Endline Evaluation of WASH & Nutrition Project
Endline Evaluation of WASH & Nutrition Project
Endline Evaluation
Emergency WASH, Nutrition and Protection Assistance Project to Conflict
Affected People in Borno State, North East Nigeria
September 2019
International Medical Corps‐ Nigeria
1.1 List of Acronyms
BSFP Blanket Supplementary Feeding Program
CG Care Group
CMAM Community‐based Management of Acute Malnutrition
ENA Emergency Nutrition Assessment
OFDA Office of Foreign Disaster Assistance
IDP Internally Displaced Persons
FGD Focus Group Discussion
GAM Global Acute Malnutrition
IMC International Medical Corps
IYCF Infant and Young Child Feeding
IPC Integrated Phase Classification
LGA Local Government Areas
NFI Non Food Item
MMC Maiduguri Metropolitan Council
1.2 List of figures
Figure 1: Children Assessed by LGA (0‐23months) .................................................................................................... 10
Figure 2: Frequency of five critical handwashing times mentioned by respondents ............................................... 12
Figure 3: Generic IYCF Household Survey Questionnaire .......................................................................................... 20
Figure 4: WASH household questionnaire ................................................................................................................. 20
1.3 List of Tables
Table 1: Distribution of communities by LGA .............................................................................................................. 3
Table 2: WASH Sample Size …………………………………………………………………………………………………………………………………. 7
Table 3: IYCF Sample Size………………………………………………………………………………………………………………………………….… 8
Table 4: Children between ages 0‐ 23 months assessed ........................................................................................... 10
Table 5: Foods and liquids infants 0‐5 months were fed with breast milk ............................................................... 10
Table 6: Percentages of times at least any of the 7 food groups were consumed by children 6‐23months ........... 11
Table 7: Number of beneficiaries assessed at WASH household level ...................................................................... 11
Table 8: Litre of water used by respondent household ............................................................................................ 12
Table 9: Indicators – WASH ....................................................................................................................................... 12
Table 10: Indicators – Protection ............................................................................................................................... 13
Table 11: Indicators – Nutrition ................................................................................................................................. 13
Table 12: IYCF household survey locations ................................................................................................................ 19
Table 13: WASH household survey locations ............................................................................................................. 19
Table 14: Qualities data collection types of respondents and locations ................................................................... 20
1.4 Executive Summary
International Medical Corps (IMC), with funding from USAID/OFDA, implemented the ‘Emergency WASH, Nutrition
and Protection Assistance Project to Conflict Affected People in Borno State, North East Nigeria’ in four (4) local
Government Areas (LGAs) of Borno State. The project was implemented to ensure that conflict affected people
had access to water, sanitation and hygiene (WASH) promotion services; to increase protection for women and
girls; to provide critical response services for survivors of GBV; and to prevent and reduce morbidity/mortality
resulting from Acute Malnutrition among children (0‐59 months) through the provision of Community‐based
Management of Acute Malnutrition (CMAM) and Infant and Young Child Feeding (IYCF) in Damboa, Maiduguri,
Jere, and Konduga LGAs, Borno State.
The endline evaluation was conducted to evaluate the project’s implementation and to measure its impact on the
targeted beneficiaries by assessing the project’s achievement on its outputs and outcomes. The results of the
endline evaluation are vital in determining the success of the intervention in achieving the project objectives.
The endline evaluation was designed as a “before‐and‐after” mixed methodology study to assess the extent that
the project contributed to achieving its proposed results, contribute to improving the lives of the project
beneficiaries and evaluate lessons learned for future programming. The mixed methods approach involved the
use of both qualitative and quantitative tools. In all, 2,112 households (1,440 IYCF and 672 WASH) were targeted
for interviews. Eight (8) Focus Group Discussions (FGD) were conducted with lactating women in eight (8)
communities where IYCF program was implemented to further understand the variations and practices on
breastfeeding of infants. An additional 25 sessions of Key Informant Interviews (KII) were conducted with
community leaders (n = 14) and IMC staff (n = 11); the IMC staff included: Program Director, Program Coordinators
from nutrition, WASH and GBV and Program Officers based in both the Maiduguri and Damboa field offices.
1.5 Introduction
In August 2019, Matma Plus Consult Nigeria (MPC NG) was contracted by International Medical Corps to conduct
an endline evaluation of a project funded by the Office of United States Foreign Disaster Assistance (OFDA). This
report presents the findings of the final evaluation. The report is divided into four sections. Section 1 gives an
overview of the OFDA funded project, an update on the emergency situation in North East Nigeria, and the
objectives of the evaluation. The methodology employed in conducting the evaluation is presented in section 2,
whilst section 3 covers the findings of the evaluation. The findings are presented in line with the DAC criteria for
evaluation, which is based on the conception that an evaluation is an assessment “to determine the relevance and
fulfilment of objectives, developmental efficiency, effectiveness, impact and sustainability”. The conclusions and
recommendations of the evaluation are presented in the section 4.
1.6 Background
1.6.1 Overview of the IMC OFDA funded project
The conflict in North East Nigeria has now entered its tenth year with over 1.8 million people displaced and facing
large‐scale humanitarian needs. In addition, the loss of livelihood and destruction to infrastructure have further
threatened the survival among this vulnerable population. Humanitarian assistance is needed to support the
WASH, Health, Protection, Food Security and Nutrition needs of 6.1 million people to guarantee their survival,
basic human rights and dignity. Prior to the conflict, up to 80% of the population relied on crop and animal
production as their primary source of livelihood. Now, these people depend on food assistance programs to meet
their minimum daily food needs. The high level of food insecurity is directly linked to the burden of acute
malnutrition. The four LGAs proposed in this project account for 40% of the total SAM burden projected for Borno
in 2018 (Damboa (7,620), Jere (24,590), Konduga (9,451), and Maiduguri (41,725).
With the support of OFDA in 2019, International Medical Corps implemented a project to provide WASH, nutrition,
and GBV services to vulnerable IDPs and host populations in and outside IDP camps in 4 LGAs of Borno State. In
terms of nutrition, prior to the project, IMC was already implementing CMAM alongside the emergency food
assistance program in Damboa, Maiduguri and Jere in partnership with World Food Program (WFP). The project
with OFDA in 2019 expanded on this program and was integrated into the emergency food assistance activities as
a multi‐pronged strategy to secure a sustained reduction in incidence, morbidity and mortality due to acute
malnutrition. This guaranteed a continuum of care for households (HH) and ensured access to food commodities
to reduce vulnerability to acute malnutrition, and the availability of treatment services to prevent mortality and
long‐term complications. IMC also worked in close coordination with the State Ministry of Health and the nutrition
sector to operate 26 Outpatient Therapeutic centres in Damboa, Maiduguri, Jere and Konduga Local Government
Areas (LGAs) targeting 22,939 children with Severe Acute Malnutrition (SAM). One Stabilization Centre was
supported in Damboa to provide treatment for SAM among children under 5 years of age. The Care Group Model
was a hallmark of IMC’s Social and Behavioural Change Communication strategy to promote IYCF‐iE. IMC also
leveraged its BSFP and strengthened referrals to provide linkages for treatment of Moderate Acute Malnutrition.
As reported in the 2018 Humanitarian Response Plan (HRP), approximately 28% of IDPs do not have access to
adequate safe water for cooking, drinking and other domestic use. To address gaps in access to safe water, IMC
conducted water trucking in Damboa, while in Maiduguri, water systems were maintained and rehabilitated and
equipped with solar systems as alternative power sources. Water monitors were trained and supervised to conduct
community based water quality management across all the sites to ensure safe water access. IMC provided water
testing materials and HH water treatment chemicals. Community participation and ownership in the governance
of water and sanitation infrastructure was a priority of the WASH intervention to ensure sustainability and
maintenance of the WASH facilities. Sanitation (latrine and shower) coverage in the areas covered by the project
were below the Sphere standards. As a result, IMC prioritized latrine desludging and repair to keep the latrines
usable. IMC also procured laundry and bathing soap to distribute for hygiene promotion and reusable sanitary
pads for women and girls in the target IDP camps for Menstrual Hygiene Management.
As of 2018, approximately 2.4 million people are in need of GBV response services in Borno, Adamawa and Yobe
States (HRP 2018). Prolonged uncertainty and shrinking resources have also led to new vulnerabilities, including
exposure to sexual exploitation and abuse (SEA), survival sex, and opportunistic violence perpetrated by
community members as IDPs live in crowded conditions without appropriate safeguards. In this context, GBV
incidents remain significantly under reported, underscoring the need for active community sensitization and
improving access to GBV response services. IMC is one of the few partners recognized by the GBV subsector in
providing comprehensive GBV response services in Northeast Nigeria. To date, with the support of OFDA and other
donors, IMC has established 21 Women Friendly Spaces (Damboa 3, Maiduguri 15, and Dikwa 3) to provide access
to GBV response services. With the support of OFDA in 2019, IMC supported 3 WFS in Damboa, 5 WFS and one
health facility GBV service centre in Maiduguri for GBV survivors and vulnerable women/girls to receive GBV case
management and psychosocial support. IMC is developing a complementary project with WFP that will strengthen
the livelihood component of the PSS intervention.
1.6.2 Overview of the emergency situation in North East Nigeria
With a population of approximately 197 million, Nigeria accounts for about 47% of West Africa’s population, and
has one of the largest populations of youth in the world. A federation that consists of 36 states, Nigeria is a multi‐
ethnic and culturally diverse society. With an abundance of resources, it is Africa’s biggest exporter of oil, and has
the largest natural gas reserves on the continent.
The nine years of insurgency and armed attacks carried out by Boko Haram (BH), also known as Jama’atuAhlis
Sunna Lidda Awatial‐Jihad, on civilians since 2009 in the North‐East Nigeria has affected over 15 million people.
More than 20,000 people have been killed and over 4,000 women and girls abducted since the conflict began ten
years ago1. An estimated 7.7 million people in the three most affected states of Borno, Adamawa and Yobe now
depend on humanitarian assistance for their survival.
In 2016 and 2017, in close cooperation with the Government of Nigeria, the humanitarian community provided
life‐saving assistance and helped stabilize living conditions for millions of people. In 2017, the response was scaled
up and as of October 2018, humanitarian partners had reached 5.6 million people. Some major successes were
achieved, including a decrease in the number of food insecure people from 5.1 million to 3.9 million, the rapid
containment of the cholera outbreak through the innovative use of an oral cholera vaccine, and improved
agricultural production through assistance to 1.3 million farmers. These results can be attributed to strong
coordination, extensive engagement and generous funding. The Government of Nigeria succeeded in stabilizing
several regions in mid‐2017 that enabled the humanitarian community to provide much‐needed life‐saving
assistance2.
As reported in UNCHR’s Displacement Tracking Matrix (DTM) in May 29 2019, the estimated number of IDPs in
conflict affected northeastern Nigerian states of Adamawa, Bauchi, Borno, Gombe, Taraba and Yobe States was
1,980,036 people, or 392,019 households. The figure represents a nominal increase of 31,687 (less than 2%)
compared to the DTM assessment conducted in January 2019. The most‐affected state is Borno state, which
continues to host the highest number of IDPs, with 1,467,908 IDPs residing in the state as per Round 27 of the
DTM. The total number of IDPs observed in Round 27 represented a 2 per cent increase (32,091 IDPs) from the
1,435,817 IDPs that were recorded in Borno during Round 26 assessment. The increase the IDP population
between Round 26 and Round 27 can be contributed to the increase in insecurity over the period. In addition, the
figure is an underestimate of the total IDPs in Borno state due to the lack of data from LGAs which remain
inaccessible due to the security situation, including Kala/Balge, Kukawa and Guzamala.
1
ACAPS Thematic Report 2017 Nigeria; Protection in the Northeast
2
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Table 1: Distribution of communities by LGA
1.6.3 Purpose and scope of the evaluation
The endline evaluation was conducted to assess the project performance and analyse the key criteria of evaluation
in emergency contexts such as effectiveness, relevance, coverage, and expected/unexpected effects on targeted
communities. In addition, this assessment also provides recommendations of priority areas of need and direction
for future programming in the areas of WASH, GBV and Nutrition for the IDPs and host communities in Maiduguri
and Damboa in Borno State. The evaluation included both quantitative and qualitative approaches such as WASH
and IYCF household surveys inform practical and sustainable recommendations based on the survey findings.
The scope of the evaluation was as follows:
1. Project Timeframe: July 1, 2018 – June 30, 2019
2. Geographical Coverage: Maiduguri Metropolitan Council (MMC), Konduga, Jere and Damboa in Borno
State, Nigeria
3. Target groups: primary and secondary beneficiaries as well as broader stakeholders
4. Human Resources: A consultant, supported by IMC M&E staff, conducted the evaluation. The consultant
and the IMC M&E Coordinator worked as a team to support each other in developing methodologies, tools
and approaches of the evaluation. The team worked to organize and conduct Key Informant Interview (KII)
with relevant stakeholders, training for enumerators, data collection/validation, data analysis and
interpretation and finalization of report.
The overall objectives of the evaluation were to:’
1. Evaluate the project in terms of effectiveness, relevance, efficiency, coverage and impact, with a strong
focus on assessing the results against the project’s outcome and project goals;
2. Generate key lessons and identify promising practices in humanitarian work for learning purposes;
3. Undertake a comparative assessment on the progress achieved in delivering the program results and to
identify key successes, gaps, and constraints that need to be addressed.
4. Document good practices and generate evidence‐based lessons learned and actionable recommendations
to strengthen the strategies of ongoing and future programs.
2. Methodology
The evaluation was designed as a “before and after” mixed methods study to compare the situation of the
beneficiaries before and after the project. The mixed methods approach involved the use of both qualitative and
quantitative methods. The quantitative methodology was used to quantify achievements against the targets as
per the project’s indicators while a qualitative methodology was employed to develop a deeper understanding of
the relevance of the project interventions. The methodology also included the collection and review of secondary
data.
2.1 Qualitative data collection
Qualitative data was collected through focus group discussions (FGD) and key informant interviews. The FGDs
were held with pregnant and lactating mothers in communities. The focus groups were designed to assess the
developments and changes in the perception of participants in the project’s intervention areas, and as a holistic
and participatory approach whereby participants assessed project activities, outcomes and impacts. It also
provided insight into some of the barriers affecting nutrition and hygiene practices amongst the projects’
beneficiaries.
Selected by IMC project staff, community leaders served as the key informants and were interviewed using a key
informant interview (KII) guide. The guide for each group of respondents focused on the roles they played in the
project. The questions included critical reflection that allowed respondents to mediate on both project success
and challenges and to capture new knowledge and actions for future projects.
In total, 8 FGDs and 25 KII were conducted as part of the evaluation. During the focus groups and KIIs, inquires
focused first on what worked well within the project and what beneficiaries would like to see more of. These
elements were translated into a Strengths and Opportunities, Weaknesses and Threats (SWOT) Analysis which will
inform and enhance the sustainability and development of future phases of the project.
2.2 Quantitative data collection
The quantitative data was collected using a WASH household questionnaire and IYCF generic household
questionnaire. The tool was administered using an electronic mobile phone platform (Kobo Tool Box). The mobile
application was chosen to ensure the quality of the data collected, improve data integrity, reduce human error
during data entry, and ensure data security.
WASH household beneficiaries and IYCF households with children 0‐23 months were selected for the household
surveys. The respondents for the household questionnaire were the head of household or any representative of
the household above the age of 17, and caregiver/mother of children between the ages of 0‐23 months for IYCF.
The household questionnaire was used to collect information on the key project results at the outcome level and
contained questions pertaining to the WASH and nutrition sector. This included information on the socio
demographic characteristics of the respondents.
2.3 Sample size determination
The sample size adopted the same methodology for both WASH and IYCF household survey as was used at
baseline. The sample sizes are outlined below:
For WASH, 672 households were included in the sampling unit. The sampling size was sufficient and representative
enough to allow reasonable levels of certainty that findings are representative of target population in the two
LGAs.
Table 2: WASH Sample size
No of Households: 51598 (Number of households in the project area
covered by the survey).
N
d2
During the enumeration, a sample size was assigned to the communities proportionally and then a systematic
random sample was used to select the households in each unit.
For IYCF, the sample size of two OFDA indicators, exclusive breastfeeding under 6 months and minimum dietary
diversity, was calculated based on the prevalence rates from a survey conducted by Save the Children3 (point 1).
The target for the OFDA project (point 2) was based on the CARE guidelines on IYCF surveys.4 Using the prevalence
rates of point 1 and 2, the sample size for each indicator was calculated separately. The highest sample size
between the two indicators was used for the survey. Using the point estimates for prevalence both OFDA
indicators the sample size below: The following other variables were used to calculate the sample size.
Table 3:IYCF Sample size
Indicator Estimated prevalence, point Estimated prevalence, point Number of persons to
1 2 select
per group
Precision 95%
Power 80
Design effect 1.5
Number of clusters 30
2.4 Sampling criteria
3
Save the Children, Nutrition and mortality survey report, Borno state, August 2018
4 Infant and young child feeding practices. Collecting and Using Data: A Step‐by‐Step Guide. Care USA, Jan 2010.
For the IYCF survey, since the focus is on children between the ages of 0‐23 months, the primary caregiver
(mothers) in the household were asked questions on child feeding and food intake patterns. This method used a
multi‐stage sampling technique, which involved two stages:
Stage One: With a list of the areas and population, a random selection of 30 clusters. The total population of study
was divided into small distinct units. At this stage, the primary unit of the selection was the community/village.
The clusters were randomly selected from communities/ villages using according to their population proportion.
Stage Two: To determine how many children 0‐23 months of age were selected per cluster. With a sample size of
1,440, data was collected from 30 clusters, having 48 children per cluster. For each cluster, the team arrived at
the first household, and identified a least one child 0‐23 months of age for the survey. The team continued with
the surrounding households, identifying children 0‐23 months until the cluster limit was reached.
2.5 Consent process and ethical consideration
Consent of all respondents was sought before interviews. The consent process involved explaining the nature of
the evaluation, confidentiality issues, the time the interview will take place and the risk involved. Where children
were too young to provide consent, consent was provided from their respective guardians.
The information collected from the respondents was handled confidentially and the views of any individual
respondent cannot be traced to him/her. The training of the data collectors covered topics on research ethics with
different target groups, and how to interview and ensuring confidentiality.
2.6 Recruitment and training of local data collectors
Local data collectors from the LGAs were recruited to support the collection of the data, especially the household
data. The recruited data collectors were trained in the sampling methodology, how to use the mobile app and on
the data collection tools. The training also covered research ethic and conducting research with breast feeding
mothers. In all we recruited and trained 20 data collectors in MMC, Jere and Konduga and 10 in Damboa.
2.7 Data analysis and report writing
An electronic mobile app (Kobo Collect) was used for the collection of the quantitative data. The use of the
electronic mobile app helped to limit data collection errors.
Quantitative data was analysed with MS Excel and SPSS. Descriptive statistics were used to describe the basic
features of the data collected. Summary results about the data collected is presented in charts and tables with a
narration below.
The analysis also focused on comparing the evaluation results with that of the baseline. The report was presented
according to the format provided in the ToR.
3.1 Findings
3.1.1 Nutrition
Figure 1: Children Assessed by LGA (0‐23months)
187
164
133
120
44 52
Damboa Jere Konduga Maiduguri
LGA
Table 4: Children between ages 0‐ 23 months assessed
Age in months Male Female Total
%
0‐5 166 147 24.9
6‐11 190 180 29.4
12‐17 182 185 29.2
18‐23 87 122 16.6
Total 625 634 100
In total 1440, children were assessed, including 1259 children aged between 0‐23 months. The rest of the children
(181) were aged between 24‐36 months and were not included in the analysis and presentation of these findings.
Table 5: Foods and liquids infants 0‐5 months were fed with breast milk
Age Group in Months
Foods/Liquids 0‐1 2‐3 4‐5 Total
ORS 10(20%) 19(37%) 22(43%) 51(13.0%)
Plain water 39(29%) 52(39%) 43(32%) 134(34.2%)
Infant formula 23(38%) 189 (30%) 20(33%) 61(15.6%)
Milk 11(20%) 20(37%) 23(43%) 54(13.8%)
Juice or juice drinks 1 (5%) 6(30%) 13(65%) 20(5.1%)
Other water‐based liquids 7(21%) 11 (33%) 15(45%) 33(8.4%)
Sour milk or yogurt 4(22%) 8(44%) 6(33%) 18(4.6%)
Thin porridge 5(24%) 10(48%) 6(29%) 21(5.4%)
Proportion of children 6‐23 months of age who receive foods from four or more food groups, by sex (MDD)
41.9% of the children between 6‐23 months of age assessed were fed solids and semi solids from at least from
four food groups. A breakdown of the ages could be found in figure 4. Percentages of food feed to children 6‐23
month is in the table below.
Table 6: Percentages of times at least any of the 7 food groups were consumed by children 6‐23months
Age in months
Food Score 6‐11 12‐17 18‐23 Total
0 22% 8% 4% 13%
1 21% 14% 5% 15%
2 12% 16% 15% 14%
3 13% 15% 25% 16%
4 11% 20% 17% 16%
5 9% 8% 12% 9%
6 4% 7% 12% 7%
7 8% 12% 10% 10%
3.1.2 Water, Sanitation and Hygiene
Overall 85% of the respondents assessed were female, while 15% of them were male. The average household size
across the camps assessed between Damboa and Maiduguri was 6 (5 Damboa, 7 Maiduguri). The population of
the households assessed according to their age groups is found in the table below:
Table 7: Number of beneficiaries assessed at WASH household level
Age Group Total Number of people Percentage
Hand Washing Practices
Across the two LGA’s 90.5% of the respondents could mention at least 3 critical handwashing times. 9.5% could
only mention between 1 to 2 of the five critical handwashing times. A breakdown of the frequency of the
handwashing times mentioned by respondents is included the figure below.
Figure 2: Frequency of five critical handwashing times mentioned by respondents
652
550
445
Frequency
265 253
173
Before After defecation Before eating Before Before feeding Cleaning a child’s
breastfeeding cooking/meal children bottom
preparation
Critical handwashing times
Drinking Water Storage
From observation across the two LGAs, 81% (544) of the respondents' stored their drinking water in clean
containers after fetching from the source. The common container used in storing this drinking water is either a
used paint bucket or Jerry can.
Drinking water storage in a clean and No Yes
protected container?
127 (19%) 545 (81%)
Functional handwashing facility within the defecation site
90 percent of the respondents have a local kettle within their tents, however on closer observation for functional
handwashing facilities within the communal latrines, less than 50 percent of them (41. 2%) are functional within
the camps assessed.
Litre of water and Source of water for household use
The average number of litres of water per person per household is approximately 20 litres per person across the
households assessed in the two LGA’s. About 96.7% (656) of the household assessed fetch water for household
use from an improved water source.
Table 8: Litre of water used by respondent household
Litre Number of respondent Percentage Respondent
The delivery of outputs is central to the achievement of project results. The evaluation analysed the extent to
which the project outputs and outcome indicators for each sector was achieved as shown in table 9, 10, and 11.
Table 9: Indicators – Nutrition
Outputs – Nutrition Target Baseline Endline % of target met
IYCF
Proportion of infants 0‐5 months of age who are fed
exclusively with breast milk, by sex 15% 7.1% 5.4% 36%
Proportion of children 6‐23 months of age who receive
40% 41.90% 100.75%
foods from 4 or more food groups, by sex 46.4%
Number of people receiving behavior change
interventions to improve infant and young child feeding 9259 30898 12988 140%
practices
CMAM
Number of health care staff trained in the prevention
and management of acute malnutrition, by sex 150 0 153 102%
Number of supported sites managing acute
malnutrition, Type of Facility (OTP, SFP, SC 27 27 27 100%
Number of people screened for malnutrition by
community outreach workers, by sex; age : children ≤5, 60000 0 133,701 223%
PLWs (10‐14, 15‐19, 20‐49, 50+)
Table 10: Indicators – WASH
Baselin % of target
Outputs – WASH Target Endline
e met
Environmental Health
Number of people receiving improved service quality from solid
waste management, drainage, or vector control activities 51598 0 59720 116%
(without double Counting) by sex
Average number of community cleanup/debris removal
activities conducted per community targeted by the 240 0 200 83%
environmental health program, N/A
Average number of communal solid waste disposal sites
created and in use per community targeted by the 150 0 165 110%
environmental health program, N/A
Hygiene
Number of people receiving direct hygiene promotion
(excluding mass media campaigns and without double‐ 50050 0 55935 112%
counting) by sex
Percent of people targeted by the hygiene promotion program
who know at least three (3) of the five (5) critical times to wash 90% 78.7% 90.5% 101%
hands by sex
Percent of households targeted by the hygiene promotion
program who store their drinking water safely in clean 65% 51% 81.1% 125%
containers, N/A
Sanitation
Number of people directly utilizing improved sanitation services
51598 0 56216 109%
provided with OFDA funding by sex
Percent of excreta disposal facilities built or rehabilitated in 0%
100% 0 0%
health facilities that are clean and functional, N/A
Water Supply
Number of people directly utilizing improved water services
51598 65,670 127%
provided with OFDA funding, by sex
Average liters/person/day collected from all sources for 28
15 20 133%
drinking, cooking, and hygiene, N/A
Table 11: Indicators – Protection
Outputs – Protection Target Baseline Endline % of target met
Prevention and response to Gender Based Violence
Number of individuals accessing GBV response
services, by sex; age: <5, 5‐9, 10‐14, 15‐19, 20‐49, 50+ 1780 822 681 38%
This section elaborates on the findings that came from this evaluation. The findings are presented based on the
five OECD/DAC evaluation criteria, which include relevance, effectiveness, efficiency, impact and sustainability.
The OECD DAC criteria assesses the extent to which objectives of an intervention are consistent with beneficiaries'
requirements, country needs, global priorities and partners' and donors' policies.5
3.2.1 Relevance
The evaluation team concludes that the USAID/OFDA project connected all the three (3) strategic objectives of the
Nigeria 2018 Humanitarian Response Plan (HRP). For example, Strategic Objective 3 of the USAID/OFDA project
aimed to increase protection for women and girls and provide critical response services for survivors of GBV. This
was in line with the Strategic Objective 1 of the HRP 2018 which aimed at providing lifesaving activities and
alleviating suffering through integrated and coordinated humanitarian response focusing on the most vulnerable
people.
To a greater extent, the USAID/OFDA project was also aligned with the priority humanitarian concerns of Nigeria.
The project addressed the urgent needs of vulnerable people by implementing interventions focused on
promoting the protection, nutrition and WASH/NFIs among the most vulnerable populations. The populations
included children, pregnant women, lactating mothers and boys and men in Borno State. At the completion of the
project interventions, 228,342 beneficiaries were supported with WASH, nutrition, and protection services. This
included, 65,670 beneficiaries supported with improved access to water, safe excreta disposal infrastructure and
access to solid waste management systems, 248,752 people reached with GBV prevention and response services,
and 133,701 people reached by nutrition support, including the admission of 6,484 children aged 6‐59 months to
CMAM and screening of 107,294 people for acute malnutrition. The implementation of a multi‐sectorial project
contributed to ensuring that beneficiaries received lifesaving and integrated support that contributed to alleviating
their suffering.
Findings from KIIs revealed that water shortages, malnutrition especially among young children, and rampant
cases of sexual and gender based violence (SGBV) were among some of the most serious challenges before the
project was implemented. Internally displaced persons (IDP) camps in particular were reported to have a high
incidence of rape cases, denial of resources and other domestic violence when compared to host communities.
The project contributed to addressing these challenges through WASH, nutrition and GBV services. These services
included, but were not limited to: water supply, sanitation, hygiene promotion and solid waste management
services through the installation and renovation of WASH infrastructure, community mobilization, sensitization
activities, and distribution of non‐food items (i.e. hygiene kits and waste bins); screening of children and referral
for management of Severe Acute Malnutrition in OTPs, referral to in‐patient care for severely malnourished
children with medical complications, sensitization on exclusive breastfeeding for children of 0‐5 months, health
5
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care promotion and referral for services of children and lactating mothers; and sensitization against Gender Based
Violence, knowledge and skill acquisition for GBV survivors, and distribution of relief materials.
3.2.2 Effectiveness
The evaluation demonstrated that there was a strong and effective M&E system in place, which generated quality
and timely data to inform decision making. As part of the M&E system, a baseline was conducted for the GBV,
WASH and Nutrition sectors. The M&E system was supported by accountability mechanisms for affected person
that allowed beneficiaries and staff to give feedback on IMC’s activities. There was however need for improvement
regarding how the information generated by the M&E systems and the accountability mechanism was used in
decision‐making.
The project made significant improvement in mitigating the harmful effects of violence and displacement on the
IDPs and host communities. This was achieved through improvement in their safety and protection and improved
access to WASH infrastructure and nutrition services. The improvement in access to water was significant with
94% of the beneficiaries having potable water within 500 meters from their homes.
3.2.3 Efficiency
In both the design and implementation of the project, IMC took steps to ensure that the project was efficient. The
project design allowed IMC to train and work with selected community members as volunteers in all the sectors.
The use of the volunteers enabled IMC to increase community mobilization the reach of the project.
From its inception, communities were involved in the planning of the project interventions. Lawans and Bulamas,
which are the primary community leaders were engaged series of meetings. Community volunteers were engaged
in each beneficiary community during the implementation of the project.
Communities were given opportunities to provide feedback, which informed IMC of beneficiary satisfaction. The
feedback mechanism was appropriate, however, IMC could still improve by having a dedicated person employed
to be in communities to increase its capacity to field and address feedback.
Spaces were identified within the communities for establishment of women‐friendly spaces. In the General
Hospital in Damboa, a meeting point was established within the hospital building, and shades were also used
during distribution of materials to promote the safety and dignity of beneficiaries accessing IMC’s services.
3.2.4 Impact
The impact of the OFDA project was measured by reviewing and reflecting on the project performance and
achievements per indicator. Analysis of the respective achievements together with beneficiary narrations and
perspectives obtained from FGDs were used to draw conclusions on the project impact. It is important to note
that some of the targets set were based on existing secondary literature obtained by IMC from other humanitarian
agencies, and therefore some caution has been exercised in the interpretation of achievements of targets.
The project made significant improvements in mitigating the harmful effects of violence and displacement on the
IDPs and host communities. This was achieved through improvement in their safety, access to WASH infrastructure
and nutrition services. There was an improvement in water, sanitation and hygiene indicators at the endline
(average baseline of 53.5% compared to an average endline of 66.1%). This achievement was driven largely by the
improvement in the storage of water in clean containers and improved water sources.
Women in communities where the project was implemented felt confident and began to report sexual and
domestic violence, although some cases of sexual assault and rape were reported after seventy‐two hours.
Key changes identified in the lives of beneficiaries included the increased awareness of women rights and
mitigation of exposure to GBV risk through women’s empowerment. The project’s achievements included reduced
level of sexual and domestic violence, increased youth support in the mitigation of violence against women and
adolescent girls, communities where husbands assist their wives with household’s chores, and sustained GBV
activities after the project interventions.
3.2.5 Sustainability
Involvement of community volunteers assisted in the community ownership of the project. At present , community
volunteers and community leaders, who benefitted from the training conducted by IMC, are engaged in
community mobilization and sensitization and awareness creation of community members on various aspects of
the project. Respondents reported that that through the knowledge gained from IMC, they were able to
strengthen their cooperation among each other. Their weakness however remains poverty, which does not allow
them to carry out activities requiring more substantial financial resources.
3.2.6 Effectiveness of Monitoring Mechanisms in Providing Timely Data to Inform Programming Decisions
IMC used different forms of monitoring mechanisms to track project implementation. They included routine data
collection on service delivery for nutrition, protection and WASH sectors; surveys conducted during
implementation, indicator tracking sheets designed across sectors, customised data collection tools developed for
respective sector indicators and routine field monitoring tools. A baseline was also conducted for the nutrition
(IYCF) and WASH sector.
The M&E Officers under the leadership of the M&E Coordinator were largely responsible for collecting routine
monitoring data in collaboration with program staff. The M&E team developed monitoring tools in collaboration
with the program staff, and recruited and trained data collectors to support the data collection when it involved
surveys and a large number of beneficiaries. The collected data was analysed based on the indicator definitions
and the results shared with the sector leads. Some of the monitoring data collection processes for the project
included Post Distribution Monitoring (PDM) for every round of distribution; a WASH household survey, water
quality tests, monthly protection monitoring, safety audits, a SQUAEC Survey and mass MAUC screening. Nutrition
service statistics was also collected monthly from all CMAM treatment sites. The beneficiaries were involved in
collecting the required information to feed into these monitoring systems. For example, IMC trained Camp
Management officials and community volunteers on how to monitor the services delivered by the service
providers.
Mobile technology was employed to ensure that the monitoring information was available in a timely manner. For
all surveys conducted, IMC used mobile phones and the mobile app “kobo collect” for data collection. With this
method, there was reduced need for data entry and cleaning . There was an integrated M&E system, which allowed
each sector to collect their monitoring data to track project outputs and other results.
4. RECOMMENDATIONS AND CONCLUSION
The exclusive breastfeeding rate among children 0‐5 months was recorded at 5.4%, a decline from the baseline
value which was at 7.1%, while the proportion of children 6‐23 months of age who receive foods from four or
more food groups was recorded at 41.5%. The low rate of exclusive breastfeeding in the project intervention area
requires a barrier analysis to identify key factors that prevent mothers from exclusively breastfeeding their babies.
Furthermore, most caregivers include water in their definition of exclusive breastfeeding out of fear that the infant
will die or delay in growth. IYCF messages should put an immediate and increased focus on EBF through
sensitization sessions and support through home visits and emphasis on the proper knowledge of exclusive
breastfeeding.
For WASH, more than half of the respondents (90.5%) were reported to have knowledge of at least three of the
five critical hand‐washing moments, although is difficult to know if they practice these handwashing times. Less
than of 50 percent of the respondents mentioned handwashing before breastfeeding (39%), before feeding
children (38%) and changing a diaper (26%). This suggests that there is still need to intensify hygiene messages on
handwashing particularly before feeding and changing a baby’s diaper. This will help break the circle between
waterborne diseases and acute and chronic malnutrition. Availability of water was found to be sufficient in quantity
with 20l/person/day, above the Sphere indicator of 15l/p/d.
From the analysis above, the evaluation concludes that while some indicators met or surpassed the targets, others
need additional strategy and in order to increase low performance. There is a need to re‐emphasize IMC’s SBCC
strategy focusing on the identified areas (EBF and handwashing before feeding a child) where knowledge and/or
practices are poor.
The following recommendations have been put forward to help IMC improve its programming.
1. IMC should ensure that incentives for volunteers in the different sectors remain uniform. Giving different
incentives to volunteers based on the sectors in which they work breeds dissatisfaction among the
volunteers.
2. Use of community members in the identification of vulnerable groups in the community is key in efforts to
reach the most vulnerable groups. However, the process should be monitored closely to avoid a situation in
which community leaders and volunteers select only their favorites or their family members. The process can
be further enhanced by developing a joint criterion for identifying the vulnerable groups within the
community members.
3. Adopt and use Pico camera and projectors in the development and use of behavior change communication
messages. This technology allows community members to develop videos on simple practices that can be
used for documentary purposes at the community level.
4. IMC should consider prioritizing implementing multiple interventions in the same location. This will help
increase the integrated nature of the project. In doing this, IMC should ensure that protection, which is a
cross cutting theme, is implemented in all communities and also integrated across all sectors.
5. IMC should continue to build on the relationship it has with the government and INGO agencies working in
the same states and sectors. This will promote complementarity.
6. Market surveys on the WASH components costs (bore holes and construction materials) should continue to
be conducted prior to the review and awarding of WASH Infrastructure (latrine and borehole) contracts is to
ensure efficiency.
7. IMC should consider developing a more clear criterion for setting targets for indicators in all projects and the
criteria used in setting targets should be clearly documented. It is critical for the M&E team to collaborate
with the sectors on the plans for the collection and use of monitoring data at the start of each project.
8. The use of an accountability to affected population (AAP) system is a great initiative that can be a source of
information for improving program quality and ensuring that interventions respond to the needs of the
beneficiaries. However, IMC should focus on re‐assuring staff and community members that the information
will not be used against them. The re‐assurance process should include examples on how the information
from the system has been used to improve implementation.
9. IMC should improve its vehicle management system to allow teams from different sectors to more effectively
share vehicles when going to the same community for activities.
Table 12: IYCF household survey locations
Table 13: WASH household survey locations
Table 14: Qualitative data collection and types of respondents and locations
Type of qualitative Type of Respondent Location of Respondent Number of
session Respondents
GBV coordinator IMC, Maiduguri 1
GBV Officer IMC, Damboa 1
Case Management Officer IMC, Damboa 1
Case Management Officer IMC, Maiduguri 1
WASH Coordinator IMC, Maiduguri 1
WASH Officer IMC, Damboa 1
Nutrition Coordinator IMC, Maiduguri 1
Nutrition Officer IMC, Damboa 1
Key Informant Interviews Stabilization Centre IMC, Damboa 2
Doctor
Programme Coordinator IMC, Maiduguri 1
Lead Mothers 1 each in 8 host 8
communities where FGDs
were conducted
Camp Chairmen Bakassi camps 4
Community Volunteers 2
Dalori Quarters 10
Gambori 10
Maisandari II 10
Shokari 10
Damboa Central 10
Wuvi 10
Focus Group Discussions Lactating Mothers Afonori 10
Gumsuri 10
FINAL Generic IYCF
Questionnaire.doc
Figure 3: Generic IYCF Household Survey Questionnaire
WASH Household
Questionnaire.docx
Figure 4: WASH household questionnaire