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RESEARCH Open AccessDiscover Public HealthDuah Discover Public Health (2026) 23:773 https://doi.org/10.1186/s12982-026-02141-4Conf l ict-aware geospatial diagnostics to inform subnational immunization microplanning in Somalia from 2015 to 2023John Kwame Duah 1* * C o r r e s p o n d e n c e : John Kwame Duahjkd0046@auburn.edu1 Department of Political Science, Health Services Administration Program, Auburn University, Auburn, AL 36849, USA© The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modif i ed the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit h t t p : / / c r e a t i v e c o m m o n s . o r g / l i c e n s e s / b y - n c - n d / 4 . 0 / . AbstractBackground Conf l ict patterns in Somalia vary by region, causing uneven disruptions to routine immunization and outbreak control. National summaries often conceal district-level risks. Using conf l ict-aware geospatial diagnostics can support more targeted subnational planning by identifying areas where insecurity may limit immunization delivery and monitoring.Methods Armed Conf l ict Location and Event Data (ACLED) conf l ict events (battles, explosions, or remote violence, and violence against civilians) were aggregated to district-years. Global Moran’s I with queen contiguity and permutation-based p-values and Local Getis-Ord Gi* statistics were applied to identify spatial clustering and hotspots (z > 1.96). Annual hotspot proportion was def i ned as the percentage of districts classif i ed as hotspots. A static set of 74 district boundaries was used to ensure temporal comparability across the study period.Results Conf l ict events showed signif i cant positive spatial autocorrelation each year, with Moran’s I = 0.27 (z = 4.61, p < 0.001) in 2015 and Moran’s I = 0.33 (z = 5.50, p < 0.001) in 2023. Districts classif i ed as hotspots comprised 5.4% in 2015, peaked at 10.8% in 2019, and remained at 10.8% in 2023. Multi-year maps showed persistent concentration of conf l ict in a limited subset of districts rather than dispersion.Conclusions Descriptive spatial diagnostics show recurrent, non-random clustering of violent conf l ict across Somali districts. The analysis of f ers an operational, conf l ict-focused framework to inform subnational immunization microplanning, delivery modality selection, and monitoring when combined with relevant programmatic data. The workf l ow is reusable for conf l ict-sensitive planning and surveillance in fragile settings.Keywords Health services planning, Service delivery, Immunization microplanning, Conf l ict zones, Humanitarian health, Somalia, Measles program planning, Geospatial analysis, ACLED