About

The United States Agency for International Development (USAID) is seeking applications for a Cooperative Agreement from qualified entities to implement the Integrated Health Initiative (IHI) Activity.

The Integrated Health Initiative (IHI) Activity (Activity) will increase equitable access to and use of quality health services, and increase adoption of healthy behaviors, especially for women and children, in USAID target areas in Afghanistan. The Activity’s priority health areas are maternal and newborn health (MNH); family planning and reproductive health (FP/RH); child health; nutrition; tuberculosis (TB); and mental health. This Activity will build on prior USAID investments, particularly the Assistance to Families and Indigent Afghans to Thrive (AFIAT), the Urban Health Initiative (UHI), and the Local Health System Sustainability (LHSS) activities. 

The IHI Activity will focus on five high-density population provinces - Kabul, Kandahar, Nangarhar, Herat, and Balkh - with a total population of 12.2 million, which is approximately 25 percent of the total population of the country. These five provinces have a high disease burden, vulnerable populations, and limited access to health services due to distance, high costs, low awareness, and a shortage of female health care providers. Additionally, Kandahar, Herat and Nangarhar have recently received large numbers of Afghans returning from neighboring countries. These populations settle in urban areas for long periods of time before they go to their native provinces, resulting in increased stress to health and other social services. 

Objectives 

• The overall goal of the IHI Activity is to improve health outcomes for women and children. USAID does not intend to mandate a particular approach, specific actions, or delivery of specific services to achieve the proposed activity goal, objectives, and intermediate results but rather expects the potential applicants to propose an evidence-based approach to achieving them. 

• Objective 1: Increase Equitable Access to Health Services 

  • IR 1.1 High impact interventions at facility and community levels scaled up 

  • IR 1.2 Access to health services and products through the private sector improved 

  • IR 1.3 Referral systems from community to health facilities and between facilities strengthened 

• Objective 2: Improve the Quality of Health Services 

  • IR 2.1 Innovative quality improvement tools and approaches adapted and scaled up 

  • IR 2.2 Health care provider competence and confidence to provide quality, respectful care improved 

  • IR 2.3 Private sector health data integrated into DHIS2 

• Objective 3: Improve Healthy Behaviors and Health Care Seeking Practices 

  • IR 3.1 Innovative behavior change approaches developed and implemented 

  • IR 3.2 Community engagement and social accountability strengthened 

Funding Information

• Subject to funding availability and at the discretion of the Agency, USAID intends to provide $92,500,000.00 in total USAID funding over a five (5) year’s period. 

Eligible Activities

• Objective 1: Increase Equitable Access to Health Services  

  • Adapt and expand a core set of proven high impact MNCH, FP/RH, nutrition, MHPSS, and TB interventions, including self-care (e.g. home-based practices) as needed. 

  • Adapt and expand innovative approaches to reduce gender, cultural, age-related, and other barriers to access basic health and nutrition services and products. 

  • Support implementation of affordable primary health care packages in private hospitals. 

  • Strengthen market development approaches to increase availability of priority products, including contraceptives (including long-acting reversible contraception) with linkages between social marketing, public, and private sectors. 

  • Strengthen implementation of light-touch social franchising models to promote quality essential products and improve priority interventions and referral systems, using the network of CHWs and midwives. 

  • Strengthen community-to-facility referral systems, including transportation, emergency calls, and follow-ups in urban and rural areas, including in the private sector. 

  • Work with the private sector to establish/strengthen their current community-based programs and establish health camps to promote health care and improve referrals, including for MHPSS.

• Program Objective 2: Improve the Quality of Health Services:   

  • Implement and expand quality improvement standards in public and private health facilities and at the community level. 

  • Improve clinical and non-clinical capacity of healthcare providers (e.g. doctors, midwives, nurses, psychosocial and nutrition counselors, and CHWs) to deliver quality health and nutrition services and counseling. 

  • Strengthen the technical capacity of professional associations to serve as champions for improving the quality of services. 

  • Support client-driven interventions to seek feedback from communities to understand their needs related to priority health services. 

  • Strengthen supportive supervision and mentoring. 

  • Support the private sector to improve data collection, processing practices, data analysis, reporting tools and SOPs; and to use quality data for decision- making. 

  • Support private sector health facilities to regularly report their health service data to the DHIS2. 

• Objective 3: Healthy Behaviors and Health Seeking Practices Improved 

  • Review and modify existing health messages before selecting context-appropriate health messages. 

  • Promote and support the use of telecommunication technology, mass media, and mobile messaging to reach more women and girls, particularly those with low literacy and in rural areas. 

  • Engage communities, especially religious leaders and community elders, in a constructive dialogue related to promoting health seeking behaviors.                  

  • Support increased male engagement in counseling sessions to improve healthy practices and decision-making. 

  • Train public and private sector health providers, CHWs and community members, including CSOs, to implement community engagement activities to improve healthcare and social accountability. 

Eligibility

• Eligibility for this NOFO is not restricted. All qualified U.S. and non-U.S. organizations (other than those from foreign policy restricted countries) are eligible to apply. Pursuant to Code of Federal Regulations (CFR) 200.400(g), it is USAID policy not to award profit under assistance instruments such as Cooperative Agreements, and as such, for-profit organizations must waive profits and/or fees to be eligible to submit an application. Forgone profit does not qualify as cost share or leverage. Faith based organizations are eligible to apply for federal financial assistance on the same basis as any other organization and are subject to the protections and requirements of Federal law. 

• 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 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. 

• Faith-based organizations are eligible to apply for federal financial assistance on the same basis as any other organization and are subject to the protections and requirements of Federal law.   

• Additionally, USAID welcomes applications from organizations that have not previously received financial assistance from USAID. 

Post Date: December 16, 2024