Presentation (CTI)

OBJECTIVES: This study examined factors influencing healthcare utilization among adolescents living in internally displaced persons (IDP) camps in Northeastern Nigeria and assessed how these factors affect the cost-effectiveness and equity of service delivery models used in humanitarian settings.
METHODS: A mixed-methods real-world study was conducted in four IDP camps in Adamawa and Yobe States. Quantitative data were collected from 420 adolescents aged 10-19 years using structured surveys on healthcare use, delays in care, perceived quality, confidentiality concerns, and indirect costs. Qualitative data were obtained through focus group discussions with adolescents and interviews with camp health workers. Logistic regression identified predictors of healthcare utilization. A cost-consequence analysis compared mobile clinic services with fixed primary healthcare facilities from a provider and patient cost perspective.
RESULTS: Healthcare utilization was significantly associated with travel distance, waiting time, stigma, and confidentiality concerns (p<0.05). Adolescents reporting fear of stigma or lack of confidentiality were 2.3 times less likely to seek care. Mobile clinics reduced indirect patient costs by 31% and increased timely service uptake by 17% compared to fixed facilities. Fixed facilities showed better continuity of care, particularly for follow-up services, but had lower overall utilization among adolescents.
CONCLUSIONS: Adolescents in conflict-affected IDP camps face significant barriers to healthcare use that undermine equitable access. Mobile clinics offer a more cost-effective approach for improving timely service uptake, while fixed facilities support continuity of care. A hybrid delivery model that combines mobile outreach with strengthened facility-based follow-up may improve efficiency, equity, and health outcomes in humanitarian contexts.