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Background: Underreporting of infectious diseases is a pervasive challenge in public health that has emerged as a central issue in characterizing the dynamics of the COVID-19 pandemic. Estimating reporting accuracy via analytical methods is not always feasible due to time and resource constraints. We developed a model that predicts reporting completeness at the country/pathogen level from input variables accessible from the literature. Methods: We performed a literature search that collected estimates of reporting completeness for 32 pathogens, representing reporting estimates from 52 countries. We combined epidemiological and social science theory to identify factors that may influence empirical reporting rates, developed a model that can be used to estimate reporting completeness. We then applied this model to estimate reporting rates for SARS-CoV-2. Findings: Pathogen- and country-specific factors were predictive of reporting rates. Country epidemic preparedness was positively associated with reporting completeness, while countries with high levels of media bias in favor of incumbent governments were less likely to report infectious disease cases. Deadlier pathogens and sexually transmitted pathogens were more likely to be reported. Our model predicts that COVID-19 cases are widely underreported, with the true number of infections ranging from approximately 2·5 to 43 times the reported cases. Interpretation: Underreporting is a complex phenomenon that is driven by pathogen-level, health system, and political factors. This model can characterize and correct for the uncertainty in reported infectious disease statistics, particularly when outbreak-specific empirical estimates of underreporting are unavailable. More precise estimates can inform control policies and improve the accuracy of infectious disease models. Funding: None reported. Declaration of Interests: No competing interests to declare.

Background: Globally, there is a large unmet need for family planning in the postpartum period: 90% of women in this group want family planning for birth spacing or to avoid unintended pregnancies and stop child bearing once desired family size has been reached. In total 76% of Rwandan women want family planning postpartum, yet a 26% unmet need remains. Currently, the four most commonly used postpartum family planning methods in Rwanda are injections, subdermal implants, pills, and condoms. The economic and health benefit impact of the current method selection has not yet been evaluated. Methods: To evaluate the impact of current usage rates and method types, this cost effectiveness analysis (CEA) compared the most frequently used family planning methods in Rwanda broken into two categories, longer-acting reversible contraception (LARC) (injections and subdermal implants) and shorter-acting reversible contraceptives (non-LARC) (pills and condoms). A time horizon of 24 months was used to reflect the World Health Organization suggested two-year spacing from birth until the next pregnancy, and was conducted from a health systems perspective. This CEA compared two service package options to provide a comparator for the two method types, thus enabling insights to differences between the two. Results: For women of reproductive age (15-49 years) in Rwanda, including LARC postpartum family planning methods in the options, saves $18.73 per pregnancy averted, compared to family planning options that offer non-LARC methods exclusively. Conclusion: There is an opportunity to avert unplanned pregnancies associated with increased utilization of LARC methods. The full benefits of LARC are not yet realized in Rwanda. Under the conditions presented in this study, a service package that includes LARC has the potential to be cost-saving compared with one non-LARC methods. Effective health messaging of LARC use for the postpartum population could both enhance health and reduce costs.