Knowledge, Practice and Perceived Barriers of Healthcare Provider Adherence to the Notifiable Disease Surveillance System (NDSS) in Government Hospitals and Primary Healthcare Centers in Jazan, Saudi Arabia: A Cross-Sectional Study.

Objective: To assess and compare healthcare providers' understanding of the Notifiable Disease Surveillance System (NDSS), alongside reported and perceived challenges, across public hospitals and primary healthcare centers in Jazan, Kingdom of Saudi Arabia. Methods: A cross-sectional study was conducted between 10 January 2025 and 30 December 2025 among health care providers at Jazan hospitals and primary healthcare centers (PHCs) (n = 420). Data were collected via structured self-administered questionnaire that included the following sections: demographic data, knowledge of the NDSS, reporting practices, competency of the Health Electronic Surveillance Network (HESN) and perceived barriers. Descriptive and inferential statistics were used to analyze the data. Results: Most participants knew the purpose of the NDSS (78.1%) and knew the diseases that needed to be reported immediately (71.9%). Only 50% reported notifiable diseases to health authorities, but 77.4% reported suspected or confirmed cases during the previous year. Only 24% of the participants reported receiving formal HESN training, and 59% reported poor knowledge of HESN reporting. Nurses and laboratory staffs exhibited significantly higher noncompliance rates than physicians and public health workers were. The most significant obstacles were high workload (68.6%), poor supervision (71.7%) and a lack of communication infrastructure (59.5%). Conclusion: In Jazan, healthcare providers reported fair knowledge of the NDSS, but optimal reporting was lacking. Support for the implementation of NDSS through strengthening practical surveillance training, improving digital reporting competency and strengthening institutional support can enhance the performance of NDSS and preparedness for outbreaks.