In 1995 in Kenya, an operations research study was conducted of integration activities using both clinic and community-based approaches to service delivery at two clinics of the Mkomani Clinical Society (MCS) in Mombasa. The activities included a routine risk assessment for sexually transmitted diseases (STD)/HIV/AIDS; information, education, and communication (IEC) activities; child welfare services; diagnosis and treatment of STDs; syphilis testing for all pregnant clients; and contact tracing. The two clinics had the basic equipment and other requirements for providing STD/HIV/AIDS and maternal and child health/family planning (MCH-FP) services. MCS is constructing its own incinerator to address the lack of adequate waste disposal facilities. The current structures did not facilitate client flow between services and group IEC activities or provide for adequate client privacy. More appropriate IEC materials are needed for STD/HIV/AIDS for use in the clinics and community-based activities. During 1994, the two clinics served 22,551 MCH-FP clients. In 1994, there was only 1 nurse in each MCH-FP unit for a daily average of 34 clients/day. Two other nurses have since been hired. MCS provides in-house staff training sessions on STD/HIV/AIDS. Some staff did not ask risk assessment questions, fearing that they were too offensive. There were no formal guidelines, protocols, or service manuals to help clinic staff implement integrated activities. Clients shared some of the costs with MCS. Costs for STD treatment and HIV screening have surpassed what they can afford. A cost analysis showed that the cost of providing FP and STD services separately to a new client choosing the pill who also needed STD services was higher than that for the same services using the integrated approach (US $12.4 vs. US $8.6). The analysis did not include capital costs (e.g., renovations), however. The cost savings would vary depending on the FP method and STD services received.