USAID/Benin: Open Call for Strengthening Health Services, Demand, and Systems

The United States Government as represented by the U.S Agency for International Development, Benin (USAID/Benin) Office of Health (OOH), invites applications (concept papers) for consideration for potential award(s) under this Annual Program Statement (APS).

This Annual Program Statement (APS) publicizes the intention of the United States Agency for International Development, Benin (USAID/Benin) to fund one or multiple Cooperative Agreements to address the overarching APS programmatic purpose of implementing the Strengthening Health Services, Demand, and Systems in Benin program.

Components

• The APS is composed of the following three components:

  • Component 1, Health Systems Strengthening, focused on strengthening human resources, data driven decision-making, Universal Health Coverage (UHC) expansion as well as governance and accountability of the Ministry of Health (MOH). The geographic focus is national.

  • Component 2, Health Facility Services, which will provide comprehensive support to the different levels of the MOH (central, departmental, facility) to ensure that quality maternal, neonatal, child and youth health care is offered in both public and private health centers. The geographic focus is all 24 communes in the departments of Atacora (9), Donga (4), Mono (6), and Plateau (5).

  • Component 3, Community Health Outcomes Strengthening, which will support strengthening the network of interdisciplinary community health programs to improve the quality, access to, and uptake of high-impact services while increasing local administration of and citizen engagement in community health services. The geographic focus is the following 21 communes: Djougou, Copargo and Ouake (Donga Department); Come, Bopa, Houeyogbe, Grand-Popo (Mono Department); Natitingou, Toucountouna, Boukoumbe, Kouande, Kerou, Pehounco, Tanguieta, Materi, Cobly (Atacora Department); and Adja-Ouere, Ifangni. Ketou, Pobe, Sakete (Plateau Department).

Funding Information

• Award Ceiling: $65,000,000.

Challenges

• The health system as a whole is characterized by the following cross-cutting challenges:

  • Service Delivery: Main challenges include poor compliance with existing care protocols, weak and uneven distribution of quality healthcare and services, unaffordability of fees for services, insufficient qualified human resources, lack of continuity in quality services, and insufficient control in all health facilities.

  • Human Resources for Health: Main challenges include insufficient number of health personnel; lack of medical specialists; absence of a career plan in the private health sector; barriers to Continuing Professional Development opportunities; and absence of an effective system of planning, retention, and deployment of human resources for health.

  • Health Information: Main challenges include limited capacity to collect, analyze, and use health data for decision-making which impedes the efficiency, effectiveness, and sustainability of the health information system and consequently the broader health system. The quality, timeliness, and completeness of data are often a limiting factor that contributes to the lack of confidence in using the data. In addition, the private sector’s contribution to national information systems remains low.

  • Essential Medical Technologies and Products: Main challenges include insecure supply of essential medicines, lack of geographical access to essential medicines, and stock shortages in pharmacies and health facilities. Private health facilities may have more difficulty accessing essential medicines and inputs than public health facilities, despite new laws.

  • Health Financing: Main challenges include insufficient mobilization of resources, high cost of care and services offered in the private sector, long-delayed reimbursements from third-party payers or the national social protection agency, and difficulty mobilizing domestic as well as private sector resources.

  • Governance: Main challenges include weak or ineffective governance structures within the health system, insufficient quality engagement of civil society and private sector, limited systems for strategic planning and management, lack of accountability and responsiveness to needs, and insufficient influence of local and decentralized structures in promoting health interventions.

Outcomes

• The major issues affecting health outcomes in Benin also include the following:

  • Malaria: The entire population of Benin is at risk for malaria, and the disease remains the leading cause of mortality for children under five and morbidity for adults.

  • Family Planning: Benin has one of sub-Saharan Africa’s highest total fertility rates and lowest modern contraceptive prevalence rates. Unmet need for family planning remains high at 35 percent, leading to unplanned, high-risk pregnancies and contributing to maternal and infant deaths.

  • Maternal and Child Health: The main causes of maternal deaths in Benin are hemorrhage, severe infection, eclampsia, obstructed labor, and complications from abortions. The drivers of this mortality are limited access to quality health care services and less-than-ideal care-seeking behaviors.

  • Global Health Security: In recent years, Benin faced repeated outbreaks of viral hemorrhagic fever, cholera, meningitis, measles, yellow fever, and other diseases.