HM Medical Clinic

Even if Viagra is not needed, it is possible that the doctor will be able to determine the etiology of erectile dysfunction and prescribe appropriate treatmen priligy australia it doesn't pay to forget about sexual activeness even at the first sings of malfunction.

Koica.go.kr


Federal Agency Name:
United States Agency for International (USAID) Mission to Ethiopia
Funding Opportunity Title:
TRANSFORM/Primary Health Care Unit (TRANSFOR/PHCU) Announcement Type:
Annual Program Statement (APS) Notice of Funding Opportunity Number: APS-663-16-000005
Catalog of Federal Domestic Assistance
(CFDA) Number:
Issuance Date:
Deadline for Questions before the First
Round Concept Papers (Round 1):
April 12, 2016 at 5:00 pm Addis Ababa Deadline for First Round Concept
Papers Submission (Round 1):

May 12, 2016 at 2:00 pm Addis Ababa Time Questions before the Second Submission
of Concept Papers (Round 2 if requested): TBD
Deadline for Second Submission
of Concept Papers (Round 2 if requested): TBD
Submit questions and concept papers electronically to:with a
copy to:
Henok Amenu Oljira Senior Acquisition & Assistance Specialist NFO in the form of an APS is used when USAID intends to support a variety of creative
approaches towards developing methodologies to assess and implement development
objective activities. The closing date of this APS is six months after issuance date unless
amended.



Subject:
Notice of Funding Opportunity (NFO) Number: APS-663-16-000005
Program Title: TRANSFORM/Primary Health Care Unit (PHCU)
Ladies/Gentlemen:
The United States Agency for International Development, Mission in Ethiopia,
(USAID/Ethiopia) is seeking concept paper for selecting a consortium led by an
organization for a Cooperative Agreement from qualified U.S. and Non-U.S.
organizations to fund a program entitled TRANSFORM-Primary Health Care Unit
(TRANSFORM/PHCU). Eligibility for this award is not restricted; see Section C of this
NFO for eligibility requirements. The authority for this Notice of Funding Opportunity
(NFO) is found in the Foreign Assistance Act of 1961, as amended.
Please be aware that this NFO is non-traditional and contains three merit review phases
(Evaluation Phase 1 and 2 and Final Program Description). Full application will be
requested from the applicant selected from evaluation Phase-2 after a Program
Description is developed in collaboration with USAID/Ethiopia, the Host Government
and stakeholders. The apparently successful applicant will take the lead in development
of the Program Description/Technical Application as this program will be its program.
Evaluation Phase 1: Applicants will submit a concept paper. After review of the concept
papers, those applicants whose concepts are determined technically capable will be
invited to participate in Phase-2.
Evaluation Phase 2: Qualified applicants from Phase-1 will be invited to participate in
oral presentations of their proposed technical approach in Addis Ababa, Ethiopia.
Evaluation Phase 3: One applicant whose application and proposed consortium best
meets the objectives of this funding opportunity based on the selection criteria contained
herein will be selected to co-create a program description which will be incorporated into
resulting Cooperative Agreement. USAID will review the final program description and
grade it as acceptable or not acceptable.
This NFO will remain open for six months from the date signed by the Agreement
Officer. If concept papers received during the first-round are found to be unacceptable,
USAID will call for second round concept papers by issuing Amendment to this NFO.
Detailed instructions can be found in Section D of this NFO.


APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU)
TABLE OF CONTENT
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 1 of 99
ABREVIATIONS AND ACCRONYMS USED IN THIS NFO

Agreement/Contracting Officer's Representative Artemisinin-Based Combination Therapy Automated Directives System Active Management of Third Stage of Labor Agreement Officers Annual Program Statement Adolescent Reproductive Health Antiretroviral Therapy Apparently Successful Applicant Approval for the Use of Partner Government Systems Basic Emergency Obstetric and Newborn Care USAID/Ethiopia Best Practices at Scale in the Home, Community and Facilities Action Plan The Business Process Re-Engineering Community Based Newborn Care Community Based Nutrition Community-Based Organization Community Conversations United States Centers for Disease Control and Prevention Country Development Cooperation Strategy 2011-2015 Commune Development Program Case Detection Rate Comprehensive Emergency Obstetric and Newborn Care Code of Federal Regulations Charities and Societies Agency Community Mobilization Community-Based Management of Acute Malnutrition Cooperative Agreement Consortium of Reproductive Health Associations Contraceptive Prevalence Rate Civil Society Organizations Couple Years Protection Deputy Chief of Party Development Objective Department of Defense Directly Observed Treatment Data Quality Assessment Developing Regional States Dun and Bradstreet Universal Numbering System Ethiopian Demographic and Health Survey APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 2 of 99
Environmental Mitigation and Monitoring Plan Elimination of Mother to Child Transmission of HIV Essential Newborn Care End Preventable Child and Maternal Deaths Expanded Program on Immunization IFHP-Evidence to Action Federal Democratic Republic of Ethiopia Female Genital Cutting Federal HIV/AIDS Prevention, Control and Coordinating Federal Ministry of Health Family Planning/Reproductive Health Female Sex Worker Gender-Based violence The Global Fund to Fight AIDS, Tuberculosis and Malaria Greatest Impact Analysis Government of Ethiopia Growth and Transformation Plan Health, AIDS, Population and Nutrition Health Communication Unit Health Care Workers Health Development Army Health Extension Program Health Extension Worker Hamlin Fistula Ethiopia Hospital Health Management Information System Human Resources for Health Health Sector Development Programme IV 2011-2015 Health Sector Financing Reform Health Sector Transformation Plan Harmful Traditional Practices Integrated Community Case Management Information, Education and Communication/Behavior Change Communication Integrated Family Health Program Integrated Management of Newborn and Childhood Illness Infant Mortality Rate Interpersonal Communication Intermediate Result Indoor Residual Insecticide Spraying Integrated Supportive Supervision Insecticide-Treated Net APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 3 of 99
Intrauterine Contraceptive Devices WHO/UNICEF Joint Monitoring Program Korean Organization for International Cooperation Lactation Amenorrhea Long-Acting Reversible Contraceptives Local Capacity Development Long-Lasting Insecticide-Treated Net Leadership, Management and Governance Most-at-risk populations Maternal and Child Health Maternal Child Survival Program Millennium Development Goal Multi-drug Resistant TB Monitoring, Evaluation, Learning, and Adapting Mission Environmental Officer Malaria Indicator Survey Maternal Mortality Ratio Maternal, Neonatal and Child Health Ministry of Health Ministry of Labor and Social Affairs Ministry of Women's Affairs Ministry of Women, Youth and Children's Affairs Monitoring and Evaluation Non-Governmental Organization Negotiated Indirect Cost Rate Agreement Neonatal Intensive Care Units Neonatal Mortality Rate National Nutrition Program National Network of Positive Women Ethiopians Notice of Funding Opportunity (NFO and APS are interchangeably used in this package and have similar mining) No-scalpel Vasectomy Neglected Tropical Diseases Obstetric Fistula Orphans and Vulnerable Children One WASH National Plan President's Emergency Plan for AIDS Relief Primary Health Care Unit Public International Organization Persons Living with HIV/AIDS Permanent Methods Performance Monitoring and Evaluation Plan President's Malaria Initiative Prevention of Mother to Child Transmission APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 4 of 99
Point of Contact Quality Improvement Questions and answers Rapid Diagnostic Tests Request for Assistance Regional Health Bureau Reproductive, Maternal, Newborn, and Child Health successful applicants Successful Applicant System for Award Management Social and Behavior Change Communication Selection Committee Supply Chain Management Strengthening Ethiopia's Urban Health Extension Program Strategic Plan II for Intensifying Multisectoral HIV and Response in Ethiopia Southern Nations, Nationalities, and Peoples' Region Technical Assistance Total Estimated Amount Total Fertility Rate United States Agency for International Development United States Government Under-five Mortality Rate Woreda-Based Health Sector Planning Women's Development Army World Health Organization WASH Implementation Framework Woreda Health Offices Extremely Drug Resistant TB Youth Friendly Service Zonal Health Bureau APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 5 of 99
SECTION A: GENERAL PROGRAM DESCRIPTION
USAID/Ethiopia, in partnership with the Korean Organization for International Cooperation (KOICA) intends to award a five-year assistance activity, entitled TRANSFORM/ Primary Health Care Unit (PHCU), not to exceed $120 million to support an organization or group of organizations, from here on known as "Applicant" or "Consortium" who share the expressed public purpose of improving healthcare outcomes to End Preventable Child and Maternal Deaths (EPCMD) in Ethiopia, which in turn support GoE efforts in EPCMD; this will be accomplished through a competitive Annual Program Statement (APS) subject to the availability of funding. TRANSFORM/PHCU will operate in the four most populous rural regions of Ethiopia (Amhara, Oromia, Tigray and Southern Nations, Nationalities and People's Region (SNNPR)). USAID/Ethiopia will support the successful Applicants in achieving the applicant's public purpose of improving EPCMD outcomes. This will be accomplished in part by: mitigating the drivers of child and maternal mortality in Ethiopia's most populous regions through the facilitation and implementation of quality health service delivery; improved management and performance of health systems; and implementation of innovative and evidence-based social behavioral change and communication interventions. TRANSFORM/PHCU will be implemented to support health sector actors in their declared purpose of contributing to EPCMD efforts, and in close coordination with the Government of Ethiopia (GoE) and other sector actors, to meet the ambitious goals outlined in the GoE's Health Sector Transformation Plan (HSTP). The selection and design process follows a different pathway than most USAID assistance instruments. Consortia of Applicants will submit a ten-page Concept Paper to express their interest. USAID/Ethiopia will then select the top ranked Consortia to give oral presentations in Addis Ababa on their proposed program. Based on the oral presentations, one Consortium will be invited to collaboratively develop a final program description with USAID/Ethiopia and the GoE. USAID/Ethiopia contemplates substantial involvement in this assistance instrument; however, a final determination on the type of assistance instrument and nature of the partnership will be made during the collaborative-development phase. A full description of Application Instructions and Merit Review Criteria can be found in Section D, Section E, respectively. Please note that while one award is anticipated as a result of this APS, USAID reserves the right to fund any or none of the applications submitted. The authority for this Notice of Funding opportunity APS is found in the Foreign Assistance Act of 1961, as amended. For US organizations, 2 CFR 200, 2 CFR 700, OMB Circulars, and USAID Standard Provisions for U.S. Nongovernmental recipients will be applicable. For non-U.S. organizations, the Standard Provisions for Non-U.S., Nongovernmental recipients and the applicable cost principles (OMB Circular A-122 for non-profit organizations and OMB Circular A-21 for universities) will apply. The OMB circulars are available in the following link: APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 6 of 99
http://www.whitehouse.gov/omb/circulars/index.html. For both U.S. and non-U.S. for-profit organizations Federal Acquisition Regulation (FAR) Part 31 will be applicable. While 2 CFR 200and 2 CFR 700 do not apply directly to non-U.S. Applicants, the Agreement Officer (AO) will use the standards of 2 CFR 200 and 2 CFR 700 in the administration of the award. Further information including the referenced documents may be obtained via our agency websitehttp://www.usaid.gov directly or via links in USAID Automated Directive System (ADS) Chapter303: http://www.usaid.gov/policy/ads/300/303.pdf. Copies may also be obtained from the listed agency points of contact for this APS. Background
In the past two decades, Ethiopia has experienced significant improvements in its health system and the health status of its populations. Ethiopia reduced its under-five mortality by two thirds between 1990 and 2012 meeting the target of Millennium Development Goal 4 on child survival. The GoE has also made remarkable progress in improving access to basic health services by increasing the number of Health Extension Workers (HEWs) to more than 38,000 and expanding primary health care facilities for millions of Ethiopians. In addition, the GoE has improved health care financing during the past five years by doubling their budget for health. While there have been notable improvements in the health sector, the population as a whole still has limited access to clean water, sanitation facilities, and quality health services; and is characterized by low levels of literacy and persistent food insecurity in some areas. These factors, among others, contribute to a high incidence of communicable diseases including TB, HIV/AIDS, malaria, neglected tropical diseases (NTDs), and respiratory infections, as well as nutritional deficiencies, maternal, neonatal, and child mortality. USAID recognizes that to support health sector actors in their public purpose of contributing to EPCMD goals, and to also support the GoE HSTP and achieve sustainable improved maternal and child health outcomes, will depend on the contributions of multiple interconnected actors – health sector actors whose public purpose is to contribute to EPCMD goals; the government, civil society, and other development organizations with advanced approaches that provide breakthrough, (not incremental) solutions. Advances could include new ways of delivering evidence-based interventions to meet the needs of hard to reach populations, new ways to increase uptake or more cost effective adaptations of these interventions or policy innovations. Ultimately, TRANSFORM/PHCU seeks to support the end of preventable child and maternal deaths through supporting health sector actors' public purpose to contribute to EPCMD efforts, and also improve engagement with the GoE on the implementation of its new HSTP. It will focus primarily in the areas of Maternal, Newborn, and Child Health; Family Planning and Reproductive Health; and Malaria within Ethiopia's four major regions of Amhara; Oromia; SNNPR; and Tigray. APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 7 of 99
Family Planning and Reproductive Health
Ethiopia has made significant gains in family planning and reproductive health evidenced
by significant increases in modern contraceptive prevalence rate including increase in
long-term methods. Despite observed progress, unmet need for family planning remains
high and there is regional disparity and urban rural divide is huge. Rural women bear an
average of 5.5 children – more than double that of their urban counterparts.
Maternal and Newborn Health
Ethiopia has made significant strides in improving the quality of maternal care and has
significantly increased births in facilities. Although recent UN estimate indicated that
Ethiopia is making progress towards achieving Millennium Development Goal (MDG) 5,
the MMR still remains high at any standard. The high maternal and neonatal mortality is
primarily due to poor quality of, access to and utilization of evidence-based high impact
maternal and newborn health services, such as skilled attendance at birth and emergency
obstetric care.
Child Health
Ethiopia has made significant strides in improving the health status of its children and
officially met its MDG 4 Goal of reducing under-five mortality by 67 percent since 1990.
Nevertheless, the rate is still unsatisfactorily high, and neonatal mortality rates (NMR)
have remained stagnant since 2005. Major causes of death in under-five children include
pneumonia, malaria, diarrhea, and severe acute malnutrition. Malnutrition in Ethiopia
contributes to more than half of all infant and child deaths as well as poor maternal
health.
Malaria
Malaria remains a major public health problem in Ethiopia. Malaria Indicator Surveys in
2007 and 2011 have shown that malaria prevalence has remained at about 1 percent
among children aged less than five years, and measures of severe anemia have also
remained unchanged in that interval. According to the FMOH, in 2012/2013, malaria was
the leading cause of outpatient visits and health facility admissions, accounting for 11.7
percent of reported outpatient visits and 10.9 percent of admissions. Malaria was also
among the ten leading causes of inpatient deaths among children under five years of age.
The transmission of malaria in Ethiopia depends on altitude and rainfall.
Project Objective

TRANSFORM/PHCU will support an Applicant that shares the expressed public purpose
of supporting the GoE's priorities and its recently finalized HSTP (2015/6-2019/20) to
end Preventable Child and Maternal Deaths. The GoE has set very ambitious targets for
health, and allocates significant resources to meet its objectives.
TRANSFORM/PHCU is aligned with USAID/Ethiopia's current Country Development
Cooperation Strategy (CDCS) and the EPCMD multi-year strategy by working to
sustainably reduce preventable maternal and child deaths, and furthermore supports the
GoE's goal for achieving ‘the highest quality of life for all its citizens' through
‘excellence in health service delivery'. Finally, this activity contributes directly to the
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 8 of 99
U.N. Global Goal number 3 for Sustainable Development: ‘ensure healthy lives and promote well-being for all at all ages' and directly will support 4of its targets (reduction in maternal mortality; end preventable deaths of newborns and children under 5; end the epidemics of Malaria; and ensure universal access to sexual and reproductive health-care services, including family planning). USAID Programming

Ending Preventable Child and Maternal Deaths
In line with global strategies of the World Health Organization (WHO), the United
Nations Child Fund (UNICEF) and, more recently, the United Nations Sustainable
Development Agenda, USAID has realigned the majority of its maternal and child health
funding to 24 countries, which includes Ethiopia, that account for 70 percent of child and
maternal deaths and half of the unmet need for family planning – phasing out funding in
26 countries. Supporting these multi-lateral initiatives, USAID has undertaken a review
of every dollar it spends in its 24 priority countries to accelerate reductions in maternal
and child death. These reviews were undertaken to ensure that country programs focus
on those interventions that will have the greatest impact on maternal and child death
reductions. USAID seeks that its funded activities: deliver results on a meaningful scale;
promote sustainable development through high-impact partnerships and local solutions;
and identify and scale up innovative, breakthrough solutions to intractable development
challenges.
TRANSFORM Summary
TRANSFORM/PHCU is part of the TRANSFORM awards, an overall package of linked
activities that USAID has funded to support organizations working towards EPCMD in
Ethiopia. The overall goal of the TRANSFORM awards is to support health sector actors
in their expressed public purpose to improve EPCMD outcomes in Ethiopia, and through
such support of sector actors, to assist the GoE's attainment of its ambitious goals as
articulated in its new HSTP for EPCMD-related health impacts. Through support of its
implementing partners, USAID intends to make an important contribution to the
following aspirational targets presented in the HSTP:
∙ Maternal Mortality Ratio (MMR) to decrease from an estimated 420 to 199 per 100,000 live births; ∙ Total Fertility Rate (TFR) to decrease from 4.1 to 3 births per woman; ∙ Under-five Mortality Rate (U5MR) to reduce from 64 to 30 per 1,000 live births; ∙ Infant Mortality Rate (IMR) to reduce from 44 to 20 per 1,000 live births; and ∙ Neonatal Mortality Rate (NMR) to reduce from 28 to 10 per 1,000 live births. To reach these goals and impact, USAID, through the TRANSFORM partnerships, intends for its investments to achieve four key results over the next 5 years: a. Increased numbers of healthy mothers-successful birth outcomes
Illustrative Indicators include: 4 ANC visits; skilled birth attendance; fistula cases identified, referred and reintegrated; improved maternal nutrition; and PNC visit at least once post-partum. APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 9 of 99
b. Expanded access and uptake of family planning
Illustrative Indicators include: Modern Method Contraceptive Prevalence Rate; use of long-acting methods; age at first birth; access to post-abortion and postpartum family planning; birth spacing of at least two years apart; unmet need for family planning; and total fertility rate. c. Increased numbers of healthy newborns (birth to 28 days)
Illustrative Indicators include: skilled birth attendance; initiation of breastfeeding; PNC visit at least once PP; and neonatal sepsis incidence. d. Sustained gains in and improved <5 mortality
Illustrative Indicators include: Penta 3 coverage; fully immunized at 1 year; measles
coverage; exclusive breastfeeding 0-6 months; cases of malaria treated; and cases of
pneumonia treated.
For more information on TRANSFORM and the USAID health program see Section H:
Annex 1.
Activity Objective

This activity will support the successful Applicant in its public purpose of contributing to
the goal of ending preventable child and maternal deaths in Ethiopia. USAID's support
will facilitate the successful Applicant's and the health sector actors' engagement with
the GoE on the implementation of its new HSTP. It will focus primarily in the areas of
Maternal, Newborn and Child Health; Family Planning and Reproductive Health; and
Malaria within Ethiopia's four major regions of Amhara; Oromia; SNNPR; and Tigray.
TRANSFORM/PHCU will support the successful Applicant in its goal of implementing
proven high impact interventions and test new and promising approaches for ending
preventable child and maternal deaths and lessons learned from the ongoing main
predecessor activity, the Integrated Family Health Program (IFHP)/Evidence to Action
(E2A). Although USAID expects that the TRANSFORM/PHCU will build on the
accomplishments of IHFP/E2A and support an evidence-based package of services and
interventions, Ethiopia seeks innovations and technologies that provide breakthrough,
(not incremental) solutions to further Ethiopia's health objectives. Organizations with
potentially transformative approaches should provide evidence that their innovation or
technology will be viable in the Ethiopian context, demonstrate significant behavioral
change and demand, and achieve significant impact at or reduced cost. Organizations will
demonstrate their understanding of how the economic, political and social environment in
Ethiopia affects the application of their technologies and innovations.
Activity Objective: Support organizations in their public purpose to reduce maternal,
newborn and child mortality and increase uptake of family planning, in line with the GoE
HSTP, in the four regions of Amhara, Oromia, Tigray and SNNPR.
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 10 of 99
TRANSFORM/PHCU will achieve this objective by means of four high level results:
RESULT 1: Improved management and performance of health systems;
RESULT 2: Increased sustainable quality of service delivery across the PHCU's
continuum of care;
RESULT 3: Improved household and community health practices and health seeking
behaviors; and
RESULT 4: Enhanced program learning to impact policy and programming related to
ending preventable child and maternal deaths.
Due to USAID's extensive partner engagement in the Ethiopian health sector, USAID
expects close programmatic integration and collaboration between and among the
successful Applicants and other USAID health implementing partners, as well as
complementary Gates Foundation funded activities, such as its PHCU Transformation
Initiative (PTI) implemented by Yale University. (See SECTION H, Annex for more
information) To generate maximum impact, where appropriate, the successful Applicant
will leverage its interventions with other USAID activities, partners and donors that are
currently working on the ground. A successful Applicant will have demonstrated an
ability and willingness to complement, versus duplicate, work under pending and current
activities. This includes active collaboration with USAID/Ethiopia's SBCC project to
ensure SBCC messages and strategies are coordinated and effective down to the
community level. The TRANSFORM/PHCU is expected to collaborate with all relevant
TRANSFORM activities. For example, USAID/Ethiopia expects the successful
Applicant to work with TRANSFORM/Monitoring Learning and Evaluation Award
(MELA), to implement a collaborative learning and adaptive management strategy to
inform real and sustained improvements across the project and the health care system.
Geographic targeting will be collaboratively determined by the successful Applicants,
USAID, and the GoE using various data points, including the results of the Greatest
Impact Analysis. The results of this study will help determine the geographic areas of
greatest need and where investments can make the most impact. For more information
on the USAID and Gates-funded health program including the TRANSFORM package
(see Annex 1).
Written into this APS is the flexibility, where it furthers the Applicant's declared public
purpose, potential for the Applicant to directly partner with the GoE through
performance-based sub-awards that directly support the Applicant's implementation
strategy. When developing the Project Approval Document for the TRANSFORM
activities, USAID approved up to $30 million that could be provided to the GoE to
enhance its approach. While more than $30 million is possible, it would require
substantial amendments of USAID strategy documents and strong justification. In order
for the Applicant to ensure proper fiscal management, disbursement of these funds will
need to be contingent on GoE entities meeting pre-determined and verifiable financial
and technical milestones.
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 11 of 99
Additionally, USAID has also received authorization for the Applicant to conduct
renovations/infrastructure improvements at selected sites in support of its implementation
strategy. USAID, along with the GoE, has agreed to support these
renovations/infrastructure improvements in "compelling" circumstances, and with a cap
of up to $3 million for the life of the project. The criteria to determine what constitutes
"compelling" will be determined by the Applicant, in collaboration with USAID, the
FMOH, and RHBs, and should directly correlate to the applicant's/consortium's impact-
focused approach. Construction and Renovation activities are approved under this
activity in accordance with an approved Initial Environmental Examination (IEE) dated
September, 2011. For further information, please consult Automated Directives System
(ADS) 303.3.30 and USAID Implementation of Construction Activities, Mandatory
Reference for ADS Chapters 303, which describes how renovations under assistance
agreements may occur. All renovations must be approved by the USAID/Ethiopia
engineer and will be partially overseen by the Mission's Engineering Services and
Construction Oversight Mechanism (ESCO).
Supporting Information

Geographic and Target Population
The geographic focus for TRANSFORM/PHCU includes the four regions of Amhara;
Oromia; SNNPR; and Tigray. The target population is women of childbearing age,
mothers and their families, children under 15 years of age with a special focus on
children under 5 and newborns. Family Planning services target both adolescents, and
adult male and female populations of reproductive age.
TRANSFORM/PHCU will have access to baseline and performance data from previous
EPCMD activities including IFHP-Evidence to Action (E2A) project and the Greatest
Impact Analysis to target the specific areas within the four regions that are most likely to
benefit from and achieve results through this activity. While the target populations are in
the four regions, in close consultation with USAID and the GoE, the Consortium may
span geographic boundaries and successful Applicants may work with other actors that
are not located solely within the four regions.
Guiding Principles
TRANSFORM/PHCU will use a facilitative and collaborative approach to support the successful applicant in its public purpose of contributing to EPCMD efforts, which in turn will catalyze systemic changes in the health sector through partnerships with government agencies and local actors, and implementation will incorporate a Collaboration Learning and Adaption technique so that real-time strategies can be adopted. Alongside results, an important determinant of the success of TRANSFORM/PHCU is how the work is accomplished and the ability to show sustained systemic changes. These key principles include: APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 12 of 99
1. Public Purpose: USAID funding will support the successful applicant/Consortium in the achievement of its declared public purpose of contributing to EPCMD efforts in Ethiopia 2. Government Ownership: The country needs to drive its own development needs
and priorities. The role of USAID and the successful Applicants is to support and assist this process as partners toward the common objectives set forth in the HSTP. 3. Collaborative Learning and Adaptive Management: Adaptive management
refers to building in iterative learning through regular analyses, adaptation of best practices, and design for local conditions to attain the greatest impact. Establishing implementation decision points/milestones will be necessary during the life of the activity. USAID/Ethiopia's substantial involvement will also reflect that commitment (see Section H, Annex 2). 4. Capacity Strengthening: Strengthen local institutions, transfer technical skills,
and promote appropriate policies at all levels of the health system to ensure sustainability of impact and results. 5. Sustainability: The program design ensures its impact will endure. Resources are
finite and the successful Applicants in partnership with USAID/Ethiopia should consider whether the program, interventions, technologies and services they are introducing to the target population will have a lasting effect. 6. Results: In support of USAID strategic priority of investing for the highest
impact to support GOE's achievement of EPCMD, direct resources to achieve clearly defined, measurable, and strategically focused objectives; 7. Partnership:
Collaborate closely with the government, communities, development partners, non-profit organizations, international organizations, and universities. Close collaboration at all levels, including the network of organizations that will make up the Consortium will leverage ongoing investments, reduce duplication and facilitate the highest likelihood of success. APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 13 of 99
SECTION B: FEDERAL AWARD INFORMATION

Estimate Of Funds Available And Number Of Awards Contemplated
Subject to funding availability, USAID intends to provide up to $120,000,000 in total funding over a five year period. A minimum 10% cost-shared will also be required, bring the overall award amount to $132,000,000. See Section H for additional information on cost-share. Actual funding amounts are subject to availability of funds. USAID intends to award one Cooperative Agreement pursuant to this APS. Please note that there are several phases to this process and the final award will be determined after a final technical and cost application are collaboratively developed between the selected consortium, USAID and the GOE. USAID is not responsible for any costs incurred prior to awarding an agreement. USAID reserves the right to fund any one or none of the applications submitted. An illustrative budget broken down by funding source is below: TRANSFORM/PHCU TOTAL BUDGET

$58,349,146
$39,850,854
$6,125,000
FP/RH Fistula
$2,625,000
$8,050,000
KOICA Contribution
(60% MCH, 40%

$5,000,000
FPRH)
TOTAL
$16,300,534
$24,179,700
$24,679,700
$26,679,700
$28,160,366
ILLUSTRATIVE APPLICANT COST-SHARE
Partner Cost-Share
$12,000,000
TOTAL
ESTIMATED

Anticipated Start Date and Period of Performance for Federal
The period of performance anticipated herein is five (5) years. The estimated start date of the award is October 01, 2016. Substantial Involvement
USAID plans to negotiate and award a Cooperative Agreement as USAID desires to be substantially involved in the implementation of the selected program that is consistent with USAID policy contained in Automated Directives System (ADS) Chapter 303 concerning non-governmental assistance activities. This substantial involvement will be through the Agreement Officer, except to the extent that the Agreement Officer delegates authority to the AOR in writing. The intended purpose of the substantial involvement during the award is to assist the consortium in achieving the supported objectives of the agreement. In addition to the requirements in 2 CFR 200 and 2 CFR 700 and other applicable regulations or provisions, USAID/Ethiopia will be substantially involved APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 14 of 99
during the implementation of this Cooperative Agreement in the following ways through the AOR or the Agreement Officer as per ADS 303.3.11: a. Approval of the Recipient's Implementation Plans b. Approval of Specified Key Personnel c. Agency and Recipient Collaboration or Joint Participation of USAID and the recipient on the program such as the following: (1) Collaborative involvement in selection of advisory committee members (2) Concurrence on the substantive provisions of sub-awards. 2 CFR 200.308 already requires the recipient to obtain the AO's prior approval for the subaward, transfer, or contracting out of any work under an award. (3) Approval of the recipient's monitoring and evaluation plans. (4) Monitor to authorize specified kinds of direction or redirection because of interrelationships with other projects. All such activities must be included in the program description, negotiated in the budget, and made part of the award. d. Agency Authority to Immediately Halt a Construction Activity. USAID may immediately halt a construction activity if identified specifications are not met Purpose of the Award
The principal purpose of the relationship with the recipient under the subject program is to transfer funds to an applicant who in partnership with other organizations accomplishes their stated public purpose of supporting the GoE in its EPCMD efforts. The Applicant will be responsible for ensuring the achievement of the activity objective highlighted in the SECTION A, Activity Objective as well as efficient and effective administration of the award through the application of sound management practices. The Applicant will assume responsibility for administering Federal funds in a manner consistent with underlying agreements, program objectives, and the terms and conditions of the Federal award. The Applicant has the primary responsibility for employing its own unique combination of staff, facilities, and experience, as well as necessary organizational and management techniques in order to assure proper and efficient administration of the resulting award. Overall Process
There will be three Merit Review phases followed by a technical and cost application collaborative development phase. The purpose of this process is to identify an Applicant with the best-combined technical approach that will have the greatest chance of success in Ethiopia. This Applicant should build on the strengths of each individual organization APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 15 of 99
in a collaborative spirit and clear shared vision on how to best impact EPCMD in
Ethiopia.
Merit Review Phase 1: Applicants are invited to submit a Concept Paper not to exceed
ten pages, and Annex not to exceed thirty pages. No budget or cost application will be
accepted.
All concept papers must be in English. More information regarding the
Concept Paper submission follows in SECTION D. Concept Papers will be evaluated to
assess technical capability and approach. A limited number of Applicants, no more than
five, will be invited to Merit Review Phase 2.
In the event USAID determines none of submitted applications are acceptable, USAID
will issue an amendment to this NFO to again seek interested applicants.
Merit Review Phase 2: Selected Applicants will be invited to orally present their
concept approximately two weeks after concept papers are received. This in-person oral
presentation is a requirement. The oral presentations will occur in Addis Ababa,
Ethiopia
. The format and technical requirements will be made available to those
Applicants invited to participate in the oral presentations. The following participants
should be present for Phase 2:
∙ Proposed Chief of Party ∙ Consortium Lead's Technical Backstop ∙ One technical representative from each of the proposed Consortium members
The apparently successful Applicant will be notified within approximately two weeks
after oral presentations are completed. USAID will not be responsible for costs associated
with travel or presentation costs.
Application Collaborative Phase: The Applicant selected from merit review Phase-2
will be the apparently successful Applicant (ASA). The Applicant will be notified by
letter approximately two weeks after the completion of oral presentations. Approximately
two weeks after ASA notification, a two-week collaborative workshop will be hosted by
USAID in Ethiopia. This workshop, attended by the ASA, USAID, KOICA, and the
GoE will bring together the various technical approaches and innovations of each partner
and further define activities. Programmatic budget levels will also be determined during
this phase. The goal is that after the two-week workshop, a programmatic framework
will be in place which clearly illustrates how the ASA will tackle EPCMD through its
engagement with the GoE. Over the following two weeks, the ASA will continue to
work remotely to refine its approach and draft an updated program description and
accompanying cost-proposal. USAID and the GoE will review these two documents and
provide additional clarification questions. The ASA will have one week to respond. At
the end of the two weeks (or earlier), USAID will then receive the final program
description and cost application.
2 Apparently Successful Applicant(s) The applicant(s) for USAID funding recommended for an award after technical evaluation, but who has not yet been awarded cooperative agreement award by the Agreement Officer. Apparently successful applicant status confers no right and constitutes no USAID commitment to an award, which still must be obligated by the Agreement Officer. APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 16 of 99

USAID reserves the right to select another applicant from the pool of merit review phase-
2 participants in case final agreement is not reached with initial selected ASA.
No funding will be made available prior to the award of the Cooperative Agreement.
Applicants including the organizations selected to collaboratively develop the Program
Description are responsible for all costs incurred prior to the award of the Cooperative
Agreement, including travel and all other costs related to the oral presentation phase.
Award Phase:
Per USAID's requirements, the final technical and cost applications will be reviewed and
an award will be drafted and submitted to the ASA for review. Once the award is signed,
the Consortium may start incurring costs.
DRAFT TIMELINE
1
NOFO on the Street for first round concept paper SC #1 Review and selection Time between Review and Oral Presentation Oral Presentations STEC #2 Review and selection Time between selection In Country Collaborative Meeting Finalization of Program Description USAID and GOE Review and Response Consortium Response and Final Application Cost Realism Analysis and Award Drafting AARAD Submission Total Time from Solicitation to Award [End of Section B]
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 17 of 99
SECTION C: ELIGIBILITY INFORMATION

Eligible Applicants
This funding opportunity is open to all eligible U.S non-governmental and non-U.S non-governmental entities and individuals (other than those from foreign policy restricted countries). While USAID welcomes all eligible entities and individuals, applicants must be non-governmental. Pursuant to Code of Federal Regulations (CFR) 2 CFR 200.400(g), it is USAID policy not to award profit under assistance instruments such as cooperative agreements. While for-profit firms may participate, pursuant to 2 CFR 700.13(A).(1) Prohibition against profit: no funds will be paid as profit to any for-profit entity receiving or administering Federal financial assistance as a recipient or sub-recipient, and as such, for-profit organizations must waive profits and/or fees to be eligible to submit an application. Applicants must have established financial management, monitoring and evaluation processes, internal control systems, and policies and procedures that comply with established U.S. Government standards, laws, and regulations. The successful applicant(s) will be subject to a responsibility determination assessment (Pre-award Survey) by the Agreement Officer (AO). The Recipient must be a responsible entity. The AO may determine a pre-award survey is required 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 and comply with the terms and conditions of the award. New Partners
a) Potential New Implementing Partners USAID encourages applications from potential new partners. In support of the Agency‘s interest in fostering a larger assistance base and expanding the number and sustainability of development partners, USAID/Ethiopia encourages applications from potential new implementing partners. However, resultant awards to these organizations may be significantly delayed if USAID must undertake necessary pre-award reviews of these organizations to determine their "risk assessment" (see below). Non-U.S. Organization Pre-award Survey Guidelines and Support is available in the following link: b) Pre-award Risk Assessment In order for an award to be made, the AO must make a positive "risk assessment," as discussed in ADS 303.3.9. This means that the applicant must possess, or have the ability to obtain, the necessary management and technical competence to conduct the proposed program. The applicant must agree to practice mutually agreed-upon methods APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 18 of 99
of accountability for funds and other assets provided or funded by USAID. In the absence of a positive risk assessment, an award can ordinarily not be made. However, in rare cases, an award can be made with "Specific Conditions" (e.g., additional non-standard award requirements designed to minimize the risk presented to USAID of making an award to an NGO for which a positive risk assessment cannot be made), but only where it appears likely that the applicant can correct the deficiency in a reasonable period. Responsible Entity
The successful applicant will be responsible for ensuring achievement of the program objectives as described in PROGRAM DESCRIPTION. Applicants under consideration for an award may be subject to a pre-award audit to determine fiscal responsibility, ensure adequacy of financial controls, and establish an indirect cost rate. The Agreement Officer may determine if a Non-U.S. Organization Pre-Award Survey is required, and if so, would establish a formal survey team to conduct an examination that will determine whether a prospective recipient has the necessary organization, experience, accounting and operational controls, and technical skills—or the ability to obtain them—in order to achieve the objectives of the NFO. Cost Sharing or Matching
USAID has established a minimum cost share of 10 percent, or $12 million, for the recipient of the award. Such funds may be mobilized from the recipient; other multilateral, bilateral, and foundation donors; host governments; and local organizations, communities and private businesses that contribute financially and in-kind to implementation of activities at the country level. Cost Share becomes a condition of an award when it is part of the approved award budget. Cost- sharing or matching means that portion of project or program costs not borne by the U.S. Government. Cost-sharing includes cash and in-kind contributions, and is subject to 2 CFR 200.306 and the USAID standard provision for U.S. NGOs entitlehich, inter alia, requires that cost-sharing be verifiable from the Recipient's records. Cost- sharing or matching is normally associated with contributions from the same prime and sub- recipient sources that also receive USAID funds under an award, but can include contributions from third parties. The Cost Share must be verifiable from the recipient's records; for U.S. organizations it is subject to the requirements of 2 CFR 200.306, and for non-U.S. organizations it is subject to the Standard Provision, "Cost Share"; and can be audited. USAID encourages cost-sharing to the maximum practicable extent. Local Registration Requirement
Governments of Ethiopia laws require prior registration for a foreign and local organization in order to implement programs or conduct any business in Ethiopia. Any APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 19 of 99
successful applicant must provide a copy of the certification of initial or final registration and license from the appropriate Ministry/Agency of the Federal Democratic Republic of Ethiopia (FDRE) prior to the start of implementation of the program. All local institutions or affiliates of international organizations must be registered as a legal entity in Ethiopia. Local registration is not a requirement at application time, but it is required prior to the award of the Cooperative Agreement. An organization may not submit more than one concept paper/application as a prime or consortium leader. However, local organizations participating in a consortium may elect to participate in another consortium under a different concept paper. Additional local sub-partners may be brought into the consortium during the joint program development phase. Also, while there is no exclusive commitment requirement on the project chief of party, a chief of party can't represent more than one entity during the presentation phase. (End of Section C)
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 20 of 99

SECTION D: APPLICATION AND SUBMISSION INFORMATION
General Instructions
Applicants are expected to review, understand, and comply with all aspects of the NFO. Failure to do so will be at the Applicant's risk. This NFO and any future amendments can be downloaded fromelect "Find Grant Opportunities", then click on "Browse by Agency", and select the "US Agency for International Development" and search for this NFO. If there are problems in downloading this NFO, please contact the Grants.gov Help Desk at 1.800.518.4726 orfor technical assistance. Potential applicants that cannot download the application materials electronically may request paper copies of the NFO by contacting: Henok A. Oljira Senior Acquisition & Assistance Specialist Office of Acquisition & Assistance USAID/Ethiopia Telephone: +251-11-1306081 E-mail: Applicants shall acknowledge receipt of any amendment to this RFA by signing and returning the amendment. Applications must be directly responsive to the terms and conditions of this NFO. USAID may determine an application to be unacceptable if the application does not comply with all of the terms and conditions of the NFO. If an Applicant does not follow the instructions set forth herein, the Applicant's application may be eliminated from further consideration or the application may be down-graded and not receive full or partial credit under the applicable review criteria. Applicants must set forth full, accurate and complete information as required by this NFO. The penalty for making false statements to the U.S. Government is prescribed in 18 U.S.C. 1001. USAID may, without discussion or negotiations, award an Agreement resulting from this NFO to the responsible Applicant whose application conforms to the NFO and offers the greatest value to the Government, cost and technical factors considered. Therefore, the initial application should contain the Applicant's best terms from a cost and technical standpoint. USAID reserves the right (but is not under obligation to do so) to enter into discussions with one or more applicants in order to obtain clarifications, additional detail, or to suggest refinements in the program description, budget or other aspects of the application. APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 21 of 99
While USAID intends to award on Cooperative Award, USAID reserves the right to (a) reject any or all applications, (b) accept other than the lowest cost application, (c) accept more than one application, (d) accept alternate applications, and (e) waive informalities and minor irregularities in applications received. Other Submission Requirements
Applicants are required to submit their applications electronically via e-mail to the given
address specified below and under "Section D – CONCEPT APPLICATION AND
SUBMISSION INFORMATION". All concept papers received by the submission
deadline will be reviewed for responsiveness to the required information outlined in these
guidelines and the application format. No additions or modifications will be accepted
after the submission date.
a) Submission of Electronic Concept Paper and Full Application as applicable:
All submissions shall be made electronically. Applications will be submitted with the
name and address of the Applicant and the APS number (referenced above) inscribed
thereon, to insert POCs, via e-mail towith a copy to Henok Amenu
Oljira, aFor electronic submissions, your organization must ensure
that the applications are received at USAID/Ethiopia in its entirety. No addition or
modifications will be accepted after the submission date. E-mail attachments should be
formatted in Microsoft Word and/or Microsoft Excel format with 5 MB limit per e-mail.
Please convert your documents to one of these formats before sending them to
USAID/Ethiopia, or provide scanned copies of pages in .PDF format (Adobe PDF) if
they include signatures or forms.
In addition to the aforementioned guidelines, the Applicant is requested to take note of
the following:
Applications submitted electronically must be in either Microsoft Word (for narrative
text) or Excel (for tables), unless you are providing scanned copies of pages that include
signatures or forms.
After you have sent your applications electronically, please immediately check your own
email to confirm that the attachments you intended to be sent were indeed had been sent.
If you discover an error in your transmission, please send the material again and note in
the subject line of the email or indicate in the file name that it is the "corrected"
submission. Please do not send the same email more than once unless there has been a
change, and if it is the case, please note that in the "corrected" email.
USAID/Ethiopia will not be responsible for errors in compiling electronic applications if
no instructions are provided or are unclear.
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 22 of 99
Submission Dates and Times
Concept Papers are due to USAID/Ethiopia by day and time specified on the cover page of this NFO. USAID will determine whether an application that is not received by the Agreement Officer by the time and date indicated will be late. Because making an award is critical to USG foreign policy goals, time is important and late applications may not, at the sole discretion of the Agreement Officer, be considered. Questions and Answers: All questions regarding this NFO should be submitted by e-mail towith copy to Henok Amenu Oljira aon or before the indicated date for submission of questions at the top of the Cover Letter of this NFO to provide sufficient time to address the questions and incorporate the questions and answers as an amendment to this solicitation. Unless otherwise notified by an amendment to this NFO, no questions will be accepted after this date and time. Applicants must not submit questions to any other USAID staff. Any information given to a prospective Applicant concerning this NFO will be furnished promptly to all other prospective Applicants as an amendment to this NFO, if that information is necessary in submitting applications or if the lack of it would be prejudicial to any other prospective Applicant. Content and Form of Application Submission
USAID/Ethiopia will follow three-phase merit review process of application/selection process. The First Phase is the submission and review of written Concept Paper. The Second Phase is Oral Presentations, wherein the best technically acceptable applicants from the First Phase will be invited to present their applications orally in Addis Ababa, Ethiopia. USAID will provide notices to all applicants selected to participate in oral presentation. During the Third Phase, the apparently successful applicant(s) from the Second Phase will collaboratively develop a program description and submit a written full technical and cost application(s). Applicants not selected for the consecutive phase will be notified at end of each phase. Phase 1 - Concept Paper Content and Format:
The 10-page concept paper should be written from a comprehensive viewpoint that shows innovations and approaches proposed by applicant and its consortium partners. The concept paper should lay out how the Applicant and its consortium partners are uniquely capable of supporting health sector actors in their stated missions of improving results in key aspects of EPCMD in Ethiopia. USAID/Ethiopia strongly encourages that each Applicant and its consortium partners are thoroughly involved in the development of the concept paper and fully in agreement with the proposed technical approach and management structure The three criteria below reflect the requirements of this particular NFO. Applicants must note that these factors serve as the standard against which all Concept Papers will be APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 23 of 99
evaluated, and serve to identify the significant matters, which Applicants must address in their Concept Papers. Each Concept Paper will be reviewed for merit by the Selection Committee (SC) in accordance with the merit review criteria set forth below in this NFO. The Applicant and proposed consortium must demonstrate clear capacity and experience to accomplish the range of technical interventions described in the broader program description. Applicants should describe 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 resulting Cooperative Agreement. In addition, as demonstrated by USAID's Local Sustainability objectives, involving a wide array of local partners - private, non-profit, and public – is a key Agency priority. Whenever possible, the proposed activity should bring new development actors into partnership with USAID and or expand USAID's engagement with Health Services, social entrepreneurs, foundations, business, diaspora and communities. The partners should demonstrate a strong commitment to addressing the Health sector development challenge, experience partnering with others, and, where applicable, a proven track record in their particular areas of expertise. Applicants are expected to demonstrate how they will successfully engage other partners in their proposed activities, such as through building sustained private sector or foundation collaborations. The applicant must format the Concept Paper as follows: a. Spacing: Singled-spaced; b. Font: Times New Roman, 12-point; c. Margins: One (1") margins on all sides; d. Paper Size: 8.5 inch X 11 inch; and e. Any graphs, charts, exhibits, tables, etc. contained in the body of the concept paper application shall be numbered and included in the stated page limits (see below). Table font may be reduced to Times New Roman, 10-point. The Concept Paper should be no more than 10 pages exclusive of cover page, table of contents, and annexes and should include the following sections: (i) Title Page (ii) Cover Page; (iii) Table of Contents (iv) Concept Paper body; (v) Annexes (this may be provided as a separate document.). The detailed format for the concept paper is the following: i. Acronym List/Definition; ii. Curriculum Vitae (CVs)/Resumes for Key Personnel and others; iii. Staffing Plan iv. Past Performance and References; v. Other charts, graphs, tables, data or information considered essential to the application. APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 24 of 99
The concept paper must demonstrate a complete understanding of Transform/PHCU program and the applicant's strategy and methodology. The presentation shall take into account and be arranged in the order of the technical evaluation criteria found in Section E: APPLICATION REVIEW INFORMATION The concept paper should discuss the applicant's General Approach; Key Personnel and Management Plan; and Institutional Capacity and Past Performance as follows: i. General Approach (5 pages):
In this section the Applicant should present an overall vision for EPCMD in Ethiopia and how the Applicant and its Consortium partners can support this vision. Since the ASA will collaboratively develop the final program description with USAID and the GOE, it is not necessary to present a full and detailed technical application addressing every aspect of the priority areas listed under the activity objective. The general approach as described in the concept paper will be used to demonstrate an understanding of the Ethiopian context, the main actors, and the key questions and guiding principles outlined in Section A. As such, the Applicant will only present a technical and management approach at an appropriate level of depth for addressing reproductive, maternal and child health programming to meet the four results outlined in Section A. The Applicant must present an approach demonstrating a clear understanding of the activity with regards to EPCMD and the technical pieces that are needed to support their approach. This must include the identification of problems limiting the functionality between system actors and appropriate facilitative interventions to enhance management and system performance and quality service delivery across the continuum of care. Gender, as a special cross-cutting priority area, must be clearly integrated within the interventions. The document should also clearly describe how the consortium will support the GOE's national obstetric fistula elimination strategy. In addition to the Applicant's technical vision, they should describe a proposed collaborative process that describes how they will support the public purposes/mission statements of other health sector actors in achieving EPCMD objectives, and engage USAID, the Federal Ministry of Health, Regional Health Bureaus, Gates Foundation partners, and other key actors in the health sector to ensure an inclusive approach that will have the greatest potential for impact. USAID understands that to improve health sector outcomes to help meet the ambitious goals of the GOE HSTP and achieve sustainable improved maternal and child health outcomes will depend on the contributions of multiple interconnected actors with specific advanced knowledge and approaches. USAID recognizes that each individual member of the proposed Consortium will not possess all skills, but combined, the Consortium should possess the capacity to meet each high level result. As stated in Section A, TRANSFORM/PHCU allows for up to $30 million in sub-awards to GOE entities as well as $3 million in construction activities. The Applicant should use this section to briefly describe its vision and decision process for how it will use these APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 25 of 99
funds for greatest EPMCD impact. ii. Key Personnel and Management Plan (4 pages):
Due to the large scope of this activity, USAID/Ethiopia does not expect any one
organization to have all the required skills and capacity to implement the award. For this
reason, USAID/Ethiopia expects that organizations will come together to form consortia.
We ask that Applicants list members of consortium as well as list their individual
capabilities. While we understand that each Consortium's members have their own
organizational culture and identifies, the Concept Paper must clearly describe how each
organization will put aside their corporate identities to present a united vision for
EPCMD in Ethiopia.
While USAID/E understands that each Consortium must have a lead or "Prime"
organization, we see the Prime's role as a "First among Equals," understanding that each
Consortium member is critical to the overall success of the award. The Prime should
clearly define a management approach that will empower each of its subs to actively
engage in the implementation of the award. We expect strong headquarters buy-in from
each Consortium member and the ability to iterate a cohesive vision of how their
proposed management approach will facilitate technical implementation. The plan should
clearly describe how the headquarters team and field teams will complement each other
to achieve their ambitious goals within the TRANSFORM/PHCU activity.
The Applicant should also use this section to lay out how it will manage for results; this
applies to Consortium members, sub-awards to GOE entities, sub-grants to local
organizations, and construction activities. For further information, please consult
Automated Directives System (ADS) 303.3.30 and USAID Implementation of
Construction Activities, Mandatory Reference for ADS Chapters 303, which describes
how renovations under assistance agreements may occur.
Key Personnel: The Applicant may propose a maximum of five (5) Key Personnel. Of
those five positions, the following positions must be proposed and their qualifications
must meet or exceed the qualifications described below, with at least one candidate
having experience using adaptive management techniques. Key Personnel required will
be: the Chief of Party; at least two Team/Technical Leaders; and a Monitoring,
Evaluation and Learning Manager; with the remaining key personnel proposed by the
Applicant. The responsibilities for each position are described below.
The Applicant must propose individuals for key personnel positions that are highly
qualified and are able to fulfill the responsibilities as described below. The staffing plan
and its annexes (i.e. resumes) should clearly show how the individuals as well as the
proposed staffing mix are appropriate to achieve TRANSFORM/PHCU's objectives and
support implementation at all levels. Key personnel must have sufficient managerial as
well as technical capacity, expertise and experience to effectively manage and support the
overall project and its staff as outlined in the responsibilities below. The Applicant must
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 26 of 99
include resumes for all key personnel (no longer than 2 pages each) to be included in an
annex. Each resume must include multiple (maximum of five) references per candidate
ideally from supervisors, colleagues, employees, and most importantly relevant donor
organizations. The Applicant must include a letter of commitment for each key personnel
in an annex.
Please note that USAID expects the Applicant to nominate the best mix of key personnel
to oversee the implementation of their activities, regardless of their national origin. That
said, please note that the Ethiopian government highly scrutinizes international project
staff. Currently in Ethiopia, Ethiopian key personnel implement the majority of the
Health Office's awards. In order for international staff to obtain the required visa and
work permits, they must be able to clearly demonstrate the unique skills of those
international staff and how their skills are not locally available in country.
a) Chief of Party: The Chief of Party is absolutely critical for the success of this activity
as s/he will both lead the collaborative-creation process and also serve as the
representative of the Consortium, communicating its vision for EPCMD in Ethiopia, both
with USAID as well as the GOE and other development partners. The COP must
demonstrate strong inclusive leadership traits and the ability to bring lead a diverse
Consortium for success.
The position requires an individual with:
A Master's degree (equivalent) or higher in any area of health and development, health or related field with significant years of relevant experience; Fifteen years or more of relevant experience in managing RMNCH projects, of this size and scope (in terms of dollar amount and number of people managed), in developing countries and preferably in Africa; Strong ability to manage and deal with diverse stakeholders; Demonstrated ability to lead/supervise a diverse team on projects of similar scale (financially, culturally, staff size and activities); Experience in leading similar work for donors/U.S. Government agencies or international NGOs; Strong technical expertise in RMNCH programming; and Demonstrated strong writing and oral presentation skills in English
b) Team/Technical Leader: The position requires an individual with:
Master's degree (equivalent) or higher in the health field and significant years of relevant experience; A minimum of 10 years of relevant experience must be in managing health sector interventions and/or sub-sectors of interventions in the respective areas they proposed to manage; Excellent interpersonal and leadership skills and experience in managing teams Experience relevant to accomplishment of the cross-cutting objectives in the cooperative agreement, including gender; and Demonstrated strong writing and oral presentation skills in English APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 27 of 99

c) Monitoring, Evaluation and Learning Manager: The position requires an individual
with:
Master's degree in a relevant field At least ten years of relevant experience Experience managing the monitoring and evaluation for activities of similar size Experience using a Learning Plan to inform activity implementation Experience in monitoring and evaluation work for donors/U.S. Government agencies or international NGO or institutions Demonstrated strong writing and oral presentation skills in English Excellent interpersonal and leadership skills
Management Plan: TRANSFORM/PHCU will require specialized skills from a multiple
set of partners and USAID/Ethiopia does not expect one organization to have all of the
professional skills, services, and knowledge base required to meet the results; it is for this
reason that we expect organizations to bid in consortia. USAID/Ethiopia encourages
applications to clearly describe the individual skills of and capacity of each organization
and how they complement one another. Partnerships with local entities will be critical in
achieving the results of the program and USAID encourages Applicants to suggest local
partners clearly defining the value each partner brings.
The Applicant will present its strategy to retain key personnel throughout the life of the
program (especially the Chief of Party for the application for the Lead Organization), as
well as its contingency plan in the event any of the key personnel leaves the program.
The Prime should succinctly outline an inclusive leadership approach that will create a
shared common vision and purpose that builds trust and recognizes the value and
contribution of all partners.
The Prime will coordinate the strategic approach of TRANSFORM/PHCU on two levels.
The first level of coordination will be at the Mission level where the program coordinates
with relevant current and upcoming projects managed by USAID/Ethiopia's technical
offices. As TRANSFORM/PHCU is USAID's flagship RMNCH supported activity,
working with other smaller awards is essential to avoid overlap and increase synergies.
The second level of coordination will focus on broader coordination across the Applicant
and Consortium members and with the GOE, USAID, civil society organizations (CSOs),
and other donors. Through GOE-led technical working groups and direct engagement,
applications for the lead should also demonstrate how it will ensure the sharing of
information that results from coordination efforts with stakeholders. To promote
collaboration and strengthen the leverage of TRANSFORM/PHCU, the lead is also
expected to set an example for each organization to speak with one voice as a member of
TRANSFORM/PHCU, not their individual organizations, when representing the activity
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 28 of 99
in conversations and other fora with external stakeholders. The Applicant should explain how it envisions effective coordination, collaboration and working arrangements which will result in clear outcomes and maintain value for the contribution of all partners, including its approach to the development of: 1) the individual partner roles and responsibilities regarding the division of labor; 2) shared and transparent decision-making processes; 3) a communication plan for all levels within the partnership and with external stakeholders promoting effective and shared communication with the GOE; 4) shared goals and aims to ensure sound coordination of policies, programs, and service delivery, and, ultimately, better health outcomes for women and children. iii. Institutional Capability and Past Performance (1 page):
USAID/Ethiopia understands that the poor performance of one Consortium member can negatively impact the overall performance of the TRANSFORM/PHCU. For this reason, USAID/Ethiopia will heavily scrutinize both the Applicant and all proposed Consortium members. We will not only look at technical capacity, but the ability of each Consortium member to work well with others, focused on a common purpose. Past performance information must be provided and should relate to the specific technical nature of the Activity. The Applicant must provide performance information for each Consortium member (no longer than 2 pages per organization) to be included in an annex. Applicants are strongly encouraged to provide examples of significant impact of their past projects and how cooperation in prior consortia contributed to that impact. The Applicant must include specific examples of past partnerships where the organization served as part of a consortia or other partnership. Where the Applicant served as a sub-awardee or prime, please provide points of contact with the prime. Where the Applicants served as prime, please provide points of contact with the sub-awardee(s), no longer than 2 pages, to be included in an annex. USAID will initially determine the relevance (complexity, scope, size and magnitude) of similar performance information as a predictor of probable performance under the subject requirement. USAID may consider relevant projects successfully performed during recent 3 to 5 years to be "recent performance information". The Applicant should address the following points: Demonstrated successful experience in managing and implementing similar programs, in size and scale, preferably in Africa; Timeliness of performance, cost, and scope; and How the Headquarters management team contributed to success Phase-2 Oral Presentations/Interview
Only applicants whose concept papers are determined technically acceptable and/or innovative will be considered for oral presentation. a. Based on USAID's merit review of Concept Papers, only the best technically acceptable applicants will be invited to present their applications orally at APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 29 of 99
USAID/Ethiopia. The order of presentations among the selected applicants will be determined randomly by the Agreement Officer. b. Applicants who will be invited to the Oral Presentations will be notified promptly as to the date of their scheduled presentation. They should expect at least two week's notice before their expected in-country presence in Ethiopia to conduct their Oral Presentation. At the time of the invitation, USAID will provide initial topics for discussion items based on reviews of written applications. c. In-person Oral Presentations are a condition of award as technical discussions will also occur at this stage. There will be no conference call-in option for the presentation. d. The proposed Chief of Party of the consortium, the Senior Program manager and at least one other Key Personnel should attend and serve as presenters. The Applicant is limited to five attendees and all attendees must be present in-person in Ethiopia on the date and time specified for the presentation. e. The audience for the Oral Presentations will consist of the Selection Committee (SC), the Agreement Officer and the Senior Acquisition & Assistance Specialist. The Agreement Officer will chair the Oral Presentations. However, USAID may use in-house or contracted moderator to facilitate the presentations. While the first presentation will be in PowerPoint format, the remaining discussions will be in Question/Answer (Q&A) format with little time for consultation. Each Representative should be an expert on the Consortium's approach to TRANSFORM/PHCU and will be expected to "think on their feet" and is expected to participate in the presentation and subsequent Q&As. The Oral Presentation Agenda is as follows: a. Introductions [10 minutes] (Lead: Agreement Officer) b. PowerPoint Presentation [ 1 ½ hour] (Lead: Applicant) c. Q&A/Discussions-Round 1 [2 hours] (Lead: SC and Applicant) d. Break for Applicant/USAID Deliberations [1 hour] e. Q&A/Discussions-Round 2 [1 hour] (Lead: SC and Applicant) f. Adjournment/Next Steps [10 minutes] (Lead: Agreement Officer) The factors below highlight the requirements of this NFO for the second stage of selection, which is an oral presentation in Addis Ababa. Each oral presentation will be evaluated and scored by the Selection Committee (SC) in accordance with the evaluation factors set forth under Section E of this NFO. The Applicant's presentation must not last more than one and a half hours and in addition to responding to the questions from USAID, the presentation must address the following five areas: APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 30 of 99
i. Overview of General Approach:
Each Applicant must present an overview of the general approach to the activity as outlined in their concept paper. The general approach component should demonstrate an understanding of the Ethiopian context and the Key Questions and Guiding Principles specified in SECTION A. Specifically, the overview must: Demonstrate a comprehensive understanding of the Ethiopian Health System from the national to the primary health care facility level; the Health Extension Program and the Health Sector Transformation Plan; and identification of the system actors and the various relationships among them. Identify how the Applicant/Consortium's proposed approach will support the Applicant's/Consortium's/other health sector actor's declared public purposes of improving health sector outcomes in Ethiopia, including obstetric fistula; Lay out the most applicable innovative and evidence-based strategies to ensure an integrated package of services along a continuum of care from household to primary hospital level for the Ethiopian context; TRANSFORM/PHCUs role and level and nature of involvement in these approaches must be clearly described. Specifically, describe how approaches will lead to: Improved effectiveness and efficiency of functions, management and performance systems at each level of the health system; Stronger referral systems, outreach, and information linkages between communities and facility services within each level of the PHCU; Improved functioning and coordination of the health system components including HRH, HMIS, logistics & SCM and health financing at woreda and PHCU levels; Sustained improvements in the quality of RMNCH service delivery across a continuum of care; Improved identification, treatment, and rehabilitation of Obstetric Fistula (OF) Effective approaches to partner closely with the HEWs to implement strategies to strengthen their capacity to support the HDAs including the new roll-out of Level I and Level II HEWs Effective engagement of particularly the PHCU in promoting healthy household and community practices and health seeking behaviors and implementation of evidence based SBCC interventions Enhanced program learning to impact EPCMD outcomes and facilitation of the RHB in each region to develop and/or fine-tune a mutually-supporting strategy to identify and support both the high and poor-performing zones, woredas, and PHCUs in the region; In addition, the overview should Describe how gender-related activities will take advantage of international best practices and experiences while adapting them to a highly sensitive Ethiopian context. This discussion should describe how gender-related challenges will be APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 31 of 99
addressed and how such interventions are ideal considering the local context, keeping in mind a do-no-harm approach; and Application of adaptive management techniques to inform program management and key decisions ii. Personnel and Management Structure
Applicant's preparation and presentation of the oral presentations, must clearly demonstrate the key personnel's understanding of the guiding principles specified in SECTION A of this NFO. The presentation should be prepared in a concise and understandable way while showing the Key Personnel's ability to effectively and clearly present the general approach to the activity as outlined in the applicant's concept paper; key personnel ability to respond to the key questions that outline priority areas for this activity under SECTION A. Activity Objective of this NFO should be incorporated and presented during the oral presentation. The presentation must explain the proposed mix of positions and management structure, and the comparative strengths of the proposed Applicant. Applicants are encouraged to have representation from each Consortium member; this both demonstrates a shared vision, but also allows USAID to specifically question and evaluate the strength of each individual Consortium member. iii. Monitoring and Evaluation:
The Applicant must prepare a clear Monitoring, Evaluation and Learning (MEL) methodology that facilitate adaptive learning and management. The MEL plan must describe and demonstrate how the Applicant will structure the MEL system, give examples of this approach and describe how they will utilize minimal but sufficient data to adaptively manage interventions. The Applicant should also describe how they will apply adaptive management techniques to inform program management and key decisions. See Section H Annex-2 for more information on Adaptive Management. iv. Proposed Co-Creation/Collaborative Approach:
In addition, the Applicant must identify the personnel that will participate in the collaborative-development phase, as well as the role of the Chief of Party/Prime in this phase. The Chief of Party is expected to participate in person during the collaborative-development process. The Applicant should present how they envision the collaborative-development process, specifically coordination and communication with USAID/Ethiopia and the role of the Applicant's organization and any partners if applicable. Applicants should also propose a logical process for collaborative-development with a notional timeline for completion of the Activity Description with USAID/Ethiopia. During the first two weeks of collaborative development, the Successful Applicants, in collaboration with USAID and the GOE will develop the program description/technical approach to include, general resource requirements, and management control of the project under the guidance of the Contracting Officer/Agreement Officer. APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 32 of 99
v. Proposed Cost Efficiency Plan (Value for Money)
As budget details depend on the specifics outlined in the final program description, a full cost-application will be developed by the apparently successful Applicant once the program description is finalized. During their oral presentations, the Applicants should lay out the argument why their Consortium offers the best value for money and cost effectiveness for results achieved. Applicants are required to briefly describe the thought process that has gone into budgeting and what they expect key parts of their intervention strategy will cost. This can be a discussion on approach to cost-share, staff salaries, efficient use of resources and sub-agreements and contracts, use of local solutions, etc. As these funds are managed through our bilateral agreement with the GOE, the Applicant should expect that the GOE will pay significant attention to this portion of the presentation. The presentation will be followed by a two-hour questions and answers (Q&A)/Discussion period where the Applicant will respond to questions related to its presentation as well as to any other questions arising from their written application. This will be followed by USAID deliberations and then a second, one-hour Q&A/Discussion period. USAID/Ethiopia will provide the conference room and media presentation equipment for the Oral Presentations. The afore-mentioned Presentation must be in PowerPoint and sent via e-mail to:and two days prior to the scheduled Oral Presentation. Soon after the last Oral Presentation, USAID plans to inform applicants if their application has been selected to proceed to the next stage of the review process. For selected applicants, USAID will provide (1) a written summary (feedback) of their Oral Presentation/Discussion to further guide the Applicant's Full Technical Application preparation. Phase-3 Technical Application Format/Instruction
Only the apparently successful applicant who succeeded from phase-2 merit review will be invited to submit a Full Technical and Cost application. The apparently successful applicant will develop technical application which will be program description of the resulting Cooperative Agreement in collaboration with USAID/Ethiopia and the Government of Ethiopia. The Technical Application is the most important part of consideration in making award decision. It shall demonstrate the applicant's capabilities and expertise with respect to achieving the goals of this program. It shall be specific, complete and presented concisely. The Technical Application must be numbered and not exceed 30 pages. Both the overall page limit and the individual section page limit must be adhered to. Pages in excess of stated limitations will not be considered. However, the list of items with no page limits below is not included in either count. Dividers will not count towards the page limit. APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 33 of 99
The Applicant must format the Initial Technical Application as follows: a. Spacing: Singled-spaced; b. Font: Times New Roman, 12-point; c. Margins: One (1") margins on all sides; d. Paper Size: 8.5 inch X 11 inch; and e. Any graphs, charts, exhibits, tables, etc. contained in the body of the concept paper application shall be numbered and included in the stated page limits (see below). Table font may be reduced to Times New Roman, 10-point. Application Contents: The Full Technical Application should be no more than 30 pages exclusive of cover page, table of contents, and annexes and should include the following sections: (i) Title Page (ii) Cover Page; (iii) Table of Content (iv)) Technical Application; (v) Annexes (this may be provided as a separate document.). The detailed format for the technical application is the following: Detail format and content of the Full Technical approach which will be the Program Description of the resulting Cooperative Agreement will be developed in collaboration between the apparently successfully Applicant, GoE, USAID, and other stakeholders that USAID may bring in based on the programmatic goals of the TRANSFORM/PHCU stated under Section A of this NFO. Cost Application Format/Instructions
Only apparently successful applicant(s) who succeeded from phase-2 merit review will be requested to submit their full technical and cost application. Funds Available: Subject to the availability of funds, USAID and KOICA funding will not exceed $120,000,000. Of the overall award, during the life of the project, up to $3 million for renovations and up to $30 million for sub-awards to GOE entities will be available. Of the overall $120 million, the Korean International Cooperation Agency (KOICA) is providing $5 million. KOICA funds will be provided via the U.S. Treasury and USAID will manage the resources, however, KOICA will be involved in both selection and implementation. The apparently successful applicant must contribute at least 10% ($12 million) cost-share. The Cost or Business Application shall be submitted separately from the technical application. The Applicant must submit the SF-424 series, which includes: a. SF-424, Application for Federal Assistance; b. F-424A, Budget Information – Non-construction Programs; and c. SF-424B, Assurances – Non-construction Programs. These documents can be found at : APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 34 of 99
The Applicant must submit a complete set of the afore-mentioned forms. The Cost Application must specify the financial breakdown for the Total Estimated Award (TEA) amount over the five (5) year period. The TEA for the USAID-funded portion must not exceed $120 million. Applicant's cost-share may also be applied to increase the overall funding of the Cooperative Agreement to at least $132 million. The Applicant must include a Cost Share Narrative. Detailed explanation must be provided regarding the proposed Cost Share. The Cost Share must consist of non-federally funded contributions (in cash or in kind) that meet all the criteria detailed in 2 CFR 200, and must be discussed in detail within the Cost Share Narrative; the Applicant must clearly indicate if the Cost Share will be in-kind or cash. Once included as part of the award, the Recipient will be responsible for meeting the Cost Share commitment regardless of intended sources. All required documents such as "CERTIFICATIONS, ASSURANCES, OTHER STATEMENTS OF THE RECIPIENT AND SOLICITATIONS STANDARD PROVISIONS" attached as Annex to this NFO must be completed and submitted along with the full application. Certain documents are required to be submitted by the Applicant in order for an Agreement Officer to make a determination responsibility. However, it is USAID policy not to burden applicants with undue reporting requirements if that information is readily available through other sources. While there is no page limit for the Cost Application, applicants are encouraged to be as concise as possible. Asset Liquidation of other USAID Activities: In the development of the cost proposal, please note that it is expected that IFHP will transfer all usable equipment including computers, vehicles, furniture, etc, to the Successful Applicant for implementation of the TRANSFORM awards. It is also expected that when the JSI L10K and MCSP end, their assets will also be transferred to the TRANSFORM awards as well. Applicants must provide a Cost Application based on U.S. dollars and the Cost Application must be valid for 120 days. The cost application is to be submitted via a separate e-mail from the technical application. The Cost Application will be reviewed separately from the Technical Application. Although the Cost Application will not be scored, the Applicant should have a structure that will allow it to provide the greatest value (highest results) at the lowest cost; minimizing non-value added costs. It is USAID policy not to burden applicants with undue reporting requirements if that information is readily available through other sources. While there is no page limit for this portion, applicants are encouraged to be as concise as possible, but still provide the necessary detail to address the requirement on the following contents of Cost Application: i. Title Page: [Not to exceed 1 page]
The Applicant must include the following basic information on the title page:
i. Proposed project title; APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 35 of 99
iii. Name of organization(s) submitting the application; iv. Address of organization(s) submitting the application; v. Point of contact (POC) at organization; and vi. POC's title, telephone number, fax number and e-mail address. ii. Cover Letter: [Not to exceed 1 page] The Cover Letter should list all the organizations/institutions involved in the proposed application, with the lead or prim Applicant clearly identified, and any proposed sub-awardees listed separately. A summary table should be included that lists the Prime Applicant and all consortium/partner organizations as well as the percentage of overall program activities that each partner will contribute. The Cover Page must be signed by the organization's official with authority to negotiate/sign on such an application to USAID. iii. Cost/Budget application: In general the Cost Application must coincide with the line items set forth below. Cost spreadsheets must be prepared in Excel which detail the breakdown of each line item captured in the SF-424A. The Excel spreadsheet must be submitted electronically and all formulas must be accessible and unlocked. The breakdown must show separate costs according to each partner organization involved in the program. - Table of contents - Acronym List, if necessary - The SF-424 series: which includes SF-424, Application for Federal Assistance, SF-424A, Budget Information – Non-construction Programs and SF-424B, Assurances – Non-construction Programs. The Summary Budget must include the following cost line items, as ∙ Direct Labor ○ Fringe Benefits (As Applicable) ∙ Consultants ∙ Travel, Transportation and Per Diem ∙ Equipment ∙ Supplies ∙ Sub-awards ∙ Other Direct Costs ∙ Construction ∙ Indirect Costs (As Applicable) ∙ Total Estimated Cost APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 36 of 99
Also, the apparently successful applicant is required to present its summary budget by program areas (maternal, newborn, child health, family planning, malaria). The cost application of consortium members or proposed subawards must follow the same format and summary cost line-items as the prime. Budget details and summary must be submitted in MS excel with an accompanying budget narrative which provides in detail the total costs for implementation of the project the organization is proposing. In general the detailed budget shall include: - The breakdown of all costs associated with the project according to costs of, if applicable, headquarters, regional and/or country offices; The breakdown of all costs of the Prime and sub-awardees according to each organization involved in the project, in the same detail and format as the budget template; breakdown, if applicable, of sub-awards to GoE entities; Breakdown of costs associated with external, expatriate technical assistance and those associated with local in-country technical assistance; The breakdown of the financial and in-kind contributions of all organizations involved in implementing the resulting Cooperative Agreement; Potential contributions of non-USAID or private commercial donors to the resulting Cooperative Agreement; Breakdown of equipment and supplies including number of units and unit price; separate cost line items for other direct costs such as supplies, communication costs, visas, passports, and other general costs. Procurement plan for commodities (note that contraceptives and other health commodities will not be provided under this Cooperative Agreement); Summary of program/direct Vs. administrative/indirect costs Detailed budgets and supporting notes and justifications should also include the following: The name, annual salary, fringe benefits and expected level of effort of each person charged to the program (LOE, in days—note: 260 days equals one year of labor); If not included in the indirect cost rate agreement negotiated with the U.S. Government, specify the applicable fringe benefit rates for each category of employee, and all benefits covered by the rate; The same information shall be provided for individual consultants as for regular personnel. Breakdown of allowances by specific type and by person and must be in accordance with the applicant's policies. All salaries, benefits and allowances must be based on written compensation policies of the employer organization. APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 37 of 99
Other direct costs such as visas, passports and other general costs should be separate cost line items. Travel, per diem and other transportation expenses should be detailed in the financial plan to include number of international trips, from where to where, number of per diem days and rates. Per Diem and other travel allowances must be based on written travel policies of the employer organization. Details of all home office support to be provided. Specific budget details and narrative information, in addition to the percentage and total dollar amount of the proposed cost-share contribution, if applicable; Cost-share, once accepted, becomes a condition of payment of the federal share. No profit shall be included in the prime and subawards at any subtier. USAID policy is not to award profit under assistance instruments. However, all reasonable, allocable and allowable expenses, both direct and indirect, which are related to the agreement program and are in accordance with applicable cost principle under 2 CFR 200 Subpart E. of the Uniform Administrative Requirements may be paid under the anticipated award. Applicants who intend to utilize contractors or sub-awardees should indicate the extent intended and a complete cost breakdown. Extensive contracts/agreement financial plans should follow the same cost format as submitted by the primary Applicant. A breakdown of all costs according to each partner organization, contract or sub-awardee involved in the program should be provided. Pursuant to 2 CFR 200 Contract means a legal instrument by which the Applicant purchases property or services needed to carry out the project or program under a resulting award. The term does not include a legal instrument when the substance of the transaction meets the definition of a Federal award or sub-award (see § 200.92 Sub-award), even if the Applicant considers it a contract. The Applicant must describe the work to be performed, the risk borne by the contractor, the contractor's investment, the amount of subcontracting proposed by the contractor, and the quality of its record of past performance for similar work. For-profit contract organizations that work under the award and do not meet the above definition of a sub-awardee are eligible for profit/fee. A budget narrative (in Word) explaining costs to be incurred; and other administrative documentation as required. Budget Narrative cost notes must be provided containing detailed explanations regarding each cost proposed; it must provide detailed budget notes and supporting justification of all proposed budget line items. The Budget Narrative must clearly identify the basis of all costs, such as market surveys, price quotations, current salaries, historical experience, etc. Detail must be adequate for USAID to evaluate the necessity, reasonableness, allocability, and allowability in accordance with applicable cost principles of each cost element. Detailed explanation must be provided regarding the proposed Cost Share. The required cost share for this award is 10% of the total USAID contribution. The Cost Share must consist of non-federally funded contributions (in cash or in kind) that meet all the criteria detailed in 2 CFR 200, and must be discussed in detail within the Budget Narrative; the APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 38 of 99
Applicant must clearly indicate if the Cost Share will be in-kind or cash in the Budget Narrative. The Recipient is responsible for meeting the Cost Share commitment regardless of intended sources. Information regarding the proposed cost share should be included in the SF 424 (for U.S. organizations only) and the Budget as indicated on those documents. The cost sharing plan should be discussed in the Budget Notes to the extent necessary to demonstrate its feasibility and applicability to the activity. Additionally, applicants should inform themselves on the GoE's "70/30" law,
implemented by the Charities and Societies Agency (CHSA). For all dollars spent in
country, 70 percent of budgets must be used in implementation with a maximum of 30
percent of funds allowed to management and overhead costs. At present, the 70/30 split
does not apply to US-administered Negotiated Indirect Cost Rate Agreement (NICRA),
but all funds that are transferred into the country. The CHSA heavily scrutinizes partners
and audits them on a yearly basis for compliance. Those organizations not in compliance
may have their registration revoked which could lead to a cancellation of any awards with
the USG.
The Applicant must submit a Negotiated Indirect Cost Rate Agreement NICRA if the
organization has such an agreement with an agency or department of the U.S.
Government. If no NICRA the Applicant should submit the following:
Reviewed Financial Statements Report: a report issued by a Certified Public Account
(CPA) documenting the review of the financial statements was performed in accordance
with Statements on Standards for Accounting and Review Services; that management is
responsible for the preparation and fair presentation of the financial statements in
accordance with the applicable financial reporting framework and for designing,
implementing and maintaining internal control relevant to the preparation. The account
must also state that he or she is not aware of any material modifications that should be
made to the financial statements; or
Audited Financial Statements Report: An auditor issues a report documenting the audit
was conducted in accordance with Generally Accepted Auditing Standards (GAAS), the
financial statements are the responsibility of management, provides an opinion that the
financial statements present fairly in all material respects the financial position of the
company and the results of operations are in conformity with the applicable financial
reporting framework (or issues a qualified opinion if the financial statements are not in
conformity with the applicable financial reporting framework.
Applicants should submit additional evidence of responsibility they deem necessary
for the Agreement Officer to make a determination of responsibility when requested. The
information submitted should substantiate that the Applicant:
Has an adequate financial resource or the ability to obtain such resources as required during the performance of the award. Has the ability to comply with the award conditions, taking into account all existing and currently prospective commitments of the applicant, APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 39 of 99
nongovernmental and governmental. Has a satisfactory record of performance. Past relevant unsatisfactory performance is ordinarily sufficient to justify a finding of non-responsibility, unless there is clear evidence of subsequent satisfactory performance. Has a satisfactory record of integrity and business ethics; and Is otherwise qualified and eligible to receive a cooperative agreement under applicable laws and regulations (e.g., EEO).
Required certifications, assurances, and other statements: All Certifications and
Representations found under Section H Annex 7 must be completed and submitted with
the cost application.
Applicants that have never received a cooperative agreement, grant or contract from the
U.S. Government are required to submit a copy of their accounting manual. If a copy
has already been submitted to the U.S. Government, the applicant should advise which
Federal Office has a copy.
Each applicant (unless the applicant is an individual or Federal awarding agency that is
excepted from those requirements under 2 CFR 25.110(b) or (c), or has an exception
approved by the Federal awarding agency under 2 CFR 25.110(d)) is required to:
1. Be registered in System for Award Management (SAM) before the award of the 2. Provide a valid Dun and Bradstreet Universal Numbering System (DUNS) number in its application; and 3. Continue to maintain an active SAM registration with current information at all times during which it has an active Federal award or an application or plan under consideration by a Federal awarding agency. Note that USAID may not make an award to an applicant until the applicant has complied with all applicable DUNS and SAM requirements and, if an applicant has not fully complied with the requirements by the time USAID is ready to make an award, USAID may determine that the applicant is not qualified to receive a Federal award and use that determination as a basis for making an award to another applicant. If the Applicant has established a consortium or another legal relationship among its partners, the Cost/Business application must include a copy of the legal relationship between the parties. The agreement should include a full discussion of the relationship between the Applicant and Sub-Applicant(s) including identification of the Applicant with whom USAID will work with for purposes of Agreement administration, identity of the Applicant which will have accounting responsibility, how Agreement effort will be allocated and the express agreement of the principals thereto to be held jointly and severely liable for the acts or omissions of the other. (End of Section D)
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 40 of 99
SECTION E: APPLICATION REVIEW INFORMATION

All applications will be reviewed in accordance with the review criteria set forth below. Technical applications will be evaluated using an adjectival rating against each evaluation criterion and sub-criterion. The purpose of the merit review process is to identify an Applicant and its proposed consortium partners with the best feasible technical and innovative approaches to supporting health sector actor's contributions to improving EPCMD outcomes in Ethiopia; and secondly, and just as important, to ensure that the successful Applicant and its proposed Consortium partners has the ability to work with one voice and vision to support the health sector and the GoE in its ambitious implementation of its visionary HSTP. The criteria presented below have been tailored to the requirements of this APS. Applicants should note that these criteria serve to: (a) identify the significant matters which Applicants should address in their applications and (b) set the standard against which all applications will be evaluated. To facilitate the review of applications, Applicants are requested to organize the narrative sections of concept paper according to the application format (Section D) and the merit review criteria set forth below. The criteria listed below are presented by major category, so that Applicants will know which areas require emphasis in the preparation of the technical application. To be selected for the award, the application must contain, at a minimum, these elements. The highest ranking that can be awarded in evaluating will depend on how well each element provided under Section D is addressed. There are three distinct merit review phases. The specific merit review criteria are as follows for each phase: Phase 1 - Concept Paper Merit Review (See Section D.4):
The Concept Paper demonstrates an understanding of the challenges and opportunities in implementing activities under TRANSFORM/PHCU in Ethiopia. The Concept Paper must present innovative yet realistic interventions that are in line with the approaches and desired results described under Section A, Program Description, of this APS. The Concept Paper fully understands USAID health program goals and aligns with Government of Ethiopia (GOE) priorities and builds on existing systems established by the GoE and other health actors. Concept Papers (Phase-1) will be reviewed on the basis of the following merit criteria and sub-criteria using the following rating weights: General Approach …………………………………. 35%
ii. Personnel and Management Plan …………………. 35%
iii. Institutional Capability and Past performance ……. 30%
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 41 of 99
The three criteria reflect the requirements of this particular NFO. Applicants must note that these factors serve as the standard against which all Concept Papers will be evaluated, and serve to identify the significant matters, which Applicants must address in their Concept Papers. Each concept paper will be reviewed for merit by the Selection Committee (SC) in accordance with the merit review criteria set forth in this NFO. General Approach 35% (see Section D.4.i):
The proposed concept paper will likely achieve the desired outcomes based on the approach described and represent significant strides in the overall goal of Transform/PHCU. The proposed methodology incorporates innovative and new techniques with high likelihood to increase the benefits to implement Transform/PHCU in Ethiopian. The methodology must also build upon best practices and lessons learned/developed by the applicant, other organizations, or USAID under similar programs. Additionally, the Applicant proposes specific and effective approaches to advance health programs and advance gender equity and demonstrates how it will support the health system in Ethiopia. ii. Key Personnel and Management Plan 35% (see Section D.4.ii):
Applicants will be evaluated whether its proposed consortium partners represent the best combination of organizations to develop and implement TRANSFORM/PHCU based on the capability of each member on its specialized area. The management plan must clearly describe the roles of the prime organization and sub-partners, and the comparative advantage of each organization. The division of labor among Applicant and consortium/subs is clear and appropriate to ensure the highest quality coordination and collaboration with various levels of the GoE, USAID and other key stakeholders, including beneficiaries. Applicants must have clear and legally established coordination and management plan for the consortium or other partner arrangement. The Applicant must have a lead or "Prime" organization, we see the Prime's role as a "First among Equals," understanding that each Consortium member is critical to the overall success of the award. The partnering arrangement or consortium must have clear lines of responsibilities, assigns clear roles and responsibilities relevant to the program among member organizations. The applicant's key personnel qualifications meet or exceed the required skills stated under Section D.4.ii of this APS. The proposed key personnel must have demonstrated relevant experience in implementing similar project of comparable scale. Applicant's key personnel must have the necessary knowledge, skill and experience in implementing similar project in a challenging environment such as in their world countries. iii. Institutional Capability and Past Performance 30% (see Section D.4.iii)
Applicant and any key partner organizations demonstrated experience and ability to carry out the development and implementation of TRANSFORM/PHCU activities. Institutional Capacity and Past performance records for both applicant and its proposed consortium partners will be closely reviewed and evaluated for both recency and relevancy. Recency is defined as similar projects performed within last 3-5 years. Relevancy is defined as APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 42 of 99
projects perform of a similar scope, magnitude and environment as TRANSFORm/PHCU. The Applicant and its partners have the technical and management experience and skills to implement the proposed interventions in the TRANSFOR/PHCU in Ethiopia. Rationale for subawardees needs to be explained. This APS encourages partnering with local partners. Performance information will be used for both the responsibility determination and best value decision. USAID may use performance information obtained from sources other than those identified by the Applicant. USAID will utilize existing databases of agreements performance information if any and solicit additional information from the references provided in and from other sources if and when the Agreement Officer finds the existing databases to be insufficient for evaluating an applicant's performance. In cases where an applicant lacks relevant past performance history or in which information on past performance is not available, the applicant will not be evaluated favorably or unfavorably on past performance. In such cases the applicant will be rated "neutral". The "neutral" rating provided to these applicants is at the Agreement Officer's discretion based on the past performance ratings for all other applicants. Prior to assigning a "neutral" past performance rating, the Agreement Officer may take into account a broad range of information related to an applicant's past performance. Phase 2 - Oral Presentation/Interview Merit Review (See Section D.5):
Oral Presentation (Phase-2) will be reviewed on the basis of the following merit criteria and sub-criteria using the following ratting weights: Overview of General Approach ………………………………. 30%
ii. Personnel and Management Structure ………………………… 30%
iii. Monitoring and Evaluation ……………………………………. 20%
iv. Proposed Co-Creation/Collaborative Approach………….…. 10%
V. Proposed Cost Efficiency Plan (Value for Money). 10%
These factors highlight the requirements of this NFO for the second stage of selection, which is an oral presentation in Addis Ababa. Each oral presentation will be evaluated and scored by the Selection Committee (SC) in accordance with the evaluation factors set forth in this section. i. Overview of General Approach 30% (see Section D.5.i):
Applicants will be evaluated on how well they understand the program goal and challenges of the TRANSFORM/PHCU. Each Applicant must present an overview of the general approach to the activity as outlined in their concept paper. The general approach component should demonstrate applicant's understanding of the Ethiopian context and the Key Questions and Guiding Principles specified in SECTION A. Specifically, the overview must: Demonstrate a comprehensive understanding of the Ethiopian Health System from the APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 43 of 99
national to the primary health care facility level; the Health Extension Program and the Health Sector Transformation Plan; and identification of the system actors and the various relationships among them. Discuss how the Applicant/Consortium's proposed approach will support the Applicant's/Consortium's/other health sector actor's declared public purposes of improving health sector outcomes in Ethiopia. The Presentation must lay out the most applicable innovative and evidence-based strategies to ensure an integrated package of services along a continuum of care from household to primary hospital level for the Ethiopian context; In addition, the overview should describe how gender-related activities will take advantage of international best practices and experiences while adapting them to a highly sensitive Ethiopian context. ii. Personnel and Management Structure 30% (see Section D.5.ii)
During the oral presentations, USAID/Ethiopia will evaluate the key personnel's understanding of the guiding principles specified in SECTION A of this NFO, as well as their ability to effectively and clearly present the general approach to the activity as outlined in their concept paper. The applicant's key personnel ability to respond to the key questions that outline priority areas for this activity under SECTION A will be evaluated. Activity Objective of this NFO will also be evaluated. The appropriateness of the proposed mix of positions and management structure, and the comparative strengths of the proposed Applicant will be evaluated. The SC will specifically question and evaluate the strength of each individual Consortium/partnering members. iii. Monitoring and Evaluation 20% (see Section D.5.iii):
The Applicant must present a clear Monitoring, Evaluation and Learning (MEL) methodology that facilitate adaptive learning and management. The presentation must present how the Applicant will structure the MEL system, give examples of this approach and describe how they will utilize minimal but sufficient data to adaptively manage interventions. The Applicant evaluated on how it plans to apply adaptive management techniques to inform program management and key decisions. iv. Proposed Co-Creation/Collaborative Approach 10% (see Section D.5.iv):
The Chief of Party is expected to participate in person during the collaborative-development process. The Applicant will be evaluated on workability of their plan and how they envision the collaborative program description development process. Specifically, the applicant will be evaluated on its planned coordination and communication with USAID/Ethiopia, the GoE, and the role of the Applicant's organization and any sub-partners if applicable. APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 44 of 99
Using USAID's principles for Collaborating, Learning and Adapting (See Annex 2), applicants will also be evaluated on their proposed logical process for collaborative development with a notional timeline for completion of the Activity Description with USAID/Ethiopia and the GoE. v. Proposed Cost Efficiency Plan (Value for Money) 10% (see Section D.5.v)
During their oral presentations, the Applicant should lay out the argument why their Consortium offers the best value for money and cost effectiveness for results achieved. This can be a brief general discussion on approach to cost-share, staff salaries, efficient use of resources and sub-agreements and contracts, use of local solutions, etc. The applicant will also need to demonstrate how they have applied cost-benefit into their design and that they understand the costs of doing business in Ethiopia. Phase-3 Technical Application Format/Instruction (see Section D.6)
Only the apparently successful applicant who succeeded from phase-2 merit review will be invited to submit their Full Technical and Cost application. The apparently successful applicant will develop technical application which will be program description of the resulting Cooperative Agreement in collaboration with USAID/Ethiopia and the GoE. The Technical Application is the most important part of consideration in making award decision. At this stage, USAID and the GoE will evaluate the Technical Application of the apparently successful applicant as "Pass/Acceptable" or "Fail/Unacceptable." In the event negotiations fail to improve the apparently successful applicants Technical Application/Program Description, the Agreement Officer may determine the application as "fail/unacceptable". Full Cost Application Review Criteria (see Section D.7 and Annex 4):
Once the technical review of the applications is completed, USAID will review the cost application of the apparently successful applicant. The Cost Application will be reviewed separately from the Technical Application. Although the Cost Application will not be scored, the Applicant should have a structure that will allow it to provide the greatest value (highest results) at the lowest cost; minimizing non-value added costs. Cost will be reviewed for general completeness, reasonableness, allowability and allocability. Cost realism is an assessment of the accuracy with which proposed costs represent the most probable cost of performance within the Applicant's technical and management approach. Cost realism review will be performed as part of the review process to (a) verify the Applicant's understanding of the program objective, (b) assess the degree to which the cost application reflects the approaches and/or risk assessments made in the technical application as well as the risk that the Applicant will provide the supplies or services for the offered cost; and (c) assess the degree to which the cost included in the cost application accurately represents the work effort included in the technical application. Cost-share will not be separately evaluated. However, USAID has established minimum APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 45 of 99
Cost-share of 10 percent of total USAID contribution. To be eligible for award, Applicants must meet the minimum 10 percent cost share as required. Applicants that do not meet this minimum requirement will not be considered for award. While USAID encourages cost-sharing to the maximum practicable extent, proposed cost-share above the required 10 percent will not be given additional credit. (End of Section E)
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 46 of 99
SECTION F: FEDERAL AWARD ADMINISTRATION INFORMATION

Federal Award Notices
The Agreement office will notify the apparently successful awardee (ADS 303.3.7.1.a) that they are being further considered for an award. USAID will provide this Notice electronically to the person designated to receive this information in the application. Notification will also be made electronically to unsuccessful Applicants pursuant to ADS 303.3.7.1.b. USAID will follow the procedures included in ADS 303.3.7.2 to receive and accept requests for additional information from unsuccessful Applicants. Award of the agreement contemplated by this NFO cannot be made until funds have been appropriated, allocated and committed through internal USAID procedures. While USAID anticipates that these procedures will be successfully completed, potential Applicants are hereby notified of these requirements and conditions for the award. 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. Reporting Requirements
All required reports must be submitted to the USAID AOR by the due date for the AOR's approval. The Recipient will consult with the AOR on the format and expected content of reports prior to submission. The Recipient should always be ready for revision in program indicators and reporting requirements. a. 5-Year Illustrative Work Plan:, the successful applicant will submit a five-year Implementation Plan within 60 days following the award. This document outlines a timeline for implementation of the key interventions throughout the life of the activity. b. Activity Monitoring and Evaluation Plan (AMEP): The proposed PMEP for the entire period of performance must be submitted with the five-year Illustrative Work Plan. c. First Year Work Plan: The First Year Work Plan must be submitted by the Recipient within 60 days of the award. The First Year Work Plan to be submitted will not necessarily be for a full year or may be for more than a full year, depending on the start date of the agreement; this will be defined at the time of award. d. Environmental Mitigation and Monitoring Plan (EMMP): TRANSFORM/PHCU should address potential hazards to the environment pertaining to the implementation of the program. The Recipient is expected to submit a five-year EMMP with the 5-Year APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 47 of 99
Illustrative Work Plan and regularly report on the compliance status of the activity as per the approved EMMP. e. The 5-Year Illustrative Work Plan, PMEP, First Year Work Plan and EMMP will be subject to the written approval of the AOR and USAID/E Mission Environmental Officer (MEO). 1. Annual Work Plans:
Starting with the second year of the award and for each subsequent year of performance thereafter, the Recipient should submit joint Annual Work Plans at least one month prior to the end of the previous Fiscal Year (September 30) according to a format agreed upon by USAID/E HAPN office and the Recipient. The Annual Work Plans must be submitted to the AOR for approval. The Annual Work Plans should be developed in collaboration with USAID, Gates Foundation partners, and GoE partners. Specific details on the format of the Annual Work Plans will be finalized at the time of award. Any updates to the EMPP or Activity M&E Plan should be submitted with subsequent Annual Work Plans and approved by the AOR and MEO. Progress Reports
The Recipient should submit a combined updated report on progress toward agreed performance targets every three (3) months and annually, based on the Activity M&E plan to be developed by the Recipient in collaboration with USAID. Quarterly and annual narrative reports ("Quarterly Reports" and "Annual Reports") are expected to be delivered to USAID/Ethiopia within 30 calendar days after the end of the quarter and 45 calendar days after the end of the Fiscal Year respectively. Each report should include information on activities completed during the preceding period in all regions, zones and Woredas, as well as any support provided at the national level. Each report must also include the following: ∙ Progress achieved towards benchmarks, tangible results and explanation of quantifiable output of the programs or projects, if appropriate and applicable; ∙ Reasons why established targets were not met; and ∙ Analysis and explanation of cost overruns or high unit costs (recipients must immediately notify USAID of developments that have a significant impact on award-supported activities). Further, notification must be given in the case of problems, delays, or adverse conditions which materially impair the ability to meet the objectives of the award. The standard and agreed upon indicators should be addressed in all Quarterly Reports and Annual Reports. These progress reports should also include any progress made on the learning agenda as well as any application or scale up of these results; the Recipient is expected to share separate reports of individual studies conducted under this award. A template for the reports will be provided by the AOR. APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 48 of 99
Financial Reports
Financial reporting requirements will be in accordance with 22 CFR 200. Quarterly financial reports are expected to be submitted to USAID/E within 30 calendar days after the end of the quarter. The report should follow the requirements of SF-425 and include a summary of finances, a pipeline analysis of funds obligated, funds expended, expenses accrued and funds remaining by program areas. In addition to the above, USAID Ethiopia requires the recipient to submit financial reports by program areas (maternal, newborn, child health, family planning, malaria) based on the budgeted expenditure for these program areas. Ad Hoc Reports
The Recipient may be requested to submit ad hoc reports on the status of its activities as requested by USAID/Ethiopia. Minutes of Meetings with Senior FMOH and RHB Officials
While it is preferable for the AOR to accompany the ASA to meetings with senior FMOH or RHB officials, it is not always possible. For this reason, any one-on-one meeting with any FMOH official at the Directorate Level or above or a meeting with the head of the RHB should be minuted and the minutes should be provided to the AOR within one week of the meeting occurring. This is to avoid misunderstandings with GoE colleagues. Success Stories
At least one 1-page success story on program activities shall be submitted to USAID/E in the Quarterly Report (both for the Leader Award and the Associate Awards). Please review USAID guidance on "success stories' available at Demobilization Plan
At least 180 calendar days prior to the Completion Date of the Leader Award, the Recipient must submit a Demobilization Plan for the AOR'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 the Demobilization Plan. Final Reports
USAID requires, 90 calendar days after the Completion Date of the LWA Cooperative Agreement, that the Recipient submit a Final Report which includes an executive summary of the Recipient's accomplishments, targets not achieved, lessons learned, challenges and conclusions about areas in need of future assistance; an overall description of the Recipient's activities and attainment of results and sub-results by region, as appropriate, during the life of the Cooperative Agreement; an assessment of the progress made toward accomplishing the LOP results and expected results and sub-results, and APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 49 of 99
overall project impact; analysis of the significance of these activities; important findings and recommendations; and a fiscal report that describes use of funds expended under this award. These requirements apply both to the Leader and the Associate Awards. See 22 CFR 200.328. The Recipient is expected to submit, with the Final Report, a list of all the studies conducted during the LOP and a compilation of all the publications/materials produced on the learning agenda. Administrative and National Policy Requirements
Award resulting from this NFO will be administered in accordance with; 1) Standard Provisions for U.S. Nongovernmental recipients can be accessed through USAID's websitor 2) Standard Provisions for Non-U.S., Nongovernmental recipients can be accessed through USAID's websit In addition to the above policy requirements, Applicants should inform themselves on the GoE's "70/30" law, implemented by the Charities and Societies Agency (CHSA). For all dollars spent in country, 70 percent of budgets must be used in implementation with a maximum of 30 percent of funds allowed to management and overhead costs. At present, the 70/30 split does not apply to US-administered Negotiated Indirect Cost Rate Agreement (NICRA), but all funds that are transferred into the country. The CHSA heavily scrutinizes partners and audits them on a yearly basis for compliance. Those organizations not in compliance may have their registration revoked which could lead to a cancellation of any awards with the USG. Branding Strategy And Marking Plan
The successful Applicant will be required to submit a Branding Strategy and Marking Plan together with its detailed work plan with exit strategy to USAID within 60 days of the Award. Branding and Marking plan will be evaluated and approved by the Agreement Officer with concurrence from the Agreement Officer's Representative (AOR). A Branding Implementation Strategy and Marking Plan shall be in accordance with USAID Branding and Marking Plan as required per ADS 320 as partially revised January 2015. Solicitation and award requirement and criteria will be as per on the Standard Provisionsand and ADS 303, as partially revised January 2015. The Recipient shall comply with the requirements of the USAID "Graphic Standards Manual" available at any successor branding policy. Pending formal Mission guidance, activity with a government entity will be branded, as appropriate, for the program's stabilization goals (USAID Graphic Standards Manual 4.10). Environmental Compliance
The Applicant must ensure environmental soundness and compliance in design and implementation when required by the 22 CFR 216 determinations. APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 50 of 99
Construction and Renovation activities may be approved under this activity in accordance with an approved Initial Environmental Examination (IEE) dated September, 2011. For further information, please consult Automated Directives System (ADS) 303.3.30 and USAID Implementation of Construction Activities, Mandatory Reference for ADS Chapters 303, which describes how renovations under assistance agreements may occur. [End of Section F]
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 51 of 99

SECTION G: FEDERAL AWARDING AGENCY CONTACT(S)

1.
AGENCY POINT OF CONTACT

Name: Henok Amenu Oljira
Title: Senior Acquisition & Assistance Specialist
Email:
Phone: (+251) 11-130-6081
Name: Tsegereda Gebremedhin
Title: Acquisition & Assistance Specialist
Email:
Phone: (+251) 11-130-6117
Any prospective Applicant desiring an explanation or interpretation of this NFO must
request it in writing by the due date and time specified on the cover page of this NFO in
order to allow a reply to reach all prospective Applicants before the submission of their
concept paper. Oral explanations or instructions given before award will not be binding.
Any information given to a prospective Applicant concerning this NFO will be furnished
promptly to all other prospective Applicants as an amendment of this NFO if that
information is necessary in submitting applications or if the lack of it would be
prejudicial to any other prospective Applicants.
(End of Section G)
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 52 of 99
SECTION H: OTHER INFORMATION

USAID reserves the right to fund any or none of the applications submitted.
ANNEX 1: USAID/ETHIOPIA'S HEALTH PROGRAM AREAS

Overview
USAID/Ethiopia engages with the GoE and other MNCH, FP/RH, nutrition, HIV, malaria, WASH and HSS partners to end preventable maternal and child deaths and create an AIDS-Free Generation; its activities are aligned with the GoE's HSDP IV and HSTP goals and objectives. Project Designs
In order to support the goals and intermediate results (IR) outlined in DO2 of the USAID/Ethiopia CDCS, three project designs have been developed and linked to the following IRs: (2.1) Improved Provision of Quality Health and Social Services; (2.2) Improved Health Systems Management and Integration at the National and Community Levels; and (2.3) Increased Appropriate Health Behaviors. Relevant USG Initiatives/Projects

The President's Emergency Plan for AIDS Relief (PEPFAR): PEPFAR is
implemented jointly by USAID, Center for Disease Control (CDC), Peace Corps, and the
Department of Defense (DoD). USAID's supported activities under PEPFAR focus on
the following areas: PMTCT; counseling and testing; provision of condoms and other
forms of prevention; behavioral prevention; basic palliative care; care and support for
orphans and vulnerable children; 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 provides significant support for HRH including providing
HIV/AIDS-related pre-service training to nurses, midwives, health officers, pharmacists
and other health professionals and supports extensive in-service education for health
professionals including midwives, health officers, nurses, lab and pharmacy technicians,
case managers and volunteers.
The President's Malaria Initiative (PMI): As in the other 17 PMI focus countries,
PMI's support in Ethiopia focuses on malaria prevention and control to reduce morbidity
and mortality due to malaria through proven preventive and therapeutic interventions,
including diagnosis and treatment, insecticide-treated bed nets (ITNs), indoor residual
spraying (IRS), surveillance and M&E, operational research and SBCC. PMI currently
has 11 implementing partners in Ethiopia including IFHP, through which support in
above-mentioned areas is provided. While originally PMI support primarily focused on
Oromiya Regional State, since 2011, support has increasingly been provided to the
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 53 of 99
national level, supporting the MOH national malaria prevention and control efforts. Accordingly, some of PMI's implementing partners have supported in-service training, for example, in malaria diagnosis, malaria case management, or malaria epidemic detection and response. The Integrated Family Health Program (IFHP)/Evidence to Action
(E2A)

The IFHP-Evidence to Action (E2A) project has served as USAID/Ethiopia's flagship Reproductive, Maternal, Newborn, and Child Health (RMNCH) activity since 2008. While significantly different in design and scope, TRANSFORM/PHCU is in many ways the successor to this activity. IFHP/E2A is set to start closeout in December 2016 and should slightly overlap with TRANSFORM/PHCU. It is a comprehensive and integrated program in which the prime partners, Pathfinder International, and John Snow Inc., implements activities in 300 woredas of the four major agrarian regions (Amhara, Oromiya, SNNPR and Tigray) and to a lesser extent in the emerging regions of Benishangul-Gumuz and Somali, covering 1,390 health centers and 6,083 health posts. IFHP/E2A benefits approximately 36.8 million people – roughly 40 percent of the entire population of Ethiopia. IFHP/E2A is fully aligned to assist the GoE in the realization of its goals, as set forth in the HSDP. IFHP provides assistance on an integrated package of family planning and reproductive health, maternal, newborn and child health interventions. Investments directly support universal access to primary health care via the HEP, with a focus on the delivery of key services and products through a continuum of care from the health center to the health post and community level in the rural, peri-urban and hard to reach parts of the country. While IFHP's initial focus was to support the HEP, it now supports the PHCU, in line with the GoE's direction. As a complement to the successful delivery of quality health services, IFHP works at the federal, regional, zonal, and woreda levels to enhance government capacity to build and manage the health system. A robust monitoring and evaluation system supports knowledge creation and management in order to refine existing program approaches, inform policy dialogue and improve programming of FMOH and other stakeholders. IFHP/E2A supports an integrated approach to FP/MNCH to create access to a basic package of high quality, evidence-based services for women, children and families. Services are offered by the HEWs at health posts and other health service providers at health centers, with the ultimate goal of improving MNCH health outcomes. Some of IFHP's achievements from July 2008-September 2015 include: 17,675,017 couple years protection (CYP) generated; 7,246,218 children <12 months received DPT3; -282,269 pregnant women knowing their HIV status; and 1,469,111 children under five received Artemisinin-based Combination Therapy (ACTs). With regards to IFHP's fistula activities, IFHP/E2A implements USAID's two-pronged approach to addressing OF care. One is to identify and refer existing cases for treatment and the other is to prevent future cases by encouraging women to have at least four antenatal care visits during the course of their pregnancy, promoting facility based APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 54 of 99
deliveries, strengthening routine and emergency obstetric care services, and addressing
traditional harmful practices such as early marriage and FGC. This strategy also includes
preventing unwanted pregnancies by making quality family planning services available.
Working closely with fistula partners, IFHP/E2A has centered fistula activities around the
GoE's innovative elimination strategy. This campaign-style strategy works district by
district, using extensive community outreach through the HEWs to identify fistula clients,
get them to accompany women into centers where they can be properly diagnosed,
referred for treatment, and then reintegrated into their communities.
TRANSFORM OVERVIEW
1. Intended Impact and Results for EPCMD:
The overall goal of the TRANSFORM awards is to partner with like-minded organizations to support the GoE's attainment of its ambitious goals as articulated in its new HSTP. The GoE's HSTP 2014/15-2019/20 presents ambitious goals for EPCMD-related health impacts. Through support of its implementing partners, USAID intends to make an important contribution to the following aspirational targets presented in the HSTP: ∙ Maternal Mortality Ratio (MMR) to decrease from an estimated 420 to 199 per 100,000 live births; ∙ Total Fertility Rate (TFR) to decrease from 4.1 to 3 births per woman; ∙ Under-five Mortality Rate (U5MR) to reduce from 64 to 30 per 1,000 live births; ∙ Infant Mortality Rate (IMR) to reduce from 44 to 20 per 1,000 live births; and ∙ Neonatal Mortality Rate (NMR) to reduce from 28 to 10 per 1,000 live births. To reach these goals and impact, USAID, through the TRANSFORM partnerships, intends for its investments to achieve four key results over the next 5 years: e. Increased numbers of healthy mothers-successful birth outcomes
Illustrative Indicators include: 4 ANC visits; skilled birth attendance; fistula cases identified, referred and reintegrated; improved maternal nutrition; and PNC visit at least once post-partum. Expanded access and uptake of family planning
Illustrative Indicators include: Modern Method Contraceptive Prevalence Rate; use of long-acting methods; age at first birth; access to post-abortion and post-partum family planning; birth spacing of at least two years apart; unmet need for family planning; and total fertility rate. g. Increased numbers of healthy newborns (birth to 28 days)
Illustrative Indicators include: skilled birth attendance; initiation of breast feeding; PNC visit at least once PP; and neonatal sepsis incidence. h. Sustained gains in and improved <5 mortality
Illustrative Indicators include: Penta 3 coverage; fully immunized at 1 year; measles coverage; exclusive breast feeding 0-6 months; cases of malaria treated; and cases of pneumonia treated.


APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 55 of 99
2. Structure of EPCMD Portfolio and Other Complementary Activities:
USAID/Ethiopia has chosen to use a wedding cake to represent theEPCMD approach,
intended to show commitment, a multi-layered approach, and hopefulness for the future.
The diagram of the TRANSFORM wedding cake below is a useful illustration of the
major components of USAID/Ethiopia's EPCMD portfolio of activities that USAID will
start putting in place in 2015 and be fully operational by the end of 2016.
A. Foundation of Activities
At the bottom, the base of the wedding cake, are three key principles that underscore implementation of all activities in the EPCMD portfolio: Equity. Focused on where the needs are greatest, the components of the
EPCMD portfolio will target support for EPCMD services to those most
vulnerable and with the least access to services including some of the less
populous geographic areas where health services are scarce.
Quality. The EPCMD components will focus on improving the quality of
EPCMD-related services. Quality assurance/improvement approaches
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 56 of 99
will emphasize adherence to clinical standards in a well-functioning health system as well as being client-centered and responsive to client needs. Gender. Implementation of the EPCMD portfolio will make meaningful
contributions in support of the USAID and GoE Gender Policies' key
overarching outcomes including:
a. Promoting gender equitable access to and participation in the governance of health services; b. Reducing gender-based violence and mitigating its harmful effects on individuals and communities, so that all people can live healthy and productive lives; and c. Increasing the capability of women and girls to realize their rights, determine their life outcomes, and influence decision-making in households, communities, and societies. B. Health System Strengthening Pillars
Just above the base of the wedding cake is the health systems component of the EPCMD portfolio, the specific systems which form the pillars for supporting the other components above. These systems include: Supply chain management (SCM): without drugs and commodities,
many preventive services and health care for illness cannot be provided:
Human resources for health (HRH): skilled staff are essential for
quality health services:
Monitoring and Evaluation (M&E), data for decision-making: data is
needed at a number of levels in the health system to ensure effective
delivery of on-going services and improvement over time. This also
includes increased program research, both operational and
implementation, to test new and innovative approaches that fit the
Ethiopian context:
Health sector financing reform (HSFR): increasing available funding,
especially from local sources, is critical for short-term improvements, as
well as long-term sustainability through local ownership:
Leadership, management and governance (LM&G): at all levels of
health systems and sector management, down to the community-based
service delivery points, activities need guidance and capacity to respond to
changes, i.e., leadership and management.
C. TRANSFORM/PHCU
The long-term goal for the Ethiopian Health System is that high-quality PHCUs will eventually be able to absorb the ever increasing MCNH service demand. Due to Ethiopia's largely rural, agrarian population, the largest component of the EPCMD APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 57 of 99
portfolio is TRANSFORM/PHCU. This component, and subject of this solicitation, will focus on the four agrarian regions, Tigray, Amhara, Oromiya, and SNNPR, which have the greatest population density and greatest needs for EPCMD-related services and improvements but at the same time have had the greatest improvements in some aspects of health care. Working through the PHCU structure, USAID/Ethiopia will partner with a Consortium to build its capacity to support improved health outcomes in lower performing woredas and PHCUs and sustain achievements in strong performing woredas. D. TRANSFORM/URBAN
Currently the JSI Strengthening Ethiopia's Urban Health Extension Program (SEUHEP) activity, this component will continue to expand upon, and focus, USAID's support to the GoE's Urban Health Extension Program to better target EPCMD-related services in urban areas with particularly poor MCH/FP outcomes. E. TRANSFORM/Developing Regional States (DRS)
Under this component, USAID-supported partners will engage with settled, semi-settled and mobile populations of Somali, Gambella, Afar, and Benishangul-Gumuz. Settled and semi-settled areas of high need for EPCMD-related services will be identified for particular attention; USAID may also implement NGO service delivery models to immediately improve access to health services for mobile populations while building up the overall system. F. The Model Family
At the top of the wedding cake is a "model family" a GoE concept which should be an
outgrowth of the impacts and results expected from the four components of the portfolio.
In short, if there is success, then there will be fewer maternal and child deaths, and more
model families living healthy and productive lives.
There are several cross-cutting activities that do not appear on the wedding cake but are a
critical part of the TRANSFORM approach.
TRANSFORM/WASH
The overall activity goal is to reduce mortality in children under 5 years old by increasing
correct and consistent adoption of improved WASH behaviors, through the four
interrelated objectives. The overall objective of TRANSFORM WASH is to increase use
of improved WASH products and services in Ethiopia through four inter-related
objectives as listed below:
1) Increased WASH governance and management capacity at the subnational level 2) Increased demand for low-cost quality WASH products and services, with a focus 3) Increased supply for low-cost quality WASH products and services, with a focus 4) Increased knowledge base to bring WASH innovations to scale All activities will aim to achieve sustained (product-facilitated) behavior change by combining hygiene promotion, small-scale private sector hardware interventions, and enabling environment activities that reduce barriers to attaining scale (e.g. promote cost APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 58 of 99
recovery; inform and promote policy change). The activity will work through woreda and
higher-level government and/or non-government institutions to build sustainability,
including systematic training and capacity building.
While most closely linked with the "M&E, data for decision-making" pillar, the
following activities are supportive of the overall TRANSFORM approach and cut across
the TRANSFORM PHCU, urban, and DRS components.
Greatest Impact Analysis (GIA)
The purpose of the GIA is to collect, analyze, and present data to inform the geographic
foci for new and existing health activities. In order to be responsive to the country's
changing health development context, partners must increasingly utilize systematic,
hypothesis-driven problem solving that requires data to identify high and low performing
areas of the country. This approach is consistent with the GoE's interest in being
responsive to population health needs and decreasing disparities in health outcomes, as
well as its interest in institutionalizing quality improvement. Findings from the analysis
are intended to provide information to guide resource investments for both the USG and
GoE. The most important intended use of this analysis of multiple data sources is to
provide strategic information to guide the selection of geographic programming areas so
USAID can target resources where they are most needed and will produce the greatest
public health results. This analysis will be one of multiple sources of strategic
information to guide, but not dictate, program planning. The results of the analysis will
be validated by the GoE and the final selection of intervention woredas will be decided in
coordination with the FMOH and RHBs.
TRANSFORM/Monitoring, Evaluation, Learning, and Evaluation (MELA)
This will be a five-year contract that will provide technical assistance to monitor
performance and measure the impact of the TRANSFORM interventions.
TRANSFORM/MELA will be responsible for collecting, analyzing, communicating high-quality monitoring and evaluation data for USAID/Ethiopia, with the purpose of guiding the USG and GoE in adaptive learning and management of its EPCMD portfolio. This contract will be implemented in parallel with the other TRANSFORM awards, and is responsible for completing detailed baseline, mid-line, and end-line evaluations. Additional MELA activities will include but are not limited to: external performance evaluation of select interventions, high-level monitoring of broader EPCMD result areas, geospatial analyses, and learning forums. Utilizing and strengthening M&E capacity of local Ethiopian systems will also be a major component of TRANSFORM/MELA. It is anticipated that learning generated from this contract will provide strategic information for programmatic decision-making throughout the life of TRANSFORM, and help determine necessary realignments of resources for greatest public health impact. APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 59 of 99

ANNEX 2: SPECIAL CONSIDERATIONS
Gender Issues
USAID/Ethiopia is committed to addressing gender inequalities across its development
objectives. The health of women and girls in Ethiopia is precarious, and the poor quality
of health services, especially in the rural areas, only exacerbates the problem. Women
enjoy little independent decision making on most individual and family issues, including
the option to use birth control, whether to give birth in a health facility, or to seek the
assistance of a trained provider. Harmful traditional practices—FGC, early marriage and
childbearing, gender-based violence, in addition to forced marriage and wife
inheritance—impose additional long-lasting, negative impacts on Ethiopian women's
reproductive health and overall well-being. For example, domestic violence is so
accepted that, according to the 2011 Demographic Health Survey, 68 percent of women
interviewed believed there are justifiable reasons for a husband to beat his wife.
Maternal and child mortality can be reduced with better health services, but equally as
important is the age and health of the mother during pregnancy and birth. The harmful
practices of early marriage, FGC and other types of violence against young girls are
major impediments to the improvement of maternal and neonatal health. Equally
important is allowing girls to attend and complete their schooling. Evidence in Ethiopia
has shown that the best way to protect girls is through an all-of-society approach that
advocates for the elimination of these deleterious practices.
Throughout Ethiopia, the burden of household healthcare falls disproportionately on
females, regardless of age. Women are often expected to care for sick members of the
household, and adolescent girls are often withdrawn from school to support the
household. Educational attainment, literacy, exposure to mass media and employment
are critical contributors to women's empowerment and exert considerable influence on
their position in the household.
RMNCH, youth and household/community-based programs need to involve boys and
men as well. Male gender norms influence a range of RH behaviors. Evidence suggests
that interventions that examine, question, and change male gender norms are more
effective in improving outcomes than those that merely acknowledge or mention gender
roles. RMNCH programs could exert greater and more sustainable impact by adopting
approaches that explicitly attempt to transform social norms around male and female
roles, and promote gender equality. It is important to note that TRANSFORM/PHCU is
not a stand-alone gender empowerment project; the main focus is reducing maternal and
child mortality and applicants are expected to come up with innovative and effective
ways to engage men and women to this end, ensuring a sustainable program outcome.
Clear strategy to address gender issues should be woven through out a successful
application.
Environmental Concerns
Environmental Mitigation and Monitoring Plan (EMMP): TRANSFORM/PHCU
should address potential hazards to the environment pertaining to the implementation of
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 60 of 99
the program. The Recipient is expected to submit a five-year EMMP with the 5-Year Illustrative Work Plan and regularly report on the compliance status of the activity as per the approved EMMP. Ethnic Considerations and Villagization
In 2010, the Government of Ethiopia embarked on implementing the Commune Center Development Plan and Livelihood Strategy—otherwise known as the ‘Commune Development Program (CDP)' or ‘villagization'. This involves moving up to 500,000 households in the most under-developed regions of Gambella, Benishangul-Gumuz, Afar and Somali regions of Ethiopia, into newly formed or already established communities (or ‘development centers'). The Government's stated purpose of the CDP program is: "to benefit the people of the Developing Regional States from sustainable development and good governance outcomes." Beyond the remit of the CDP, Ethiopians have also been relocated due to other development-related programs linked to food security, dam construction, urban renewal and large scale farming such as in the South Omo Valley. This valley, located in SNNPR, has drawn particular scrutiny because of tensions with indigenous populations over villagization plans connected with the development of a major sugarcane plantation along the Omo River. The USG has become aware of allegations of "forced movement" and poor quality of services related to the CDP program and other development induced resettlement. While monitoring visits by donor partners have not found evidence of "forced movement" in these areas, USAID programs nevertheless do not support activities and sites identified under the GoE CDP or other similar movements as mentioned above. Assistance in Ethiopia and in the specific aforementioned regions shall: ∙ Not be used to support activities that directly or indirectly involve forced ∙ Support initiatives of local communities to improve their livelihoods; and be subject to prior consultation with affected populations. Social Accountability
USAID strategy calls for the integration of democracy and governance "principles and practices" across the Agency's development assistance portfolio, with emphasis on participation and accountability. In Ethiopia, USAID's country strategy seeks improved governance for sustainable development outcomes, in part by bolstering and mainstreaming social accountability. As a result, USAID seeks to design a cross-sectoral social accountability program that incorporates the use of tools and techniques of social accountability that are approved by the Steering Committee of the Ethiopia Social Accountability Program (ESAP). Lessons-learned from USAID/Ethiopia's 2013 assessment of social accountability within Mission programming show that participatory approaches can improve outcomes and build community buy-in for development goals. The Social Accountability tools available to TRANSFORM/PHCU will: help improve citizen and community voice; aid in the delivery of respectful care; improve monitoring evaluation; and responsive planning. An accountability cycle for health service delivery and governance is created APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 61 of 99
through the use tools such as Citizen and Community Scorecards, among others, by informing Social Accountability Committees (SACs) and community mediators. More information on USAID's social accountability initiative can be found at: The TRANSFORM/PHCU activity will leverage USAID's forthcoming social accountability activity using these tools to improve child and maternal health outcomes. While the TRANSFORM/PHCU social accountability activities will be implemented by USAID's new social accountability mechanism, both activities will be characterized by geographic and programmatic overlap. The two activities will cooperate in an integrated program design to result in deeper citizen input for improved maternal and child health outcomes. 4) Collaborate, Learn, Adapt (CLA)
USAID's Bureau for Program Planning and Learning (USAID/PPL) has developed an approach to learning called Collaborating, Learning and Adapting (CLA). This approach facilitates a process for strategic collaboration among partners, systematically generates and captures learning, facilitates the exchange of knowledge, and promotes a learning culture. CLA posits that development efforts yield positive changes more quickly if they are collaborative, test new approaches in a continuous search for improvement, and adapt based on what works and what does not. CLA will be important, where investments at different levels of the health sector and the enabling environment are implemented by different implementing partners. Effective strategies for collaborating and collective learning will be essential. Through CLA, TRANSFORM/PHCU might engage with other RMNCH activities, as well as activities of GoE and other development partners to ensure the coordination of efforts and investments. This coordination will help to reduce duplication of efforts, eliminate working at cross-purposes, and provide a focal point to coordinate efforts to achieve the overall health development objectives. TRANSFORM/PHCU will need to coordinate and collaborate with the constellation of RMNCH activities – including but not limited to those funded under other DOs. Moreover, TRANSFORM/PHCU will need to incorporate collaborative learning and adaptive management (CLA) as part of its approach. CLA will complement more rigorous evaluations with "learning as you go," using ongoing evaluative activities that inform learning through the life-of-the activity, and understanding adoption processes and subsequent adaptive management based on that learning. CLA will allow TRANSFORM/PHCU to hone in on "what is working" and drop what is not. Collaborative learning will be critical to ensuring the RMNCH investments are working synergistically to generate impacts. Extending this collaboration to other donor activities will be equally important to ensure expected outcomes. APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 62 of 99

ANNEX 3: STANDARD PROVISIONS

1. Standard Provisions for U.S. Nongovernmental recipients can be accessed through
USAID's website
2. Standard Provisions for Non-U.S., Nongovernmental recipients can be accessed
through USAID's website
3. For award/sub-awards to Public International Organizations (PIOs), the recipient must
use the Standard Provisions for Cost-Type Awards to PIOs in ADS 308, Awards to
Public International Organizations.
4.For sub-awards to partner government entities, the recipient must adhere to ADS
303.3.21.
6. The following solicitation standard provisions can be found
at nd they are
provided below in full text.
1. Branding Strategy—Assistance (June 2012); 2. Marking Plan—Assistance (June 2012); and 3. Conscience Clause Implementation (Assistance) (February 2012).
1. BRANDING STRATEGY - ASSISTANCE (JUNE 2012)
a. Applicants recommended for an assistance award must submit and negotiate a
"Branding Strategy," describing how the program, project, or activity is named and
positioned, and how it is promoted and communicated to beneficiaries and host country
citizens.
b. The request for a Branding Strategy, by the Agreement Officer from the applicant,
confers no rights to the applicant and constitutes no USAID commitment to an award.
Failure to submit and negotiate a Branding Strategy within the time frame specified by
the Agreement Officer will make the applicant ineligible for an award.
c. Failure to submit and negotiate a Branding Strategy within the time frame specified by
the Agreement Officer will make the applicant ineligible for an award.
d. The applicant must include all estimated costs associated with branding and marking
USAID programs, such as plaques, stickers, banners, press events, materials, and so
forth, in the budget portion of the application. These costs are subject to the revision and
negotiation with the Agreement Officer and will be incorporated into the Total Estimated
Amount of the grant, cooperative agreement or other assistance instrument.
e. The Branding Strategy must include, at a minimum, all of the following:
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 63 of 99
(1) All estimated costs associated with branding and marking USAID programs, such as plaques, stickers, banners, press events, materials, and so forth. (2) The intended name of the program, project, or activity. (i) USAID requires the applicant to use the "USAID Identity," comprised of the USAID logo and brandmark, with the tagline "from the American people" as found on the USAID Web site at transition.usaid.gov/branding, unless Section VI of the RFA or APS states that the USAID Administrator has approved the use of an additional or substitute logo, seal, or tagline. (ii) USAID prefers local language translations of the phrase "made possible by (or with) the generous support of the American People" next to the USAID Identity when acknowledging contributions. (iii) It is acceptable to cobrand the title with the USAID Identity and the applicant's identity. (iv) If branding in the above manner is inappropriate or not possible, the applicant must explain how USAID's involvement will be showcased during publicity for the program or project. (v) USAID prefers to fund projects that do not have a separate logo or identity that competes with the USAID Identity. If there is a plan to develop a separate logo to consistently identify this program, the applicant must attach a copy of the proposed logos. Section VI of the RFA or APS will state if an Administrator approved the use of an additional or substitute logo, seal, or tagline. (3) The intended primary and secondary audiences for this project or program, including direct beneficiaries and any special target segments. (4) Planned communication or program materials used to explain or market the program to beneficiaries. (i) Describe the main program message. (ii) Provide plans for training materials, posters, pamphlets, public service announcement, billboards, Web sites, and so forth, as appropriate. (iii) Provide any plans to announce and promote publicly this program or project to host country citizens, such as media releases, press conferences, public events, and so forth. Applicant must incorporate the USAID Identity and the message, "USAID is from the American People." (iv) Provide any additional ideas to increase awareness that the American people support this project or program. APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 64 of 99
(5) Information on any direct involvement from host-country government or ministry,
including any planned acknowledgement of the host-country government.
(6) Any other groups whose logo or identity the applicant will use on program materials
and related materials. Indicate if they are a donor or why they will be visibly
acknowledged, and if they will receive the same prominence as USAID.
e. The Agreement Officer will review the Branding Strategy to ensure the above
information is adequately included and consistent with the stated objectives of the award,
the applicant's cost data submissions, and the performance plan.
f. If the applicant receives an assistance award, the Branding Strategy will be included in
and made part of the resulting grant or cooperative agreement
(END OF PROVISION)
2. MARKING PLAN – ASSISTANCE (JUNE 2012)
a. Applicants recommended for an assistance award must submit and negotiate a
"Marking Plan," detailing the public communications, commodities, and program
materials, and other items that will visibly bear the "USAID Identity," which comprises
of the USAID logo and brandmark, with the tagline "from the American people." The
USAID Identity is the official marking for the Agency, and is found on the USAID Web
site at http://www.usaid.gov/branding. Section VI of the RFA or APS will state if an
Administrator approved the use of an additional or substitute logo, seal, or tagline.
b. The request for a Marking Plan, by the Agreement Officer from the applicant, confers
no rights to the applicant and constitutes no USAID commitment to an award.
c. Failure to submit and negotiate a Marking Plan within the time frame specified by the
Agreement Officer will make the applicant ineligible for an award.
d. The applicant must include all estimated costs associated with branding and marking
USAID programs, such as plaques, stickers, banners, press events, materials, and so
forth, in the budget portion of the application. These costs are subject to the revision and
negotiation with the Agreement Officer and will be incorporated into the Total Estimated
Amount of the grant, cooperative agreement or other assistance instrument.
e. The Marking Plan must include all of the following:
(1) A description of the public communications, commodities, and program materials that
the applicant plans to produce and which will bear the USAID Identity as part of the
award, including:
(i) Program, project, or activity sites funded by USAID, including visible infrastructure
projects or other sites physical in nature;
(ii) Technical assistance, studies, reports, papers, publications, audio-visual productions,
public service announcements, Web sites/Internet activities, promotional, informational,
media, or communications products funded by USAID;
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 65 of 99
(iii) Commodities, equipment, supplies, and other materials funded by USAID, including commodities or equipment provided under humanitarian assistance or disaster relief programs; and (iv) It is acceptable to cobrand the title with the USAID Identity and the applicant's identity. (v) Events financed by USAID, such as training courses, conferences, seminars, exhibitions, fairs, workshops, press conferences and other public activities. If the USAID Identity cannot be displayed, the recipient is encouraged to otherwise acknowledge USAID and the support of the American people. (2) A table on the program deliverables with the following details: (i) The program deliverables that the applicant plans to mark with the USAID Identity; (ii) The type of marking and what materials the applicant will use to mark the program deliverables; (iii) When in the performance period the applicant will mark the program deliverables, and where the applicant will place the marking; (iv) What program deliverables the applicant does not plan to mark with the USAID Identity , and (v) The rationale for not marking program deliverables. (3) Any requests for an exemption from USAID marking requirements, and an explanation of why the exemption would apply. The applicant may request an exemption if USAID marking requirements would: (i) Compromise the intrinsic independence or neutrality of a program or materials where independence or neutrality is an inherent aspect of the program and materials. The applicant must identify the USAID Development Objective, Interim Result, or program goal furthered by an appearance of neutrality, or state why an aspect of the award is presumptively neutral. Identify by category or deliverable item, examples of material for which an exemption is sought. (ii) Diminish the credibility of audits, reports, analyses, studies, or policy recommendations whose data or findings must be seen as independent. The applicant must explain why each particular deliverable must be seen as credible. (iii) Undercut host-country government "ownership" of constitutions, laws, regulations, policies, studies, assessments, reports, publications, surveys or audits, public service announcements, or other communications. The applicant must explain why each particular item or product is better positioned as host-country government item or product. APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 66 of 99

(iv) Impair the functionality of an item. The applicant must explain how marking the item
or commodity would impair its functionality.
(v) Incur substantial costs or be impractical. The applicant must explain why marking
would not be cost beneficial or practical.
(vi) Offend local cultural or social norms, or be considered inappropriate. The applicant
must identify the relevant norm, and explain why marking would violate that norm or
otherwise be inappropriate.
(vii) Conflict with international law. The applicant must identify the applicable
international law violated by the marking.
f. The Agreement Officer will consider the Marking Plan's adequacy and reasonableness
and will approve or disapprove any exemption requests. The Marking Plan will be
reviewed to ensure the above information is adequately included and consistent with the
stated objectives of the award, the applicant's cost data submissions, and the performance
plan.
g. If the applicant receives an assistance award, the Marking Plan, including any
approved exemptions, will be included in and made part of the resulting grant or
cooperative agreement, and will apply for the term of the award unless provided
otherwise.
(END OF PROVISION)
3. CONSCIENCE CLAUSE IMPLEMENTATION (ASSISTANCE) –
SOLICITATION PROVISION (FEBRUARY 2012)

(a) An organization, including a faith-based organization, that is otherwise eligible to
receive funds under this agreement for HIV/AIDS prevention, treatment, or care—
1) Shall not be required, as a condition of receiving such assistance—
(i) to endorse or utilize a multisectoral or comprehensive approach to combating
HIV/AIDS; or
(ii) to endorse, utilize, make a referral to, become integrated with, or otherwise
participate in any program or activity to which the organization has a religious or moral
objection; and
2) Shall not be discriminated against in the solicitation or issuance of grants, contracts, or
cooperative agreements for refusing to meet any requirement described in paragraph
(a)(1) above.
(b) An applicant who believes that this solicitation contains provisions or requirements
that would require it to endorse or use an approach or participate in an activity to which it
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 67 of 99
has a religious or moral objection must so notify the cognizant Agreement Officer in accordance with the Mandatory Standard Provision titled "Notices" as soon as possible, and in any event not later than 15 calendar days before the deadline for submission of applications under this solicitation. The applicant must advise which activity(ies) it could not implement and the nature of the religious or moral objection. (c) In responding to the solicitation, an applicant with a religious or moral objection may compete for any funding opportunity as a prime partner, or as a leader or member of a Consortium that comes together to compete for an award. Alternatively, such applicant may limit its application to those activities it can undertake and must indicate in its submission the activity(ies) it has excluded based on religious or moral objection. The offeror's proposal will be evaluated based on the activities for which a proposal is submitted, and will not be evaluated favorably or unfavorably due to the absence of a proposal addressing the activity(ies) to which it objected and which it thus omitted. In addition to the notification in paragraph (b) above, the applicant must meet the submission date provided for in the solicitation. (END OF PROVISION) APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 68 of 99

ANNEX 4: BUDGET PREPARATION GUIDANCE

The following object class categories are those required on USAID Form 424A (Section
B – Budget Categories):
Personnel
The category includes the salary of each long-term and short-term, paid position for the
total estimated life-of-project, except consultants, and the projected cost-of-living or
bonus/merit increase for each position.
Fringe Benefits & Allowances
This category includes the amount and percentage of fringe benefits for each
headquarters and field personnel identified above. Include here all allowances such as
housing, schooling, leave benefits and other items.
Travel & Per Diem
This category includes all projected travel, per diem and other related costs for personnel
except consultants. Include the method by which airfare costs were determined; i.e.
quotes for coach and if per diems are based on established policies.
Equipment & Supplies
In accordance with 22 CFR 226, ‘equipment' means tangible non-expendable personal
property, including exempt property charged directly to the award having a useful life of
more than one year and an acquisition cost of $5,000 or more per unit. Information
should be included in the application on how pricing was determined for each piece of
the equipment.
There are statutory constraints relating to the purchase of agricultural commodities, motor
vehicles, pharmaceuticals, pesticides, rubber compounding chemicals and plasticizers,
used equipment and fertilizer with USAID project funds. Applicants may obtain specific
information on these regulations on USAID Web Site
at
In accordance with 22 CFR 226, ‘supplies' means all personal property excluding
equipment, intangible property, debt instruments and interventions.
Contractual Services
This category is for all subcontracts with organizations, which will provide services to the
project and any short- or long-term consultant cost including fees, travel and per diem.
This category is not to be used for sub-grant, which should be included in other direct
costs.
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 69 of 99
Construction
As applicable
Other Direct Costs
Applicants are to identify all costs associated with training of project personnel.
Applicants planning to use USAID funds to send project staff or local counterparts for
training in the U.S. or a country other than the host country, will be required to follow the
guidance on USAID Participant Training Regulations, which may be found on the
USAID Web Site http://www.usaid.gov/pubs/ads.
The Applicant should provide information on any costs attributed to the project not
associated above; i.e., communications, facilitate, fuel vehicles, repair, maintenance and
insurance.
Sub-agreements
Include in this budget class category all subawards.
Indirect Costs/Charges
Include a copy of the Applicant's most recent negotiated indirect cost rate agreement
(NICRA) from the cognizant audit agency showing the overhead and/or general
administrative rate. In the absence of a NICRA all costs must be charged as direct costs.
USAID Form 424A, Section C should reflect the Applicant's and other sources' cash
contribution to this program, if applicable. A cash match means that funds are used to
support the budget elements discussed above. The cash value of donated equipment or
supplies must be documental.
A narrative that justifies the costs as appropriate and necessary for the successful
completion of the program should be attached to USAID Form 424. The narrative must
provide clear explanations for cost reasonableness, particularly when proposed costs
exceed market rates.
The Cooperative Agreement Budget generally has four (4) different categories called
Budget Cost Elements: Program, Training, Procurement, and Indirect Costs. A sample
Agreement Budget is included below. On Standard Form 424A, Section B-Budget
Categories, all eleven Object Class Categories have a footnote number next to them. The
footnote numbers next to the Object Class Categories correspond to one of the four Cost
Elements of the Cooperative Agreement Budget. The 11 Object Class Categories fit
within the four Cost Elements of the Cooperative Agreement Budget. For this
application, submit only the Standard Form 424 and 424A, with the corresponding eleven
(11) Object Class Categories, supported by a detailed narrative.
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 70 of 99
Cost Elements
Total Cost
Fringe Benefits & Allowances Travel & Per diem ices Contractual Services Other Direct Costs Total Direct Costs Administrative Costs Grand total cost APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 71 of 99

ANNEX 5: PAST PERFORMANCE INFORMATION

PAST PERFORMANCE INFORMATION
CONTRACTORPERFORMANCEREPORT
PARTI: Contract Information (tobecompletedbyContractingOfficer)
1.NameofProject:
2.ContractNumber:
3.ContractType:
4.ContractValue(TEC):
5.DescriptionofWork/Services:
6.Problems:(Ifproblemsencounteredonthiscontract,explaincorrectiveactiontaken) 7.Contacts:(Name,TelephoneNumberandE-mailaddress) a. b. 8. Prime or Subcontractor (Circle one) InformationCollectedby: [Note: the actual dollar amount of subcontracts, if any, (awarded to the Prime) must be listed in Block 4 instead of the Total Estimated Cost (TEC) of the overall contract. In addition, a Prime may submit attachments to this past performance table if the spaces provided are inadequate; the evaluation factor(s) must be listed on any attachments.] APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 72 of 99

ANNEX 6: OTHER ACTIVITIES COMPLEMENTARY TO TRANSFORM/PHCU
A. USAID Implemented Activities
Maternal Child Survival Program (MCSP): This activity supports high-impact
health interventions with the ultimate goal of ending preventable maternal and child
deaths (EPMCD). It is a follow on to the Maternal and Child Health Integrated
Program (MCHIP) that was jointly implemented by Jhpiego and Save the Children
from 2010-2014. MCHIP supported pre-service education in midwifery at national
and regional levels, quality improvement interventions for MNCH care, Basic
Emergency Obstetrics and Newborn Care (BEmONC) implementation of integrated
community case management (iCCM), and evaluation of the feasibility of
Community Kangaroo Mother Care (CKMC) at the household and community level.
MCSP builds on the successes of MCHIP and has three major scopes: 1) BEmONC;
2) Community-Based Newborn Care (CBNC); and 3) WASH. MCSP-BEmONC is
implemented by Jhpiego while the latter two are implemented by Save the Children
respectively.
Strengthening BEmONC services;
The BEmONC piece of the MCSP (MCSP-BEmONC) project aims at increasing
facility based birth with skilled birth attendants (SBA) and scaling up the
provision of quality BEmONC services. MCSP-BEmONC project works with the
FMOH and partners to develop a standardized quality improvement approach and
tool for MNH care for hospitals and health centers. In line with these standards
and tools, its supports selected health facilities for improving the quality of
comprehensive MNCH services. Building on MCHIP's efforts, MCSP supports
increasing access to post-partum family planning (PPFP) and post-partum
intrauterine contraceptive device (PPIUCD) services. MCSP-BEmONC conducts
operations research to inform and guide policy and programming in reducing
maternal, newborn and child mortality and morbidity. This activity will end in
March 2016.
Scale-up of Community Based Neonatal Care (CBNC); and
To address the stagnant neonatal mortality rate, the GoE launched a Community
based Newborn Care Initiative with implementation rolling out in a phased
approach. This activity supports the GoE in scaling up CBNC throughout the
country through building capacity to provide high-impact services both at
community and primary health care unit level, building geographically on USAID
MCH investments. Improved community maternal and newborn health practices
and care seeking behaviors are supported through sensitization and training of
healthcare workers in the health extension program to promote maternal and
newborn health and through implementation of evidence-based and culturally
sensitive BCC interventions. This three year activity is implemented through
Save the Children and is set to end in September of 2016.
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 73 of 99
Increased Access and Use of WASH Products and Services
Save the Children, under MCSP, will be implementing a two year activity focused
on WASH in Ethiopia in 5-10 woredas. The interventions under this activity will
support reductions in child mortality and morbidity associated with WASH
related diseases such as diarrhea and malnutrition. In order to align with
USAID's goals of reducing stunting, the WASH activities described in this scope
of work will take place in woredas where there is no geographic overlap with both
IFHP and ENGINE/WASH activities. The overall activities will support the
PHCU to increase access to and use of WASH products and services. This will be
accomplished through a focus on: Increasing the provision of WASH services at
health facilities; Increasing the capacity of water point managers and HEWs to
use and maintain WASH services; and Testing and disseminating models for
private sector engagement in WASH. This activity is set to end in July 2017.
The Last 10 Kilometers: Improving Demand, Access and Use of key MNCH
interventions:
This project is implemented by JSI/L10K in 115 Woredas in the four
major regions. The L10K project is primarily funded by the Bill and Melinda Gates
Foundation (BMGH); USAID support complements the project through
implementation of ICCM and selected MNH interventions including basic emergency
obstetric and newborn care (BEmONC). This project implements MNH activities in
the 115 L10K platform Woredas and CBNC/iCCM in an additional 55 Woredas in
four Oromiya Zones, with the purpose to increase access to and utilization of selected
maternal, newborn and child health services and tocontribute towards the reduction of
maternal, newborn, and child morbidity and mortality to accelerate the achievement
of Millennium Development Goals related to maternal and child mortality. In support
of the GoE's goal to address child survival through the EPI program, L10K is also
implementing a new activity focused on strengthening the national immunization
program. The overall goal of this activity is to increase immunization demand and
access in targeted areas of Ethiopia to support the reduction in the incidence of
vaccine preventable diseases. The GoE has identified 51 poorly performing zones
that contain low performing Woredas in terms of immunization coverage. USAID,
along with UNICEF and WHO, is supporting the GoE to focus on seven zones in five
regions. The three-year activity also supports the implementation the GoE's Routine
Immunization Improvement Plan drafted in 2013 through three main programmatic
foci. These include: increased demand for immunization services in low performing
Woredas; reducing bottlenecks to prevent access to quality immunization services;
and strengthening overall health systems to enhance immunization services. This
activity is set to end in 2016.
Strengthening Ethiopia's Urban Health Program (SEUHP): With JSI as the lead,
this project implement's TRANSFORM's strategy to improve urban MNCH and
FP/RH services. The goal of SEUHP is to improve the health status of the urban
population in Ethiopia by reducing HIV/TB-related and maternal, neonatal and child
morbidity and mortality and the incidence of communicable diseases. SEUHP has
built on achievements of the predecessor USAID-supported Urban Health Extension
Program (UHEP) which supported the training, deployment and management of
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 74 of 99
urban health extension workers. As such, SEUHP is largely a community based program targeting vulnerable population groups through household level health interventions, including health education, basic health services (immunization, postnatal care, TB screening) and improved referral between facility and non-facility level health services. Reduction of maternal, neonatal and child mortality through promotion of facility delivery, follow-on postnatal care, and other reproductive health services is a key objective of SEUHP. SEUHP is currently working in 49 cities and towns in the four major regions and Dire Dawa, Addis Ababa and Harar. TRANSFORM/PHCU will closely collaborate with SEUHP to promote synergies in
approaches and to avoid activity overlap, especially in peri-urban areas.
DELIVER II: This mechanism provides support to the GoE in managing the
contraceptive logistics system. DELIVER supports the Pharmaceutical Fund and
Supply Agency (PFSA), which is responsible for forecasting, quantification,
procurement, distribution, and management of essential drugs, contraceptives & other
health commodities at all levels of the public health system. The project supports the
implementation and increasing capacity to manage a robust paper and computer-
based Integrated Pharmaceutical Logistics System (IPLS), with particular focus on
the Logistics Management Information System (LMIS) in hospitals, health centers,
health posts and Woredas (districts). Support includes automation of IPLS at
facilities & PFSA warehouses, & upgrading of hospital and health center storerooms.
In the next year, DELIVER II will merge with the SCMS Project for one combined
supply chain award. The Recipient of this award is yet to be decided.
Contraceptive Commodity Procurement (CCP): Since 2002, USAID has
supported the Government of Ethiopia to procure contraceptive commodities through
the CCP. Annual commodity procurement support has played an important role in
assuring the availability of quality contraceptives, which has contributed to the
increased contraceptive prevalence rate (CPR) reported by Ethiopia over the past
decade. These commodities are worth $6,000,000 every year which are currently
distributed through IFHP and the government system, but this annual procurement
will significantly decline over the next five years as the GoE's own commodity
procurement system expands.
Health Sector Financing Reform (HSFR): The goal of this mechanism is to
increase the utilization of quality FP/RH, TB and MCH services through improved
availability and sustainability of locally generated financial resources. The
HSFR/HFG project provides targeted technical assistance to the FMOH, RHBs, and
health facilities to effectively design, implement and monitor health sector financing
reform. Specifically it works 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 and
exemptions system; and promote health insurance schemes. Health financing reform
is a key priority for the GoE. Major activities include supporting consolidation of the
reform in all regions and the scale up of community-based health and social health
insurance schemes, expanding the waiver system for the poor and generating
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 75 of 99
evidence to inform policy changes. These activities complement those supported by
PEPFAR, which target Ethiopians living with or affected by HIV.
National Polio Eradication Initiative: Through the CORE Group and WHO,
USAID is supporting the Government of Ethiopia (GoE) to eradicate polio and to
prevent importation and circulation of the Wild Polio Virus from neighboring
countries. Due to Ethiopia's location in the Horn of Africa, there was a wild
poliovirus outbreak in 2013, which makes the country vulnerable to further
importation from neighboring countries. The CORE Group supports national polio
eradication with the following activities: surveillance in emerging regions of Acute
Flaccid Paralysis (AFP), active surveillance of hard-to-reach areas and cross border
coordination, immunization campaigns and awareness-raising events. CORE
supports community-based surveillance, supplementary immunization, routine
immunization, and documentation activities to help eradicate and prevent polio in
Ethiopia. CORE's activities complement the USAID grant to WHO for polio
eradication efforts in the most remote areas of Ethiopia, as well as routine
immunization activities throughout the country.
HMIS and M&E Scale-up: USAID's support of the HMIS scale-up is part of a
larger Mission initiative with the Federal Ministry of Health (FMOH) to improve
health information systems. The program strengthens data collection, analysis and
utilization at all levels of the health services delivery system. The information
generated from this system is critical to regularly monitor health services and status
of disease patterns, and to plan future health interventions. Support includes technical
assistance to train health managers and health workers at regional, zonal, and Woreda
health offices in HMIS, and build capacities of health facilities at the various levels of
the administrative structure. Training is also provided to strengthen data
management, processing and use of HMIS data for decision making and monitoring
and evaluation. This project is implemented by John Snow Inc.

Strengthening Social Behavior Change and Communications: This new activity,
recently awarded to Johns Hopkins University is a five-year cross-cutting activity that
will support and collaborate with the HEP for community based- SBCC. This award
is USAID/Ethiopia's flagship program on SBCC with regard to malaria, tuberculosis,
family planning/reproductive health, PMTCT, MNCH, WASH, and nutrition. The
purpose is to improve health-related behavior in the community and ensure
sustainable, comprehensive and coordinated evidence-based SBCC interventions at
the national, regional and sub-regional levels. The activity's objectives are to:
strengthen local capacity to implement and sustain SBCC activities; improve SBCC
coordination and collaboration; and support SBCC activities/campaigns.
Implementation activities include:
∙ Updating national SBCC policy, strategy, and training materials
∙ Strengthening communication and collaboration between SBCC stakeholders
∙ Developing, producing and disseminating SBCC materials
∙ Training health professionals on SBCC
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 76 of 99
∙ Identifying, documenting and disseminating SBCC best practices
∙ Supporting GoE systems to conduct health promotion activities.
Systems for Improved Access to Pharmaceuticals and Services (SIAPS): is a
cooperative agreement mechanism implemented by Management Sciences for Health
(MSH). The goal of the SIAPS Program is to assure the availability of quality
pharmaceutical products and effective pharmaceutical services to achieve desired
health outcomes. The SIAPS result areas/objectives include improving governance,
building capacity for pharmaceutical management and services, addressing
information needed for decision-making in the pharmaceutical sector, strengthening
financing strategies and mechanisms to improve access to medicines, and increasing
quality pharmaceutical services.
Strengthening Human Resources for Health (HRH): is a five year (2012–2017)
bilateral cooperative agreement funded by USAID, with an overall goal of improving
the human resources for health status in Ethiopia implemented by lead partner
Jhpiego. The intended result will be the availability of adequate numbers of skilled &
motivated staff who are committed to working & staying in a well-managed health
sector & facilities, & this will impact utilization of quality MCNH, FP and HIV/AIDS
prevention, care & treatment services in all regions. The program's goal is to
strengthen the capacity of the GoE to develop and strengthen HRH in Ethiopia. This
will be accomplished through pre-service education of key health care workers
including midwives, anesthetists, HEWs and Paramedics for emergency MNCH
services, addressing retention and incentive issues, and supporting systems
strengthening to effectively manage HRH in the country to allow transfer of skills and
sustainability. The major objectives of the program are; 1) support pre-service and
in-service training standardization and institutionalization including capacity building
of public and private training institutions; 2) strengthen HR planning, retention
strategies and gender equity, 3) support quality assurance through continued
professional development and implementation of accreditation and licensing of health
professionals.
Private Health Sector Program (PHSP): is a five year bilateral program
implemented by Abt Associates and ends on September 2014. The goal of PHSP is to
enhance the role of the private health sector in expanding access to affordable public
health services, especially HIV/TB, FP, Malaria, and STI services through improved
government stewardship, private sector networking and financing, and enhanced
consumer health knowledge. The program is designed to achieve the following
results: (i) establishment of a supportive policy environment for the private health
sector; (ii) enhancement of both geographic and financial access to packages of
essential health services through the private sector; (iii) sustained improvements in
the quality of these services; and (iv) increased demand for quality services by
informed, proactive consumer populations.
Support for International Family Planning Organizations (SIFPO)-Project: This
activity, implemented by Marie Stopes International, has the goal to reduce maternal
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 77 of 99
and child mortality rates through increased contraceptive prevalence by increasing
awareness, access, and uptake of permanent family planning methods like voluntary
non-scalpel vasectomy (NSV) services and tubal ligation, while also exploring,
identifying, and seeking to remove barriers that prevent men from seeking NSV
information and services. Specific objectives of the mechanism are to increase access
to information and education on all methods of FP, with particular emphasis on NSV
and tubal ligation services; increase access to comprehensive FP services, with a
particular focus on voluntary NSV and tubal ligation (TL) service provision; and
identify barriers and opportunities to increase voluntary NSV and tubal ligation
uptake in Ethiopia. This activity also supported social franchising of clinics to
provide quality FP/RH services until August 2014.
Empowering New Generations to Improve Nutrition and Economic
Opportunities (ENGINE):
Implemented by Save the Children Federation, Inc., in
partnership with Tufts University, Valid International, Jhpiego, JHU CCP and Land O
Lakes, the project aims to improve the nutritional status of women and young
children through sustainable, comprehensive, and coordinated evidenced-based
nutrition interventions in 100 Woredas in Oromiya, Amhara, SNNPR and Tigray
Regions.
Challenge-TB: This project is a USAID global field support TB mechanism
implemented through the partnership of KNCV and MSH. This national level
support to TB program activities aims to strengthen Government's technical and
management capacity and coordinate the overall TB control efforts in the country. It
primarily supports the health system at federal and regional levels including regional
laboratories.
HEAL-TB: This project supports case detection, treatment, and diagnosis targeting
691 health facilities (23 hospitals and 668 health centers) in 199 Woredas found in
five zones in Oromiya and five zones in Amhara. Management Sciences for Health
(MSH) is the prime partner, with All African Leprosy, TB Rehabilitation, Research
and Training Center (ALERT), Program for Appropriate Technology in Health
(PATH), and Kenyan Association for the Prevention of Tuberculosis and Lung
Diseases (KAPTLD) as sub-awardees. The objectives of this activity are primarily
focused on expanding TB and MDR DOTS and expanding the knowledge base
around TB in Ethiopia.
ENVISION: Implemented by Research Triangle Institute (RTI) through
USAID/Washington core funds, in close collaboration and consultation with the
FMOH, ENVISION will intervene on a wide range of technical and capacity-building
activities to impact Neglected Tropical Diseases in Ethiopia through three main
interventions:
∙ Increased mass drug distribution coverage among at-risk populations in endemic communities; ∙ Improved evidence-base for action to control and eliminate targeted NTDs; APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 78 of 99
∙ Strengthened environment for implementation of national integrated NTD control and elimination programs. In Oromiya, ENVISION partners with the Oromiya Regional Health Bureau (RHB) and other partners to target onchocerciasis, lymphatic filariasis and trachoma through the support of mass distribution of ivermectin, albendazole, Zithromax, and tetracycline eye ointment in targeted endemic zones. Based on the availability of USAID resources, RTI may also work to address certain aspects of NTD morbidity management during the life of the project. Local Awardees:
Consortium of Reproductive Health Associations (CORHA): A new bilateral local
partner for USAID, CORHA works to improve the capacity of NGO member
organizations to improve RH outcomes in their project areas, as well as strengthening
strategic partnerships through participation and dialogue. The activity focuses on:
∙ Improving CORHA's institutional capacity for planning, management, monitoring, evaluation and fund-raising; ∙ Enhancing member organizational culture for ensuring transparency and accountability by establishing websites and strategic plans; ∙ Increasing member participation and dialogue for strengthening strategic partnerships and collaboration by providing public relations training; and ∙ Improving member organization communication for information, experience, and knowledge sharing by conducting training on knowledge management and through dissemination of a quarterly newsletter. Organization for Development in Action (ODA): A new bilateral local partner for
USAID, ODA's "Improving the Health Status of Children through Education and
Communication" project aims to reduce the incidence of common childhood diseases
through BCC using community and school approaches. The activity focuses on in-
and out-of-school youth in three Woredas in Oromiya. Implementation activities
include:
∙ Building capacity of health extension workers and teachers in BCC through training/mentorship; ∙ Establishing school health clubs; ∙ Facilitating community and school conversations; ∙ Conducting home visits; and ∙ Developing, producing and disseminating information, education and communication (IEC) materials. Confederation of Ethiopian Trade Unions (CETU): A new bilateral local partner,
CETU implements an FP/RH to expand engagement of employers in promoting and
supporting FP/RH services. The activity is implemented in 50
workplaces/factories/plantations located in Oromiya, Amhara, and Afar regions. It
focuses on improving availability and utilization of quality sexual and reproductive
health and maternal and child health services in the worksites. The capacity of local
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 79 of 99
implementing organizations will be strengthened by fostering a sustainable model for development. Through this activity: ∙ Health promotion done through peer education sessions by peer promotors; ∙ Referral linkages strengthened; ∙ Families will be referred for MCH, FP, ANC, and labor and delivery services either to worksite or other health facilities; and ∙ The quality of FP services in worksite health facilities will be improved through provider training on FP counseling and LARCs; availing FP commodities. B. Other Development Partner Complimentary Activities
The Bill & Melinda Gates Foundation has many current and potentially future
investments in Ethiopia which directly align with the USAID TRANSFORM/PHCU
initiative. These include the Last 10 Kilometers Project (JSI), the Universal
Immunization for Family Health Services Project (JSI), the Health Extension
Program Capabilities project (HEPCAPS/Harvard) and a maternal-newborn health
quality program developed by the Institute for Healthcare Improvement (IHI). The
foundation is continuing to develop its primary health care agenda and will be an
active and important partner for the eventual awardee. Thus close and active
collaboration with the foundation and its implementing partners will be critical to the
success of this initiative.
The HEPCAPS Project: Funded by the Gates Foundation, HEPCAPS worked to
develop the long-term capability of Ethiopia's Health Extension Program Platform –
work with Ethiopia's FMOH to develop strategies to improve outcomes and
sustainability in primary care service delivery. The overall objective of HEPCAPS is
to sustain and increase achievements in priority primary care health outcomes and
equity through Ethiopia's HEP Platform. Specifically, HEPCAPS provides support
for a collaborative program with the FMOH to:
∙ Develop the diagnostics needed to identify the challenges facing the FMOH in sustaining the HEP over a 10-20 year time horizon; ∙ Formulate a conceptual and operational framework underpinning a strategy to develop the long-term capacity of the HEP; ∙ Establish a committee to focus on medium-to-long-term visioning with the FMOH and other stakeholders for HEP platform capability and sustainability; ∙ Develop Collaborative policies and strategies to transform concepts and vision into feasible and locally-owned plans, including scoping and initiating steps for moving into implementation; and ∙ Design, demonstrate, and evaluate innovative strategies to improve primary care performance and adapt to changing conditions for a sustainable future primary care system. The HEP platform also holds promise to spread lessons learned to other countries on APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 80 of 99
the African continent about how to implement and maintain a large-scale health care extension service and community linked service delivery model. Primary Health Care Transformation Initiative (PTI):
Deepening the work completed under HEPCAPS, PTI, implemented by Yale
University, is a three-year effort to transform management and leadership capacity
across woredas health offices and primary health care facilities in Ethiopia.
Specifically, this project aims to build a culture of performance management and
accountability at the woreda-level in Ethiopia. Key activities of the project include
development, testing and national endorsement of key performance indicators,
application of effective management standards, establishing a well-functioning
management team in woreda health offices and primary health care facilities through
a partnership mentoring model and yearlong certificate-level training, and fostering
consistent governance and community engagement through effective governing
boards.
Universal Immunization through Improving Family Health Services (UI-FHS)
through the BMFG
: Established to help Ethiopia strengthen its immunization
program, in 2011 the Bill and Melinda Gates Foundation (BMGF) awarded JSI
Research & Training Institute, Inc. (JSI) the Universal Immunization through Family
Health Services (UI-FHS) project, which is a learning grant. The original goal of the
project was to develop evidence on whether and how the Ethiopian Federal Ministry
of Health should pursue nationwide universal child immunization in Ethiopia,
integrated with family health approaches, and what it would take to do so effectively.
At first, UI-FHS was implemented in three Woredas in Ethiopia—Arbegona,
Assaieta, and Hintalo Wajerate in SNNP, Afar, and Tigray regions respectively—
each representing very different scenarios in terms of health system development.
UI-FHS has been building evidence for the past 3.5 years on how to improve the
quality and service provision of routine immunization and family health services,
which has led to the development of a "Reaching Every District using Quality
Improvement" (RED-QI) approach.
In October 2014, UI-FHS received an extension of the original grant to expand into
128 Woredas in six regions of Ethiopia—Afar, Benishangul-Gumuz, Gambella,
SNNP, Somali and Tigray—over the next 4.5 years. In this next phase of the project,
UI-FHS seeks to solidify lessons learned from RED-QI small-scale exploration and to
expand the concepts through a simultaneous scale-out and scale-up process. This
coincides with the Ethiopian Federal Ministry of Health's concerted efforts to
strengthen national routine immunization through several different initiatives, and is
an opportunity not only to strengthen routine immunization in the country, but the
overall delivery of family health services.
Quality Improvement in Healthcare: Improving the quality of maternal and
newborn health care services and outcomes in Ethiopia while building the foundation
for continuous quality improvement. The Institute for Healthcare Improvement (IHI)
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 81 of 99
has been working in partnership with the Ethiopia Federal Ministry of Health (FMOH) since October 2013 to consider how Quality Improvement (QI) methodologies might bolster efforts and accelerate progress towards government aims to reduce mortality among mothers and newborns. During this period, an Ethiopia Health Care Quality Landscaping was completed, capacity building on QI for ministry and RHB staffs initiated, benchmarking visits conducted, and a national quality summit convened. IHI is currently supporting the FMOH on developing a unified Ethiopian National Quality Strategy aligned with the Health Sector Transformation Plan (HSTP 1), designing a working model of scalable learning collaboratives focused on maternal and newborn health, and strengthening local leadership and capability for quality improvement to sustain these efforts over time.
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 82 of 99

ANEXE 7: CERTIFICATIONS, ASSURANCES, OTHER STATEMENTS OF THE
RECIPIENT AND SOLICITATIONS STANDARD PROVISIONS

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 STANDARD PROVISIONS
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 will, 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. (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 APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 83 of 99
must be applicable to the entire institution unless the recipient establishes to the satisfaction of the USAID Administrator that the institution's practices in 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. 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 must complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. (3) The undersigned must 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 must 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 will be subject
to a civil penalty of not less than $10,000 and not more than $100,000 for each such
failure.
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 must
complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 84 of 99
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 will be subject to a civil penalty of not less than
$10,000 and not more than $100,000 for each such failure."
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 must 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.
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 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 APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 85 of 99
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 Web site: 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. d. References in this Certification to the provision of material support and resources must not be deemed to include the furnishing of USAID funds APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 86 of 99
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 will be grounds for unilateral termination of the
agreement by USAID prior to the end of its term.
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.
These certifications and assurances are 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 these assurances, and that the United States will
have the right to seek judicial enforcement of these assurances. These assurances are
binding on the recipient, its successors, transferees, and assignees, and the person or
persons whose signatures appear below are authorized to sign these assurances on behalf
of the recipient.
Request for Application or Annual Program Statement No.
_
Application No.
Date of Application
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 87 of 99

Name of Recipient
Typed Name and Title
Signature
Date
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.
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 88 of 99
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.
PART V - OTHER STATEMENTS OF RECIPIENT
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
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 89 of 99



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:
Data Universal Numbering System (DUNS) Number
(a) Unless otherwise specified in the solicitation using an applicable exemption, 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 globalinfo@dbisma.com 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. APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 90 of 99
Letter of Credit (LOC) Number
If the recipient has an existing Letter of Credit (LOC) with USAID, please indicate the
LOC number:
LOC: _
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, 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) Source If the recipient plans to purchase any goods/commodities which are not in
accordance with the Standard Provision "USAID Eligibility Rules for Procurement of
Commodities and Services," indicate below (using a continuation page, as necessary) the
types and quantities of each, estimated unit costs of each, and probable source. "Source"
means the country from which a commodity is shipped to the cooperating country or the
cooperating country itself if the commodity is located in the cooperating country at the
time of purchase. However, where a commodity is shipped from a free port or bonded
warehouse in the form in which received, "source" means the country from which the
commodity was shipped to the free port or bonded warehouse. Additionally, "available
for purchase" includes "offered for sale at the time of purchase" if the commodity is listed
in a vendor's catalog or other statement of inventory, kept as part of the vendor's
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 91 of 99
customary business practices and regularly offered for sale, even if the commodities are not physically on the vendors' shelves or even in the source country at the time of the order. In such cases, the recipient must document that the commodity was listed in the vendor's catalog or other statement of inventory; that the vendor has a regular and customary business practice of selling the commodity through "just in time" or other similar inventory practices; and the recipient did not engage the vendor to list the commodity in its catalog or other statement of inventory just to fulfill the recipient's request for the commodity. TYPE/DESCRIPTION _ QUANTITY _ ESTIMATED GOODS _ PROBABLE GOODS _ PROBABLE (Generic) _ UNIT COST _ SOURCE _ (e) Restricted Goods. If the recipient plans to purchase any restricted goods, indicate below (using a continuation page, as necessary) the types and quantities of each, estimated unit costs of each, intended use, and probable source. Restricted goods are Agricultural Commodities, Motor Vehicles, Pharmaceuticals, Pesticides, Used Equipment, U.S. Government-Owned Excess Property, and Fertilizer. TYPE/DESCRIPTION QUANTITY ESTIMATED PROBABLE INTENDED USE (Generic) UNIT COST SOURCE (f) Supplier Nationality. If the recipient plans to purchase any goods or services from suppliers of goods and services whose nationality is not in accordance with the Standard Provision "USAID Eligibility Rules for Procurement of Commodities and Services," indicate below (using a continuation page, as necessary) the types and quantities of each good or service, estimated costs of each, probable nationality of each non-U.S. supplier of each good or service, and the rationale for purchasing from a non-U.S. supplier. TYPE/DESCRIPTION _ QUANTITY _ ESTIMATED _ PROBABLE SUPPLIER _ NATIONALITY _ RATIONALE (Generic) _ UNIT COST (Non-US Only) _ FOR NON-US _ APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 92 of 99
Past Performance References
On a continuation page, please provide past performance information requested in the
RFA.
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.
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.
PART VI - STANDARD PROVISIONS FOR SOLICITATIONS
Branding Strategy - Assistance (JUN 2012)
a. Applicants recommended for an assistance award must submit and negotiate a "Branding Strategy," describing how the program, project, or activity is named and positioned, and how it is promoted and communicated to beneficiaries and host country citizens. b. The request for a Branding Strategy, by the Agreement Officer from the applicant, confers no rights to the applicant and constitutes no USAID commitment to an award. c. Failure to submit and negotiate a Branding Strategy within the time frame specified by the Agreement Officer will make the applicant ineligible for an award. APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 93 of 99
d. The applicant must include all estimated costs associated with branding and marking USAID programs, such as plaques, stickers, banners, press events, materials, and so forth, in the budget portion of the application. These costs are subject to the revision and negotiation with the Agreement Officer and will be incorporated into the Total Estimated Amount of the grant, cooperative agreement or other assistance instrument. e. The Branding Strategy must include, at a minimum, all of the following: (1) All estimated costs associated with branding and marking USAID programs, such as plaques, stickers, banners, press events, materials, and so forth. (2) The intended name of the program, project, or activity. (i) USAID requires the applicant to use the "USAID Identity," comprised of the USAID logo and brandmark, with the tagline "from the American people" as found on the USAID Web site at transition.usaid.gov/branding, unless Section VI of the RFA or APS states that the USAID Administrator has approved the use of an additional or substitute logo, seal, or tagline. (ii) USAID prefers local language translations of the phrase "made possible by (or with) the generous support of the American People" next to the USAID Identity when acknowledging contributions. (iii) It is acceptable to cobrand the title with the USAID Identity and the applicant's identity. (iv) If branding in the above manner is inappropriate or not possible, the applicant must explain how USAID's involvement will be showcased during publicity for the program or project. (v) USAID prefers to fund projects that do not have a separate logo or identity that competes with the USAID Identity. If there is a plan to develop a separate logo to consistently identify this program, the applicant must attach a copy of the proposed logos. Section VI of the RFA or APS will state if an Administrator approved the use of an additional or substitute logo, seal, or tagline. (3) The intended primary and secondary audiences for this project or program, including direct beneficiaries and any special target segments. (4) Planned communication or program materials used to explain or market the program to beneficiaries. APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 94 of 99
(i) Describe the main program message. (ii) Provide plans for training materials, posters, pamphlets, public service announcement, billboards, Web sites, and so forth, as appropriate. (iii) Provide any plans to announce and promote publicly this program or project to host country citizens, such as media releases, press conferences, public events, and so forth. Applicant must incorporate the USAID Identity and the message, "USAID is from the American People." (iv) Provide any additional ideas to increase awareness that the American people support this project or program. (5) Information on any direct involvement from host-country government or ministry, including any planned acknowledgement of the host-country government. (6) Any other groups whose logo or identity the applicant will use on program materials and related materials. Indicate if they are a donor or why they will be visibly acknowledged, and if they will receive the same prominence as USAID. e. The Agreement Officer will review the Branding Strategy to ensure the above information is adequately included and consistent with the stated objectives of the award, the applicant's cost data submissions, and the performance plan. f. If the applicant receives an assistance award, the Branding Strategy will be included in and made part of the resulting grant or cooperative agreement
(END OF PROVISION)
Marking Plan - Assistance (JUN 2012)
a. Applicants recommended for an assistance award must submit and negotiate a "Marking Plan," detailing the public communications, commodities, and program materials, and other items that will visibly bear the "USAID Identity," which comprises of the USAID logo and brand mark, with the tagline "from the American people." The USAID Identity is the official marking for the Agency, and is found on the USAID Web site at http://www.usaid.gov/branding. Section VI of the RFA or APS will state if an Administrator approved the use of an additional or substitute logo, seal, or tagline. b. The request for a Marking Plan, by the Agreement Officer from the applicant, confers no rights to the applicant and constitutes no USAID commitment to an award. APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 95 of 99
c. Failure to submit and negotiate a Marking Plan within the time frame specified by the Agreement Officer will make the applicant ineligible for an award. d. The applicant must include all estimated costs associated with branding and marking USAID programs, such as plaques, stickers, banners, press events, materials, and so forth, in the budget portion of the application. These costs are subject to the revision and negotiation with the Agreement Officer and will be incorporated into the Total Estimated Amount of the grant, cooperative agreement or other assistance instrument. e. The Marking Plan must include all of the following: (1) A description of the public communications, commodities, and program materials that the applicant plans to produce and which will bear the USAID Identity as part of the award, including: (i) Program, project, or activity sites funded by USAID, including visible infrastructure projects or other sites physical in nature; (ii) Technical assistance, studies, reports, papers, publications, audio-visual productions, public service announcements, Web sites/Internet activities, promotional, informational, media, or communications products funded by USAID; (iii) Commodities, equipment, supplies, and other materials funded by USAID, including commodities or equipment provided under humanitarian assistance or disaster relief programs; and (iv) It is acceptable to cobrand the title with the USAID Identity and the applicant's identity. (v) Events financed by USAID, such as training courses, conferences, seminars, exhibitions, fairs, workshops, press conferences and other public activities. If the USAID Identity cannot be displayed, the recipient is encouraged to otherwise acknowledge USAID and the support of the American people. (2) A table on the program deliverables with the following details: (i) The program deliverables that the applicant plans to mark with the USAID Identity; (ii) The type of marking and what materials the applicant will use to mark the program deliverables; (iii) When in the performance period the applicant will mark the program deliverables, and where the applicant will place the marking; APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 96 of 99
(iv) What program deliverables the applicant does not plan to mark with the USAID Identity , and (v) The rationale for not marking program deliverables. (3) Any requests for an exemption from USAID marking requirements, and an explanation of why the exemption would apply. The applicant may request an exemption if USAID marking requirements would: (i) Compromise the intrinsic independence or neutrality of a program or materials where independence or neutrality is an inherent aspect of the program and materials. The applicant must identify the USAID Development Objective, Interim Result, or program goal furthered by an appearance of neutrality, or state why an aspect of the award is presumptively neutral. Identify by category or deliverable item, examples of material for which an exemption is sought. (ii) Diminish the credibility of audits, reports, analyses, studies, or policy recommendations whose data or findings must be seen as independent. The applicant must explain why each particular deliverable must be seen as credible. (iii) Undercut host-country government "ownership" of constitutions, laws, regulations, policies, studies, assessments, reports, publications, surveys or audits, public service announcements, or other communications. The applicant must explain why each particular item or product is better positioned as host-country government item or product. (iv) Impair the functionality of an item. The applicant must explain how marking the item or commodity would impair its functionality. (v) Incur substantial costs or be impractical. The applicant must explain why marking would not be cost beneficial or practical. (vi) Offend local cultural or social norms, or be considered inappropriate. The applicant must identify the relevant norm, and explain why marking would violate that norm or otherwise be inappropriate. (vii) Conflict with international law. The applicant must identify the applicable international law violated by the marking. f. The Agreement Officer will consider the Marking Plan's adequacy and reasonableness and will approve or disapprove any exemption requests. The APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 97 of 99
Marking Plan will be reviewed to ensure the above information is adequately included and consistent with the stated objectives of the award, the applicant's cost data submissions, and the performance plan. g. If the applicant receives an assistance award, the Marking Plan, including any approved exemptions, will be included in and made part of the resulting grant or cooperative agreement, and will apply for the term of the award unless provided otherwise.
(END OF PROVISION)
Conscience Clause Implementation (Assistance) - Solicitation Provision (FEB 2012)
a. An organization, including a faith-based organization, that is otherwise eligible to
receive funds under this agreement for HIV/AIDS prevention, treatment, or care-
(1) Must not be required, as a condition of receiving such assistance-
(i) to endorse or utilize a multisectoral or comprehensive approach to combating
HIV/AIDS; or
(ii) to endorse, utilize, make a referral to, become integrated with, or otherwise
participate in any program or activity to which the organization has a religious or moral
objection; and
(2) Must not be discriminated against in the solicitation or issuance of grants, contracts,
or cooperative agreements for refusing to meet any requirement described in paragraph
(a)(1) above.
b. An applicant who believes that this solicitation contains provisions or requirements
that would require it to endorse or use an approach or participate in an activity to which it
has a religious or moral objection must so notify the cognizant Agreement Officer in
accordance with the Standard Provision "Notices" as soon as possible, and in any event
not later than 15 calendar days before the deadline for submission of applications under
this solicitation. The applicant must advise which activity(ies) it could not implement and
the nature of the religious or moral objection.
c. In responding to the solicitation, an applicant with a religious or moral objection may
compete for any funding opportunity as a prime partner, or as a leader or member of a
consortium that comes together to compete for an award. Alternatively, such applicant
may limit its application to those activities it can undertake and must indicate in its
submission the activity(ies) it has excluded based on religious or moral objection. The
offeror's proposal will be evaluated based on the activities for which a proposal is
submitted, and will not be evaluated favorably or unfavorably due to the absence of a
proposal addressing the activity(ies) to which it objected and which it thus omitted. In
addition to the notification in paragraph (b) above, the applicant must meet the
submission date provided for in the solicitation.
APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 98 of 99
3006.4 4. Prohibition on Providing Federal Assistance to Entities that Require
Certain Internal Confidentiality Agreements – Representation (APR 2015)

APPLICABILITY: This pre-award provision must be included in Section IV of all
assistance solicitations.
PROHIBITION ON PROVIDING FEDERAL ASSISTANCE TO ENTITIES THAT
REQUIRE CERTAIN INTERNAL CONFIDENTIALITY AGREEMENTS –
REPRESENTATION (APRIL 2015)
(a)
In accordance with section 743 of Division E, Title VII, of the Consolidated and further Continuing Resolution Appropriations Act, 2015 (Pub. L. 113-235), Government agencies are not permitted to use funds appropriated (or otherwise made available) under that or any other Act for providing federal assistance to an entity that requires employees, subawardees or contractors of such entity seeking to report fraud, waste, or abuse to sign internal confidentiality agreements or statements prohibiting or otherwise restricting such employees, subawardees, or contractors from lawfully reporting such waste, fraud, or abuse to a designated investigative or law enforcement representative of a Federal department or agency authorized to receive such information. (b) The prohibition in paragraph (a) of this provision does not contravene requirements applicable to Standard Form 312, Form 4414, or any other form issued by a Federal department or agency governing the nondisclosure of classified information. (c) By submission of its application, the prospective recipient represents that it does not require employees, subawardees, or contractors of such entity seeking to report fraud,
waste, or abuse to sign internal confidentiality agreements or statements prohibiting or
otherwise restricting such employees, subawardees, or contractors from lawfully
reporting such waste, fraud, or abuse to a designated investigative or law enforcement
representative of a Federal department or agency authorized to receive such information.
(END OF PROVISION)
AAPD 14-03 REPRESENTATION BY ORGANIZATION REGARDING A
DELINQUENT TAX LIABILITY OR A FELONY CRIMINAL CONVICTION
(August 2014)

(a)
In accordance with section 7073 of the Consolidated Appropriations Act, 2014 (Pub. L. 113-76) none of the funds made available by that Act may be used to enter into an assistance award with any organization that – (1)Was "convicted of a felony criminal violation under any Federal law within the preceding 24 months, where the awarding agency has direct knowledge of the conviction, unless the agency has considered, in accordance with its procedures, that this further action is not necessary to protect the interests of the Government"; or (2)Has any "unpaid Federal tax liability that has been assessed for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in APS-663-16-000005 TRANSFORM/Primary Health Care Unit (PHCU) Page 99 of 99
a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability, where the awarding agency has direct knowledge of the unpaid tax liability, unless the Federal agency has considered, in accordance with its procedures, that this further action is not necessary to protect the interests of the Government". For the purposes of section 7073, it is USAID's policy that no award may be made to any organization covered by (1) or (2) above, unless the M/OAA Compliance Division has made a determination that suspension or debarment is not necessary to protect the interests of the Government. (b) Applicant Representation: (1)The Applicant represents that it is [ ] is not [ ] an organization that was convicted of a felony criminal violation under a Federal law within the preceding 24 months. (2)The Applicant represents that it is [ ] is not [ ] an organization that has any unpaid Federal tax liability that has been assessed for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability. [END of NFO]

Source: http://www.koica.go.kr/dev/download.jsp?strFileSavePath=/ICSFiles/afieldfile/2016/04/14/1.pdf&strFileName=%BA%D9%C0%D3%201.%20(USAID_TRANSFORM.PHCU)aps-663-16-000005%20(final%2003-29).pdf

copasah.net

CIVIL SOCIETY ORGANISATION (CSO) Shadow Report on the Performance of the Health Sector in 2011/2012 ACTION GROUP FOR HEALTH, HUMAN RIGHTS AND HIV/AIDS (AGHA) - UGANDA Acronyms iiiExecutive Summary ivChapter One 11.1 Introduction and Background 11.1.1 About AGHA 21.2 Background 31.2.1 Social determinants of health 41.2.2 Health service delivery system 41.2.3 The policy and legal framework 5Chapter Two 72.1 Technical approach and methodology 72.1.1 Methodology 72.1.2 Data collection methods 72.1.3 Scope of the study 82.1.4 Limitation of the study 8Chapter Three 93.1 Findings 93.1.1 General findings 93.1.2 Findings by HSSP III thematic areas and indicators 103.1.2.1 HIV&AIDS, TB and Malaria 103.1.2.2 Human Resources for Health 153.1.2.3 Essential medicines and health supplies 203.1.2.4 Non communicable disease 223.1.2.5 Reproductive Health 283.1.2.6 Health Financing 323.1.2.7 Summary of emerging issues

Microsoft word - trematodes texto.doc

TREMATODES DE LOS de inundaciones, o el incremento en las temperaturas medias de algunos años, hechos que aumentan la dispersión y Rodrigo Sanabria - Prof. Adjunto – intermediarios. También el transporte CEDIVE, Fac. Cs. Veterinarias, UNLP de parásitos adultos mediante el traslado de hacienda desde zonas endémicas hacia zonas donde no se presentaba anteriormente pero donde