Two health facilities (Coko and Rushashi) were selected based on their poor reporting rate (timeliness and completeness) while the third facility (Rwankuba) was selected based on its good performance in 2022. We counted the number of cases in clinical registers to compare with eIDSR reports. For comparison, we used verification factor (VF) calculated as recounted divided by reported times 100.   Accuracy was categorized as accurate if VF is between 95% and 105%, under-reporting if VF &amp;gt;105% and over-reporting if VF&amp;lt;95%)  