DHA - REQUEST FOR INFORMATION.pdf

REQUEST FOR INFORMATION

RFI number: 72066324RFI00002 Release date: 08/08/2024 Response due date: 08/22/2024, COB Addis Ababa Time

The United States Agency for International Development, Regional Development Mission for Ethiopia (USAID/Ethiopia) is in the process of gathering information to support anticipated activity design for the Enhance Digital Health activity.

This request for information (RFI) intends to offer the opportunity for interested individuals and organizations to provide recommendations on approaches to support inclusive digital health ecosystems in Ethiopia. In responding to this RFI, significant emphasis should be placed on federal, regional, zonal, woreda and health facility level issues to achieve inclusive, equitable and improved health service delivery using health information systems and digital health tools.

USAID is seeking responses to the questions of this RFI outlined below, USAID is not seeking technical or cost applications/proposals at this time. This request for information is issued solely for planning purposes and is published in accordance with FAR Part 10, FAR 15.201(e) and ADS 201.3.4.5 (c). It does not constitute a Request for Proposals (RFP) or Notice of Funding Opportunity (NOFO). Responses to this RFI shall not be portrayed as proposals or applications and will not be accepted by the U.S. Government (USG) to form a binding agreement.

Responses to this RFI are voluntary. Respondents are free to address any or all of the below items, as well as provide additional information that they think is relevant to inclusive digital ecosystems. USAID will not pay respondents for any information provided in response to this RFI. Any future solicitations of funding opportunities related to an inclusive digital ecosystems activity will be announced on the Federal Business Opportunities website at www.sam.gov or at www.grants.gov at a later date.

Please note that issuance of this RFI is not to be construed as a commitment by the USG to issue any solicitation or ultimately award of a contract/agreement on the basis of this RFI, or to pay for any information submitted as a result of this request. Responders are solely responsible for all expenses associated with responding to this RFI.

Responses to this RFI will be retained by USAID and will not be returned. USAID may elect to use the information submitted at its discretion. Organizations must not submit any proprietary or otherwise sensitive information. This RFI does not restrict the Government's acquisition or assistance approach on a future solicitation, and USAID reserves the right to modify the scope, scale or other details of the planned activities. Similarly, USAID is not obligated to modify its planned approach or otherwise incorporate the input that organizations offer.

It should be noted that responding to or providing input in response to this RFI will not give any advantage to an organization in any subsequent procurement action. Likewise, organizations that choose not to respond will not be precluded from submitting a proposal in response to a subsequent solicitation, if one is ultimately issued. Respondents will receive a confirmation of receipt of its submission. However, USAID will not provide feedback on submissions or answers to any questions submitted in response to this request.

Thank you for your assistance and interest in USAID programs.

Sincerely, /S/ Amy McQuade Supervisory Contracting / Agreement Officer USAID/Ethiopia

Request For Information number: 72066324RFI00002- Enhance Digital Health

1. BACKGROUND

Background on Ethiopia and HIS Strategy

Ethiopia, located in the Horn of Africa, is a nation of over 120 million people. Despite its rich cultural heritage and economic growth, the country faces significant health challenges. The Ethiopian government, with international support, has made considerable progress in developing a robust Health Information System (HIS) to improve public health outcomes.

The HIS strategy in Ethiopia is multifaceted and includes several key components designed to improve data collection, management, and utilization. One of the central pillars of this strategy is the District Health Information Software 2 (DHIS2), an open-source platform that supports various health programs, including immunization and disease surveillance. Additionally, the Electronic Community Health Information System (eCHIS) empowers health extension workers to collect, provide service and manage health data at the community level.

To streamline the supply chain for health commodities, Ethiopia employs the Electronic Logistic Management Information System (eLMIS). This system ensures the efficient distribution and availability of essential medicines and vaccines. Furthermore, the implementation of Electronic Medical Records (EMRs) in health facilities has improved patient record management and service delivery. The Integrated Human Resource Information System (iHRIS) and the Medical Equipment Management Information System (MEMiS) further enhance the management of health workforce data and medical equipment inventory, respectively.

The Government of Ethiopia has outlined a comprehensive Health Information System plan within its Health Sector’’s Medium-Term Development and Investment Plan (HSDIP) for the period 2023-2026. This plan aims to strengthen health systems through systemic reforms and increase the use, equity, and coverage of essential health services. Key components include enhancing digital health infrastructure, integrating various HIS components for interoperability, and improving data quality and utilization for decision-making. The government is committed to increasing health spending as a share of the national budget, aiming to raise it from 6 percent to 10 percent. Furthermore, the HSDIP emphasizes the need for strong policy dialogue, efficient use of resources, and strategic engagement with the private sector to achieve these goals (HSDIP), (Ethiopian Digital Blueprint).

Despite these advancements, Ethiopia's HIS faces several challenges. Infrastructure limitations, particularly in remote areas, hinder consistent use of digital health tools due to low literacy of technology and data use by the health workforce, unreliable internet connectivity and power supply. There is also a shortage of skilled personnel to manage and operate these systems, impacting data quality and overall system effectiveness. Inconsistent data collection practices and incomplete entries remain significant issues, affecting the reliability of health data.

Additionally, integrating various HIS components and ensuring their interoperability is an ongoing challenge.

https://drive.google.com/file/d/1YIGvqsQOK3uQrbCItIqedB02ucuRShOn/view?usp=drive_link https://drive.google.com/file/d/1YIGvqsQOK3uQrbCItIqedB02ucuRShOn/view?usp=drive_link https://drive.google.com/file/d/1YIGvqsQOK3uQrbCItIqedB02ucuRShOn/view?usp=drive_link https://cdhi.uog.edu.et/wp-content/uploads/2024/03/Ethiopian-Digital-Blueprint_V2_16April2021.pdf

International donors have played a crucial role in supporting Ethiopia’s HIS. USAID has been a key partner, providing extensive support through initiatives like the Enhance Digital Health activity (EDH) and Bill and Melinda Gates Foundation (BMGF), developed a new collaboration model called the Data Use Partnership (DUP). In addition to BMGF, other contributing donors to support HIS in Ethiopia includes; the Doris Duke Foundation (DDF), Gavi, the Vaccine Alliance, Clinton Health Access Initiative (CHAI), and the Global Fund (GF). This support has included developing and implementing digital health tools, such as DHIS2, eCHIS, and eLMIS, and training health workers on data management and use.

The World Health Organization (WHO), USAID, the UN, and World Bank has provided technical support and guidance in developing health information policies and standards, aligning Ethiopia’s HIS with global best practices.

USAID is committed to strengthening the Ministry of Health (MoH) in Ethiopia through comprehensive support for HIS strategies (HSDIP). This support focuses on several key areas:

capacity building and workforce development, enhancing data quality and use, infrastructure development, governance and coordination, and interoperability and integration (Ethiopian Digital Blueprint). The rationale behind this support is to achieve sustainable health outcomes, strengthen the health system's resilience, promote evidence-based decision-making, improve accountability and transparency, encourage innovation and technology use, and foster collaboration among stakeholders. Adopting a systems-thinking approach, involving all relevant stakeholders, and promoting continuous learning and adaptation are strategic approaches that underpin USAID's support. This comprehensive support aims to build a robust, efficient, and sustainable HIS in Ethiopia, ultimately enhancing the country's health outcomes.

In this context, Enhance Digital Health aims to significantly improve health outcomes in Ethiopia through a comprehensive approach to strengthening HIS and digital health capabilities.

Specifically, the new digital activity is considering focusing on the following four strategic objectives:

First, enhance service delivery and coordination by improving HIS workforce capacity at the facility level and within the Ministry of Health, creating strong policies and frameworks for effective health information management, and building partnerships between the government, private sector, and academic institutions.

Second, increase health system efficiency by implementing best practices for data collection and analysis, encouraging the use of health data for informed decision-making, and developing standards to ensure interoperability between different health information systems.

Third, boost the use of quality health services by supporting digital health solutions like Electronic Medical Records (EMRs) and Logistic Management Information Systems (LMIS) such as Dagu and mBrana. Although USAID and other donors cannot directly improve internet connectivity, it’s important to recognize that enhancing connectivity and power access is crucial for the effective use of digital health tools. This is especially important in rural areas, where https://drive.google.com/file/d/1YIGvqsQOK3uQrbCItIqedB02ucuRShOn/view?usp=drive_link https://extranet.who.int/countryplanningcycles/sites/default/files/public_file_rep/ETH_Ethiopia_Digital-Health-Blueprint_2021.pdf https://extranet.who.int/countryplanningcycles/sites/default/files/public_file_rep/ETH_Ethiopia_Digital-Health-Blueprint_2021.pdf digital tools can significantly reduce patient waiting times and improve overall satisfaction and service delivery.

Finally, strengthen health system resilience by enhancing the ability to handle crises like epidemics and natural disasters and promoting continuous learning and adoption of new technologies to effectively address health challenges. Through these efforts, USAID aims to establish a sustainable, efficient, and resilient HIS that supports better health outcomes for the people of Ethiopia.

2. INFORMATION REQUESTED

USAID/Ethiopia is seeking input on the following key areas to inform the design and implementation of the Enhance Digital Health. Respondents are limited to 7 pages for their response. Respondents are encouraged to address any or all of the following topics, providing detailed recommendations, best practices, and any supporting documentation or case studies.

1. How well do the proposed objectives frame the strategy required to develop a robust and inclusive Digital Health and Health Information System in Ethiopia? Are there any critical challenges that are not included?

2. What opportunities do you see for a regional platform to effectively foster a robust and inclusive DH/HIS in Ethiopia? What specific supply and demand problems would you prioritize to be solved at a regional level?

3. What opportunities for strengthening Ethiopia's HIS and digital health capabilities do you see emerging from recent systemic shocks (e.g., COVID-19, climate change, technological advancements, etc.)?

4. What are the most significant gaps related to national and sub-national (regional, zonal, and woreda) level coordination in the development of inclusive DH/HIS policies.

5. What are the most significant gaps related to national & regional coordination in the development of inclusive DH/HIS policies that meet international standards, and how could a regional platform help address these gaps?

6. What are the most common and important cybersecurity issues that affect healthcare providers trying to harness the potential of digital health tools in Ethiopia? What opportunities exist for a national & regional approach to strengthening cybersecurity for healthcare providers?

7. What do you think are the main barriers for further growth and strengthening of e-health initiatives in Ethiopia? What are common barriers for healthcare providers to participate in the digital health ecosystem that are distinct from traditional healthcare practices?

8. What innovative financing and public-private partnership models could be leveraged to drive digital health transformation and strengthen the health information system in Ethiopia?

3. RESPONSE SUBMISSION GUIDELINE

All comments and recommendations must be submitted electronically with the title “RFI No.:

72066324RFI00002, USAID/ETHIOPIA - Enhance Digital Health” to ethiopiaprocurement@usaid.gov. Responses to this RFI will be accepted through the date and time indicated above.

You will only receive an electronic confirmation acknowledging receipt of your response, but will not receive individualized feedback on any suggestions. No basis for the claims against the U.S.

Government shall arise as a result of a response to this request for information or from the Government’s use of such information. Specific questions about this RFI should be directed only to the email addresses identified above.

The submitted response should include:

Reference number: RFI No. 72066324RFI00002, USAID/ETHIOPIA - Enhance Digital Health [Date] _______________ Name/Email_______________ Affiliation/Organization ___________________ Address __________________________

Attachments: Please attach any documents that support your comments to the above questions.

Respondents may also include self/organization information including past experiences working on this subject area, experience working with other stakeholders, or capacity information.

[END OF REQUEST FOR INFORMATION]

Background on Ethiopia and HIS Strategy