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

In conflict-affected settings facing polycrisis and a contraction in humanitarian funding, service integration helps sustain care with fewer resources, yet lacks a simple measure. We examine how the Caafimaad+ consortium's vaccination, nutrition, and mental health services functioned under pressure in Somalia in 2025-2026. Using the Levesque conceptual framework with a sequential mixed-methods approach, we organised participatory workshops with 21 frontline workers, then nine managers, from nine structures around Mogadishu area in November-December 2025. We built an integration indicator from

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