s

MULTI -SECTOR

NEEDS

ASSESSMENT

MONGUNO AND NGALA

RECEPTION CENTERS

BORNO STATE, NIGERIA

OCTOBER 2020

OCTOBER 2020

Photo: Ngala Reception Center ©INTERSOS Table of Contents

Table of Contents ...... 1 LIST OF ABBREVIATIONS ...... 2 INTRODUCTION ...... 3 Background ...... 3 Objectives ...... 4 METHODOLOGY ...... 5 Assessment scope and population ...... 5 Assessment design ...... 5 Sampling ...... 5 Data collection and Analysis ...... 5 Ethical Consideration ...... 6 Limitations ...... 6 FINDINGS AND DISCUSSION ...... 7 Demographics ...... 7 Health and Nutrition ...... 7 CCCM/Site Management ...... 9 WASH ...... 9 Protection, vulnerability and Disability ...... 10 DG ECHO Protection mainstreaming indicator ...... 12 Service Mapping ...... 13 CONCLUSION AND RECOMMENDATIONS ...... 14 Nutrition and Health ...... 14 CCCM/Site Management ...... 14 WASH ...... 14 Protection/Vulnerability/Disability ...... 14

INTERSOS│MSNA│NGALA & MONGUNO RC│SEPTEMBER 2020 1

LIST OF ABBREVIATIONS AOG Armed Opposition Group

BAY Borno, Adamawa and Yobe

CMAM Community based Management of Acute Malnutrition

DTM Displacement Tracking Matrix

FGD Focus Group Discussion

HNO Humanitarian Needs Overview

IDP Internally Displaced Person

IOM International Organization for Migration

IGA Income Generating Activity

KII Key Informant Interview

LGA Local Government Area

MEAL Monitoring, Evaluation, Accountability and Learning

OCHA United Nations Office for the Coordination of Humanitarian Affairs

PHC Primary Health Care

PSEA Prevention of Sexual Exploitation and Abuse

NGO Non-Governmental Organization

RC Reception Center

UNHAS Uniter Nations Humanitarian Air Service

WASH Water, Sanitation and Hygiene

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INTRODUCTION Background The protracted armed conflict in north-eastern Nigeria; now in its eleventh year has continued to cause displacement and with it gaps that need filling by humanitarian action. The Nigeria DTM report 33 published by IOM put displacement figures in the region to over 2.1 million1. The 2020 HNO published yearly by OCHA highlighted that across Borno, Adamawa and Yobe States (BAY states) in the north- eastern part of Nigeria, about 7.9 million people out of a total of 13 million will need humanitarian assistance in 2020; that is one in two people in the region2. This marks an 11% increase from the 7.1 million people in need of some form of assistance reported in the 2019 HNO. This highlights the dynamic nature of the humanitarian situation in the region and the need to monitor the trends and assess needs. Borno state is home to over 80% of the IDPs affected by the crisis; this makes Borno the most affected and the epicenter of the crisis. The 2020 HNO concluded that “over 75 per cent of people living in Borno State are in need of humanitarian assistance in 2020”.

The COVID-19 pandemic that swept across the world in 2020 also infiltrated the shores of Nigeria; with the first case confirmed on 27th of February 2020 in Lagos state, Nigeria. A short period after the confirmation of the first case in the country, other states in Nigeria also began recording cases- the BAY states included. To curb the spread of the disease, the state governments of Borno, Adamawa and Yobe states issued lockdown restrictions throughout March and April of the same year. These movement restrictions alongside other measures put in place due to COVID-19 have affected smooth humanitarian operations in the area. The various complexities caused by the effects of the pandemic has only worsened the already difficult situation in North-Eastern Nigeria; with more people needing various humanitarian intervention in the area. The OCHA situation report for July 2020 posted a rise in the number of people in need in the north-east from 7.9 million at the beginning of 2020 to 10.6 million since the onset of COVID-193.

Ngala is an LGA situated in the east central area of Borno state, northeastern Nigeria and has an area of 1,465 km2. It was among the tens of towns captured by the AOG. Majority of the population within the community are elderly, women and children. Children are estimated to represent a third of the population in Ngala. Ngala was cleared for humanitarian activities since November 2016 despite the occasional attacks by the AOGs although humanitarian access to the town is by air through UNHAS. Due to the presence of humanitarian assistance there is influx of new arrivals from bordering Cameroon and other LGAs within Borno state affected by the armed conflict. The new arrivals come in through the reception centers before they are relocated to the IDP camps.

1 IOM (2020)- North-East Nigeria: Displacement report 33 2 OCHA (2020) 'Humanitarian Needs Overview' 3 OCHA (2020) 'Nigeria Situation Report' INTERSOS│MSNA│NGALA & MONGUNO RC│SEPTEMBER 2020 3

Monguno is an LGA located to the north of the Borno state capital- Maiduguri. It has an area of 1,913 km2. Monguno has been hugely affected by the ongoing conflict and has continued to record attempted infiltration by the AOGs. Monguno, due to the presence of humanitarian actors play host to displaced individuals mostly from neighboring Kukawa, Marte and Guzamala that are hugely inaccessible. Just as in Ngala, the new arrivals are hosted at the reception center before being relocated to the IDP camps.

INTERSOS Humanitarian Organization has been present in Nigeria since the beginning of 2016 and has been implementing life-saving activities with a focus on camp coordination, food security, livelihood, primary health, nutrition, protection services, PSS, shelter, WASH and other essential lifesaving services. INTERSOS have been managing the reception centers in Monguno and Ngala since January 2018 and August 2018 respectively.

The Multi-Sector Needs Assessment (MSNA) is a crisis-wide assessment to identify inter-sectoral humanitarian needs which aims to provide a strong evidence base for the Humanitarian Needs Overview (HNO) and Humanitarian Response Plan (HPR)4. As part of INTERSOS mandate to better understand the context of its intervention areas; so as to improve on its current humanitarian interventions, a multi- sector needs assessment was conducted in the Monguno and Ngala reception centers. Objectives The main objective of the assessment is to identify needs and gaps as regards to health, nutrition, WASH and protection in the reception centers of Monguno and Ngala. The specific objectives include;

i. Proscribe recommendations to identified needs in the Ngala and Monguno reception centers. ii. Assess disability, vulnerability and protection issues in the reception centers of Monguno and Ngala. iii. Calculate the DG ECHO protection mainstreaming indicator (% of beneficiaries reporting that humanitarian assistance is delivered in a safe, accessible, accountable and participatory manner).

4 REACH (2019)'North East MSNA INTERSOS│MSNA│NGALA & MONGUNO RC│SEPTEMBER 2020 4

METHODOLOGY Assessment scope and population This assessment was confined to the reception centers of Monguno and Ngala. The population targeted were new arrivals hosted through the reception center within the last six (6) months. In the event such new arrivals were relocated to IDP camps, the INTERSOS CCCM team managing the reception centers supported in tracing their specific locations in the camp. Assessment design A desk review was first done to obtain Secondary data. Updated demographic information of the reception centers in Monguno and Ngala was collected from the INTERSOS CCCM database. For primary data collection, a cross sectional study design to capture quantitative and qualitative data was employed in the assessment. Households survey was conducted to acquire quantitative data, while FGDs and KIIs were conducted to obtain qualitative data to properly triangulate findings. The tools and questionnaires for the assessment were designed by the various sector technical leads of INTERSOS Nigeria mission with the support of the MEAL department.

A protection mainstreaming indicator calculation tool created by DG ECHO, in collaboration with a selection of partners working in South Sudan as well as the South Sudan Protection Cluster was used to calculate the indicator; “% of beneficiaries (disaggregated by sex, age and diversity) reporting that humanitarian assistance is delivered in a safe, accessible, accountable and participatory manner”. The indicator was calculated using the 7 mandatory questions as described in the practical guidance note of the protection mainstreaming toolbox in Nigeria5. Sampling For the household survey, a two-step sampling methodology was employed in this assessment. Purposive sampling was first done to determine new arrivals to the reception centers within the last six (6) months. The total figures obtained in both Monguno and Ngala reception centers was 2049 and 1653 respectively. A significant sample at 95% level of confidence, 5% margin of error and 50% response distribution was then calculated using Raosoft sample size calculator6. This resulted in a calculated sample size of 312 for Ngala and 324 for Monguno. An additional 5% of the calculated sample size was added to cater for non-responders. In order to choose participants for the assessment, a simple random sampling was done among the sampled target population.

In addition to the household surveys, four (4) KIIs and eight (8) FGDs were conducted each in Ngala and Monguno. The KIIs targeted community and religious leaders while the FGDs conducted comprised 2 each for elderly males, elderly females, adolescent males and adolescent females in both reception centers. Data collection and Analysis The training and data collection exercise was conducted in Ngala and Monguno from 9th to 13th November 2020. Training of the enumerators was done on the first day, after which the tools were piloted to minimize errors. Final modification and checks were done based on feedback from the field

5 DG ECHO Toolbox 6 Raosoft Sample size calculator INTERSOS│MSNA│NGALA & MONGUNO RC│SEPTEMBER 2020 5 test, in order to ensure a smooth data collection and analysis process. Questionnaires were deployed electronically using the KoboToolbox7 platform on smartphones.

Quantitative data was analyzed using statistical software and spreadsheets; with results summarized using measures of central tendency, percentages and averages. Qualitative data was analyzed using methodology described by Measure evaluation8. In the representation of results, ‘no responses’ and responses of “do not know” were not represented. Ethical Consideration All data collection ethics and rules were observed during this study, including pre informed consent taken from all respondents before commencing interviews. Data collectors were also briefed on protection monitoring and PSEA during the training.

Furthermore, safety protocols against the spread of COVID-19 was ensured during data collection; this included social distancing during interviews, also the use of face-masks, sanitizers and disinfectants. Limitations The limitations of this study are as below;

• There is the likelihood of errors during translation as the tools were created in English and the respondent primary languages are Hausa and Kanuri. To mitigate this, proper care was taken during the training sessions, where translation was done in conjunction with enumerators. • The overall quality of response depended on the skills of the enumerators. However, clear instructions and training was given on when to probe, how and other good ethics of data collection.

7 KoboToolbox 8 Measure-Evaluation INTERSOS│MSNA│NGALA & MONGUNO RC│SEPTEMBER 2020 6

FINDINGS AND DISCUSSION Demographics From the period of May to October 2020, 628 households (2049 individuals) arrived Monguno reception center while 556 Sex of Respondents households (1653 individuals) were hosted in the Ngala 68% 62% reception center. The average age of head of household of the 38% new arrivals in Monguno is 36.72 and that of Ngala is 37.39. For 32% those new arrivals, in Ngala RC, 62.9% of the head of households were females while 37.1% were males. Monguno RC had 67.5% females as head of households and 32.5% as Monguno RC Ngala RC

males. Female Male A total of 710 respondents participated in this assessment, 352 in Monguno RC and 358 in Ngala RC. From the total respondents across both locations, 65% were female and 35% were males.

AGE GROUP OF RESPONDENTS Above 50 The average number of household members in 8% Monguno RC is 4.02 while that of Ngala RC is 4.9.

In Ngala RC, 80% of the respondents were the head of 35 to 50 the household while for Monguno RC was 69% were the years 18 to 35 head of the household. Of those that were not the head 33% years of households, 56% 12 to 18 years 3%

Health and Nutrition Information collected shows that 48.6% and 48.7 percent of households in Monguno RC and Ngala RC have a pregnant or lactating woman Types of Health Facility by currently residing in shelter. The average location number of reported pregnant/lactating women in the households was 1.07 for Monguno and 1.35 for Ngala. Also, 71.3% PHC 15% 11% respondents in Monguno RC and 70.7% in Mobile/outreach clinic (NGO’s) 66% Ngala RC have children under the age of 5 89% in their households. The average number of Hospital 19% children under 5 years in the households was 1.55 in Monguno RC and 1.84 in Ngala Ngala RC Monguno RC RC.

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Findings show that 47% in Monguno RC and 56% in Ngala RC reported that someone in their family has Most reported Symptoms been sick in the past 2 weeks. The major symptoms reported with the sickness is fever (38%), cough Injury 7% (25%) and diarrhea (13%). In Monguno RC, 100% of Vomiting 5% the respondents reported that the distance to the Dizziness 2% nearest health facility is less than 2km while in Ngala Eye infection 4% RC, 82% say the nearest health facility is less than Skin infection 4% Diarrhea 13% 2km away and another 3% say it is within 2km to Cough 25% 5km. Fever 38%

“Some of our people have critical illnesses the health facility in Ngala cannot treat and we don’t have means to travel” – FGD

The type of health facility reported in both locations collectively are mobile/outreach clinic; NGO operated (78%), PHC (13%) and Hospital (19%).

Since arriving the reception center, 12% in Monguno RC and 36% in Ngala RC reported that someone in their household gave birth. The place of birth by location showed that 59% in Monguno and 38% in Ngala gave birth at home while 41% in Monguno and 57% in Ngala gave birth at an NGO facility.

Of those recorded births, 30% in Ngala RC and 20% Place of delivery by location in Monguno RC said a skilled birth attendant (doctor, nurse midwife) attended to the birth, 32% in Monguno RC and 9% in Ngala RC was attended 59% 57% to by a traditional birth attendant, while another 41% 38% 24% in Monguno RC and 25% in Ngala RC was attended to by other women in the community. 5% A total of 16% of respondents in Monguno RC and At Government At home At NGO health 13% in Ngala RC have a child suffering from health facility facility malnutrition in the household. Of those with Monguno RC Ngala RC malnutrition in both locations, 64% in Monguno RC and 72% in Ngala RC are enrolled in a nutrition treatment programme.

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CCCM/Site Management Results obtained show that 92% in Monguno RC and 88% in Ngala RC report that the shelters they stay in are built out of solid material. In Monguno RC, 90% of respondents say the shelters have secure doors with lock while for Ngala RC that value is 49%, with the remaining 51% in Ngala RC saying their shelters do not have secure doors with locks.

As a follow up, enquiries were made on reports of breaches, breakages or theft. The responses by location are represented in the table below;

Are there reports of breaches, breakages or thefts in the shelters within the RC?

Monguno RC Ngala RC Total No 88% 66% 77% Yes 8% 33% 21%

The values of those who received basic NFI kits upon arrival to the RC was 72% and 65% for Monguno RC and Ngala RC respectively.

During the FGD and KII sessions the major issues reported with regards to site management was delay in receiving NFI kits upon arrival to the reception center and limited access to fuel for cooking.

WASH When asked if members of their households have access to a functional latrine in the RCs, 78% in Monguno RC and 93% in Ngala responded that they have latrine access. Of those that reported not having access to Type of latrine latrines, 8% in Monguno and 3% in Ngala defecate in the 71% bush while 16% in Monguno RC and 4% in Ngala RC 65% defecate in an area designated by the community. 35% 29% Collectively across both locations, 45% use block latrine while 55% use pit latrine. Also, 57% of respondents in Monguno RC and 71% in Ngala RC have members of their household unable to use the latrine. The individuals most Block latrine Pit latrine mentioned that could not use the latrines are children Monguno RC Ngala RC under 5 years (51%), Elderly people (6%) and also people suffering from chronic illness (5%).

“Water is not always available at the borehole and when it is, it is overcrowded” – FGD

INTERSOS│MSNA│NGALA & MONGUNO RC│SEPTEMBER 2020 9

82% in Ngala RC and 69% in Monguno RC indicated that the source of their water is a borehole, while 8% in Ngala RC and 12% in Monguno RC get their water through water truck. All respondents in Monguno (100%) indicated that they do Barriers associated with laterine use not pay for water, while 96% do Latrines is not adapted for disabilities 4% not pay for water in Ngala RC, 4% indicated that they do. Latrine is dirty and smells 10%

Latrine is filled 3% In Ngala RC, 70% of the respondents could recall at least Latrine is not safe at night or certain… 9% 3 of the 5 essential Latrine hole is too big, not safe for… 47% handwashing moments while in Monguno RC, 76% could recall Latrine is damaged, not safe to use 26% at least 3.

Protection, vulnerability and Disability The Washington Group on Disability Statistics short set of questions was used to measure difficulty in functioning of five basic universal actions (capabilities) that would place an individual at risk of restricted social participation.9 The basic capabilities assessed are seeing, hearing, moving, speaking and remembering.

The table below summarizes difficulty levels of individual respondents in doing the five basic actions by location.

Do you have any Do you have any Do you have any Do you have any Do you have any difficulty in difficulty in difficulty in difficulty in difficulty in seeing? hearing? moving speaking? remembering? (walking)?

Monguno Ngala Monguno Ngala Monguno Ngala Monguno Ngala Monguno Ngala No difficulty 84% 90% 88% 94% 88% 88% 91% 98% 84% 85% Some 13% 6% 9% 4% 7% 8% 4% 1% 11% 11% difficulty A lot of 1% 3% 1% 2% 1% 4% 3% 1% 5% 4% difficulty Cannot do at 2% 0% 1% 0% 3% 0% 0% 0% 0% 0% all

Furthermore, to get some insight on household prevalence of difficulty in the five basic actions, respondents were asked of the presence of such difficulty among household members. Across both locations, 7% of respondents have members of their households with some level of difficulty in seeing,

9Washington Group on Disability Statistics INTERSOS│MSNA│NGALA & MONGUNO RC│SEPTEMBER 2020 10 another 7% had household members with difficulty in hearing, 5% with difficulty in moving, 5% with difficulty in speaking and 6% with household members having difficulty in remembering.

21% of respondents in Monguno RC and 14% in Ngala RC has had Major Security Incidents someone in their household experience a form of security incident Sexual assault / Gender-based violence 9% in the last three months. Of those, Destruction of properties 11% 61% in Monguno RC and 27% in Ngala Fire outbreak 20% RC say the incident occurred in their current location, 30% in Monguno RC Armed attacks 45% and 50% in Ngala RC say the incident Abduction 11% occurred in their location of origin, Killing / physical violence while 9% in Monguno and 23% say 18% the incident occurred while traveling between locations. The major security incidents mentioned across both RCs are armed attacks (45%), fire outbreak (20%), physical violence (18%), abduction (11%), destruction of properties (11%) and gender-based violence (9%).

When asked on legal documentation status of their households, 30% in Monguno RC and 56% in Ngala RC highlighted that none of the adults in their household have any form of legal documentation, 28% in Monguno RC and 29% in Ngala RC have some members of their households with legal documentation.

The places where women and girls feel most unsafe are waterpoints (38% Ngala RC and 20% Monguno RC), during collection of fuel Is there a designated space (18% Monguno RC and 10% Ngala RC), toilets where women and girls (8% Monguno RC and 9% Ngala RC), gather to socialize and unoccupied shelters (3% Monguno RC and 9% Ngala RC) and along routes to access services learn skills? 53% 57% (5% Monguno RC and 7% Ngala RC). 43% 47%

53% of respondents in Monguno RC and 43% in Ngala RC say there is no designated women and girl friendly space within the reception No Yes center for women and girls to socialize and Monguno RC Ngala RC learn new skills while 47% in Monguno RC and 57% in Ngala RC say there is a designated space.

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DG ECHO Protection mainstreaming indicator The DG ECHO Protection mainstreaming indicator was calculated by answers from seven mandatory questions that measure elements that promote meaningful access, safety and dignity in humanitarian aid. These responses from combined from both Monguno RC and Ngala RC are as below;10

Do you know of anyone in your community who was Yes 52% consulted by the NGO [in the past 6 months] on what your needs are and how the NGO can best help? No 48%

Was the assistance received Since you came into the RC Yes 65% appropriate to your needs or those of members of your community? No 34%

Did you feel that every member of the household or the Yes 64% community who should receive assistance was included in receiving humanitarian assistance since arriving the RC? No 35%

When you received assistance since arriving the RC, did you feel safe while going to receive assistance, waiting for Yes 83% assistance and coming back to your home after assistance? No 17%

Did you feel that you were treated with respect by NGO Yes 91% staff since you came into the reception center? No 9%

Have you or anyone in your community ever raised any Yes 69% concerns on the assistance you received to the NGO either

through the helpdesk, suggestion box or speaking to a staff No 28% since arriving the reception center?

Very satisfied 69%

Partially satisfied 22% If yes, how satisfied were you with the response you have

received?

Partially dissatisfied 3%

Very dissatisfied 3%

10 ‘No response’ and ‘don’t know’ not included INTERSOS│MSNA│NGALA & MONGUNO RC│SEPTEMBER 2020 12

After permutations, 85.71% of beneficiaries reported that humanitarian assistance is delivered in a safe, accessible, accountable and participatory manner.

Service Mapping

NGALA

Management of RC NFI Mercy Corps, IOM, INTERSOS UNHCR, Solidarites International Health and Nutrition Food security INTERSOS, FHI360, MSF, DRC/WFP UNICEF, WHO

WASH Registration Mercy Corps, FHI 360, IOM Solidarites International

Protection Child protection INTERSOS, CARE, FHI CHAD, FHI360 360, GISCOR

MONGUNO

Management of RC NFI ICRC, Solidarites INTERSOS International Health and Nutrition Food security ACTED/WFP

WASH Registration Solidarites International, IOM UNICEF

Protection Child protection GISCOR, UNHCR CHAD, ICRC

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CONCLUSION AND RECOMMENDATIONS Although there have been interventions at the reception center to cater for the urgent needs of new arrivals in both Ngala RC and Monguno RC, the continuous conflict in the zone and changing situations due to the effects of the COVID-19 pandemic calls for stepping up of interventions in these locations. As new arrivals continue to come in through the reception center, there is need for specific interventions in various sectors to alleviate the suffering of the affected population.

Findings from this study thus provides evidence to which the following recommendation are made; Nutrition and Health • Set up health screening and primary health care facilities within reception centers to cater for health needs of new arrivals • Include sexual and reproductive health in health implementation to support the high number of pregnant/lactating women • Provide nutrition services, especially CMAM in reception centers • Incorporate an effective referral system in health interventions for severe illness that cannot be handled in Ngala

CCCM/Site Management • Improve security structures on shelters • Provide adequate fuel for new arrivals

WASH • Increase hygiene promotion to new arrivals to combat the spread of diseases in particular; COVID-19. • Increase the capacity to water points

Protection/Vulnerability/Disability • Ensure inclusion of vulnerable groups, especially those with various disabilities in program planning and implementation. • Provision of women/girl friendly spaces at reception center.

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