The protracted humanitarian situation in northeastern Nigeria, particularly in Borno, Adamawa, and Yobe (BAY) States, remains a concern due to ongoing insecurity, displacement, food insecurity, disease outbreaks, and climate-related shocks. To address these complex challenges, the health sector has developed a comprehensive humanitarian response strategy aligned with the three States Development plans, Durable Solutions for the Population Displacement Plan, and the Humanitarian Need Response Plan for 2025. This strategy aims to reduce morbidity and mortality among crisisaffected populations by ensuring timely, equitable, and effective delivery of lifesaving health services, while strengthen the resilience of health system and enhancing local and national capacities for sustainable health response in protracted emergency. Supported by an in-depth analysis of the ongoing health humanitarian response using the Strengths, Weaknesses, Opportunities, and Threats (SWOT) methodology, the strategy is guided by three key objectives: 1. Provide access to lifesaving interventions and sustain an effective response to the prolonged health emergency. 2. Prevent, mitigate, and prepare for health risks from all hazards and respond to all health emergencies. 3. Advance the primary health care approach and essential health system capacities for universal health coverage. To achieve these objectives, the strategy employs the “Five C” framework which refers to: • Collaborative Surveillance: Enhancing collaborative efforts for effective monitoring. • Community Protection: Implementing community-based protection measures. • Safe and Scalable Care: Ensuring care that is both secure and scalable. • Access to Countermeasures: Facilitating access to necessary countermeasures. • Emergency Coordination: Coordinating emergency responses efficiently. These proactive approaches are designed to be more anticipatory and preemptive rather than reactive, aiming to meet the needs of the crisis-affected population by providing lifesaving interventions, enhancing preventive and anticipatory actions, and ensuring the resilience of the health system. All actions are guided by International Humanitarian Standards and the Humanitarian Principles. The implementation of the health humanitarian response strategy will involve collaboration with local authorities, non-governmental organizations (NGOs), and international organizations. The strategy emphasizes localization and resource mobilization, efficient logistics and supply chain management, mainstreaming protection, and the deployment and training of healthcare workers. Continuous monitoring and periodic evaluation will ensure the effectiveness of the response. Cross-sector collaboration with sectors such as WASH, Nutrition, Education, and Protection will be crucial to enhance the quality and reach of health interventions. Additionally, sustainability and transition approaches will ensure long-term health outcomes and benefits, bridging the gap from humanitarian to development efforts. By adopting this comprehensive approach, the humanitarian response in northeastern Nigeria, particularly in BAY States, can be effectively guided, ultimately reducing the suffering of affected populations.