Barriers and enablers to effective collaboration and coordination mechanisms among humanitarian organisations delivering health and nutrition programmes in Somalia: an exploratory qualitative study.

Abstract

The effectiveness of humanitarian health and nutrition programmes in Somalia is critically dependent on seamless collaboration and coordination among a diverse array of actors. While existing literature acknowledges broad challenges to coordination such as insecurity, resource competition and fragmentation, a significant gap remains in understanding how these barriers and their corresponding enablers actively manifest in the daily operations and decision-making processes of frontline practitioners. This study aims to provide a systematic, in-depth exploration of the barriers and enablers influencing collaboration and coordination mechanisms from the perspective of those directly involved in the response. A qualitative study was conducted using semi-structured, in-depth interviews. Data were analysed using a deductive thematic approach guided by the Consolidated Framework for Implementation Research. The study was conducted across the entire territory of Somalia, encompassing its five member states, the capital city Mogadishu, and the self-declared independent state of Somaliland. A total of 26 participants, including executive directors, health and nutrition programme managers, coordinators from international and national non-governmental organisations (NGOs), government officials and community members, were interviewed. Key barriers included poor adaptability and high complexity related to collaborative initiatives (intervention characteristics); armed conflicts, climatic shocks, deeply ingrained sociocultural practices and restrictive government policies (outer setting); inadequate information technology infrastructure and hierarchical communication (inner setting); high staff turnover (individual characteristics). Key enablers included strong inter-agency partnerships (outer setting); supportive organisational culture (inner setting); competent and motivated staff (individual characteristics); and robust planning, engaging and evaluation processes (process). The study highlights the complex contextual factors that impact the effectiveness of collaboration and coordination mechanisms among humanitarianorganisations operating in Somalia. Policymakers should unify governance, agencies prioritise localisation and donors allocate quotas to local NGOs to enhance aid delivery.