STRENGTHENING HUMAN RESOURCES FOR · Web viewThe United States Agency for International...

Issuance Date: September 26, 2011Deadline for Questions: October 11, 2011Closing Date: October 26, 2011Closing Time: 4.00 p.m. Addis Ababa time

Subject: Request for Applications No RFA-663-11-000009

Dear Prospective Applicant:

The United States Agency for International Development (USAID) is seeking applications for an Assistance Agreement in support of a five-year program entitled Strengthening Human Resources for Health (HRH),” as more specifically described in Section I- Funding Opportunity Description. The authority for this RFA is found in the Foreign Assistance Act of 1961, as amended.

The Recipient will be responsible for ensuring achievement of the program objectives as described in the program description. Please refer to the Program Description for a complete description of goals and expected results.

Subject to the availability of funds, USAID intends to provide approximately $55,000,000 in total USAID funding to be allocated over the five-year period to support these activities.

Pursuant to 22 CFR 226.81, it is USAID’s policy not to award profit under assistance instruments. However, all reasonable, allocable, and allowable expenses, both direct and indirect, which are related to the grant program and are in accordance with applicable cost standards (22 CFR 226, OMB Circular A-122 for non-profit organization, OMB Circular A-21 for universities, and the Federal Acquisition Regulation (FAR) Part 31 for for-profit organizations), may be paid under the agreement.

The Government of Ethiopia laws require prior registration for a foreign and local organization in order to implement programs or conduct any business in Ethiopia. An apparently successful applicant must provide a copy of the certification of registration and license from Federal Democratic Republic of Ethiopia Ministry of Justice prior to receiving an award.

The resulting award shall be made in accordance with federal regulations and agency policy. For U.S organizations, awards shall be administered according to 22 CFR 226 and OMB Circulars and USAID Standard Provisions for U.S Nongovernmental Recipients (http://www.usaid.gov/policy/ads/300/303maa.pdf). For non U.S. organizations, USAID provisions for Non-U.S., Nongovernmental Recipients will apply

RFA-663-11-000009Human Resources for Health

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(http://www.usaid.gov/policy/ads/300/303mab.pdf)

This RFA consists of this cover letter and the following:

1. Section I – Funding Opportunity Description2. Section II – Award Information2. Section III – Eligibility Information3. Section IV – Application and Submission Instructions4. Section V – Evaluation Criteria5. Section VI – Award and Administration Information6. Section VII – Required Certifications, Assurances, and Other Statements of

Applicant/Grantee;7. Annex I – Form - Survey on Ensuring and Equal Opportunity for Applicants8. Annex II – Form - Application for Assistance form SF – 424

The preferred method of distribution of USAID RFA information is via the Internet. This RFA and any future amendments to it can be downloaded from http://www.grants.gov.

Issuance of this RFA does not constitute an award commitment on the part of the Government, nor does it commit the Government to pay for costs incurred in the preparation and submission of an application. Further, the Government reserves the right to reject any or all applications received. In addition, final award of any resultant grant cannot be made until funds have been fully appropriated, allocated and committed through internal USAID procedures. While it is anticipated that these procedures will be successfully completed, potential applicants are hereby notified of these requirements and conditions for award. Applications are submitted at the risk of the applicant; should circumstances prevent award of a cooperative agreement, all preparation and submission costs are at the applicant's expense.

Any questions concerning this RFA should be submitted in writing to Sam Nagwere at [email protected]. Answers to questions and any additional information regarding this RFA will be furnished through an amendment to this RFA and posted on grants.gov.

Thank you for your interest in USAID programs.

Sincerely,

//Signed//

Gregory E. TaittAgreement OfficerUSAID/Ethiopia


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Table of ContentsACRONYMS/ABBREVIATIONS...............................................................................................4

SECTION I - FUNDING OPPORTUNITY DESCRIPTION...................................................61.1. SUMMARY......................................................................................................................62. BACKGROUND..................................................................................................................63 PROBLEM ANALYSIS.....................................................................................................154 GOAL, OBJECTIVES AND RESULTS............................................................................165 ENVIRONMENTAL COMPLIANCE...............................................................................286 ADDRESSING GENDER ISSUES...................................................................................297 MONITORING AND EVALUATION..............................................................................298 KEY PERSONNEL............................................................................................................31

SECTION II - AWARD INFORMATION................................................................................35

SECTION III - ELIGIBILITY INFORMATION....................................................................48

SECTION IV - APPLICATION AND SUBMISSION INSTRUCTIONS.............................49

SECTION V - EVALUATION CRITERIA..............................................................................58

SECTION VI - AWARD AND ADMINISTRATION INFORMATION...............................62

SECTION VII - CERTIFICATIONS, ASSURANCES, AND OTHER STATEMENTS OF THE APPLICANT.......................................................................................................................64

ANNEX I – SURVEY ON EEO FORM....................................................................................75

ANNEX II – SF 424.....................................................................................................................76


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ACRONYMS/ABBREVIATIONS

ADS Automated Directives SystemAHOTP Accelerated Health Officer Training ProgramAIDS Acquired Immune Deficiency SyndromeAOTR Agreement Officer’s Technical RepresentativeBEO Bureau Environmental OfficerCDC U.S. Centers For Disease ControlCFR Code Of Federal RegulationsCME Continuing Medical EducationCPD Continuing Professional DevelopmentDQA Data Quality AuditsEA Environmental AssessmentEPHT Ethiopia Public Health TrainingEPHTI Ethiopia Public Health Training InitiativeEMMP Environmental Mitigation And Monitoring PlanFMHACA Food, Medicine And Health Administration And

Control AgencyFMOH Federal Ministry Of HealthFP Family PlanningFP/RH Family Planning/Reproductive HealthGHI Global Health InitiativeGOE Government Of EthiopiaHAPCO HIV/AIDS Prevention And Control OfficeHAPN Health, AIDS, Population And NutritionHD Health DepartmentsHEW Health Extension WorkerHMIS Health Management Information SystemHPN Health, Population And NutritionHRIS Human Resource Information SystemHRH Human Resources for HealthHRM Human Resource ManagementHSDP Health Sector Development ProgramHSS Health System StrengtheningICAP International Center For Aids Care And Treatment

Program (Colombia University’s)IEE Initial Environmental ExaminationIFHP Integrated Family Health ProgramITECH International Training And Education Center For

HealthJSI John Snow Inc.LOE Level Of EffortM&E Monitoring And EvaluationM&M Mitigation And MonitoringMARP Most At Risk Population


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MNCH Maternal, Neonatal and Child HealthMOE Ministry Of EducationMOE Ministry Of EducationMOH Ministry Of HealthNHA National Health AccountsPFSA Pharmaceutical Fund and Supply AgencyPHCU Primary Health Care UnitPMI President’s Malaria InitiativePMP Performance Monitoring PlanPMTCT Prevention Mother To Child TransmissionPPD Planning And Program DepartmentRCE Request For Categorical ExclusionRFA Request For ApplicationsRHB Regional Health BureauSARS Semi-Annual Performance ReviewsSNNP Southern, Nations, Nationalities And PeopleTB TuberculosisUCSD University Of California San DiegoUHEP Urban Health Extension ProgramUNFPA United Nations Population FundUNICEF United Nation Children’s FundUSAID/E United States Agency For International Development

EthiopiaUSG United States GovernmentWHO World Health Organization


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SECTION I - FUNDING OPPORTUNITY DESCRIPTION

1.1. SUMMARY

The United States Agency for International Development in Ethiopia (USAID/E) Office of Health, AIDS, Population and Nutrition (HAPN) is seeking services for a Strengthening Human Resource for Health (HRH) program. It envisaged that the activities outlined in this program description will assist all of USAID/E’s (and the Global Health Initiative’s [GHI’s]) health sector involvement, including in maternal, neonatal and child health (MNCH); family planning (FP) and reproductive health; HIV/AIDS; tuberculosis (TB); malaria; and neglected tropical diseases.

2. BACKGROUND

2.1 Introduction

The 2007 Ethiopian Population Census projected that Ethiopia’s population in 2010 was approximately 79.8 million. Ethiopia is one of the world's poorest nations with a gross domestic product of $19.4 billion and a per capita income of $220. Half of the population is estimated to live below the poverty line (World Bank, 2007). The country’s health indices are among the lowest in the world. More than 670 in 100,000 mothers die giving birth each year and about 120 and 77 in 1,000 children die before celebrating their fifth and first birth days respectively. The overall quality of health care delivery is poor and health service utilization per person per year is only 0.24 (FMOH, 2008).

In Ethiopia, the underlying causes of poor quality health services include a severe health workforce crisis, weak service delivery infrastructure, limited health financing mechanisms, deficient supply chain management and information systems, and overall weak governance structures. The Fourth National Health Accounts (NHA-2007/08) showed that between 1999/2000 to 2007/08, per capita health expenditure increased from $5.6 to $16.1. Despite this increase, the health sector remains underfinanced when compared with the World Health Organization (WHO) Commission on Macroeconomics and Health’s recommendation that a minimum expenditure of $34 per person per year is needed to provide basic health care services in developing countries (WHO, 2001).

2.2. Human Resources for Health in Ethiopia

WHO has designated Ethiopia as having a ‘critical’ health workforce shortage (WHO 2006). The crisis in Ethiopia is characterized by an absolute shortage of trained health workers; an imbalance in the numbers of different health worker cadres; uneven distribution of health workers between urban and rural areas; under-production of trained personnel, especially at high and mid-levels; low retention, including a “brain drain” of health workers to more developed countries that offer better compensation; and a poorly motivated health workforce.

Ethiopia has a total health work workforce of 55,373 (counting only health professionals), which translates to 0.7 health workers per 1,000 population (PPD, 2006/07) compared with the WHO


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recommended 2.3 health workers per 1,000 population required to attain adequate coverage of essential health interventions (World Health Report, WHO, 2006). Health worker density ranges from 0.24 per 1,000 population in rural areas to 2.7 per 1,000 population in urban areas. This low health sector workforce density poses a serious challenge to the delivery of essential health care services in the country, especially in rural areas where the majority (83.9%) of the country’s population live and work. The greatest deficit in health sector workforce density is for physicians, with only one doctor serving 36,158 people1. Further disaggregation by geographic regions shows that the physician to population ratio can be as low as 1:183,248 in Oromiya (PPD, 2006/7). Among physicians, the shortage is most critical for surgeons and obstetricians and gynecologists, with ratios of 1:1.6 million and 1:1.8 million, respectively; the ratio for midwives is 1: 57,350. This strikingly low physician-to-population ratio in Ethiopia is a result of a high annual attrition rate of medical doctors, fast population growth and lack of capacity to train doctors fast enough.

Furthermore, the unavailability of quality health worker training affects the quality of graduates in the short-term as well as, subsequently, the provision of health services in the mid and long term. The Government of Ethiopia (GOE)’s current HRH Strategic Plan focuses on training and educating as many health professionals as possible (sometimes referred to as the “flooding” strategy). To accommodate the planned new graduates, the GOE has rapidly expanded training institutions by, for example, increasing public universities offering health education from five in 2000 to 22 in 2008 with an additional ten under construction. However, the instructors, teaching materials and infrastructure have not grown proportionately to the rapid expansion of training institutions and the increased number of student enrollees. This, together with overburdened clinical training sites and insufficient numbers of patients with relevant ailments to treat at these sites, has compromised the quality of the education provided.

In 2010, the GOE released a draft HRH Strategic Plan (2009-2020). This strategic plan identifies many challenging issues related to health workforce development in Ethiopia. These include:

Low ratio of health workers per population served with insufficient skill mix among these;

Low training capacity with low output for major HRH categories; Pre-service education output not well aligned with the needs of the health sector; Health staff unevenly distributed in the country with significant deficits in rural areas and

underserved regions; High attrition rate of physicians from public services due to outmigration and internal

recruitment outside the public sector; Staffing patterns that are highly variable and not aligned to actual workload; Lack of standardized in-service training; Weak HRH management structures at all levels that is inadequate to address the concerns

of health workforce including motivation and performance evaluations; Lack of organized human resource information system (HRIS); Inadequate regulatory framework in support of HRH development and management as

well as licensing; and Absence of monitoring and evaluation framework for HRH.

1 Federal Ministry of Health’s (FMoH) Health Indicators Survey, 2008


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Under the GOE’s draft HRH Strategic Plan, the primary approach to addressing geographic disparities in health has been to construct nearly 15,000 health posts and over 3,000 health centers to improve coverage and access to health services in rural areas. The GOE’s main strategy for addressing the health workforce crisis is to rapidly expand the health workforce to adequately staff existing and planned expansion of public and private health facilities. The total requirement for all health workforces is estimated to be nearly 188,000 by 2020 - a more than three-fold increase compared to the 2008 figure. According to the targets set by the HRH Strategic Plan, medical doctors, midwives and anesthesia professionals are cadres with the greatest deficits. Health extension workers (HEWs), general nurses (clinical and public health nurses), and health officers are on track to meet the targets set forth by the GOE. The GOE strategy involves expanding the number of doctors and midwives and establishing a post-graduate program in integrated emergency surgery for health officers. The strategy outlines plans to pursue an accelerated midwifery training program. To decrease the rural/urban health worker disparity, the HRH strategy proposes rural, public service bonding schemes post-education. In order to retain the health workforce and maximize performance, the Strategy proposes implementing incentive (including non-monetary) and retention mechanisms, career development strategies, and institutionalizing continuing education and in-service training through credit-based standardization. To improve human resources for health management in Ethiopia, a Directorate of Human Resource Management has been established under the Ministry of Health (MOH) that is responsible for HR planning, personnel management, deployment of professionals, HR studies (in collaboration with universities), and liaison with the Ministry of Education (MOE). Also established is a Directorate of Health Facilities and Professionals Licensing under the Food Medicine and Health Administration and Control Agency (FMHACA), responsible for registration and licensing of degree health professionals and HRH legal frameworks; updating job descriptions, career structure, and staff development plans; establishing a performance based evaluation system; creating an HRH database and human resource information system; and creating a national HRH steering body with Regional Health Bureaus (RHBs) to monitor implementation of HRH strategic planning.

2.3. USAID/Ethiopia’s Strategy to Strengthen HRH

USAID/E supports the GOE’ health programs as articulated in the new Health Sector Development Plan (HSDP IV) for 2011 to 2015, which includes strategic approaches for HIV/AIDS, TB, malaria, MNCH, FP, infectious diseases; non-infectious diseases; mental health; and health systems strengthening (HSS). With the advent of the U.S. Government (USG)’s Global Health Initiative (GHI), HRH has taken on revitalized importance to USAID/E’s heath portfolio. Launched in 2010, the GHI intends to commit a total of $63 billion dollars over six years to support many partner countries, including Ethiopia, in improving health outcomes through strengthened health systems, with a particular focus on improving the health of women, newborns, and children. The GHI provides USAID/E with a framework to design a more strategic and comprehensive approach to improving HRH in Ethiopia though coordinated investments in the six health systems elements and across USG funding streams. Specifically, investments will be made to: a) Strengthen HRH; b) Expand health financing options; c) Strengthen strategic information (SI) and evidence-based decision making; d) Increase health


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commodity and essential drug security; e) Improve health infrastructure and laboratory systems for service delivery; and f) Strengthen policy, planning and governance.

The GHI will focus on the key systems elements where the USG has a comparative advantage and will strengthen the functioning of the health care system to particularly address issues, including key HRH bottlenecks, facing MNCH services. The USG will build on its work already underway in MNCH and FP, HIV/AIDS (implemented under PEPFAR), malaria (implemented under PMI) and other areas to strengthen the health sector workforce in Ethiopia. The following GHI principles are embedded as core values in this new HRH program:

Building sustainability through HSS: HRH is the cornerstone of HSS. Producing and retaining competent and motivated HRH for the health system is fundamental to averting morbidity and mortality.

Encouraging country ownership and invest in country-led plans: In collaboration with the GOE, USAID’s Accelerated Health Officer Training program (AHOTP) has successfully trained more than 5,000 health officers to directly support GOE plans for expanding primary health care in Ethiopia. This program was implemented by five public sector local universities, whose capacity was built to conduct similar training in the future. This new program is designed based on the priorities of the GOE outlined in HSDP IV and the HRH Strategic Plan, both of which were developed with close collaboration with USG and other development partners. It also builds upon the network of higher institutions initiated through the AHOTP.

Implementing a woman- and girl-centered approach: In addition to focusing on the reduction of maternal mortality and morbidity, in part by training midwives to increase the number of deliveries performed by skilled professionals, this program will work together with the MOE and MOH to support enrollment and training of female health science students. This focus will also positively impact reproductive health outcomes as these trained female health workers should have greater capacity to understand women’s issues and empowered to assist women and girls in making improved health choices for their families.

Increasing impact through strategic coordination and integration: Multiple stakeholders are involved in improving HRH conditions in Ethiopia. This new HRH program promotes coordination, integration and harmonization with other capacity development and health service quality improvement programs supported by the USG and other donors, utilizing to the extent possible existing GOE coordination structures.

Strengthening and leveraging key multilateral organizations, global health partnerships and private sector engagement: Harmonizing the efforts of USG partners and other multilateral agencies will enable the GOE to more efficiently implement HSDP. The HRH program includes activities that benefit private academic institutes, as students graduating from these schools make important contributions to Ethiopia’s health sector workforce.

Improving metrics, monitoring and evaluation (M&E) and promote research and innovation: The HRH program will support clear metrics in a M&E framework and a plan to develop and identify best practices through operations research projects. Close affiliation with academic and training institutions should enable efficient sharing of information and knowledge.


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2.4. USAID-Supported HRH Related Activities Many ongoing USAID/E investments align with the GOE’s draft HRH Strategic Plan. USAID/E supports the Ethiopian government sector in addressing Ethiopia’s health sector human resource crisis by:

Supporting the development, deployment and retention of an appropriately skilled workforce through pre-service and in-service training including of health extension workers (HEWs), health officers, and other public health professionals.

Building the capacity of public and private health science and social work educational institutions by supporting curriculum development, faculty development, provision of essential materials, and renovation and furnishing of educational institutions and field sites.

Improving the environment in which the health workforce operates in order to motivate them and optimize their performance, e.g., through health finance reform that allows facilities to retain revenue and make improvements.

Strengthening national and regional leaders and planners to provide evidence-based leadership and management in health workforce planning and policy-making.

Some specific projects and initiatives that USAID/E has been supporting are described below:

Ethiopian Public Health Training Initiative (EPHTI II); implementing partner: Carter Center (2005 – 2010). To support GOE’s HSDP III, the five-year EPHTI II trained more than 5,000 health officers; produced over 200 health learning materials including lecture notes and modules on topics including nutrition, biostatistics, environmental health, epidemiology, health services management, health economics, research methodology, health education, and clinical subjects such as gynecology/obstetrics, internal medicine, surgery and pediatrics. EPHT II provided institutional capacity building through provision of pedagogic, reproductive health and HIV/AIDS core competency training to instructors and equipped universities and health facilities in order to facilitate the teaching and learning process. In addition, the project succeeded in bringing the MOH and MOE together in a single forum to address the provision of skilled human resources at primary health care level.

An external evaluation supported by USAID/E in May-June 2008 identified the need to focus on quality and competency. The evaluation also identified the following gaps in relation to the EPHTI II:

There is an acute shortage of health professionals, especially physicians, at training sites. Training sites lack adequate supplies and equipment.

Students do not receive adequate clinical skills training at clinical sites due to shortages of patients with clinical findings appropriate for medical education.

The quality of service delivery at hospitals visited by the team was extremely variable, affecting the clinical experience of the students. This is reflective of (a) a larger problem in Ethiopia and (b) the overcrowding of students at some clinical training sites. Several key informants also mentioned the additional burdens that the training of Health Officer students placed on non-medical hospital staff.


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The number of students is disproportionately high relative to the number of qualified instructors and clinical preceptors to provide supervision and clinical teaching.

ACCESS to Maternal and Newborn Health Services Project;; implementing partner: JHPIEGO (2007 – 2010). The ACCESS project, implemented the following activities pertaining health workforce development:

In collaboration with the Carter Center, strengthened pre-service education of health officers, in particular in the acquisition of clinical skills for essential maternal and newborn care.

Built the capacity of the Ethiopian Nurse Midwife Association to establish a health center-based apprenticeship to provide in-service training to health extension workers in selected districts of Oromiya Regional State in the areas of: safe and clean delivery; essential newborn care; postpartum care within 72 hours for all mothers and newborns; prompt recognition, management and referral of maternal and newborn complications; HIV prevention, care and support including HIV counseling and testing for pregnant women; and provision of prevention of mother-to-child transmission of HIV (PMTCT) services during pregnancy and childbirth.

With UNICEF support, trained HEWs on clean and safe delivery.

Ethiopian Urban Health Extension Program (UHEP); implementing partner: John Snow Inc. (JSI) (ongoing). This project is designed to:

Improve access and decrease barriers to health services for populations most at risk of acquiring HIV/AIDS (MARPs) through engagement of household and communities; Increase demand for health services through active engagement of MARPs, household and communities using behavior change communication (BCC) for health prevention, promotion and risk reduction.

Improve quality of UHEP service delivery though training and professional development of UHEWs, including HIV services for MARPs.

Support an enabling environment to implement a sustainable UHEP, including support for community information systems to support a multi-sectored HIV/AIDS and health program.

To date, the project has trained and deployed over 1,500 UHEP professionals and their supervisors.

Leadership, Management and Sustainability Project (LMS); implementing partner: Management Sciences for Health (MSH) (2005 – 2010). This project was designed to provide management and leadership capacity building support and technical assistance at the Regional and Zonal levels for HIV/AIDS Prevention and Control Offices (HAPCOs) and Health Departments (HDs) so that they can better plan, manage, and coordinate HIV/AIDS activities. Project accomplishments included supporting Haramaya University to integrate leadership development in pre-service training for health science students and supporting all zonal and regional offices in Amhara and Oromiya to assess their organizational, financial and human resource management systems.


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USAID/E has, since 2007, also provided direct support to MOH’s RHBs in the Amhara and Southern Nations, Nationalities and Peoples (SNNP) regional states for midwifery schools. This support, which includes financial support for trainees and teachers, was extended to regional midwifery colleges, allowing regional states to deploy appropriately trained midwives to meet their needs based on their health center expansion plans.

Other USAID/E programs build the capacity of the current health sector workforce through in-service training. These include Pathfinder International’s Integrated Family Health Program (IFHP), and JSI’s USAID/DELIVER project. Their focus is improving the quality of health service delivery through improving skills at health facilities.

2.5. Other USG Support for HRH

Other USG agencies supporting the health sector in Ethiopia, largely under PEPFAR, include the U.S. Centers for Disease Control (CDC), the Peace Corps, the Department of Defense, and the State Department Office of Population, Refugees, and Migration.

For example, with CDC/PEPFAR support, Tulane University is actively engaged in health workforce development through training and continuing medical education (CME). Tulane University’s areas of focus include developing the HRH strategic plan, pre-service training in M&E at the graduate level, training of health workers on data management for health management information systems (HMIS), training on emergency medicine, in-service training on HIV/AIDS care and treatment, and strengthening pre-service education and training in selected public universities teaching medicine. Johns Hopkins University has initiated telemedicine and video conferencing for e-learning and CME for health professionals, in part to solve the problem of shortages of staff at health facilities, the shortage of health instructors, and to enhance learning among regions and hospitals. Other CDC partners include Columbia University’s International Center for AIDS Care and Treatment Programs (ICAP), University of Washington’s ITECH, and the University of California San Diego (UCSD) all of which are actively involved in providing in-service training and mentoring in hospitals and seven universities (including those operated by the military) in four regional states. CDC also has supported the development of a curriculum and legal and institutional frameworks for the new National Medical Education Initiative; an assessment of five sites proposed by the MOH for establishing medical schools; and strengthening the capacity of Regional Health Bureaus/HAPCO by twinning them with health departments in the U.S.

2.6. Other Development Partner Support for HRH

There are several other donors and agencies supporting HRH development in Ethiopia. The successful applicant of the program described here is expected to partner with all relevant stakeholders such as the MOE, MOH, academic institutions, private colleges, both public and private health facilities, professional associations (including the Ethiopian Nurses Association, Ethiopian Nurse Midwife Association, Ethiopian Public Health Association, and Ethiopian Medical Association), other USG implementing partners and other donor agencies.


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The United Nations agencies, i.e. UNICEF, WHO and UNFPA, together with the MOH, assessed maternal health needs throughout Ethiopia. These agencies have also supported training of different health cadres such as health extension workers, midwives and health officers in safe delivery and emergency surgery in selected institutions and regions. Support included equipping health posts, revising training curricula and developing a national task shifting scheme. Irish Aid and the World Bank were involved in drafting the national HRH Strategic Plan.

2.7. USAID’s Other Health Programs

The USAID/E HAPN Office HPN Team has a number of projects which provide potential for synergy to efficiently utilize limited resources and to maximize results. Additionally, many of USAID/E HAPN activities are integrated and cut across the HPN, PEPFAR, and PMI teams.

Integrated Family Health Program (IFHP); implementing partner: Pathfinder International (ongoing). This project primarily addresses maternal and child health as well as works on malaria and PMTCT integration with maternal and child health interventions. It strengthens the health extension program in 286 districts in Oromiya, Amhara, SNNP, Tigray and Somali regional states.

USAID/DELIVER II; implementing partner: JSI (ongoing). This project supports the MOH and RHBs in strengthening the contraceptive and other essential drugs logistics system, and, generally, the implementation of the national Logistics Master Plan. DELIVER brings technical assistance to the MOH and USAID/E implementing partners for commodities security.

Health Care Financing Reform; implementing partner: Abt Associates Inc. (ongoing). This project supports the implementation of the GOE’s Health Care Finance Strategy to: authorize health facilities to retain revenue generated in their facilities; decentralize the management of health facilities to a health management board; expand private wings in public hospitals; improve the waiver system and exemptions; and promote health insurance schemes.

Tenawo Beijo Newu Water, Sanitation and Hygiene Program in Ethiopia; implementing partner: Save the Children U.S. (ongoing). This project provides safe water supplies and basic sanitation for rural populations. USAID/E supports the capping of springs; construction of hand-dug wells, masonry reservoirs, and pit latrines; roof rain water harvesting schemes and community education in hygiene and sanitation as well as the operation and maintenance of water systems in focus woredas.

USAID/Washington provides funding for the National Polio Eradication Initiative through World Vision/Core Group and WHO.

USAID/Ethiopia provides direct support to the Addis Ababa Fistula Hospital to prevent and treat fistula cases in Ethiopia.


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PEPFAR. USAID/E’s support under PEPFAR focuses on the following areas: prevention of mother-to-child transmission of HIV; counseling and testing; provision of condoms and other forms of prevention; basic palliative care; care and support for orphans and vulnerable children; treatment through the support of services and the provision of antiretroviral drugs; partnerships with government entities; and procurement of commodities. In addition, PEPFAR provides significant support for HSS, including training and other capacity-building activities; supply chain logistics, infrastructure development including construction and renovation of health facilities; support for Ethiopia’s health management information system; health care finance reform; and supporting an expanded role for the private healthcare sector. Together with its USG PEPFAR partners, USAID/E provides significant support for HRH including providing HIV/AIDS-related pre-service training to doctors, nurses, midwives, health officers, pharmacists and other health professionals and supporting extensive in-service education for health professionals including medical doctors, health officers, nurses, lab and pharmacy technicians, case managers and kebele-oriented outreach workers.

PMI. As in the other 17 PMI focus countries, PMI support in Ethiopia focuses on malaria prevention and control (e.g. by procuring and distributing insecticide-treated bednets), case management (e.g. by procuring and distributing laboratory supplies, malaria rapid diagnostic tests, anti-malarial drugs), surveillance and M&E, and operational research [http://pmi.gov/countries/mops/fy11/ethiopia_mop-fy11.pdf]. PMI currently has 11 implementing partners in Ethiopia, through which the support in above-mentioned areas is provided. Whilst originally PMI support primarily focused on Oromiya Regional State, since 2011, support has increasingly been provided to national level, supporting the MOH national malaria prevention and control efforts. Several of PMI’s implementing partners have supported in-service training in, for example, malaria diagnosis, malaria case management, or malaria prevention and control.

3 PROBLEM ANALYSIS

The following table is strengths, weaknesses, opportunities, and threats (SWOT) analysis regarding HRH in Ethiopia:

Strengths The GOE has trained and deployed more than 32,000 HEWs in rural areas and 3,000 in urban areas;

There is an expansion of health centers as the primary health care unit throughout Ethiopia;

The GOE is committed to ensuring the availability of health workers There is a draft GOE HRH Strategic Plan, developed with the support of

major donors.

Weaknesses Limited capacity of MOH to plan and monitor HRH production and deployment;

There is no clear link between the MOH and the MOE to address HRH cross-cutting issues such as training and certification of health science professionals


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and accreditation of training institutions; There is no clear mechanism for licensing and providing continuing education

for health workers; There are no incentive mechanisms to reduce the high attrition of health

workers; The current government “flooding” strategy has compromised the quality of

health science education and thus the quality of graduates.

Opportunities GHI focuses on HSS and HRH; The anticipated finalization and implementation of the HRH Strategic Plan; The GOE prioritizes the availability of health workers throughout the country; HSDP IV incorporates HRH as health priority.

Threats High turnover of health workers in the country; The growing population increasing the demand for health services; Increased intake of health science students in health science education

institutions and imbalanced investments in teachers/trainers and training facilities.

4 GOAL, OBJECTIVES AND RESULTS

4.1. Goal

The goal of this program is to improve health outcomes for all Ethiopians by reducing infectious disease and MNCH morbidity and mortality through ensuring the availability and quality of health professionals at all levels of health service delivery.

4. 2 Objectives

The objectives of the program are to: Support the implementation of the GOE HRH Strategic Plan under HSDP IV; Improve the quality of public health teaching institutions; and Improve the availability of key HRH categories through scaling-up the training of

midwives, anesthetists and health extension workers

Impact-level indicators to measure performance against these objectives, but for which it may be difficult to attribute USAID’s contributions, include:

Health workforce density (by categories of health workers) Health worker to population ratio (by categories of health workers) Rate of increase of health service utilization Proportion of primary health care unit (PHCU) staffed as per standard in all geographic

areas

4.3. Results


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Towards addressing key HRH bottlenecks to achieving MNCH goals, this HRH program will focus on pre-service training and on three health worker cadres identified by the GOE in the HSDP IV – midwives, anesthetists and HEWs. HRH issues extend well beyond pre-service education of health workers. The regulatory environment (including licensure and certification of providers and accreditation of teaching institutions and training sites) and health worker recruitment, deployment, management, motivation and retention are critical issues to the success of the HRH Strategic Plan. For this reason, this HRH program places greater emphasis on cross-cutting elements and strengthening of HRH systems than did prior USAID/E efforts, and thus, is not designed simply to replace existing USAID/E programs (for instance, the Accelerated Health Officer Training Plan [AHOTP]), but to build on their successes and achievements. In order to improve the utilization of quality health services in a sustainable manner, it is essential that the availability of HRH at all levels of the health system is ensured. The HSS components of the program will address issues including recruitment, licensure, deployment, and retention across cadres – that is, not singling out a single health workforce cadre for attention, but rather looking at the HRH system as a whole. Similarly, clinical training sites are used for the training of multiple health workforce cadres, and, therefore, clinical site strengthening will not be cadre-specific. However, work on specific curricula, course syllabi and lesson plans will address specific cadres such as midwives and anesthetists, building on existing partnerships and working very closely with MOH and MOE and with local training institutes. The program will also support capacity building for the training of other cadres that are essential for improving maternal and neonatal services including health extension workers. To this end the program has four results (relative levels of effort (LOE) anticipated for accomplishing each result are also indicated):

Result 1: Improved HRH management (approx. 20% LOE);Result 2: Increased supply and availability of midwives, anesthetists, HEWs and

non-clinical health workers (approx. 35% LOE); Result 3: Improved quality of training of health workers (approx. 35% LOE);Result 4: Program learning and research conducted (approx. 10% LOE).

The anticipated outcome of the achievement of these results is the availability of adequate numbers of skilled and motivated health sector professionals that are committed to working and staying in a well-managed health sector.

Result 1: Improved HRH Management

This result entails establishing the necessary governance structures, policies and mechanisms required for effective management of Ethiopia’s HRH systems. These may include leadership and governance development; evidence-based human resource planning, development and management including recruitment, deployment and retention; and health education and health workforce regulation.

The successful applicant is expected to propose and implement innovative strategies and approaches in the context of the contribution of human resources to achieving HSDP IV targets. A well-managed HRH system requires ensuring demand-driven production of human resources;


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improving human resource information systems for evidence-based planning and management of the health workforce; maximizing use of the available resources in producing key categories of health workers of which there is scarce supply; improving inter-sectoral collaboration and enhancing private sector involvement in human resource development; improving the quality of training of health professionals; improving the geographic distribution of HRH; strengthening regulatory systems; and promoting cost effective retention and motivation schemes.

Illustrative strategies (activities) include (but are not limited to):

IR 1.1 Improved Human Resource Management (HRM) CapacityEffective HRM entails key staff and offices having the capacity to: assess the current HRH situation, utilizing data generated from the HRIS and other sources; develop relevant policies based on the prevailing situation and desired outcomes; and plan, manage, monitor and evaluate the HRH Strategic Plan. A well-managed HRH system is one in which there are adequate health professionals with the appropriate skills who are available both where and when they are required. This will be achieved when managers have the ability to conduct functional and planned HRH recruitment, training, deployment, transfer and career development to ensure equitable distribution of the health workforce in the country. Planning and equitable distribution of HRH requires well-structured collaboration between the federal MOH, MOE and RHBs. To improve HRM, the program is expected to strengthen human resource directorates in the MOH, RHBs and woreda health offices and provide training in HRM to selected staff so they can become effective HR managers.

Through distance-based education, the management skills, leadership and health administration capacity of health sector management staff can be improved. Well organized post-graduate distance education can play the dual role of professional development and creating incentive mechanisms to reduce attrition. Distance learning can also help address serious shortages in qualified health teaching staff. In collaboration with the FMOH and upon the request of the same, this program will design and facilitate post-graduate distance-based education in several areas including HRH management, and health administration.

IR 1.2 Improved HRH Motivation and Retention Schemes There are a number of motivation and retention schemes that are outlined in HRH Strategic Plan, and much can be learned through testing and implementing these and other financial and non-financial incentives to determine which ones work. The successful applicant is expected to design and implement long and short term retention schemes that are relevant to the Ethiopian health delivery system, including strategies specifically focused on retention of health workers in rural areas and in the area of their expertise. Possible incentive and retention mechanisms include: developing clear and equitable career structures; providing access to continuing education and professional development opportunities; establishing programs that offer psychosocial support to health workers; ensuring transparent, efficient and equitable recruitment, deployment, and transfer policies and practices, especially for female workers; improving the working climate including better-equipped facilities and safe working environments for health workers; providing health workers with supportive supervision and management; ensuring manageable workloads for health workers; and providing incentives, such as increasing paid leave, and providing housing allowances, and opportunities for spousal employment and


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children’s education. To further ensure improved retention in rural areas, strategies such as selecting students with rural backgrounds, tailoring health education to practice in rural areas, deploying new health workers to under-served areas, periodically rotating health workers between rural and urban areas, and ensuring policies promote rural retention should be explored.

Understanding and expressing concern for employees and treating them in a manner that fulfills their basic human needs and wants, including gender-specific considerations, will ultimately result in better performance. An important practice would be to commit to workplace-level implementation of international and national policy protocols that ensure a safe, equitable, and supportive work environment for women and men alike.

IR 1.3 Improved HRH Policies and Practices Regulation of the HRH system entails developing and implementing/enforcing requirements and procedures for the production, recruitment, deployment, and management of health workers to ensure the quality of health service delivery. Key mechanisms for the regulation of HRH include licensing/registration, certification and accreditation of teaching facilities and providers. In addition to ensuring quality, these mechanisms have the added advantage of setting parameters and goals for service improvement (when clear standards are set and used for regulation) and can also be used to recognize individual and organizational quality improvement efforts and achievements, thus serving as a motivational tool. Accreditation, in particular, is an important tool for ensuring that health training institutions and teaching staff deliver quality health education.

The successful applicant is expected to formulate cost effective and sustainable mechanisms to ensure improved regulation of health teaching facilities and providers in Ethiopia. Regulation of HRH may be enforced (or compliance encouraged using incentives) by governmental or nongovernmental organizations such as professional associations. Multiple institutions, including those in the private and public sectors, train health science students in Ethiopia. The program will work closely with the MOE, MOH, RHBs, the private sector and professional associations, which together share the responsibility for ensuring deployment of quality health professionals to strengthen the national health system. Regulation also requires the existence of functional and standard health science training protocols and monitoring procedures for both public and private sectors and pre-established performance or quality standards. Establishing and engaging networks of public health training institutions, public health associations and promoting peer review amongst these players can play a critical role in improving the quality of training institutions. Engaging professional associations can be of particular help in ensuring quality among private sector providers. Experience sharing with other countries and promoting networking of Ethiopian public health training institutions with institutions in other counties has proven added value.

As licensing/registration, certification and accreditation are key tools for quality assurance of teaching institutions and faculty, this strategy also applies to Result Three below.

IR 1.4 Enhanced HRH Fora at Different LevelsThe Ethiopian health system suffers from lack of well-organized networking with other key HRH partners. No single organization, sector, or program can satisfactorily address all of the


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HRH challenges on its own. It is therefore imperative to establish viable and effective partnerships among stakeholder groups. This includes planned linkages among programs within the health sector; between the health sector and the education and other sectors; with private health training institutions and health service providers; and with nongovernmental and civil society organizations, professional associations, public health associations and public health teaching institutions. The program will build on and expand the existing forum created with USAID/E support through the EPHTI II, bringing other stakeholders on board and building upon the lessons learnt from the AHOTP and using this for HRH planning on the basis of the national HRH strategy.

IR 1.5 Improved Management of Staff TrainingsStaff training is usually offered on an ad hoc basis, and is not based on a formal process of assessing staff needs nor is it linked to the organization’s key priorities and changes in the health sector and health practices. The successful applicant should strengthen the staff training needs assessment system. The applicant is also expected to enhance the management and leadership development of staffs and strengthen the link to external pre-service training.

Illustrative indicators include (but are not limited to):

a) Human Resource Management (HRM) Capacity Proportion of HRH departments at various levels that have at least one professional

trained on HRM; Existence of rational and objective process for allocating the number and types of

positions in management; Existence of updated responsive national human resource/health workforce strategic plan; Existence of institutional models for projecting, monitoring and evaluating staffing

requirements; Existence of distance learning processes for developing managers and leaders

b) HRH Motivation and Retention Schemes Staff attrition rates Annual total outflow of health workers Existence of national or sub-national plans to increase recruitment, retention and

participation where applicable, including provisions such as incentives, flexible scheduling/staffing; healthy workplaces, etc.

Operational professional development program in place Existence of career job descriptions and career ladder structures Numbers and ratios of public/private health workers working in urban and rural areas Availability of qualitative data, including: satisfaction survey data; expressed reasons for

leaving or staying Existence of national health occupational health and safety plans or programs Percentage of facilities with workplace safety initiatives

c) HRH Policies and Practices

Existence of staff education and training quality standards Existence of national professional standards


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Existence of health professional councils/boards Existence of processes for credentialing or certifying practitioners with achieved

competencies Existence of an effective national human resource/health workforce policies; Implementation of personnel policies and guidelines; policies and guidelines are

interpreted consistently and accurately;

d) Enhanced HRH Fora at Different Levels Existence of a national coordination body to plan/manage health workforce; Existence of functional networking of public health training institutions Existence of active public-private sector partnership forum addressing HRH issues Existence of evidence of collaboration between health and non-health sectors Existence of national education plans for health professionals responsive to health

workforce needs;

e) Improved Management of Staff Trainings Staff training needs assessment conducted and documented Number of staffs involved in management and leadership development programs Existence of links to external pre-service training

Result 2: Increased Supply and Availability of Skilled Midwives, Anesthetists, HEWs and Non-Clinical Health Workers

The priority focus of the five-year HSDP IV is reducing maternal mortality, which is currently at an unacceptably high level by any standard. The strategy the MOH formulated to achieve a reduction in maternal mortality is to increase the training and deployment of midwives. Building on the experiences of the AHOTP, this program will address key HRH bottlenecks to achieving MNCH goals. In addition to supporting the development and strengthening of broader HRH systems (Result One) of the GOE HRH Strategic Plan, the successful applicant is expected to focus on the training and supply of midwives, anesthetists and HEWs.

Illustrative strategies (activities) include (but are not limited to):

IR 2.1 Increased Availability of Midwives and AnesthetistsThe successful applicant will gather best practices and employ innovative strategies to increase the supply and availability of midwives, and anesthetists and to ensure the sustainable replacement and retention of HEWs. This could include: targeted recruitment of candidates into pre-service programs; instituting continuing education; curriculum assessment, development and/or revision; lesson plan development; material, financial and other resource support; faculty development including development of standardized teacher training programs; and renovation and/or furnishing of educational institutions and clinical practicum sites. Collaboration with the private sector, which trains a significant number of health workers, also will be critical. Through this HRH program, the successful applicant will support the training and deployment of midwives and anesthetists that are adequate enough to address the currently established needs.

IR 2.2 Skills of HEWs Enhanced Through Blended Career Development Schemes


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The GOE has successfully trained and deployed more than 32,000 HEWs at Health Posts throughout the country. These HEWs have made significant contributions to the improvement of access to basic health service. However, there are emergent needs to enhance the skills of HEWs (to Level 4) in order to improve the health services they deliver and respond to their career development needs. The GOE, together with its partners, is currently implementing blended career development programs for HEWs.

The successful applicant will support and work with MOH and other relevant stakeholders to enhance the skills of HEWs through the blended career development approach and using innovative and effective strategies. The successful applicant will also document lessons learned and best practices in the implementation of this blended career development approach.

IR 2.3 Trained HEWs Available for Replacement Schemes at Health Posts There is evidence that the attrition rate of HEWs, currently estimated by the GOE to be 5%, is increasing in some regional states while replacement schemes for HEWs are inadequate. Through this intermediate result, the successful applicant will support the FMOH and RHBs to strengthen the GOE health extension program (HEP) through enhanced HEW replacement training schemes. Throughout the life of this program, the successful applicant will support the training of HEWs in order to fill existing gaps in the staffing of Health Posts.

IR 2.4 Pre-Service Training of Essential Non-Clinical Health Workers Promoted While most HRH activities are generating encouraging results in relation to improved health service delivery and health sector performance overall, there is a need for building a sustainable, systematic way of ensuring adequate numbers of non-clinical professionals to complement the corresponding increase of health service access and utilization. For instance, access to medicines and other health supplies is critical to achieving positive health outcomes and requires a functioning commodity supply chain and logistics system. This system in turn requires a skilled health supply chain workforce. USAID is considering support for pre-service education in health (including HRH) management, supply chain (and pharmaceuticals) management and health care financing including, where appropriate, incorporating relevant content in these areas into the training curricula for existing health worker cadres, developing centers of excellence and competencies in these disciplines in selected teaching institutes and universities and supporting initiation of graduate and/or post graduate programs in these areas. [A separate initiative is working to establish a social worker education program at the university level].

The successful applicant will closely work with the MOH, MOE, Pharmaceutical and Supply Fund Agency (PFSA) and other relevant stakeholders in the design and implementation of pre-service education programs for non-clinical health workers. The main responsibilities of the successful applicant will include, but not be limited to, working with the GOE to develop policies and strategies for the education of these non-clinical cadres, fostering the development of curricula, building the capacity of higher learning institutions and providing ongoing technical support during the implementation of training.

Illustrative indicators include (but are not limited to): Number of midwives trained and deployed Number of anesthetists trained and deployed


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Number of HEWs trained through the blended career development approach Number of HEWs trained and deployed through replacement schemes. Number of non-clinical health workers trained Midwives to population ratio Number of health posts staffed with two HEWs Health extension worker to population ratio Numbers and ratios of midwives working in urban and rural areas

Result 3: Improved Quality of Training of Health Workers

Key to the successful implementation of the HRH Strategic Plan is ensuring there are sufficient numbers of motivated workers who have adequate knowledge and technical skills. A crucial element of ensuring technical competence of health service providers is focusing on the quality of health training. Quality clinical training requires adequate instructors, facilities, equipment, supplies, communications infrastructure, and teaching materials. The successful applicant is expected to propose and implement innovative strategies to improve the quality of health education for all cadres, but with a focus on midwifery training. Some key approaches to improving the quality of health training include: improving the management of health training institutions; designing curricula that are appropriate for the service delivery demands and working environments of different cadres; improving clinical training sites to focus on skills-based training; promoting, standardizing and integrating continuing education and in-service training in the health system; improving the availability and quality of instructors; improving efficiency by introducing innovations such as distance-based learning using information technology; improving quality through standard setting and regulation including ensuring adherence to standards; and collaboration and networking, including with the private sector.

IR 3.1 Improved Quality of Pre-service Training of Health WorkersUsing standard quality improvement processes and working closely with the MOH, MOE, FMHACA, Higher Education Relevance and Quality Assurance Agency and other relevant partners, the successful applicant is expected to improve the quality of pre-service training of health workers, within the context of increasing the numbers of health workers, by incorporating quality improvement efforts in training curricula, training teaching staff, training institutions and clinical training sites. Illustrative strategies (activities) include (but are not limited to):

Sub-intermediate result 3.1.1 Curriculum Assessment and DevelopmentIn resource poor settings, a critical element to producing more health workers equipped with the skills and knowledge to provide quality services is increasing the efficiency of training by focusing on the elements that are essential for health workers to do their jobs and ensuring the application of these skills. Existing curricula need to be assessed for their relevance to the specific job responsibilities and work environment of employees, their efficiency in focusing on only the necessary content and their focus on job performance, i.e., their use of experiential, competency-based training. The HRH program should explore competency-based learning approaches incorporating new learning methodologies such as case-based learning, employment of expert and standardized patients, computer-assisted learning and other emerging methodologies to produce graduates with applicable skills who can function in a minimally


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supported manner upon graduation. A key component to ensuring competency-based learning is improving the quality of clinical training sites (see below).

Sub-intermediate result 3.1.2 Improved Clinical Training SitesClinical training sites are critical to ensuring midwives and other health workers are equipped with appropriate technical competencies, yet in Ethiopia, clinical training sites are weak. A key component of competency-based training is clinical rotations so that health workers can practice and hone their clinical skills with real patients. An effective clinical training site is one which provides exemplary services to clients and applies current service delivery guidelines. It is also one which is organized to maximize opportunities for trainee health workers to practice and develop their clinical skills. Improving clinical sites may include: training relevant staff; ensuring there is adequate space to provide services; assisting the clinic’s management to incorporate students into the patient flow; reviewing and revising the number, distribution and mix of students in health facilities; providing equipment, supplies, training models and educational resources; and introducing/improving service delivery in key areas, including clinical skills, counseling, client care, infection prevention, privacy/clients’ rights and pharmaceutical management. An additional critical element to the success of a clinical training site is ensuring a sufficient and suitable client load for health workers to practice their clinical skills.

Sub-intermediate result 3.1.3 Improved Training Facilities in Training InstitutionsIn order for faculty to perform effectively and be motivated in their jobs, learning facilities must be adequately prepared and equipped. In addition to ensuring clinical training sites are prepared for teaching, sites for classroom training should have adequate space, furniture and equipment for faculty to exercise different teaching techniques (including group work, simulation of clinical skills, etc.), sufficient supplies and equipment in working order. The successful applicant is thus expected to support the establishment/strengthening of learning facilities (demonstration rooms, practical labs, etc.) in order to improve the quality of health training in higher learning institutions.

Sub-intermediate result 3.1.4 Teaching Staff Development and RetentionKey to ensuring that health workers are equipped with the skills and knowledge to provide quality services is making sure that there are adequate, qualified, skilled and motivated faculty, tutors, instructors, trainers, clinical preceptors and other facilitators to train them. These key staff may need: training in technical content; improved teaching skills (for example, in competency-based training techniques, experiential learning techniques, effective communication and presentation skills, coaching, skills assessment, supportive feedback, effective use of learning materials, etc.). The successful applicant should thus implement effective and efficient teaching staff development and retention strategies.

IR 3.2 Improved Quality of In-Service Training of Health workersShort-term in-service training and continuing professional development (CPD) are crucial not only for professional development, quality improvement and maintenance/acquisition of new knowledge and skills, but are also important as motivational tools to improve performance and retention of health workers. Quality improvement actions in this mechanism will also focus on quality of in-service trainings and CPD for health workers.


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Sub-intermediate result 3.2.1 Improved Quality of Short-Term In-Service TrainingMost short-term in-service training in the country is being conducted in an inadequately coordinated manner. Quality assurance of in-service training is not often conducted. The successful applicant is expected to work towards improved coordination of short-term, in-service training for health workers and ensuring that it meets set standards and follows national guidelines and curricula. Quality improvement activities are expected to address all in-service trainings but with special focus on those in the areas of MNCH, FP/RH, HIV/AIDS, malaria and tuberculosis.

Sub-intermediate result 3.2.2 Improved Quality of CPD Schemes CME, which may or may not be linked to licensure and accreditation, is a strategy for continuing professional development. CPD may be provided by private institutions, government entities, national medical councils and/or professional associations. The existence of a legal framework for CPD is important as it may provide a basis for enforcement of CPD. The successful applicant is expected to strengthen CPD in Ethiopia. This may include: working with key government agencies to establish a legal framework for CPD; developing clear policies and mechanisms for CPD; and ensuring CPD is based on current health worker needs. For both in-service training and continuing professional development, exploring new information technologies such as internet and mobile phone-based training as well as distance learning can not only improve the cost effectiveness of training, but also address faculty and teaching staff shortages.

Illustrative indicators include (but are not limited to):

a) Improved Quality of Pre-service Training of Health Workers Academic standards, curricula and student outcome competencies appropriate to country

needs Number of academic institutions implementing competency-based learning approaches Workforce skill mix supportive of maximal functional utilization of health workers and

effectiveness, measured by proportions of different skill types, skills, grades Number of clinical training sites with improved quality training setups Number of staff working in clinical training sites trained Existence of institutional academic quality improvement and/ or accreditation programs Existence of staff education and training quality standards Existence of national professional standards Existence of health professional councils/boards Existence of processes for certifying practitioners with achieved competencies Existence of staff education and training quality standards The ratios of full-time academic staff to students by health worker category

b) Improved Quality of In-Service Training of Health workers Existence of national training/continuing education policy and plan Existence of provision for in-service/continuing education training Percentage of facility staff receiving in-service training/continuing education annually


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Evidence of a link between continuing education, performance review and career development

Number of training days or continuing education credits for each staff member annually

Result 4: Program Learning and Research Conducted

The intent of this result is to promote evidence-based decision making and strengthen local capacity for documentation and research. Program learning will address major HRH issues and might include surveys and pilot schemes with associated operations research. The major intermediate results under Result 4 include the following:

IR 4.1 Generating Research and Evaluation Evidence on Critical HRH IssuesUnder this sub-intermediate result, the successful applicant may suggest critical issues for study in addition to the following (optional):

Effective strategies, including non-monetary ones, that the GOE can employ to improve the retention and maximize performance of the trained health service providers within the HRH Strategic Plan. Implement a pilot that develops and evaluates innovative strategies to retain a particular cadre of health workers.

Explore the possibilities and the potential of engaging the private sector and civil society to assist the GOE with retention issues.

Evaluate how the GOE can increase production of new HWs, e.g. medical doctors, and recruit and retain instructors, while at the same time maintaining quality of education.

Explore the impact of the new problem-based learning approach on preparation for clinical service upon graduation.

IR 4.2 Building Local Capacity in HRH M&E and Research The successful applicant is expected to build institutional capacity to monitor and evaluate competency oriented training in a timely fashion for planning and management through effective capacity building mechanisms and participatory development of national HRH monitoring and evaluation framework. The program should outline a “ladder of competencies,” including both foundational and content-specific knowledge, attitudes and skills to ensure a solid, standardized base of knowledge attitudes and practices for all health professionals. This should be sensitive to the current regulatory environment surrounding student practice as well as other factors such as time delays between graduation and deployment, disease burden and expected frequency of skill use, etc.

In addition, Result Four is aimed at ensuring proper documentation, learning and ownership of the HRH program by universities, MOH and MOE and building the capacity of training institutions in documenting and disseminating promising practices.

Illustrative indicators include (but are not limited to): Number of success stories documented Number of surveys/researches conducted Number of policy decisions made upon evidence generated through surveys conducted Number of lesson learning/dissemination workshops conducted Number of staffs trained in HRH monitoring, evaluation and research


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Availability of evaluation data to determine outcomes and impact of health professional educational programs on improved service delivery

5 ENVIRONMENTAL COMPLIANCE

The new mechanism should address potential hazards to the environment in regards to the HRH programs and interventions. A proper environmental mitigation and monitoring plan to address environmental concerns should be submitted with the application and should include a plan for the proper disposal of materials and syringes (for clinical training sites). The mission’s environmental compliance conditions for the award are described below.

a) Conditions for Award:

The Foreign Assistance Act of 1961, as amended, Section 117 requires that the impact of USAID’s activities on the environment be considered and that USAID include environmental sustainability as a central consideration in designing and carrying out its development programs. This mandate is codified in Federal Regulations (22 CFR 216) and in USAID’s Automated Directives System (ADS) Parts 201.5.10g and 204 (http://www.usaid.gov/policy/ads/200/), which, in part, require that the potential environmental impacts of USAID-financed activities are identified prior to a final decision to proceed and that appropriate environmental safeguards are adopted for all activities. Applicant’s environmental compliance obligations under these regulations and procedures are specified in the following paragraphs of this RFA. Implementing agencies must adhere to USAID’s Environmental Compliance Procedures, Title 22, Code of Federal Regulations, Part 216 (22 CFR 2163). Specific procedures for every new and/or amended program or project are set forth in this guidance. In addition, the Contractor/Recipient must comply with host country environmental regulations unless otherwise directed in writing by USAID. In case of conflict between host country and USAID regulations, the latter shall govern.

No activity funded under this Cooperative Agreement will be implemented unless an environmental threshold determination, as defined by 22 CFR 216, has been reached for that activity, as documented in a Request for Categorical Exclusion (RCE), Initial Environmental Examination (IEE), or Environmental Assessment (EA) duly signed by the Bureau Environmental Officer (BEO). (Hereinafter, such documents are described as “approved Regulation 216 environmental documentation”).

Implementing agency shall prepare an EMMP or M&M Plan describing how the contractor will, in specific terms; implement all IEE and/or EA conditions that apply to proposed project activities within the scope of the award. The EMMP or M&M Plan shall include monitoring the implementation of the conditions and their effectiveness. b) Environmental Regulations and References

USAID's general launching point for information relating to environmental assessments and guidelines are available at:


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i. http://www.usaid.gov/our_work/environment/compliance/index.html ii. USAID's list of key contacts (Environmental Officers) in Bureaus and Missions at

http://www.usaid.gov/our_work/environment/compliance/officers.html#aeciii. USAID's Environmental Training Course Materials, including Title 22 of the Code of

Federal Regulations, Part 216 that governs the U.S. government’s environmental impact abroad. The site also contains various forms and templates relating to Initial Environmental Examinations. http://www.encapafrica.org/EPTM.htm

6 ADDRESSING GENDER ISSUES

Gender plays a critical role in determining the position of women and men in the health labor force. Gender biases influence how work is recognized, valued and supported with differential consequences at the professional level (career trajectories, pay, training and other technical resources, professional networks) and at the personal level (personal safety, stress, autonomy, self-esteem, family and other social relationships). Women tend to be over-represented in caring, informal, part-time, unskilled and unpaid work and as a result, women’s contributions to health systems are unsupported as they are under-valued or not recognized at all. There are well-documented gender differences in terms of employment security, promotion, remuneration, etc. With increased migration of health workers, not only are more female health workers migrating than before, but as skilled labor is drawn to more formal, better financed and functioning health systems, lower level health workers, who are more likely to be women, whether paid or not, are expected to shoulder the burden of sustaining crumbling health systems in source countries. In addition, women health workers experience significant and disproportionately high levels of violence in the health sector

To improve gender equity among health professionals, the project will focus on addressing the gender issues that constrain women’s potential and that drive inequities in the health workforce. This potentially includes mentoring, professional assessment and guidance programs to quantitatively increase the number of women at key levels and in certain positions; addressing gender biases through training; and making structural changes, including improving access to family leave or child care provisions in a gender equitable manner; resolving gender differences in access to strategic resources like mentoring and supervision, administrative and infrastructural support, secure funding sources and employment contracts, formal and informal networking; addressing gendered vulnerabilities to sexual harassment and other forms of violence experienced by health workers; and addressing gender biases in measuring, rewarding and supporting work. In addition, more research is required to understand, from a gender perspective, the specific opportunities and vulnerabilities faced by migrating health workers as well as those left to shoulder the burden of high workforce attrition.

7 MONITORING AND EVALUATION

HRH program will formulate a rigorous Monitoring and Evaluation (M&E) system that will identify staffing requirements, technical support and a routine data collection system. Applicants are encouraged to propose additional program indicators in addition to the ones provided in the document that will measure program success and impact more effectively. A framework for a

http://www.encapafrica.org/EPTM.htm

http://www.usaid.gov/our_work/environment/compliance/officers.html#aec

http://www.usaid.gov/our_work/environment/compliance/index.html


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mid-term and final evaluation should be proposed in the application. The successful applicant will submit a detailed implementation plan including the M&E plan within 60 days following the award. The program will work closely with USAID/E to refine indicators and performance targets for each technical area covered.

USAID/E and the HRH program staff will conduct annual performance reviews with the RHBs and with the MOH, to document achievements and advise on future plans.

7.1. Performance Monitoring

The Agreement Officer’s Technical Representative (AOTR) will be designated by USAID/E’s Agreement Officer shortly after the award is made. The AOTR will monitor and evaluate the recipient’s overall performance in accordance with the progress towards deliverables and expected performance against agreed upon indicators. Semi-annual performance reviews (SARS) will be conducted through the life of the program based on USAID/E’s SARS calendar. USAID may conduct external evaluations of the program two years after the award is made as well as towards the end of the award. USAID may also conduct management reviews of work progress during the life of the program.

7.2. M&E and Reporting

Plans to document, monitor and evaluate program performance must be included in all applications. Data quality audits (DQAs) will be conducted to ensure that quality data is collected. Quality data is critical to the success of this program. All applicants must develop systems to ensure the quality of data. Applicants should always be ready for revision in program indicators and reporting requirements. Initially, these requirements may include the following:

Initial Plan a) Performance Monitoring Plan (PMP): The proposed PMP for the entire period of

performance including the collection of baseline data must be submitted in the initial work plan

b) Situational assessment on prioritized geographic area will be conducted in the first month after the award and submitted to USAID for approval

c) First year work plan: The first year work plan shall be submitted by the recipient within 90 days of the award.

d) Exit strategy: The initial work plan should propose an exit strategy documenting steps to sustain the deliverables of the agreement by the host government.

e) Environmental mitigation and monitoring plan (EMMP): The new mechanism should address potential hazards to the environment pertaining to the implementation of the program.

The work plan, exit strategy, IEE, EMMP and PMP will be subject to the written approval of the AOTR and USAID/E Environmental Officer.

Annual Work Plans


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The program needs to submit the subsequent annual work plans in the time frame given by the USAID/E Office of Acquisition and Assistance. The EMMP needs to be submitted together with annual work plans for approval.

Progress ReportsQuarterly and annual narrative reports are expected to be delivered to USAID/Ethiopia within two-weeks after the end of the quarter and 45 days after the end of the Fiscal Year. Each report will cover activities completed during the preceding period indicating progress achieved towards benchmarks, tangible results as well as identify and address problems encountered during implementation. A template for the quarterly reports will be provided by the AOTR.

Financial ReportsQuarterly financial reports are expected to be submitted to USAID/E within four weeks after the end of the quarter. The report should include a summary of finance, a pipeline analysis of funds obligated, funds expended, expenses accrued and funds remaining by program area.

Demobilization Plan At least two quarters prior to the completion date, the recipient shall submit a demobilization plan for the AOTR’s approval. A property disposition plan, plan for the phase-out of in-country operation and delivery schedule for all required reports or deliverables along with a timetable for completing all required actions should be included in this plan. A final project report will be due 30 days after project completion.

Success StoriesAt least one one-page success stories on HRH program activities shall be submitted to USAID/E in the quarterly report. Please review USAID guidance on “success stories’ available at http://www.usaid.gov/stories/.

Performance IndicatorsThe standard and agreed upon indicators should be addressed in all progress reports.

EvaluationMid-term and final evaluations: USAID will do the evaluations. Mid Term evaluation will be conducted after 30 months of the award by USAID internal reviewers. Final evaluation will be done by external reviewers subjected to availability of funding or by internal USAID reviewers.

8 KEY PERSONNEL For the new mechanism the five key staff positions will include:

i. Chief of Partyii. Deputy Director/Senior Pre-service Education Advisor

iii. Senior HRH Management Advisoriv. Senior HRH Quality Improvement Advisorv. Senior M&E and Research Advisor


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USAID/Ethiopia will give preference to applications that have Ethiopian key personnel who meet or exceed the minimum qualifications described below.

i) Chief of Party:

S/he shall have at least fifteen years of progressively responsible experience in each of the following areas:

1. Designing and implementing HRH programs2. Providing HRH technical leadership 3. Managing similar health projects 4. Interacting with other donors, implementing partners and host country government

S/he shall have at least a Masters’ Degree in Public Health or an advanced degree in a related health field from an accredited college or university with proven experience in the management of HRH programs at national or international levels. The responsibilities shall include overall planning, coordination, and technical direction of all activities including the work of sub-recipients (if any). S/he is responsible for the oversight the management of all program staff. The Chief of Party is expected to have regular and transparent communication with the AOTR.

ii) Deputy Director/Pre-service Education Advisor:

S/he shall have at least twelve years of progressively responsible experience in each of the following areas:

1. Designing and implementing HRH programs in a similar setting to Ethiopia’s2. Providing technical leadership in the implementation of HRH programs in general and

specifically pre-service education programs for health cadres3. Managing similar health projects in the areas of HRM, pre-service and in-service training4. Interacting with other donors, implementing partners and host country government

S/he shall have at least a Masters’ Degree in Public Health or in a related health field from an accredited college or university with proven experience in the management of HRH pre-service programs. The individual’s responsibilities shall include planning, coordination, and technical direction of all program activities including the work of sub-recipients (if any). S/he is responsible for the oversight the management of all program activities.

iii) Senior HRH Management Advisor:

S/he will have at least ten years of experience in each of the following areas:

1. Implementing HRH management and related programs 2. Providing technical leadership/support to Federal and RHBs in HRM3. Interacting with implementing partners and host country governments in HRM


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S/he shall have at least a degree in Health Services Management from an accredited college or university. A master’s degree in an HRH-related field and experience working on health programs and human resource management are desired. The Senior HRH Management Advisor’s responsibilities shall include the overall strategic planning, coordination, and technical direction of HRH management activities for the project. S/he will work closely with the MOH’s HR Directorate. S/he shall be expected to work with the Senior M & E and Research Advisor to ensure progress is being made towards ensuring quality HRH management services.

iv) Senior HRH Quality Improvement Advisor:

S/he will have at least ten years of progressively responsible experience in each of the following areas:

1. Designing and implementing HRH quality improvement programs 2. Providing technical leadership to training institutions, regional, zonal and district health

offices on HRH quality improvement activities 3. Guiding and providing technical assistance to project/host country governments staff

working on HRH 4. Interacting with other donors, implementing partners and host country government in

HRH quality improvement issues

S/he shall have at least a Health Management or Quality Improvement degree from an accredited college or university. Having a Masters of Public Health in Health Services Management is desirable. The Senior HRH Quality Improvement Advisor’s responsibilities shall include the overall strategic planning, coordination, and technical direction of HRH quality improvement activities for the project. S/he shall be expected to work with the M & E Advisor to ensure progress is being achieved towards HRH quality improvement targets.

v) Senior M&E and Research Advisor:

S/he will have at least ten years of progressively responsible experience in each of the following areas:

1. Designing and implementing monitoring and evaluation of HRH programs 2. Providing technical leadership in HRH program monitoring and evaluation3. Guiding and providing M&E/research technical assistance to project/host country

governments staff working on HRH4. Designing and managing HRH related research programs 5. Interacting with other donors, implementing partners and host country government

S/he shall have at least a Monitoring and Evaluation or related degree from an accredited college or university. A Master’s degree in Health Monitoring and Evaluation is desirable. The Senior M&E and Research Advisor’s responsibilities shall include the overall strategic planning, coordination, and technical direction of HRH monitoring, evaluation and research activities for the project. S/he shall be expected to work closely with all program staff and government counterparts to ensure progress is being achieved towards HRH targets.


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SECTION II - AWARD INFORMATION

A. Anticipated Award Schedule

It is anticipated that a five-year, cooperative agreement will be awarded. .

B. Funding Level, Support and Duration of the Award

Applicants should assume the ceiling for the Cooperative Agreement of $55 million over five years. The USAID/Ethiopia funding for the first year is $19 million. Subject to availability of funding and satisfactory annual performance of the recipient, this activity may be further funded to the ceiling of $55,000,000 for a total period of 5 years, spread in equal amounts.

USAID/E’s HAPN Office is organized under three teams: 1) the Health, Population and Nutrition (HPN) Team, 2) the HIV/AIDS (President’s Emergency Plan for AIDS Relief [PEPFAR]) Team, and 3) the Malaria (President’s Malaria Initiative [PMI]) Team. Although this program will be primarily managed by the HAPN Office’s Health, Population and Nutrition (HPN) Team, this cross-cutting program will receive funding from all three HAPN Office Teams, i.e. HPN, HIV/AIDS/PEPFAR, Malaria/PMI. It is envisaged that HPN, PEPFAR and PMI will contribute approximately 70%, 20% and 10%, of project funding respectively, over the course of the five years of this program. When preparing the application and addressing the program description outlined herein, the applicant should ensure that – to the extent possible – the program’s inputs, outputs, and outcomes can be linked to these funding levels.

C. USAID Management of the Activities

The Agreement Officer’s Technical Representative (AOTR) will serve as the primary contact between USAID and the Recipient. The AOTR will assist in linking HRH with other projects.

D. Authorized Geographic Code

The authorized geographic code for procurement of goods and services under the cooperative agreement is 935.

E. Substantial Involvement

USAID shall be substantially involved during implementation of this program in the following ways:

1. AOTR approval of the recipient’s initial and annual work plan and M&E plan in accordance with 22 CFR 226;

2. AOTR and AO approval of key personnel. All changes thereto must be submitted for the approval by the AO and AOTR.


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i. Chief of Partyii. Deputy Director/Senior Pre-service Education Advisor iii. Senior HRH Management Advisoriv. Senior HRH Quality Improvement Advisorv. Senior M&E and Research Advisor

3. AOTR and AO approval of sub-awards, transfers or the contracting out of any work worth more than $100,000 in accordance with 22 CFR 226

F. The Government may award a cooperative agreement on the basis of initial applications received, without discussion. Therefore, each initial application should contain the applicant’s best terms from a cost and technical standpoint. As part of its evaluation process, however, USAID may elect to discuss technical, cost or other pre-award issues with any applicant. Alternatively, USAID may proceed with awardee selection based on its evaluation of initial applications received and/or commence negotiations with any applicant.

G. Although technical evaluation factors are significantly more important than cost factors, the closer the technical evaluations of the various applications are to one another, the more important cost considerations become. The Agreement Officer may determine what a highly ranked application based on the technical evaluation factors would mean in terms of performance and what it would cost the Government to take advantage of it in determining the best overall value to the Government.

H. Applicants are reminded that U.S. Executive Orders and U.S. law prohibits transactions with, and the provision of resources and support to, individuals and organizations associated with terrorism. It is the legal responsibility of the recipient to ensure compliance with these Executive Orders and laws. This provision must be included in all subcontracts/subawards issued under this contract/agreement.

H. Foreign Government Delegations to International Conferences - Funds in this prospective agreement may not be used to finance the travel, per diem, hotel expenses, meals, conference fees or other conference costs for any member of a foreign government's delegation to an international conference sponsored by a public international organization, except as provided in ADS 303 Mandatory Reference "Guidance on Funding Foreign Government Delegations to International Conferences [http://www.info.usaid.gov/pubs/ads/300/refindx3.htm] or as approved by the Agreement Officer.

I. “USAID Disability Policy - Assistance (December 2004)

a) The objectives of the USAID Disability Policy are (1) to enhance the attainment of United States foreign assistance program goals by promoting the participation and equalization of opportunities of individuals with disabilities in USAID policy, country and sector strategies, activity designs and implementation; (2) to increase awareness of issues of people with disabilities both within USAID programs and in host countries; (3) to engage other U.S. government agencies, host country counterparts, governments,

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implementing organizations and other donors in fostering a climate of nondiscrimination against people with disabilities; and (4) to support international advocacy for people with disabilities. The full text of the policy paper can be found at the following website: http://www.usaid.gov/about/disability/DISABPOL.FIN.html.

b) USAID therefore requires that the recipient not discriminate against people with disabilities in the implementation of USAID funded programs and that it make every effort to comply with the objectives of the USAID Disability Policy in performing the program under this grant or cooperative agreement. To that end and to the extent it can accomplish this goal within the scope of the program objectives, the recipient should demonstrate a comprehensive and consistent approach for including men, women and children with disabilities.”

J. Branding & Marking RequirementsIf recommended for award, the Applicant must submit a Branding Strategy and Marking Plan according to the guidelines in the Standard Provisions, Branding Strategy and Marking Plan below:

BRANDING & MARKING STRATEGY - ASSISTANCE (December 2005)

(a) DefinitionsBranding Strategy means a strategy that is submitted at the specific request of a USAID Agreement Officer by an Apparently Successful Applicant after evaluation of an application for USAID funding, describing how the program, project, or activity is named and positioned, and how it is promoted and communicated to beneficiaries and host country citizens. It identifies all donors and explains how they will be acknowledged.

Apparently Successful Applicant(s) means the Applicant(s) for USAID funding recommended for an award after evaluation, but who has not yet been awarded a grant, cooperative agreement or other assistance award by the Agreement Officer. The Agreement Officer will request that the Apparently Successful Applicants submit a Branding Strategy and Marking Plan. Apparently, Successful Applicant status confers no right and constitutes no USAID commitment to an award.

USAID Identity (Identity) means the official marking for the Agency, comprised of the USAID logo and new brand mark, which clearly communicates that our assistance is from the American people. The USAID Identity is available on the USAID website and is provided without royalty, license, or other fee to recipients of USAID-funded grants or cooperative agreements or other assistance awards or sub-awards.

(b) SubmissionThe Apparently Successful Applicant, upon request of the Agreement Officer, will submit and negotiate a Branding Strategy. The Branding Strategy will be included in and made a part of the

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resulting grant or cooperative agreement. The Branding Strategy will be negotiated within the time that the Agreement Officer specifies. Failure to submit and negotiate a Branding Strategy will make the Applicant ineligible for award of a grant or cooperative agreement. The Apparently Successful Applicant must include all estimated costs associated with branding and marking USAID programs, such as plaques, stickers, banners, press events and materials, and the like.

(c) Submission Requirements

At a minimum, the Apparently Successful Applicant’s Branding Strategy will address the following:

(1) Positioning

What is the intended name of this program, project, or activity?

Guidelines: USAID prefers to have the USAID Identity included as part of the program or project name, such as a "title sponsor," if possible and appropriate. It is acceptable to "co-brand" the title with USAID’s and the Apparently Successful Applicant’s identities. For example: "The USAID and [Apparently Successful Applicant] Health Center." If it would be inappropriate or is not possible to "brand" the project this way, such as when rehabilitating a structure that already exists or if there are multiple donors, please explain and indicate how you intend to showcase USAID's involvement in publicizing the program or project. For example: School #123, rehabilitated by USAID and [Apparently Successful Applicant]/ [other donors].Note: the Agency prefers "made possible by (or with) the generous support of the American People" next to the USAID Identity in acknowledging our contribution, instead of the phrase "funded by.” USAID prefers local language translations.

Will a program logo be developed and used consistently to identify this program? If yes, please attach a copy of the proposed program logo. Note: USAID prefers to fund projects that do NOT have a separate logo or identity that competes with the USAID Identity.

(2) Program Communications and Publicity

Who are the primary and secondary audiences for this project or program?

Guidelines: Please include direct beneficiaries and any special target segments or influencers. For Example: Primary audience: schoolgirls age 8-12, Secondary audience: teachers and parents–specifically mothers.

What communications or program materials will be used to explain or market the program to beneficiaries?

Guidelines: These include training materials, posters, pamphlets, Public Service Announcements,billboards, websites, and so forth.


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What is the main program message(s)?

Guidelines: For example: "Be tested for HIV-AIDS" or "Have your child inoculated.” Please indicate if you also plan to incorporate USAID’s primary message – this aid is "from the American people" – into the narrative of program materials. This is optional; however, marking with the USAID Identity is required.

Will the recipient announce and promote publicly this program or project to host country citizens? If yes, what press and promotional activities are planned?

Guidelines: These may include media releases, press conferences, public events, and so forth. Note: incorporating the message, “USAID from the American People,” and the USAID Identity is required.Please provide any additional ideas about how to increase awareness that the American people support this project or program.

Guidelines: One of our goals is to ensure that both beneficiaries and host-country citizens know that the aid the Agency is providing is "from the American people. “Please provide any initial ideas on how to further this goal.

(3) Acknowledgements

Will there be any direct involvement from a host-country government ministry? If yes, please indicate which one or ones. Will the recipient acknowledge the ministry as an additional co-sponsor? Note: it is perfectly acceptable and often encouraged for USAID to "co-brand” programs with government ministries. Please indicate if there are any other groups whose logo or identity the recipient will use on program materials and related communications.

Guidelines: Please indicate if they are also a donor or why they will be visibly acknowledged, and if they will receive the same prominence as USAID.

(d) Award CriteriaThe Agreement Officer will review the Branding Strategy for adequacy, ensuring that it contains the required information on naming and positioning the USAID-funded program, project, or activity, and promoting and communicating it to cooperating country beneficiaries and citizens. The Agreement Officer also will evaluate this information to ensure that it is consistent with the stated objectives of the award; with the Apparently Successful Applicant’s project, activity, or program performance plan; and with the regulatory requirements set out in 22 CFR 226.91. The Agreement Officer may obtain advice and recommendations from technical experts while performing the evaluation.

MARKING PLAN – ASSISTANCE (December 2005)

(a) Definitions


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Marking Plan means a plan that the Apparently Successful Applicant submits at the specific request of a USAID Agreement Officer after evaluation of an application for USAID funding, detailing the public communications, commodities, and program materials and other items that will visibly bear the USAID Identity. Recipients may request approval of Presumptive Exceptions to marking requirements in the Marking Plan.

Apparently Successful Applicant(s) means the Applicant(s) for USAID funding recommended for an award after evaluation, but who has not yet been awarded a grant, cooperative agreement or other assistance award by the Agreement Officer. The Agreement Officer will request that Apparently Successful Applicants submit a Branding Strategy and Marking Plan. Apparently, Successful Applicant status confers no right and constitutes no USAID commitment to an award, which the Agreement Officer must still obligate.

USAID Identity (Identity) means the official marking for the Agency, comprised of the USAID logo and new brand mark, which clearly communicates that our assistance is from the American people. The USAID Identity is available on the USAID website and USAID provides it without royalty, license, or other fee to recipients of USAID funded grants, cooperative agreements, or other assistance awards or subawards.

A. Presumptive Exception exempts the Applicant from the general marking requirements for a particular USAID-funded public communication, commodity, program material or other deliverable, or a category of USAID-funded public communications, commodities, program materials or other deliverables that would otherwise be required to visibly bear the USAID Identity. The Presumptive Exceptions are:

Presumptive Exception (i). USAID marking requirements may not apply if they would compromise the intrinsic independence or neutrality of a program or materials where independence or neutrality is an inherent aspect of the program and materials, such as election monitoring or ballots, and voter information literature; political party support or public policy advocacy or reform; independent media, such as television and radio broadcasts, newspaper articles and editorials; and public service announcements or public opinion polls and surveys (22 C.F.R. 226.91(h)(1)).

Presumptive Exception (ii). USAID marking requirements may not apply if they would diminish the credibility of audits, reports, analyses, studies, or policy recommendations whose data or findings must be seen as independent (22 C.F.R.226.91(h)(2)).

Presumptive Exception (iii). USAID marking requirements may not apply if they would undercut host country government “ownership” of constitutions, laws, regulations, policies, studies, assessments, reports, publications, surveys or audits, public service announcements, or other communications better positioned as “by” or “from” a cooperating country ministry or government official (22 C.F.R. 226.91(h)(3)).

Presumptive Exception (iv). USAID marking requirements may not apply if they would impair the functionality of an item, such as sterilized equipment or spare parts (22 C.F.R. 226.91(h)(4)).


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Presumptive Exception (v). USAID marking requirements may not apply if they would incur substantial costs or be impractical, such as items too small or otherwise unsuited for individual marking, such as food in bulk (22 C.F.R. 226.91(h)(5)).

Presumptive Exception (vi). USAID marking requirements may not apply if they would offend local cultural or social norms, or be considered inappropriate on such items as condoms, toilets, bed pans, or similar commodities (22 C.F.R. 226.91(h)(6)).

Presumptive Exception (vii). USAID marking requirements may not apply if they would conflict with international law (22 C.F.R. 226.91(h)(7)).

(b) SubmissionThe Apparently Successful Applicant, upon the request of the Agreement Officer, will submit and negotiate a Marking Plan that addresses the details of the public communications, commodities, program materials that will visibly bear the USAID Identity. The marking plan will be customized for the particular program, project, or activity under the resultant grant or cooperative agreement. The plan will be included in and made a part of the resulting grant or cooperative agreement. USAID and the Apparently Successful Applicant will negotiate the Marking Plan within the time specified by the Agreement Officer. Failure to submit and negotiate a Marking Plan will make the Applicant ineligible for award of a grant or cooperative agreement.

(c) Submission Requirements

The Marking Plan will include the following:

(1) A description of the public communications, commodities, and program materials that the recipient will produce as a part of the grant or cooperative agreement and which will visibly bear the USAID Identity. These include:

(i) program, project, or activity sites funded by USAID, including visible infrastructure projects or other programs, projects, or activities that are physical in nature;(ii) technical assistance, studies, reports, papers, publications, audiovisual productions, public service announcements, Web sites/Internet activities and other promotional, informational, media, or communications products funded by USAID;(iii) events financed by USAID, such as training courses, conferences, seminars, exhibitions, fairs, workshops, press conferences, and other public activities; and(iv) all commodities financed by USAID, including commodities or equipment provided underhumanitarian assistance or disaster relief programs, and all other equipment, supplies and othermaterials funded by USAID, and their export packaging.

(2) A table specifying:

(i) the program deliverables that the recipient will mark with the USAID Identity,(ii) the type of marking and what materials the Applicant will be used to mark the program deliverables with the USAID Identity, and


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(iii) when in the performance period the Applicant will mark the program deliverables, and where the Applicant will place the marking.

(3) A table specifying:

(i) what program deliverables will not be marked with the USAID Identity, and(ii) the rationale for not marking these program deliverables.

(d) Presumptive Exceptions

(1) The Apparently Successful Applicant may request a Presumptive Exception as part of the overall Marking Plan submission. To request a Presumptive Exception, the Apparently Successful Applicant must identify which Presumptive Exception applies, and state why, in light of the Apparently Successful Applicant’s application and in the context of the program description or program statement in the USAID Request For Application or Annual Program Statement, marking requirements should not be required.

(2) Specific guidelines for addressing each Presumptive Exception are:

(i) For Presumptive Exception (i), identify the USAID Strategic Objective, Interim Result, or program goal furthered by an appearance of neutrality, or state why the program, project, activity, commodity, or communication is ‘intrinsically neutral.’ Identify, by category or deliverable item, examples of program materials funded under the award for which you are seeking an exception.

(ii) For Presumptive Exception (ii), state what data, studies, or other deliverables will be produced under the USAID funded award, and explain why the data, studies, or deliverables must be seen as credible.

(iii) For Presumptive Exception (iii), identify the item or media product produced under the USAID funded award, and explain why each item or product, or category of item and product, is better positioned as an item or product produced by the cooperating country government.

(iv) For Presumptive Exception (iv), identify the item or commodity to be marked, or categories of items or commodities, and explain how marking would impair the item’s or commodity’s functionality.

(v) For Presumptive Exception (v), explain why marking would not be cost beneficial or practical.

(vi) For Presumptive Exception (vi), identify the relevant cultural or social norm, and explain why marking would violate that norm or otherwise be inappropriate.

(vii) For Presumptive Exception (vii), identify the applicable international law violated by marking.


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(3) The Agreement Officer will review the request for adequacy and reasonableness. In consultation with the Agreement Officer’s Technical Representative and other agency personnel as necessary, the Agreement Officer will approve or disapprove the requested Presumptive Exception. Approved exceptions will be made part of the approved Marking Plan, and will apply for the term of the award, unless provided otherwise.

(e) Award Criteria

The Agreement Officer will review the Marking Plan for adequacy and reasonableness, ensuring that it contains sufficient detail and information concerning public communications, commodities, and program materials that will visibly bear the USAID Identity. The Agreement Officer will evaluate the plan to ensure that it is consistent with the stated objectives of the award; with the Applicant’s actual project, activity, or program performance plan; and with the regulatory requirements of 22 C.F.R. 226.91. The Agreement Officer will approve or disapprove any requested Presumptive Exceptions (see paragraph (d)) on the basis of adequacy and reasonableness. The Agreement Officer may obtain advice and recommendations from technical experts while performing the evaluation.

MARKING UNDER ASSISTANCE INSTRUMENTS (DEC 2005)

(a) Definitions

Commodities mean any material, article, supply, goods or equipment, excluding recipient offices, vehicles, and non-deliverable items for recipient’s internal use, in administration of the USAID funded grant, cooperative agreement, or other agreement or sub-agreement.

Principal Officer means the most senior officer in a USAID Operating Unit in the field, e.g., USAID Mission Director or USAID Representative. For global programs managed from Washington but executed across many countries, such as disaster relief and assistance to internally displaced persons, humanitarian emergencies or immediate post conflict and political crisis response, the cognizant Principal Officer may be an Office Director, for example, the Directors of USAID/W/Office of Foreign Disaster Assistance and Office of Transition Initiatives. For non-presence countries, the cognizant Principal Officer is the Senior USAID officer in a regional USAID Operating Unit responsible for the non-presence country, or in theabsence of such a responsible operating unit, the Principal U.S. Diplomatic Officer in the non-presence country exercising delegated authority from USAID.

Programs mean an organized set of activities and allocation of resources directed toward a common purpose, objective, or goal undertaken or proposed by an organization to carry out the responsibilities assigned to it.

Public communications are documents and messages intended for distribution to audiences external to the recipient’s organization. They include, but are not limited to, correspondence, publications, studies, reports, audio visual productions, and other informational products; applications, forms, press and promotional materials used in connection with USAID funded


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programs, projects or activities, including signage and plaques; Web sites/Internet activities; and events such as training courses, conferences, seminars, press conferences and so forth.

Subrecipient means any person or government (including cooperating multi-lateral agency or country government) department, agency, establishment, or for profit or nonprofit organization that receives a USAID sub-award, as defined in 22 C.F.R. 226.2.

Technical Assistance means the provision of funds, goods, services, or other foreign assistance, such as loan guarantees or food for work, to developing countries and other USAID recipients, and through such recipients to sub recipients, in direct support of a development objective – as opposed to the internal management of the foreign assistance program.

USAID Identity (Identity) means the official marking for the United States Agency for International Development (USAID), comprised of the USAID logo or seal and new brand mark, with the tagline that clearly communicates that our assistance is “from the American people.” The USAID Identity is available on the USAID website at www.usaid.gov/branding and USAID provides it without royalty, license, or other fee to recipients of USAID-funded grants, or cooperative agreements, or other assistance awards

(b) Marking of Program Deliverables

(1) All recipients must mark appropriately all overseas programs, projects, activities, publiccommunications, and commodities partially or fully funded by a USAID grant or cooperative agreement or other assistance award or sub award with the USAID Identity, of a size and prominence equivalent to or greater than the recipient’s, other donor’s, or any other third party’s identity or logo.

(2) The Recipient will mark all program, project, or activity sites funded by USAID, including visible infrastructure projects (for example, roads, bridges, buildings) or other programs, projects, or activities that are physical in nature (for example, agriculture, forestry, water management) with the USAID Identity. The Recipient should erect temporary signs or plaques early in the construction or implementation phase. When construction or implementation is complete, the Recipient must install a permanent, durable sign, plaque or other marking.

(3) The Recipient will mark technical assistance, studies, reports, papers, publications, audio-visual productions, public service announcements, Web sites/Internet activities and other promotional, informational, media, or communications products funded by USAID with the USAID Identity.

(4) The Recipient will appropriately mark events financed by USAID, such as training courses,conferences, seminars, exhibitions, fairs, workshops, press conferences and other public activities, with the USAID Identity. Unless directly prohibited and as appropriate to the surroundings, recipients should display additional materials, such as signs and banners, with the USAID Identity. In circumstances in which the USAID Identity cannot be displayed visually, the recipient is encouraged otherwise to acknowledge USAID and the American people’s support.


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(5) The Recipient will mark all commodities financed by USAID, including commodities or equipment provided under humanitarian assistance or disaster relief programs, and all other equipment, supplies, and other materials funded by USAID, and their export packaging with the USAID Identity.

(6) The Agreement Officer may require the USAID Identity to be larger and more prominent if it is the majority donor, or to require that a cooperating country government’s identity be larger and more prominent if circumstances warrant, and as appropriate depending on the audience, program goals, and materials produced.

(7) The Agreement Officer may require marking with the USAID Identity in the event that the recipient does not choose to mark with its own identity or logo.(8) The Agreement Officer may require a pre-production review of USAID funded public communications and program materials for compliance with the approved Marking Plan.

(9) Sub recipients. To ensure that the marking requirements “flow down'' to sub recipients of subawards, recipients of USAID funded grants and cooperative agreements or other assistance awards will include the USAID-approved marking provision in any USAID funded sub award, as follows:

“As a condition of receipt of this sub award, marking with the USAID Identity of a size and prominence equivalent to or greater than the recipient’s, sub recipient’s, other donor’s or third party’s is required. In the event the recipient chooses not to require marking with its own identity or logo by the sub recipient, USAID may, at its discretion, require marking by the sub recipient with the USAID Identity.”

(10) Any ‘public communications’, as defined in 22 C.F.R. 226.2, funded by USAID, in which the content has not been approved by USAID, must contain the following disclaimer:

“This study/report/audio/visual/other information/media product (specify) is made possible by the generous support of the American people through the United States Agency for InternationalDevelopment (USAID). The contents are the responsibility of [insert recipient name] and do notnecessarily reflect the views of USAID or the United States Government.”

(11) The recipient will provide the Agreement Officer’s Technical Representative (AOTR) or other USAID personnel designated in the grant or cooperative agreement with two copies of all program and communications materials produced under the award. In addition, the recipient will submit one electronic or one hard copy of all final documents to USAID’s Development Experience Clearinghouse.

(c) Implementation of marking requirements

(1) When the grant or cooperative agreement contains an approved Marking Plan, the recipient will implement the requirements of this provision following the approved Marking Plan.


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(2) When the grant or cooperative agreement does not contain an approved Marking Plan, the recipient will propose and submit a plan for implementing the requirements of this provision within 45 days after the effective date of this provision. The plan will include:

(i) a description of the program deliverables specified in paragraph (b) of this provision that the recipient will produce as a part of the grant or cooperative agreement and which will visibly bear the USAID Identity.(ii) the type of marking and what materials the Applicant uses to mark the program deliverables with the USAID Identity,(iii) when in the performance period the Applicant will mark the program deliverables, and where the Applicant will place the marking,

(3) The recipient may request program deliverables not be marked with the USAID Identity byidentifying the program deliverables and providing a rationale for not marking these programdeliverables. Program deliverables may be exempted from USAID marking requirements when:

(i) USAID marking requirements would compromise the intrinsic independence or neutrality of aprogram or materials where independence or neutrality is an inherent aspect of the program andmaterials;(ii) USAID marking requirements would diminish the credibility of audits, reports, analyses, studies, or policy recommendations whose data or findings must be seen as independent;(iii) USAID marking requirements would undercut host-country government “ownership” ofconstitutions, laws, regulations, policies, studies, assessments, reports, publications, surveys or audits, public service announcements, or other communications better positioned as “by” or “from” a cooperating country ministry or government official;(iv) USAID marking requirements would impair the functionality of an item;(v) USAID marking requirements would incur substantial costs or be impractical;(vi) USAID marking requirements would offend local cultural or social norms, or be consideredinappropriate;(vii) USAID marking requirements would conflict with international law.(4) The proposed plan for implementing the requirements of this provision, including any proposed exemptions, will be negotiated within the time specified by the Agreement Officer after receipt of the proposed plan. Failure to negotiate an approved plan with the time specified by the Agreement Officer may be considered as noncompliance with the requirements is provision.

(d) Waivers

(1) The recipient may request a waiver of the Marking Plan or of the marking requirements of this provision, in whole or in part, for each program, project, activity, public communication or commodity, or, in exceptional circumstances, for a region or country, when USAID required marking would pose compelling political, safety, or security concerns, or when marking would have an adverse impact in the cooperating country. The recipient will submit the request through the Agreement Officer’s Technical Representative. The Principal Officer is responsible for approvals or disapprovals of waiver requests.


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(2) The request will describe the compelling political, safety, security concerns, or adverse impact that require a waiver, detail the circumstances and rationale for the waiver, detail the specific requirements to be waived, the specific portion of the Marking Plan to be waived, or specific marking to be waived, and include a description of how program materials will be marked (if at all) if the USAID Identity is removed. The request should also provide a rationale for any use of recipient’s own identity/logo or that of a third party on materials that will be subject to the waiver.

(3) Approved waivers are not limited in duration but are subject to Principal Officer review at any time, due to changed circumstances.

(4) Approved waivers “flow down” to recipients of sub-awards unless specified otherwise. The waiver may also include the removal of USAID markings already affixed, if circumstances warrant.(5) Determinations regarding waiver requests are subject to appeal to the Principal Officer’s cognizant Assistant Administrator. The recipient may appeal by submitting a written request to reconsider the Principal Officer’s waiver determination to the cognizant Assistant Administrator.

(e) Non-retroactivity.The requirements of this provision do not apply to any materials, events, or commodities produced prior to January 2, 2006. The requirements of this provision do not apply to program, project, or activity sites funded by USAID, including visible infrastructure projects (for example, roads, bridges, buildings) or other programs, projects, or activities that are physical in nature (for example, agriculture, forestry, water management) where the construction and implementation of these are complete prior to January 2, 2006 and the period of the grant does not extend past January 2, 2006.

C. Standard Provisions

The Applicant will be required to adhere to and govern itself under the Standard Provisions for U.S. NGO and Non-U.S. NGOs. Links to these Standard Provisions can be found under Annex C.


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SECTION III - ELIGIBILITY INFORMATION

a. Eligible Applicants

To be eligible for the Cooperative Agreement under this RFA, an organization must be a U.S. or Non-US based organization, for-profit or non-profit, private voluntary organizations registered with USAID, or faith-based organizations.

The Recipient must be a responsible entity. The Agreement Officer (AO) may determine a Pre-Award survey is required and if so, would establish a formal survey team to conduct an examination that will determine whether the prospective recipient has the necessary organization, experience, accounting and operational controls, and technical skills – or ability to obtain them – in order to achieve the objectives of the program.

b. Cost Sharing

USAID has established a cost share minimum of 5% of the USAID-funded or obligated amount projected up to the maximum ceiling ($55 million) for the recipient of the award to help meet objectives in the program description, ensure greater programming by the applicant to provide enhanced services, leverage resources with other partners, and help ensure that the applicant and any proposed partners have additional capacity to mobilize resources. Applications that do not meet the minimum cost sharing requirement will not be eligible for award consideration and their applications will not be evaluated. Applicants shall submit an outlay of cost share contributions as an annex to the cost proposal. The proposed contributions must meet the standards set in 22 CFR 226.23 for U.S. organizations or the Standard Provision "Cost Sharing" for non-U.S. organizations. The recipient may propose cost sharing contributions from sub-recipients to the prime award. For guidance on cost sharing in grants and cooperative agreements, please see 22 CFR 226.23 at http://ecfr.gpoaccess.gov and search under Title 22 Foreign Relations.


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SECTION IV - APPLICATION AND SUBMISSION INSTRUCTIONS

A. SUBMISSION OF APPLICATIONS:If your organization decides to submit an application(s), it must be received by the closing date and time indicated at the top of this cover letter.

Electronic submission of applications is required. Please submit your applications by email, up to five (5) attachments (2MB limit) per email compatible with MS WORD, PDF, and Excel in a MS Windows environment, to all of the email addresses mentioned hereafter. Receipt by any one of these two addresses before the closing date and time will constitute timely receipt of the application. RECEIPT TIME IS WHEN THE APPLICATION IS RECEIVED BY THE USAID/W INTERNET SERVER.

The addresses for the receipt of applications are:

1) CADDIS at [email protected], Primary2) Sam Nagwere at [email protected], Secondary Contact

Applicants are encouraged to obtain confirmation of receipt of their applications.

Hard copies of the applications are NOT required and will NOT be accepted. Telegraphic or fax applications are NOT authorized for this RFA and will not be accepted.

After you have sent your applications by email, please immediately check your own email to confirm that the attachments you intended to send were indeed sent. If you discover an error in your transmission, please send the material again and note in the subject line of the email that it is a "corrected" submission. Please do not wait for USAID to advise you that certain documents intended to be sent were not sent, or that certain documents contained errors in formatting, missing sections, etc. Each applicant is responsible for its submissions, so please inspect your own emails.

Please do not send the same email to us more than one time unless there has been a change, and if so, please note that it is a corrected email. If you send multiple copies of the same email, we do not know if there has been any change from one email to the next.

Your organization should appoint one person to send email submissions. If we receive email submissions from more than one person in your organization, we do not know who the authorized person is, and we cannot tell whether there has been a change from one email to the next without considerable effort on our part. Applicants should retain for their records one copy of the application package.

Preparation GuidelinesThe following are general instructions for what constitutes an application and how applications shall be formatted:

mailto:[email protected]

mailto:[email protected]


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i. An application shall consist of a Technical application and a Cost application submitted in two separate volumes.

ii. All information shall be presented in the English language and shall be formatted in either Microsoft Word 2010 or Microsoft Excel 2010 with all formulas unlocked.

iii. Cover page shall ONLY contain following information:

RFA number and title for which this application is being submitted

Applicant Name, address, TIN, DUNS, and point of contact information for technical and cost application.

Names of sub-awardees

iv. Applications must be submitted no later than the date and time indicated on the cover page of this RFA, to the email addresses indicated in the cover letter.

v. All applications received by the deadline will be reviewed for responsiveness to the specifications outlined in these guidelines and the selection criteria presented in Section V. Applications which are submitted late or are incomplete run the risk of not being considered in the review process. vi. The Government may (a) reject any or all applications, (b) accept other than the lowest costapplication, (c) accept more than one application, (d) accept alternate applications meeting theapplicable standards of this RFA, and (e) waive informalities and minor irregularities in the application(s) received.

B. Technical Application Preparation Guidelines

(i) General

USAID requests that applications provide all information required by following the format described below. USAID requests that the application be kept as concise as possible. Detailed information should be presented only when required by specific RFA instructions.

The technical applications shall not exceed 40 pages (12 point single-spaced Times New Roman font, and a minimum of 1 inch margins all around), not including the cover page, executive summary, appendices, and certain graphics as specified below. Pages should be paginated at the bottom. Graphics and charts specifically requested in this technical application will not count against the page limit for the application, and may be included in the application. Unnecessarily elaborate brochures or other presentations beyond those sufficient to present a complete and effective application in response to this RFA are not desired and may be construed as an indication of the prospective recipient's lack of cost consciousness. Elaborate art work and other presentation aids are neither necessary nor wanted.


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Applicants may use appendices for such required supplemental information as key personnel resumes, resumes of other personnel, and a list of previous contracts, grants, and cooperative agreements and past performance reports. Applicants are requested to limit appendices to those relevant to the RFA.

Technical applications should be specific, complete and presented concisely. A lengthy application may not in and of itself constitute a well thought out application. Applications shall demonstrate the applicant's capabilities and expertise with respect to achieving the goals of this program. The applications should take into account the technical evaluation criteria found in Section V.

(ii) Technical Application Content

The technical application will be the most important item of consideration in selection for award of the proposed activity. The technical application may contain the following sections, as more fully explained below: (a) Cover Page, (b) Table of Contents, (c) Executive Summary, (d) Program Description, (e) Monitoring and Evaluation Plan, and (g) Annexes (Curriculum Vitae/Resumés, Past Performance References, and Letters of Commitment from implementing partners, if any). The technical application shall not include any cost information.

The format for the technical application is the following:

Cover PageInclude proposed Project title, Strengthening Human Resource for Health (HRH) Program, name of organization(s) submitting application, authorized individual, telephone and fax numbers, e-mail, and address.

Executive Summary (1-3 pages) This section should allow technical reviewers to quickly understand the critical elements of the application including the most salient features of the applicants’ technical vision and approach, the key personnel and management plan proposed, and the capabilities of the partners to accomplish the desired results.

Technical Application (maximum 35 pages)The technical application will meet the requirements of the program description and address the Evaluation Criteria. The application will be evaluated in accordance with the Evaluation Criteria which will give due consideration for the following elements.

A. Technical Approach

The applicant’s technical approach will address understanding of the proposed program and the overall design. This should include:

Understanding of the proposed program, the Ethiopian health sector, including its successes, constraints, institutions, programs, and opportunities, and the required interventions that will significantly impact human resources for health.


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A description of how the applicant proposes to achieve the objectives of the program and how this will contribute to the higher-level goal to improve health outcomes for all Ethiopians by reducing infectious disease and MNCH morbidity and mortality through ensuring the availability and quality of health professionals at all levels of health service delivery.

A detailed implementation plan that, for each of the four results described in the RFA, provides an overview of how the applicant will accomplish each result, with specific illustrative activities they would use to accomplish specific sub-results.

A graduation mechanism, built into the program from the commencement of the intervention, to ensure sustainability of project activities. Applicants should describe strategies for building on and strengthening local partners, networks and institutions and collaborating with other USAID implementing agencies and projects. Specifically, applicants should describe how they will involve local partners in program implementation and ensure capacity building within in-country organizations and institutions that will allow them to assume responsibility for interventions, thereby increasing transfer and sustainability.

Applicant’s proposed approach to building on the current work of the Ministry of Health, other USAID partners, other donors, local NGOs and health facilities to create synergy;

A preliminary performance monitoring plan (PMP) to track progress in achievement of the activity objective and each of the Results under the Award. The PMP will include proposed performance indicators with specific targets and benchmarks for the overall objective and each of the results. Applicants are encouraged to propose additional or modified indicators. Applicants should describe how the PMP indicators will be regularly collected and reported to facilitate results reporting to USAID/Ethiopia and USAID/Washington.

Environmental Compliance. The applicant is required to address potential hazards to the environment in regards to the HRH programs and interventions. A proper environmental mitigation and monitoring plan to address environmental concerns should be submitted with the application and should include a plan for the proper disposal of materials and syringes (for clinical training sites). The mission’s environmental compliance conditions for the award are described in Section I.

B. Personnel and Management Plan

Applicant shall include:

An overall staffing pattern, including an organizational chart, which shows the totality of individuals proposed for all components of the implementation plan, lines of communication, responsibilities and planned procedures to ensure the highest quality coordination and collaboration with the federal, regional and local governments and


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health partners. The staffing plan shall, to the maximum extent possible, optimize use of Ethiopian professionals to manage and implement the program.

Names and summary qualifications and experience for proposed key personnel and technical positions as well as their major responsibilities under this activity and the rationale for their selection and appropriateness for the proposed positions. Describe previous experience of personnel in working in collaboration with host country governments and partner organizations, and expertise in managing the administrative and financial aspects of a complex program.

Plan for start-up of the project, including plans for rapidly accessing and deploying key personnel and essential technical staff to support the implementation of the technical program and meet missions’ needs on the ground while avoiding excess staffing. In order to ensure close collaboration with national and regional government office/s, the recipient may consider seconding personnel and/or establishing regional office(s).

Management plan for project implementation, showing how responsibility and lines of

authority will be managed within the project and across any proposed partnerships, a proposed management and administrative structure, policies and practices for overall implementation of the program including personnel, financial and logistical support, and coordination. The management plan should describe how the project will relate to and respond to USAID.

C. Institutional Capacity and Experience

Applicant should provide a description of the applicant’s organization capacity and past experience in areas directly relevant to achieving the results outlined in this RFA – including its general purpose, goals, annual budget (including funding sources), and major relevant activities and projects undertaken since 2007.

Include a description of the capacity and experience of all proposed sub-partners, if any; the proposed working relationship with them; and the added value of having additional partners. The applicant should clearly distinguish between partners with whom they intend to enter into a sub-granting relationship and those with whom they intend to apply as a consortium (indicate the leader of the consortium).

D. Past Performance

USAID will evaluate past performance of the applicant based on reference checks and relevant past performance information submitted and may consider other past performance information. The applicant shall submit a list of up to 5 current grants/cooperative agreements and/or sub-awards awarded within the last three years that are similar in size, scope, and complexity to the program described in this RFA. The list should be included as annex or attachment to the technical proposal and will not count against the page limitation.


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Provide for each of the awards listed above a list of contact names, job titles, mailing addresses, phone numbers, e-mail addresses, and a description of the performance to include:

• Scope of the program/work or complexity/diversity of tasks, • Primary location(s) of work, • Term of performance, • Skills/expertise required, • Dollar value, and • Award/instrument type

(USAID recommends that offerors alert the contacts that their names have been submitted and that they are authorized to provide performance information concerning the listed contracts if and when USAID requests it).

The Government reserves the right to verify the experience and past performance record of cited projects or other recent projects by reviewing other performance reports or to interview cited references or other persons knowledgeable of the applicant’s performance on a particular project. The Government may check any or all cited references to verify supplied information and/or to assess reference satisfaction with performance. References may be asked to comment on items such as: Quality of Product or Service, Cost Control, Timeliness of Performance, Customer Satisfaction, and Key Personnel. Applicants will be provided an opportunity to explain circumstances surrounding less than satisfactory performance reports if not previously provided the opportunity.

ii Cost/Business Application Guidelines

USAID will evaluate the cost/business application separately for cost effectiveness and realism. While there is no page limit for this portion, Applicants are encouraged to be as concise as possible, but still provide the necessary details. USAID will require the following detailed information from the Applicant organization:

A. The cost/business application must be completely separate from the technical application. Theapplication must be submitted using SF-424 and SF 424A “Application for Federal Assistance.” The form is downloadable on USAID’s website at: http://www.usaid.gov/procurement_bus_opp/procurement/forms/.

The cost/business application should be for a period of 5 years using the budget format shown in the SF-424A. Cost/Business applications must be submitted in MS Word and Graphic/tables must be formatted in Microsoft Excel.

B. If the Applicant has established a consortium or another legal relationship among its partners, the Cost/Business application must include a copy of the document establishing the parameters of the legal relationship between the parties. The agreement should include a full discussion of the relationship between the Applicants including identification of the Applicant with which USAID will treat for purposes of Agreement administration, identity of the Applicant which will have accounting responsibility, how Agreement effort will be allocated and the express


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agreement of the principals thereto to be held jointly and severally liable for the acts or omissions of the other.

C. New Recipients: Applicants that have never received a grant, cooperative agreement or contract from the U.S. Government are required to submit a copy of their accounting manual andprocurement/management handbook relating to personnel and travel policies.

D. To support the proposed costs, please provide detailed budget breakdown and explanation notes/narrative for all cost categories contained SF-424A regarding how the costs were derived.

The following provides guidance on what is needed.

1. The breakdown of all costs associated with the program.2. The breakdown of all costs according to each partner organization involved in the program.3. The costs associated with external, expatriate technical assistance and those associated withlocal in-country technical assistance.4. The breakdown of any financial and in-kind contributions of all organizations involved inimplementing this program.5. Potential contributions of non-USAID or private commercial donors to this program.6. Procurement plan for commodities, goods and services (if applicable).

Usually, the cost application contains the following budget categories and supporting notes:

1. Salary and Wages: Direct salaries and wages should be proposed in accordance with theApplicant’s personnel policies; USAID requires that salary daily rates are calculated 260 working days per year. Budget narrative should explain how daily rates are calculated and whether based on established written policies of the organization or market surveys.

2. Fringe Benefits: If the Applicant has a fringe benefit rate that has been approved by an agency of the U.S. Government, such rate should be used and evidence of its approval should be provided (e.g. copy of NICRA). If a fringe benefit rate has not been so approved, the application may propose a rate and explain how the rate was determined. If the latter is used, the narrative must include a detailed breakdown comprised of all items of fringe benefits (e.g., unemployment insurance, workers compensation, health and life insurance, retirement, FICA, etc.) and the costs of each, expressed in dollars and as a percentage of salaries.

3. Travel and Transportation: The application should indicate the number of trips, domestic, regional, and international, and the estimated costs. Specify the origin and destination for proposed trips, duration of travel, and number of individuals traveling. Per Diem should be based on the Applicant’s normal travel policies and will be assessed as part of cost effectiveness.

4. Equipment: Just the need, type, the number and price of the items equipment to be procured.

5. Supplies: Justify and need and quantities of Supply items related to this activity.

6. Sub-Contracts: Any goods and services being procured through a contract mechanism.


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7. Other Direct Costs: This includes communications, report preparation costs, passports, visas,medical exams and inoculations, insurance (other than insurance included in the Applicant’s fringe benefits), equipment, office rent, etc. The narrative should provide a breakdown and support for all other direct costs;

8. Indirect Costs: The Applicant should support the proposed indirect cost rate with a letter from a cognizant U.S. Government audit agency, a Negotiated Indirect Cost Agreement (NICRA), or with sufficient information (e.g. audited financial statements) for USAID to determine the reasonableness of the rates (For example, a breakdown of labor bases and overhead pools, the method of determining the rate, etc.).

E. Ceiling on Indirect Cost Rates And Final Reimbursement for Indirect Costs- Contractor shallpropose a ceiling on their Indirect Costs.

F. Required Certifications and Representation: All Certifications and Representations found under Annex I must be completed and submitted with the cost application.


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SECTION V - EVALUATION CRITERIA

A. Technical Evaluation Criteria

The technical criteria are presented below in descending order of importance. There are no sub-criteria. The bullet statements listed under each technical criterion are illustrative, but not exhaustive, of the considerations that make up that criterion. These criteria have been tailored to the requirements of this RFA and serve to (a) identify the significant matters that the applicants should address in their applications and (b) set standards against which all applicants will be evaluated. The following four general factors, which are further described below, provide a scale of the importance of each factor:

1. Technical Understanding and Approaches (40 points)2. Personnel and Management Structure (35 points)3. Institutional Capacity (15 points)4. Past Performance (10 points)

Criterion 1: Technical Understanding and Approaches (40 points)Applicants will be evaluated on the basis of the extent to which reflects thorough understanding of the overall project description and its objective, and the ability to demonstrate innovation and the application of current and proven HRH improvement approaches. The bullet statements listed below are illustrative, but not exhaustive, of the considerations that make up this criterion.

Reflects an understanding of, and a proposed approach for achieving the overall goal improving health outcomes for all Ethiopians by reducing infectious disease and MNCH morbidity and mortality through ensuring the availability and quality of health professionals at all levels of health service delivery. Illustrative activities are relevant and likely to achieve the anticipated outcomes for each result.

Demonstrates a clear understanding of Ethiopia’s HRH challenges and issues, the draft HRH Strategy, HSDP IV, and other key health policies, strategies and initiatives. The proposal reflects technical leadership, creativity, innovation and soundness in

advancing evidence-based best practices and state-of-the-art principles, approaches and methods for human resources for health.

The proposed approaches are technically and strategically sound, and are feasible, efficient, sustainable, and have potential to be scaled-up.

Demonstrates expertise in providing technical support and capacity building in HRH management and the associated capacity building requirements.

Clearly articulates how gender related issues will be addressed.

Criterion 2: Personnel and Management Structure (35 points)Applicants will be evaluated on the basis of the extent to which they demonstrate that key personnel have the requisite breadth and depth of technical expertise and experience in HRH program implementation, and networking with GOE and other key stakeholders. The Management Structure proposed by the applicant will be evaluated for clarity of responsibilities and managerial control, use of Ethiopian talent, and organizational effectiveness. The bullet


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statements listed below are illustrative, but not exhaustive, of the considerations that make up this criterion.

Outlines a complete staffing plan with underlying rationale (including support staff), an organizational chart demonstrating lines of authority and staff responsibility, and brief position descriptions for each technical staff position.

Describes the roles and responsibilities of all staff including home office management staff, their assigned management and decision-making authorities, and the relationship the applicant will have with the GOE.

Minimizes home office support and demonstrates other effective and cost-efficient management structure to achieve project goals, objectives and targets.

Proposes personnel who have relevant professional qualifications and experience appropriate to manage and achieve results.

Demonstrates the value added by using consortia or any other implementation partnerships in case an applicant proposes such approaches.

Demonstrates commitment to using Ethiopian and regional professionals and managers who hold significant positions in the management and implementation of this project.

Proposes a management plan that establishes well-defined lines of authority, responsibility, and communication and management techniques that facilitate the early identification and resolution of problems.

Criterion 3: Institutional Capacity (15 points)Applicants will be evaluated for their institutional capacity – their ability to gather the resources and expertise necessary to implement their application, and to be able to sustain their efforts for the duration of the agreement. The bullet statements listed below are illustrative, but not exhaustive, of the considerations that make up this criterion.

Presents relevant work experience and representative accomplishments in managing and implementing similar projects;

Demonstrates organizational knowledge and institutional capability to design and implement the HRH program;

Exhibits an ability to facilitate a rapid adoption of the practices by GOE. Exhibits an ability to sustain agreement performance and capacity building.

Criterion 4: Past Performance (10 points)Applicants will be evaluated for superior past performance on similar programs, projects or engagements as evidenced by performance records and the testimony of clients. Applicants without evidence or record of relevant past performance will be evaluated neutrally for this criterion. The bullet statements listed below are illustrative, but not exhaustive, of the considerations that make up this criterion.

Exhibits a past record of customer satisfaction, including satisfactory business relationship to clients, initiation and management of several complex activities simultaneously, coordination among subcontractors and developing country partners, prompt and satisfactory correction of problems, and cooperative attitude in resolving clients’ problems.


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Exhibits a past record of timeliness of performance, including adherence to agreed schedules and other time-sensitive project conditions, and effectiveness of home and field office management to make prompt decisions and ensure efficient operation of tasks.

COST EVALUATION CRITERIA

For the purpose of this RFA, technical considerations are more important than cost. Cost criteria will not be scored. Rather, proposed costs will be analyzed for cost realism, reasonableness, completeness, effectiveness, and allocability. Applications providing the best value to the Government, including cost share, will be more favorably considered for award.


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SECTION VI - AWARD AND ADMINISTRATION INFORMATION

A. Authority to Obligate the Government: The Agreement Officer is the only individual who may legally commit the Government to the expenditure of public funds. No costs chargeable to the proposed Agreement may be incurred before receipt of either a fully executed Agreement or a specific, written authorization from the Agreement Officer.

B. A written award mailed or otherwise furnished to the successful applicant(s) within the time for acceptance specified either in the application(s) or in this RFA (whichever is later) shall result in a binding cooperative agreement without further action by either party. Before the application's specified expiration time, if any, the Government may accept an application, whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award. Negotiations or discussions conducted after receipt of an application do not constitute a rejection or counteroffer by the Government.


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SECTION VII - CERTIFICATIONS, ASSURANCES, AND OTHER STATEMENTS OF THE APPLICANT

NOTE: When these Certifications, Assurances, and Other Statements of Recipient are used for cooperative agreements, the term "Grant" means "Cooperative Agreement."

Part I – Certifications and Assurances

1. Assurance of Compliance with Laws and Regulations Governing Non-Discrimination in Federally Assisted Programs

Note: This certification applies to Non-U.S. organizations if any part of the program will be undertaken in the United States.

(a) The recipient hereby assures that no person in the United States shall, on the bases set forth below, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under, any program or activity receiving financial assistance from USAID, and that with respect to the Cooperative Agreement for which application is being made, it will comply with the requirements of:

(1) Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352, 42 U.S.C. 2000-d), which prohibits discrimination on the basis of race, color or national origin, in programs and activities receiving Federal financial assistance;

(2) Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), which prohibits discrimination on the basis of handicap in programs and activities receiving Federal financial assistance;

(3) The Age Discrimination Act of 1975, as amended (Pub. L. 95-478), which prohibits discrimination based on age in the delivery of services and benefits supported with Federal funds;

(4) Title IX of the Education Amendments of 1972 (20 U.S.C. 1681, et seq.), which prohibits discrimination on the basis of sex in education programs and activities receiving Federal financial assistance (whether or not the programs or activities are offered or sponsored by an educational institution); and

(5) USAID regulations implementing the above nondiscrimination laws, set forth in Chapter II of Title 22 of the Code of Federal Regulations. 06/23/2011 Partial Revision

(b) If the recipient is an institution of higher education, the Assurances given herein extend to admission practices and to all other practices relating to the treatment of students or clients of the institution, or relating to the opportunity to participate in the provision of services or other benefits to such individuals, and shall be applicable to the entire institution unless the recipient establishes to the satisfaction of the USAID Administrator that the institution's practices in


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designated parts or programs of the institution will in no way affect its practices in the program of the institution for which financial assistance is sought, or the beneficiaries of, or participants in, such programs.

(c) This assurance is given in consideration of and for the purpose of obtaining any and all Federal grants, loans, contracts, property, discounts, or other Federal financial assistance extended after the date hereof to the recipient by the Agency, including installment payments after such date on account of applications for Federal financial assistance which was approved before such date. The recipient recognizes and agrees that such Federal financial assistance will be extended in reliance on the representations and agreements made in this Assurance, and that the United States shall have the right to seek judicial enforcement of this Assurance. This Assurance is binding on the recipient, its successors, transferees, and assignees, and the person or persons whose signatures appear below are authorized to sign this Assurance on behalf of the recipient.

2. Certification Regarding Lobbying

The undersigned certifies, to the best of his or her knowledge and belief, that:

(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal Cooperative Agreement, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan, or cooperative agreement.

(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions.

(3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, United States Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.


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Statement for Loan Guarantees and Loan Insurance

“The undersigned states, to the best of his or her knowledge and belief, that: If any funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this commitment providing for the United States to insure or guarantee a loan, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. Submission of this statement is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required statement shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.”

3. Prohibition on Assistance to Drug Traffickers for Covered Countries and Individuals (ADS 206)

USAID reserves the right to terminate this Agreement, to demand a refund or take other appropriate measures if the Grantee is found to have been convicted of a narcotics offense or to have been engaged in drug trafficking as defined in 22 CFR Part 140. The undersigned shall review USAID ADS 206 to determine if any certifications are required for Key Individuals or Covered Participants.

If there are COVERED PARTICIPANTS: USAID reserves the right to terminate assistance to or take other appropriate measures with respect to, any participant approved by USAID who is found to have been convicted of a narcotics offense or to have been engaged in drug trafficking as defined in 22 CFR Part 140.

4. Certification Regarding Terrorist Financing, Implementing Executive Order 13224

By signing and submitting this application, the prospective recipient provides the certification set out below: 1. The Recipient, to the best of its current knowledge, did not provide, within the previous ten years, and will take all reasonable steps to ensure that it does not and will not knowingly provide, material support or resources to any individual or entity that commits, attempts to commit, advocates, facilitates, or participates in terrorist acts, or has committed, attempted to commit, facilitated, or participated in terrorist acts, as that term is defined in paragraph 3.

2. The following steps may enable the Recipient to comply with its obligations under paragraph 1:

a. Before providing any material support or resources to an individual or entity, the Recipient will verify that the individual or entity does not (i) appear on the master list of Specially Designated Nationals and Blocked Persons, which is maintained by the U.S. Treasury’s Office of Foreign Assets Control (OFAC), or (ii) is not included in any


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supplementary information concerning prohibited individuals or entities that may be provided by USAID to the Recipient.

b. Before providing any material support or resources to an individual or entity, the Recipient also will verify that the individual or entity has not been designated by the United Nations Security (UNSC) sanctions committee established under UNSC Resolution 1267 (1999) (the “1267 Committee”) [individuals and entities linked to the Taliban, Usama bin Laden, or the Al Qaida Organization]. To determine whether there has been a published designation of an individual or entity by the 1267 Committee, the Recipient should refer to the consolidated list available online at the Committee’s website: http://www.un.org/Docs/sc/committees/1267/1267ListEng.htm.

c. Before providing any material support or resources to an individual or entity, the Recipient will consider all information about that individual or entity of which it is aware and all public information that is reasonably available to it or of which it should be aware.

d. The Recipient also will implement reasonable monitoring and oversight procedures to safeguard against assistance being diverted to support terrorist activity.

3. For purposes of this Certification-

a. “Material support and resources” means currency or monetary instruments or financial securities, financial services, lodging, training, expert advice or assistance, safehouses, false documentation or identification, communications equipment, facilities, weapons, lethal substances, explosives, personnel, transportation, and other physical assets, except medicine or religious materials.”

b. “Terrorist act” means- (i) an act prohibited pursuant to one of the 12 United Nations Conventions and Protocols related to terrorism (see UN terrorism conventions Internet site: http://untreaty.un.org/English/Terrorism.asp); or

(ii) an act of premeditated, politically motivated violence perpetrated against noncombatant targets by subnational groups or clandestine agents; or

(iii) any other act intended to cause death or serious bodily injury to a civilian, or to any other person not taking an active part in hostilities in a situation of armed conflict, when the purpose of such act, by its nature or context, is to intimidate a population, or to compel a government or an international organization to do or to abstain from doing any act.

c. “Entity” means a partnership, association, corporation, or other organization, group or subgroup.


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d. References in this Certification to the provision of material support and resources shall not be deemed to include the furnishing of USAID funds or USAID-financed commodities to the ultimate beneficiaries of USAID assistance, such as recipients of food, medical care, micro-enterprise loans, shelter, etc., unless the Recipient has reason to believe that one or more of these beneficiaries commits, attempts to commit, advocates, facilitates, or participates in terrorist acts, or has committed, attempted to commit, facilitated or participated in terrorist acts.

e. The Recipient’s obligations under paragraph 1 are not applicable to the procurement of goods and/or services by the Recipient that are acquired in the ordinary course of business through contract or purchase, e.g., utilities, rents, office supplies, gasoline, etc., unless the Recipient has reason to believe that a vendor or supplier of such goods and services commits, attempts to commit, advocates, facilitates, or participates in terrorist acts, or has committed, attempted to commit, facilitated or participated in terrorist acts.

This Certification is an express term and condition of any agreement issued as a result of this application, and any violation of it shall be grounds for unilateral termination of the agreement by USAID prior to the end of its term.

5. Certification of Recipient

By signing below the recipient provides certifications and assurances for (1) the Assurance of Compliance with Laws and Regulations Governing Non-Discrimination in Federally Assisted Programs, (2) the Certification Regarding Lobbying, (3) the Prohibition on Assistance to Drug Traffickers for Covered Countries and Individuals (ADS 206) and (4) the Certification Regarding Terrorist Financing Implementing Executive Order 13224 above.

RFA/APS No. ________________________________

Application No. ______________________________

Date of Application ______________________________

Name of Recipient _______________________________

Typed Name and Title __________________________________

Signature _____________________________________

Date _______________


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Part II – Key Individual Certification Narcotics Offenses and Drug Trafficking

I hereby certify that within the last ten years:

1. I have not been convicted of a violation of, or a conspiracy to violate, any law or regulation of the United States or any other country concerning narcotic or psychotropic drugs or other controlled substances.

2. I am not and have not been an illicit trafficker in any such drug or controlled substance.

3. I am not and have not been a knowing assistor, abettor, conspirator, or colluder with others in the illicit trafficking in any such drug or substance.

Signature: ____________________________

Date: ____________________________

Name: ____________________________

Title/Position: ____________________________

Organization: ____________________________

Address: ____________________________ ____________________________

Date of Birth: ____________________________

NOTICE:

1. You are required to sign this Certification under the provisions of 22 CFR Part 140, Prohibition on Assistance to Drug Traffickers. These regulations were issued by the Department of State and require that certain key individuals of organizations must sign this Certification.

2. If you make a false Certification you are subject to U.S. criminal prosecution under 18 U.S.C. 1001.


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Part III – Participant Certification Narcotics Offenses and Drug Trafficking

1. I hereby certify that within the last ten years:

a. I have not been convicted of a violation of, or a conspiracy to violate, any law or regulation of the United States or any other country concerning narcotic or psychotropic drugs or other controlled substances.

b. I am not and have not been an illicit trafficker in any such drug or controlled substance.

c. I am not or have not been a knowing assistor, abettor, conspirator, or colluder with others in the illicit trafficking in any such drug or substance.

2. I understand that USAID may terminate my training if it is determined that I engaged in the above conduct during the last ten years or during my USAID training.

Signature: ___________________________________

Name: ___________________________________

Date: ___________________________________

Address: ___________________________________ ___________________________________

Date of Birth: ___________________________________

NOTICE:

1. You are required to sign this Certification under the provisions of 22 CFR Part 140, Prohibition on Assistance to Drug Traffickers. These regulations were issued by the Department of State and require that certain participants must sign this Certification.

2. If you make a false Certification you are subject to U.S. criminal prosecution under 18 U.S.C. 1001.


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Part IV – Survey on Ensuring Equal Opportunity for Applicants Applicability: All RFA’s must include the attached Survey on Ensuring Equal Opportunity for Applicants as an attachment to the RFA package. Applicants under unsolicited applications are also to be provided the survey. (While inclusion of the survey by Agreement Officers in RFA packages is required, the applicant’s completion of the survey is voluntary, and must not be a requirement of the RFA. The absence of a completed survey in an application may not be a basis upon which the application is determined incomplete or non-responsive. Applicants who volunteer to complete and submit the survey under a competitive or non-competitive action are instructed within the text of the survey to submit it as part of the application process.)

Survey on Ensuring Equal Opportunity for Applicants


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Part V – Other Statements of Recipient

1. Authorized Individuals

The recipient represents that the following persons are authorized to negotiate on its behalf with the Government and to bind the recipient in connection with this application or grant: Name Title Telephone No. Facsimile No. ________________________________________________________________ ________________________________________________________________ ________________________________________________________________

2. Taxpayer Identification Number (TIN)

If the recipient is a U.S. organization, or a foreign organization which has income effectively connected with the conduct of activities in the U.S. or has an office or a place of business or a fiscal paying agent in the U.S., please indicate the recipient's TIN: TIN: ________________________________

*3. Data Universal Numbering System (DUNS) Number

(a) In the space provided at the end of this provision, the recipient should supply the Data Universal Numbering System (DUNS) number applicable to that name and address. Recipients should take care to report the number that identifies the recipient's name and address exactly as stated in the proposal.

(b) The DUNS is a 9-digit number assigned by Dun and Bradstreet Information Services. If the recipient does not have a DUNS number, the recipient should call Dun and Bradstreet directly at 1-800-333-0505. A DUNS number will be provided immediately by telephone at no charge to the recipient. The recipient should be prepared to provide the following information:

(1) Recipient's name. (2) Recipient's address. (3) Recipient's telephone number. (4) Line of business. (5) Chief executive officer/key manager. (6) Date the organization was started. (7) Number of people employed by the recipient. (8) Company affiliation.

*(c) Recipients located outside the United States may e-mail Dun and Bradstreet at [email protected] to obtain the location and phone number of the local Dun and Bradstreet Information Services office.

The DUNS system is distinct from the Federal Taxpayer Identification Number (TIN) system. DUNS: ________________________________________


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4. Letter of Credit (LOC) Number

If the recipient has an existing Letter of Credit (LOC) with USAID, please indicate the LOC number:

LOC: _________________________________________ 5. Procurement Information

(a) Applicability. This applies to the procurement of goods and services planned by the recipient (i.e., contracts, purchase orders, etc.) from a supplier of goods or services for the direct use or benefit of the recipient in conducting the program supported by the grant, and not to assistance provided by the recipient (i.e., a subgrant or subagreement) to a subgrantee or subrecipient in support of the subgrantee's or subrecipient's program. Provision by the recipient of the requested information does not, in and of itself, constitute USAID approval.

(b) Amount of Procurement. Please indicate the total estimated dollar amount of goods and services which the recipient plans to purchase under the grant: $__________________________

(c) Nonexpendable Property. If the recipient plans to purchase nonexpendable equipment which would require the approval of the Agreement Officer, please indicate below (using a continuation page, as necessary) the types, quantities of each, and estimated unit costs. Nonexpendable equipment for which the Agreement Officer's approval to purchase is required is any article of nonexpendable tangible personal property charged directly to the grant, having a useful life of more than one year and an acquisition cost of $5,000 or more per unit.

TYPE/DESCRIPTION (Generic) ____________________________ QUANTITY ____________________________ ESTIMATED UNIT COST ____________________________

(d) Restricted Goods. If the recipient plans to purchase any restricted goods, please indicate below (using a continuation page, as necessary) the types and quantities of each, estimated unit costs of each, intended use, and probable source and/or origin. Restricted goods are Agricultural Commodities, Motor Vehicles, Pharmaceuticals, Pesticides, Rubber Compounding Chemicals and Plasticizers, Used Equipment, U.S. Government-Owned Excess Property, and Fertilizer.

TYPE/DESCRIPTION ______________________________ QUANTITY ______________________________ ESTIMATED ______________________________ PROBABLE ______________________________ INTENDED USE (Generic) ______________________________ UNIT COST ______________________________ SOURCE ______________________________ ORIGIN ______________________________


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(e) Proposed Disposition. If the recipient plans to purchase any nonexpendable equipment with a unit acquisition cost of $5,000 or more, please indicate below (using a continuation page, as necessary) the proposed disposition of each such item. Generally, the recipient may either retain the property for other uses and make compensation to USAID (computed by applying the percentage of federal participation in the cost of the original program to the current fair market value of the property), or sell the property and reimburse USAID an amount computed by applying to the sales proceeds the percentage of federal participation in the cost of the original program (except that the recipient may deduct from the federal share $500 or 10% of the proceeds, whichever is greater, for selling and handling expenses), or donate the property to a host country institution, or otherwise dispose of the property as instructed by USAID.

TYPE/DESCRIPTION (Generic) ______________________________ QUANTITY ______________________________ ESTIMATED UNIT COST ______________________________ PROPOSED DISPOSITION ______________________________

6. Past Performance References

On a continuation page, please provide past performance information requested in the RFA.

7. Type of Organization

The recipient, by checking the applicable box, represents that -

(a) If the recipient is a U.S. entity, it operates as [ ] a corporation incorporated under the laws of the State of, [ ] an individual, [ ] a partnership, [ ] a nongovernmental nonprofit organization, [ ] a state or local governmental organization, [ ] a private college or university, [ ] a public college or university, [ ] an international organization, or [ ] a joint venture; or

(b) If the recipient is a non-U.S. entity, it operates as [ ] a corporation organized under the laws of _____________________________ (country), [ ] an individual, [ ] a partnership, [ ] a nongovernmental nonprofit organization, [ ] a nongovernmental educational institution, [ ] a governmental organization, [ ] an international organization, or [ ] a joint venture.

8. Estimated Costs of Communications Products

The following are the estimate(s) of the cost of each separate communications product (i.e., any printed material [other than non-color photocopy material], photographic services, or video production services) which is anticipated under the grant. Each estimate must include all the costs associated with preparation and execution of the product. Use a continuation page as necessary.


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ANNEX I – SURVEY ON EEO FORM

Separately attached


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See

ANNEX II – SF 424

Separately attached

STRENGTHENING HUMAN RESOURCES FOR · Web viewThe United States Agency for International...

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