 The Integrated Disease Surveillance and Response (IDSR) strategy was introduced in Madagascar in 2007. Information was collected by Healthcare structures (HS) on paper forms and transferred to the central level by post or email. Completeness of data reporting was around 20% in 2009–10. From 2011, in two southern regions data were transmitted through short messages service using one telephone provider. We evaluated the system in 2014–15 to determine its performance before changing or expanding it.