Health Request for Information RFI No. 72030624RFI00006.pdf

Request for Information (RFI)

Subject: USAID/Afghanistan New Health Activity

Reference: RFI No. 72030624RFI00006

Date Issued: May 22, 2024

Due Date: June 7, 2024 5:00 PM Eastern Time

ATTENTION: All Interested Parties

The United States Government, represented by the U.S. Agency for International Development

(USAID)/Afghanistan, is seeking input from interested organizations and individuals who may provide information, opinions, and recommendations in response to the questions outlined in this

RFI for potential USAID interventions to increase equitable access to and utilization of quality health and nutrition services and adoption of healthy behaviors, especially for women and children in targeted areas.

This is not a solicitation. This Request for Information (RFI) notice is solely issued for information and planning purposes only. Responses to this notice are not considered an application and will not be accepted or evaluated by the Government as a result of this RFI. Only responses with the information requested in this RFI will be reviewed. Responses received may be used for planning and design purposes.

All responses regarding this RFI must be submitted electronically as a Microsoft Word document to Amanullah Baheer, Acquisition and Assistance Specialist, at abaheer@usaid.gov with mabenavente@usaid.gov in cc copy, by no later than June 7, 2024 at 5:00 PM U.S. Eastern

Time. Please include the title: “72030624RFI00006 USAID/Afghanistan, New Health Activity'' in the subject line of your email.

The submitted information must not exceed six pages, including annexes/attachments, if submitted. Submissions will receive an electronic confirmation acknowledging receipt but will not receive individualized feedback or suggestions. USAID will not provide feedback or responses to questions submitted in response to this RFI and no applications or resumes will be accepted or considered. This office will not respond to any telephone or other inquiries regarding this notice. Your responses will not be made public.

Thank you for your interest in this Request for Information.

/S/

Margaret R. Benavente

Office of Acquisition and Assistance

USAID/Afghanistan mailto:abaheer@usaid.gov mailto:mabenavente@usaid.gov

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Request for Information

A. Purpose

USAID is exploring the design of a new health activity to increase equitable access to and utilization of quality health and nutrition services and adoption of healthy behaviors, especially for women and children. This RFI solicits information, opinions and recommendations from interested organizations and individuals related to the questions below.

B. Background

Over the past two decades Afghanistan made remarkable gains in health status – significantly reducing maternal mortality from 1,600 deaths per 100,000 live births in 2000 to 620 in 2020

(UN Maternal Mortality Estimate, 2020) and decreasing under-five mortality from 97 per 1,000 live births in 2010 to 56 in 2020 (UN Child Mortality Estimate, 2020). The number of functioning health facilities grew from 496 in 2002 to more than 3,000 in 2023. Following a period of uncertainty immediately after the Taliban takeover, health service delivery and health service utilization returned to pre-2021 levels within a few months.

Afghanistan faces critical health problems, especially for women and children. While maternal mortality has fallen significantly, it is still among the highest in the world, and newborn mortality is 34 deaths per 1,000 live births (UN Child Mortality Estimate, 2021). Malnutrition in the last two years has increased, with 44.7 percent of under-five children stunted (Multiple

Indicator Cluster Survey (MICS), 2023) and the number of acute malnutrition cases is also increasing (UNICEF Nutrition Report, #12 2023). Afghanistan’s contraceptive prevalence rate remains one of the lowest in the world, with 17.4 percent of married women using a modern method (Afghanistan Health Survey 2018), contributing to a high fertility rate (2023 MICS).

Childhood illness is exacerbated by very low vaccination coverage - only 36.6 percent of children 24-36 months old have received all basic immunizations. Tuberculosis is a growing problem and in 2020 was the third leading cause of mortality in Afghanistan among communicable, maternal, neonatal and nutritional diseases, with 31 deaths per 100,000 population (2023 USAID TB Roadmap).

Contributing factors to low health outcomes/metrics include:

Poor health-related behaviors due to low literacy rates and educational levels, along with social and cultural norms and customs that continue to impact health care seeking practices and healthy behaviors.

Health service access barriers such as distance to and costs of services and transport particularly for vulnerable populations who live in peri-urban slums and hard-to-reach rural areas. Restrictions on women’s movements place additional burdens on both women seeking services and female workers trying to get to work.

Poor quality of health care services due to lack of adequate equipment and health commodities in facilities and communities; poor quality of pre-service and in-service training;

and lack of effective and timely supervision.

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Weak health system components that include collection and use of timely and accurate data for decision making and effective management of health services.

Despite serious challenges in the last three years, Afghanistan’s health system has shown tremendous resilience. Strong donor collaboration and commitment of donors and international organizations to working together have been essential.

USAID/Afghanistan is considering a new five year health activity to address priority health challenges and contribute to improved health outcomes. The proposed problem statement is:

Afghans face numerous challenges to practice healthy behaviors and to access health care when needed. Where available, the quality of services may not meet standards.

Strategic Objectives

The activity’s objective may seek to increase equitable access to and utilization of quality health and nutrition services and adoption of healthy behaviors, especially for women and children, in both the public and private sectors. Interventions could include efforts to increase access to health services, improve the quality of health and nutrition services, improve healthy behaviors and care-seeking practices, and strengthen selected health system components to enhance resilience. Results will be achieved by building on successes and lessons learned from current and previous USAID and other donor programs, focusing on emerging challenges after the

Taliban takeover, and leveraging opportunities to achieve objectives.

Questions

Respondents are asked to provide clear and concise responses to the questions below.

Respondents are not required to respond to all of the questions:

1. Given limited resources and the current operational context, what do you see as the top three health problems/challenges that USAID should focus on through this activity and why? What general approaches would have the greatest impact, and be most cost effective, in addressing these challenges?

2. What opportunities and barriers exist within the private sector to expand access to quality health services and products?

3. What approaches should USAID consider to effectively reach women and adolescent girls with health information and services, given the current restrictions on women’s movements and NGO operations?

4. What approaches should USAID consider to improve health service delivery in urban areas, particularly to vulnerable populations?

5. What opportunities and barriers exist to improve individual and community healthy behaviors?

6. What opportunities and barriers exist to improve the functionality of the health management information system and the pharmaceutical management system?

7. In what ways can other development sectors (education, workforce development, gender and rights, etc.) contribute to achieving improved health outcomes?

8. What are your recommendations for geographic targeting for this proposed health activity and what is the rationale for your recommendations?

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9. Do you have any other feedback or recommendations that you would like to share with

USAID relevant to this RFI?

Please do not copy information from publicly available reports, but you are free to include citations or references.

How to submit a response

Responses to this RFI will be accepted through June 7, 2024 5:00 PM (Eastern Time).

The submitted response should include the following information:

Reference Number: 72030624RFI00006

Date:

Affiliation/ Organization:

Business Address:

Representative Name / Email:

Up to six pages of responses to the questions in the RFI

Please note USAID is not seeking technical or cost applications at this time. Do not submit any application in response to this RFI. Only the information requested above will be considered.

STANDARD CLAUSE: 52.215-3 REQUEST FOR INFORMATION OR SOLICITATION FOR PLANNING

PURPOSES (OCT 1997)

(a) The Government does not intend to award a contract on the basis of this solicitation or to otherwise pay for the information solicited except as an allowable cost under other contracts as provided in subsection 31.205-18, Bid and proposal costs, of the Federal Acquisition Regulation.

(b) Although "proposal" and "offeror" are used in this Request for Information, your response will be treated as information only. It shall not be used as a proposal.

(c) This solicitation is issued for the purpose of: Request for Information (RFI)

(End of provision)

(END OF REQUEST FOR INFORMATION)

https://www.acquisition.gov/far/31.205-18#FAR_31_205_18