Keeping care alive in 2025-26 humanitarian Somalia: routine digital data and frontline and managerial perspectives on integrated services

In Somalia (2025–2026), Caafimaad+ service integration measured from routine data showed a significant decline in vaccination-to-nutrition integration rate, linked to nutrition contact drops and supply shortages.

• Why it matters: Humanitarian polycrises and reduced funding make it hard to sustain integrated care, but there is no simple, measurable way to track how integration holds up under pressure.
• What they did: Using the Levesque framework and sequential mixed methods, participatory workshops were held with 21 frontline workers and nine managers (Nov–Dec 2025), while an integration indicator was built from routine data for six structures (Apr 2025–Mar 2026).
• The result: Facilities maintained services via continuous adaptations and informal mechanisms, especially smaller facilities; the nutrition-to-vaccination rate fell similarly but was non-significant, and the low-cost indicator can refine service-volume monitoring where data collection is risky.

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