USAID/Ethiopia Empowered Communities Activity

The United States Agency for International Development’s (USAID) Mission in Ethiopia (USAID/Ethiopia) is seeking applications for a Cooperative Agreement from qualified entities to implement the USAID Empowered Communities Activity, subject to the availability of funds.

The overall objective of this Activity is to achieve better health and nutrition outcomes through improved community ownership of health and strengthened social accountability systems and platforms. The Activity will be primarily funded with family planning, and maternal and child health funding. Therefore, all expected results and proposed interventions should contribute to the betterment of the lives of women, children, youth and men ultimately, improved reproductive, maternal, newborn, child and adolescent health and nutrition (RMNCAH-N) outcomes.

Objectives

The Activity goal will be achieved through two key, interrelated objectives:

• Improve individual and community knowledge and understanding of their own health rights, available services, and fee and delivery structures to make informed decisions in managing their own health.

• Build the capacity of non-state actors (NSA) including but not limited to civil society organizations (CSO), community-based organizations (CBO), faith-based organizations (FBO), other formal and informal community platforms, and private sector actors to strengthen community voice and feedback in the delivery of essential health services for more transparent, responsive, and accountable health services.

Funding Information

• USAID intends to award one Cooperative Agreement pursuant to this notice of funding opportunity. Subject to funding availability and at the discretion of the Agency, USAID intends to provide U$25,000,000 for implementation of activities tied to IR 1-3 and an additional $10,000,000 for implementation of activities tied to IR4. Total funding is therefore up to US$35,000,000 in total USAID funding over a four-year period.

Results

• IR 1. Enhanced Community Ownership of Their Own Health and Health Services

  • This Activity strives to create platforms and processes to inform, engage, and encourage communities to take actions that improve their health outcomes. The goal of empowering individuals and communities is to create a well-informed (health literate) and demanding society.

  • IR 1.1. Increased Health Literacy Among Communities to Improve Health-Seeking Behavior

    • Expected Results:

      • Communities’ access to and utilization of health information performance and services enhanced.

      • Improved health literacy including patient rights at community level.

      • Improved understanding of health services standards.

      • Increased health seeking behaviors for RMNCAH-N services.

  • IR 1.2. Enhanced Community Engagement to Improve RMNCAH-N Services

    • Expected Results:

      • Increased participation of communities, households, individuals, and traditional and religious structures in the design, planning, governance, and delivery of health services.

      • Increased inclusion and participation of marginalized and underserved groups in community health governance and leadership structures.

      • Increased participation of women in decision-making forums (i.e., community facility forums) to drive improvements in RMNCAH-N services.

      • Solutions that local communities have identified are implemented and collectively monitored, with adaptations as needed.

• IR 2. Advocacy Capacity of NSAs for Accountability, Transparency, and Responsiveness of the Health System Strengthened

  • Driving increased community ownership and accountability for health services will require the involvement, partnership, and mentorship by NSAs to help build various technical, advocacy, literacy and organizational/structural functional capacities of communities, community platforms, and various stakeholders.

  • IR 2.1. Strengthened Technical and Leadership Capacity of CSOs & NSAs to Advocate, Engage Citizens to Demand and Participate in Health & Nutrition Services

    • Expected Results:

      • NSA capacity for community mobilization and engagement enhanced [for improved demand for and utilization of RMNCAH-N services].

      • CSO capacity for advocacy enhanced to improve the local health system accountability and responsiveness.

      • Improved community advocacy skills and demand for health services.

      • CSOs effectively monitor transparency and accountability of the health system and compliance and feedback into programming.

  • IR 3. Accountability Systems and Platforms Strengthened to Improve the Health Outcomes Including RMNCAH-N

    • Many elements of health systems in most countries as in Ethiopia are run by state actors. Holding these actors accountable and making them more responsive to the needs of the citizens they serve have significant potential to affect the delivery of health services.

    • IR 3.1 Strengthened Community Structures

      • Expected Results:

        • Improved community structure functionality and coordination in order to synthesize and act on community identified health priorities and solutions.

        • Improved community mobilization capacity among community platforms/structures to evaluate and develop improvement plans for the physical, financial, and/or sociocultural accessibility of health service.

        • Strengthened ability of community platforms to facilitate dialogue on RMNCAH-N issues in a routine manner.

        • Improved community platforms to generate local solutions, action planning and resource mobilization for their own health problems.

    • IR 3.2. Accountability Mechanisms Improved

      • Expected Results:

        • Improved implementation of social accountability mechanisms & approaches.

        • Feedback mechanisms routinely used and institutionalized among the community leadership, local government officials, and health service providers to enhance accountability for health service quality.

        • Increased implementation of joint community-facility actions to drive greater accountability for delivery of quality RMNCAH-N health services.

        • Community voice to contribute to health services provider responsiveness, oversight and accountability.

    • IR 3.3. Community & Health System Partnership Strengthened to Ensure High Quality Health Services, Including RMNCAH-N Services

      • Expected Results:

        • Improved trust in the health system among community, providers, and local government health authorities.

        • Promote transparency and openness of the health system using various interfaces between the community and the health system.

        • Joint planning, implementation, and monitoring of the health services by community, CSOs, and health managers.

Geographic Focus

• The USAID Empowered Communities Activity will operate in 30 districts in Oromia, Amhara, Afar and Southern Nations, Nationalities and People’s (SNNP) Regions. The Activity will have a significant focus and engagement at the woreda (i.e., district) and community level supporting the strengthening of the community platform, enhancing citizens' voices and fostering greater accountability and quality health services. It is expected that this Activity will coordinate with the MoH, the respective RHBs, Zonal Health Departments (ZHD) and Woreda Health Office.

• Final decisions on geographic selection will be made after a thorough review of relevant data and established criteria outlining partnership requirements for USAID complementary support at district, and community levels.