<p>The seven counties had dedicated surveillance teams. Only 2(29%) of the counties visited had surveillance work plans. Three (43%) of the counties had IDSR guidelines. All the counties had no budgetary allocation for surveillance activities. Ten (22%) of the facilities visited had IDSR IEC materials. There was a knowledge gap in surveillance in around 50% of the facilities visited. It was noted no IDSR training has been conducted for the last 5 years. 88% of the facilities visited had no surveillance focal person. Other gaps identified were poor understanding of case definition, inadequate reporting tools, absence of line lists for suspected AFP/Measles cases, no mapping of traditional healers, bone setters, and TBAs, and irregular ACS</p>