ABSTRACT:
Transitioning from a short-term humanitarian emergency response to rebuilding healthcare infrastructure and developing sustainable service delivery models have been identified as a challenge for post-conflict health systems. The conclusion of the Humanitarian Response Plan in Iraq has cast uncertainty on the future of healthcare services for the Internally Displaced Population (IDPs) in camps in Kurdistan Region of Iraq (KRI). Currently, there is limited understanding of both the decision-making process governing health service changes and the way providers and communities experience these changes. Guided by the Lévesque framework for access to care, this research aims to critically assess the changes in health service delivery during humanitarian-development transition, using Sexual and Reproductive Health (SRH) services for camp-based internally displaced women in KRI as a case study. The research used qualitative methods- document review, scoping review, and in-depth interviews with service planners, camp-based service providers, and women of reproductive age living in the camps in KRI. It used a participatory approach working with a Core Group of women living in IDP camps through a series of focus group discussions. Developing a nuanced and context-specific understanding of changes in service delivery and their impact on service users and providers contributes to broader debates about planning of transitions from humanitarian responses to sustainable post-conflict service delivery. Documenting the state of services for a vulnerable, often overlooked group, as the humanitarian phase concludes, highlights issues of continuity of and equitable access to care, highlighting the importance of including community perspectives in such planning. Ultimately, the findings deliver an integrated, multi-stakeholder account of how humanitarian–development transitions unfold in practice, generating in-depth context-specific insights from KRI, and broader considerations for planning more inclusive health service delivery models.