Presentation (CTI)

OBJECTIVES: This study examined the costs and service outcomes of integrating sexual and reproductive health and rights (SRHR) services into routine primary healthcare in humanitarian settings. It aimed to assess whether integrated service delivery improves access to SRHR services and offers better value for money than stand-alone programs in internally displaced persons (IDP) camps in Northeastern Nigeria.
METHODS: A cross-sectional real-world study was conducted in four IDP camps in Adamawa and Yobe States between 2023 and 2025. Program and facility data were obtained from humanitarian health providers delivering either integrated SRHR services or stand-alone SRHR programs. Cost data included personnel, medical supplies, logistics, and operational overheads from a provider perspective. Service outcomes included uptake of family planning, antenatal care, STI treatment, and adolescent SRHR services. Cost per service user and cost per additional client reached were compared using descriptive cost-outcome analysis.
RESULTS: Integrated service delivery was associated with higher SRHR service use across all age groups, especially among adolescents and young women. Facilities offering integrated care recorded a 22% higher uptake of family planning services and a 19% increase in antenatal care attendance compared to stand-alone programs. The average cost per SRHR service user was 26% lower in integrated models due to shared staffing, infrastructure, and logistics. Integrated services also reduced missed referrals and repeat visits, supporting better continuity of care.
CONCLUSIONS: Integrating SRHR services into routine humanitarian health programs improves access while lowering average service delivery costs. Integrated models provide better value for money and support more equitable access to essential SRHR services in displacement settings. These findings support the scale-up of integrated service delivery approaches in humanitarian health planning and financing.