Introduction: In refugees the Reproductive health service of females is more vulnerable result to poor utilizations and outcomes. The founding of the Inter-agency Working Group on Reproductive Health developed minimum initial standards in reproductive health response, known as the Minimum Initial Service Package for reproductive health. It was found that the Minimum Initial Service Package for reproductive health utilization is limited and not known. This study could make a significant contribution to addressing these barriers to improve its utilization.

Objective: To assess sexual and reproductive health utilization and associated factors among female Eritreans refugees in Adiharish Eritrean refugee camps in Tselemty district, Northwestern zone of Tigray, Ethiopia, 2019.

Methods: Community based cross sectional study design was conducted in Adiharish Eritrean refugee camps Tselemty district from October 07- 30, 2019 among female reproductive age groups (15-49yrs) arrived and lived in the camp from June 01 to October 07, 2019. Systematic sampling method was applied to recruit 422 participants. Data was collected by face to face interview using structured questionnaire. Logistic regression was applied to assess the associated factors.

Result: In this study 38% of the participants were utilized sexual and reproductive health. Factors like, age of 15–24 years [AOR = .382 (95% CI,0.20-0.731)], being rural residency in home country [AOR =0 .536 (95% CI,0.347-0.830], short time length of stay in the refugee camp [A OR =  0 .566 (95% CI,0.337-0.951)] were independent predictors of barriers to utilize MISP RH while health educational [, AOR = 2.241 (95% CI,1.441-3.487)],was positive predictors of MISP for reproductive health services utilization among female reproductive age group of the study area.

Conclusion: Utilization of sexual and reproductive health in Adiharush refugee camp by female reproductive age group was 38%. It is high compare to their home country.

Key word: sexual and reproductive health, refugee, women, gender based violence.