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Effect of beneficiary participation in program design and implementation on satisfaction and acceptability among internally displaced persons in Borno, Nigeria

Insurgency and other security challenges have intensified across Nigeria with a resultant displacement of over a million people from over 100,000 households who depend on interventions from government and non-governmental organizations for survival since 2009. We conducted the study to determine the level of involvement of the displaced persons in planning, implementation and review of these interventions, and the effect of the participation on satisfaction with the interventions among camp dwellers in selected camps in Borno, Nigeria. A total of 278 internally displaced persons (IDPs) across 9 IDP camps were surveyed using an interviewer-administered questionnaire. Data was collected using Android-based Open Data Kit (ODK), exported into Microsoft Excel, and analyzed with SPSS version 21. Out of the 278 respondents, 143 (51.4%) were male, 82 (29.5%) respondents were within the age bracket of 26-35 years and above (mean age 38.9±12.3), over 78% were married, and 29.9% were involved in trading before their displacement. Among the respondents, 256 (92.1%) had benefitted from at least one intervention during their stay in the IDP camps. Over 96% of the beneficiaries were female, compared to 87.4% of males, which was statistically significant (p<0.05). All the respondents within the age group 26-35 years and above 45 years old who had received information about the interventions were satisfied, and this finding was statistically significant (p<0.05). Overall, 91.5% of respondents who had benefitted from previous interventions would like to be involved in all the intervention stages (planning, implementation, and review). In comparison, 100% of IDPs who benefitted from previous interventions would like to be involved in the implementation, and 96.8% of them would like to be involved in planning the proposed interventions. To ensure maximum coverage, and that optimum benefit is derived from development projects, beneficiaries should be involved in all stages of the project cycle.


Introduction
Nigeria has experienced escalated levels of insecurity due to insurgency since 2009 (Gilbert 2014). The insurgency is predominant in Northeastern Nigeria and the Lake Chad Basin countries, described as the "headquarter of insurgency" (Albert 2017). This crisis has led to killings (Shuaibu et al. 2015) and the displacement of several people from their ancestral homes into temporary camps within and across the country's borders. As of 2019, it was estimated that over 1.8 million people were still displaced in Northeastern Nigeria, with over 80% of them being found in Borno, and needing humanitarian support (OCHA 2019). The displaced are mostly the vulnerable age groups such as the elderly, women, and children (Olanrewaju et al. 2018). Displaced persons in these camps are vulnerable and exposed to many crises ranging from food shortages, poor access to education, poor personal hygiene, shortage of potable water, diseases, and psychological trauma due to loss of loved ones and means of livelihood (Adewale 2016;Akuto 2017;Olanrewaju et al. 2018).
The sudden displacement of people who are, often, non-disabled working people could lead to a dependent situation due to loss of means of livelihood (Oyefara and Alabi 2016). The dependence on aid itself creates an emotional and psychological crisis in most humanitarian situations with victims feeling unprotected (Shehu and Abba 2020). The non-involvement of the IDPs in the decision-making about how their problems are addressed can add another layer of complexity, especially where the humanitarian agencies involved in the decision-making processes are neither religion nor culture-sensitive (Shehu and Abba 2020).
It has been documented that client participation can lead to improved satisfaction, better program design, and implementation. It is also known that community participation can draw from the already existing community resource and assets to address the community's felt need (OCHA 2017).
These displaced persons are usually provided with temporary shelter in camps while other interventions are further designed to mitigate the IDPs' challenges by the government and other partner agencies. These agencies often step in, with pre-designed interventions, to reduce the hardships of the displaced persons. The interventions are initiated and designed using a top-to-bottom approach with minimal involvement of the beneficiaries (Thwala 2010). This practice could affect acceptance, satisfaction, and sustainability of these interventions (Ofuoku 2011;Chirenje et al. 2013;Olori and Okide 2014). Laah et al. (2014), Abdullahi et al. (2014), and Bappi et al. (2018) reported that most of the community involvement in project development and implementation were education and consultation without involving the communities in designing, planning, and improvement to ensure sustainability.
This study aims to determine the level of beneficiaries' participation in the IDP camps interventions and how their involvement affects their satisfaction with the interventions, from which they have benefitted.

Methods
This study was conducted in Borno state, Northeastern Nigeria. The state shares borders with Adamawa state to the south, Yobe state to the west, Cameroun, and the Chad Republic to the east and the Niger Republic to the north. The state is located on coordinates 11°30′ N and 13°00′ E with an area of 70,898 km 2 and has a population of approximately 7,000,000 people (Babagana 2017). The Northern part of the state is home to majorly Kanuri and Shuwa speaking people who are predominantly Muslims. In the Southern part of the state, the commonly spoken languages include Marghi, Chibok, and Bura (Chama et al. 2010). The main occupation is agriculture, both subsistent and commercial, but some are involved in fishing, knitting, and trans-boundary trade with the neighbouring countries. Administratively, the state has 27 local government areas (LGAs) with a majority of them having varying levels of accessibility due to insurgents' activities (ACAPS, 2017). The study design was longitudinal and cross-sectional involving 278 caregivers in 9 IDP camps across 3 LGAs: Bama, Jere, and Maiduguri LGAs. Data was collected using interviewer-administered questionnaire configured on Android devices using Open Data Kit (ODK). Data collection teams were trained on the use of Android devices to collect data and the administration of electronically configured questionnaire before deployment. The questionnaire was designed to elicit information on the five [food, healthcare, education, livelihood, water sanitation, and hygiene (WASH)] out of the seven critical areas for humanitarian interventions.
The information elicited included socio-demographic data, duration of stay on the IDP camps, being beneficiaries of any intervention since arriving camp, involvement in intervention planning, implementation, and review. The willingness of the respondents to participate in intervention planning, implementation, and review was also assessed. Written informed consent was sought from the caregivers, and only those who consented to participate in the survey were interviewed. The questionnaire on ODK was piloted to ensure there was no ambiguity in the tool and that the data collectors were familiar with the questionnaire administration on android devices before the commencement of fieldwork.

Data analysis
Data collected through the Android/electronic platform was submitted to a central server. The collected data was downloaded to Microsoft Excel and exported to Statistical Package for Social Sciences (SPSS) version 21 for cleaning and analysis. The analysis involved univariate and bivariate approaches, including frequency, percentages, and comparative analysis with test statistics (Chi-square). Chi-square was used to assess the relationship between some of the critical variables and satisfaction, which was defined as a measure of how useful the respondents perceived interventions. The summarized data was presented in tables and charts as appropriate.

Results
Out of the 278 respondents who participated in this study, 143 (51.4%) were males, while 48.6% were females.
About one-third (29.5%) of the respondents were > 44 years. The participants' mean age was 38.9±12.3 years, and a majority (65.8%) were of Kanuri ethnic group. About 78% (78.4%) of the respondents were married. Islam was the most predominant religion among the respondents (97.8%), and 29.9% were involved in farming and fishing before their displacement. About 68.0% of these respondents had lived in the IDP camps for more than 5 years, and 91.0% had children with them in the IDP camps (Table 1).
Among respondents, 256 (92.1%) had benefitted from at least one intervention while living in the IDP camps ( Fig. 1). Distribution of the benefitting respondents shows that about 67% of them benefitted from nutrition (distribution of food items) (79.1%), vaccination (68.0%), and water supply (62.9%, Fig. 2). Table 2 shows the distribution of respondents who have benefitted from at least one intervention by their socio-demographic characteristics. Over 96% of the female respondents had benefitted from the interventions compared to 87.4% of males, and this difference was statistically significant (p<0.05). A higher proportion of older participants had received at least one intervention than younger respondents aged 34 years and below. However, this difference in proportion was not statistically significant (p=0.722). More respondents who had been married (including married, divorced, and widowed), had children, and had lived for more than 5 years in the IDP camps have benefitted from the camp intervention than those who were single, had no children, and had lived in the IDP camps for <5 years. These findings were statistically significant (p<0.05).
Among the IDP camp dwellers who benefitted from the interventions, 77.7% reported being very satisfied with the intervention while 1.6% were unsatisfied. Most (47.7%) of the respondents chose nutrition (food distribution) as the most satisfying intervention in terms of usefulness and followed by vaccination services (14.5%) and personal hygiene supplies (12.5%). In comparison, 1.4% chose the distribution of seedlings and other farming implements as the most satisfying intervention (Table 3).
Among the respondents who had benefitted from IDP camp intervention before the survey, 156 (60.9%) were consulted before the intervention. Among those who had received information about the intervention, 58.1% were informed by NGO representatives/staff in the camp. The majority (41.7%) got the information about the projects at the planning stage before commencement (Table 4). For respondents who were not consulted about the intervention, 62% responded that they would prefer food distribution ahead of the other interventions that they had received (Fig. 3).
More female (100%) of those who got information about the interventions report that they were in line with their desire compared to the male respondents (96.0%). This finding was, however, not statistically significant (p>0.05). All the respondents within the age group 25-35 years and above 45 years old who had received information about the interventions responded that the interventions were in line with their desire, which was statistically significant (p<0.05). In the same vein, 100% of the respondents who were single, divorced, widowed, had no children at the time of the survey responded that the interventions were in line with their desire. About 98% of the respondents who lived in the camps for more than 5 years accepted that the  interventions were in line with their desire. These findings were also not statistically significant (p>0.05) and are represented in Table 5. Effective project implementation to reach the beneficiaries' expectancies involves the participation of those for whom the interventions are targeted. In this study,    Page 6 of 10 we surveyed the beneficiaries' level of involvement in project planning, implementation, and review. Among the IDP camp dwellers surveyed, 46.8% preferred to be involved in all the stages of the proposed interventions (i.e., planning, implementation, and review). About a third (33.5%) of the respondents would prefer to be involved at the planning stage. In comparison, 2.9% felt they were not interested in being involved in the project activities apart from being just beneficiaries (Fig. 4). Overall, 91.5% of respondents who had benefitted from previous interventions would like to be involved in all the stages of the interventions (planning, implementation, and review). All (100%) of IDP camp dwellers who were beneficiaries of previous projects would like to be involved in the implementation, and 96.8% of them would like to be involved in planning for the proposed interventions (Table 6).
Among the respondents who were satisfied with the previous interventions received, 100% responded that they would like to be involved in the implementation, and review stages, compared to 97.0% would prefer to be involved in all intervention/project stages (Table 7).

Discussion
From the findings, more female (51.4%) respondents participated in the study compared to their male counterparts. Most (95%) of the respondents had children. These findings are in concordance with Surajo et al. (2019) report that more females were affected by the insurgency in Borno and other parts of Northeastern Nigeria. Mohammed (2017) while profiling victims of Boko Haram insurgency living in IDP camps in Maiduguri metropolis documented that about 30,236 women and 35,132 girls were victims of insurgency and living in IDP camps compared to 18,618 men and 27,252 boys in these same ICP camps. Among these women, 24% were lactating mothers with children less than 5 years old. The displacement tracking and monitoring report (DTM, June 2020) for week 32 indicated that 53% of the displaced persons in the Northeast were females and that 38% of them were within the ages of 18-59 years, many of whom will have children accompanying them during the travail. This distribution could be attributed to the fact that in the affected areas, men often stay back to defend the communities against insurgents while supporting the women, children, and the elderly to flee for safety, usually to camps of internally displaced persons.
Several organizations, comprising government agencies and non-governmental organizations, have been involved in providing support such as relief materials to the displaced persons across the country including the Northeastern (which includes Borno) (DTM 2020). This effort could be why most of the respondents confirm they have benefitted from at least one intervention across the pillars (shelter, nutrition, water supply, protection, livelihood, and health). Nutrition support in the form of food distribution was the intervention from which most (71.9%) respondents benefitted. This finding agrees with the DTM (2020) report that over 80% of the IDP camp dwellers responded to receiving food at least once over the last 12 months, and 55% of them benefitted from food distribution during the previous 2 months. Onethird of those who had benefitted from food incentives reported that the distribution was irregular, while 48% noted that food distribution is monthly (DTM 2020. Lenshie (2016) also reported that besides education, nutrition was the highest requirement among IDPs. Only 4.7% of the respondent reported having benefitted from the supply of farming implements, including receiving seedlings. This finding is supported by the DTM (2020), which highlighted that farming was not a top priority among IDP camp dwellers as most of them were involved in petty trading and daily laborer works. From the findings, 96.5% of the female respondents have benefitted from at least one of the listed interventions, which was statistically significant (p<0.05). There was a statistically significant (p<0.05) relationship between receiving at least one intervention and marital status. Over 90% of the married respondents (currently married, divorced, and widowed) had benefitted from at least one intervention since their arrival in the camp compared to those who were single at the time of the survey. Also, more (93.3%) caregivers who had children had benefitted from at least one intervention compared with those who had no children (80.0%); this relationship was statistically significant (p<0.05). Distribution of relief materials under the circumstances such as seen among IDPs prioritize the vulnerable groups (Davies 2012), including women, beneficiaries with children, and the aged as seen in this study.
Out of the interventions provided, 47.7% were satisfied with nutrition and food distribution. About 77% of the respondents were very satisfied with the interventions they had received. This finding is attributable to the fact that they were in line with the respondents' desire, as identified by DTM (2020).
Among the respondents who had benefitted from at least one intervention, 60.9% have been contacted previously about the project. Among those previously informed, 41.7% were told at the planning stage, while about a third (34.0%) of respondents were informed in all the implementation stages. These findings agree with Bappi et al. (2018) that most project beneficiaries are involved in the projects just for consultation and information but not as stakeholders in the project cycle. Greater than 90% of beneficiaries involved in planning, implementation, and all stages of the interventions had benefitted from at least one intervention. In the same vein, 90% of the respondents were satisfied with the intervention, but this finding was not statistically significant (p>0.05). These findings are in line with reports by other researchers who had stated that when beneficiaries are carried along and made stakeholders in the project cycle components, they become more satisfied and are more likely to own and sustain the interventions (Claridge 2004;Efuntoye 2015). The correlation between the duration of stay in the camp and satisfaction indicated that the longer the duration of staying on the camp, the more satisfied they were because they may have adjusted their lifestyles to live within the means of camp provision.

Conclusion and recommendations
Over 90% of the IDPs interviewed benefitted from the interventions provided to the IDP camps surveyed. Distribution of food items was the most widereaching intervention as about 79% reported being beneficiaries of the intervention. More female respondents, and ever married (married, divorced, and widowed) respondents, and respondents who had  children in the IDP camps reported having benefitted from the intervention compared to their respective counterparts. About two-thirds of the beneficiaries were contacted before the intervention commenced, while 41.7% were contacted during the planning stage alone. Only about one-third (34.0%) were engaged at all the stages of the interventions. Over 90% of the respondents involved in all the stages, planning and implementing the intervention, benefitted from the interventions compared to respondents involved in the review only.
There is a need to involve beneficiaries in IDP camps in project planning, implementation, and review more adequately to improve development projects effectiveness and efficiency. This is because IDP camp dwellers may have diverse needs which may not be adequately addressed if blanketed projects are designed without the beneficiaries' participation could reduce the project's level of impact and acceptability.