SOL_No._72068018R00001.pdf

72068018R00001

SOLICITATION, OFFER AND AWARD

4. TYPE OF SOLICITATION2. CONTRACT NUMBER 3. SOLICITATION NUMBER

7. ISSUED BY CODE 8. ADDRESS OFFER TO (If other than Item 7)

ORDER UNDER DPAS (15 CFR 700)

6. REQUISITION/PURCHASE NUMBER

NOTE: In sealed bid solicitations "offer" and "offeror" mean "bid" and "bidder".

NEGOTIATED (RFP)

SEALED BID (IFB)

5. DATE ISSUED

1. THIS CONTRACT IS A RATED RATING PAGE OF PAGES

1 121

C. E-MAIL ADDRESS

EXT.NUMBERAREA CODE

B. TELEPHONE (NO COLLECT CALLS)A. NAME

10. FOR

INFORMATION

CALL:

CAUTION: LATE Submissions, Modifications, and Withdrawals: See Section L, Provision No. 52.214-7 or 52.215-1. All offers are subject to all terms and conditions contained in this solicitation.

(Date)(Hour) local timeuntildepository located in copies for furnishing the supplies or services in the Schedule will be received at the place specified in Item 8, or if hand carried, in the

SOLICITATION

9. Sealed offers in original and

PART IV - REPRESENTATIONS AND INSTRUCTIONS

OTHER STATEMENTS OF OFFERORS

EVALUATION FACTORS FOR AWARD

INSTRS., CONDS., AND NOTICES TO OFFERORS

REPRESENTATIONS, CERTIFICATIONS AND

LIST OF ATTACHMENTS

CONTRACT CLAUSES

PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACH.

I

J

K

L

M SPECIAL CONTRACT REQUIREMENTS

CONTRACT ADMINISTRATION DATA

DELIVERIES OR PERFORMANCE

INSPECTION AND ACCEPTANCE

PACKAGING AND MARKING

DESCRIPTION/SPECS./WORK STATEMENT

SUPPLIES OR SERVICES AND PRICES/COSTS

SOLICITATION/CONTRACT FORM

PART II - CONTRACT CLAUSESPART I - THE SCHEDULE

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B

A

SEC. DESCRIPTION PAGE(S) (X) DESCRIPTION SEC. (X)

11. TABLE OF CONTENTS

18. OFFER DATE17. SIGNATURE

SUCH ADDRESS IN SCHEDULE.

IS DIFFERENT FROM ABOVE - ENTER

15C. CHECK IF REMITTANCE ADDRESS

EXT.NUMBERAREA CODE

15B. TELEPHONE NUMBER

(Type or print)AND

ADDRESS

OF

OFFEROR

CODE FACILITY

16. NAME AND TITLE OF PERSON AUTHORIZED TO SIGN OFFER15A. NAME

DATEAMENDMENT NO.DATEAMENDMENT NO.

and related documents numbered and dated):

amendments to the SOLICITATION for offerors

(The offeror acknowledges receipt of

14. ACKNOWLEDGEMENT OF AMENDMENTS

CALENDAR DAYS (%)30 CALENDAR DAYS (%)20 CALENDAR DAYS (%)10 CALENDAR DAYS (%)

(See Section I, Clause No. 52.232.8)

13. DISCOUNT FOR PROMPT PAYMENT

designated point(s), within the time specified in the schedule.

by the offeror) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the

12. In compliance with the above, the undersigned agrees, if this offer is accepted within ______________ calendar days (60 calendar days unless a different period is inserted

NOTE: Item 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period.

OFFER (Must be fully completed by offeror)

IMPORTANT - Award will be made on this Form, or on Standard Form 26, or by other authorized official written notice.

28. AWARD DATE

(Signature of Contracting Officer)

27. UNITED STATES OF AMERICA

25. PAYMENT WILL BE MADE BY

26. NAME OF CONTRACTING OFFICER (Type or print)

CODE 24. ADMINISTERED BY (If other than Item 7)

ITEM

(4 copies unless otherwise specified)

23. SUBMIT INVOICES TO ADDRESS SHOWN IN

41 U.S.C. 253 (c) ( 10 U.S.C. 2304 (c) (

22. AUTHORITY FOR USING OTHER THAN FULL AND OPEN COMPETITION:

21. ACCOUNTING AND APPROPRIATION20. AMOUNT19. ACCEPTED AS TO ITEMS NUMBERED

AWARD (To be completed by government)

CODE

REQ-680-17-00003111/27/2017

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WEST AFRICA

USAID West Africa Regional Office of Acquisition and Assistance (ROAA) No. 24 Fourth Circular Road, Cantonments, P.O. Box 1630 Accra, Ghana oplist@usaid.gov (Per Section L. 6)

1400 A 01/12/2018

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PAGE(S)

Keisha Effiom

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition is unusable

STANDARD FORM 33 (Rev. 9-97)

Prescribed by GSA - FAR (48 CFR) 53.214(c)

Eletronic (Sec. L.6)

Benin Private Sector Health Partnership Activity RFP No. 72068018R00001

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Table of Contents Page

PART I - THE SCHEDULE 5

SECTION B - SUPPLIES OR SERVICES AND PRICE/COSTS 5

B.1 PURPOSE 5

B.2 CONTRACT TYPE AND SERVICES (CPFF) 5

B.3 ESTIMATED COST, FIXED FEE, AND OBLIGATED AMOUNT 5

B.4 BUDGET AND CEILING PRICE 5

B.5 COST REIMBURSABLE 5

B.6 INDIRECT COST 6

B.7 ADVANCE UNDERSTANDING ON CEILING ON INDIRECT COST RATES

AND FINAL REIMBURSEMENT FOR INDIRECT COSTS 6

B.8 PAYMENT OF FIXED FEE 7

B.9 CANCELLATION CEILING 8

SECTION C – PERFORMANCE WORK STATEMENT 9

SECTION D - PACKAGING AND MARKING 26

D.1 AIDAR 752.7009 MARKING (JAN 1993) 26

D.2 BRANDING POLICY 26

SECTION E - INSPECTION AND ACCEPTANCE 27

E.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY

REFERENCE 27

E.2 INSPECTION AND ACCEPTANCE 27

SECTION F - DELIVERIES OR PERFORMANCE 28

F.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY

REFERENCE 28

F.2 PERIOD OF PERFORMANCE 28

F.3 PERFORMANCE STANDARDS 28

F.4 REPORTS AND DELIVERABLES OR OUTPUTS 28

F.5. DELIVERY SCHEDULE FOR REPORTS/DELIVERABLES 32

F.6 PLACE OF PERFORMANCE 34

F.7 AUTHORIZED WORK DAY / WEEK 34

F.9 AIDAR 752.242-70 PERIODIC PROGRESS REPORTS (OCT 2007) 36

F.10 AIDAR 752.7005 SUBMISSION REQUIREMENTS FOR DEVELOPMENT

EXPERIENCE DOCUMENTS (SEPTEMBER 2013) 36

SECTION G - CONTRACT ADMINISTRATION DATA 39

G.1 AIDAR 752.7003 DOCUMENTATION FOR PAYMENT (NOV 1998) 39

G.2 ADMINISTRATIVE CONTRACTING OFFICE 40

G.3 CONTRACTING OFFICER’S REPRESENTATIVE (COR) 41

G.4 TECHNICAL DIRECTIONS/RELATIONSHIP WITH USAID 41

G.5 PAYING OFFICE 42

G.6 ACCOUNTING AND APPROPRIATION DATA 43

G.7 SPECIAL INSTRUCTIONS 43

SECTION H - SPECIAL CONTRACT REQUIREMENTS 44

H.1 AUTHORIZED GEOGRAPHIC CODE 44

H.2 NONEXPENDABLE PROPERTY PURCHASES AND INFORMATION

TECHNOLOGY RESOURCES 44

H.3 AIDAR 752.7007 PERSONNEL COMPENSATION (JUL 2007) 44

H.4 ADDITIONAL REQUIREMENTS FOR PERSONNEL COMPENSATION 44

H.5 EMPLOYMENT COSTS OF THIRD COUNTRY NATIONALS AND

COOPERATING COUNTRY NATIONALS 45

H.6 LOGISTIC SUPPORT 46

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H.7 SUBCONTRACTING PLAN REPORT FOR INDIVIDUAL CONTRACTS

AND SUMMARY CONTRACTING REPORT 46

H.8 CONSENT TO SUBCONTRACT 46

H.9 AIDAR 752.7032 INTERNATIONAL TRAVEL APPROVAL AND

NOTIFICATION REQUIREMENTS (JAN 1990) 46

H.10 APPROVED INTERNATIONAL TRAVEL APPROVAL 47

H.11 ALLOWABLE AIRFARE 47

H.12 ELECTRONIC PAYMENTS SYSTEM 47

H.13 INFORMATION TECHNOLOGY REQUIREMENT 48

H.14 MANAGEMENT OF INFORMATION TECHNOLOGY RESOURCES 48

H.15 USAID-FINANCED THIRD-PARTY WEB SITES (AUG 2013) 49

H.16 ELECTRONIC AND INFORMATION TECHNOLOGY ACCESSIBILITY

(MAY 2016) 50

H.17 USE OF INFORMATION TECHNOLOGY NOTIFICATION (MAY 2016)

(DEVIATION NO. M/OAA-DEV-FAR- 16-1C) 51

H.18 CLOUD COMPUTING (MAY 2016) 52

H.19 752.7101 VOLUNTARY POPULATION PLANNING ACTIVITIES (JUN

2008) 58

H.20 DEFENSE BASE ACT (DBA) INSURANCE FOR 2015-2020 61

H.21 SUBMISSION OF DATASETS TO THE DEVELOPMENT DATA LIBRARY

(DDL) (OCT 2014) 63

H.22 ORGANIZATIONAL CONFLICT OF INTEREST 64

H.23 ENVIRONMENTAL COMPLIANCE AND MANAGEMENT 65

PART II - CONTRACT CLAUSES 67

SECTION I - CONTRACT CLAUSES 67

I.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY

REFERENCE 67

I.2 52.204-1 APPROVAL OF CONTRACT (DEC 1989) 70

I.3 FAR 52.229-8 TAXES—FOREIGN COST-REIMBURSEMENT

CONTRACTS (MAR 1990) 70

I.4 52.247-67 SUBMISSION OF TRANSPORTATION DOCUMENTS FOR

AUDIT (FEB 2006) 71

I.5 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) 71

I.6 AIDAR 752.225-70 SOURCE AND NATIONALITY REQUIREMENTS (FEB

2012) 71

I.7 AIDAR 752.229-71 REPORTING OF FOREIGN TAXES (JUL 2007) 72

I.8 AIDAR 752.7013 CONTRACTOR-MISSION RELATIONSHIPS (OCT 1989)73

I.9 AIDAR 752.7034 ACKNOWLEDGMENT AND DISCLAIMER (DEC 1991) 74

PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACHMENTS 75

SECTION J - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACHMENTS 75

PART IV - REPRESENTATIONS AND INSTRUCTIONS 76

SECTION K - REPRESENTATIONS, CERTIFICATIONS AND OTHER STATEMENTS OF

OFFERORS 76

K.1 NOTICE LISTING SOLICITATION PROVISIONS INCORPORATED BY

REFERENCE 76

K.2 AGREEMENT ON, OR EXCEPTIONS TO, TERMS AND CONDITIONS 76

K.3 COMPLIANCE WITH VETERANS EMPLOYMENT REPORTING

REQUIREMENTS 76

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K.4 52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS (NOV

2017) 77

K.5 FAR 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS

(JUL 2013) 81

K.6 FAR 52.204-11 REPRESENTATION BY CORPORATIONS REGARDING

DELINQUENT TAX LIABILITY OR A FELONY CONVICTION UNDER ANY FEDERAL

LAW (FEB 2016) 82

K.7 FAR 52.222-56 CERTIFICATION REGARDING TRAFFICKING IN

PERSONS COMPLIANCE PLAN (MAR 2015) 83

K.8 INSURANCE - IMMUNITY FROM TORT LIABILITY 83

K.9 SIGNATURE 84

SECTION L - INSTRUCTIONS, CONDITIONS, AND NOTICES TO OFFERORS 85

L.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY

REFERENCE 85

L.2 FAR 52.216-1 TYPE OF CONTRACT (APR 1984) 85

L.3 52.233-2 SERVICE OF PROTEST (SEP 2006) 85

L.4 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY

REFERENCE (FEB 1998) 86

L.5 GENERAL INSTRUCTIONS TO OFFERORS 86

L.6 PROPOSAL INSTRUCTIONS 87

L.7 INSTRUCTIONS FOR THE PREPARATION OF THE TECHNICAL

PROPOSAL 88

L.8 INSTRUCTIONS FOR THE PREPARATION OF THE COST PROPOSAL 94

L.9 INSTRUCTIONS FOR THE PREPARATION OF THE BRANDING

IMPLEMENTATION PLAN (BIP) AND MARKING PLAN 101

SECTION M - EVALUATION FACTORS FOR AWARD 103

M.1 GENERAL INFORMATION 103

M.2 EVALUATION CRITERIA 103

M.3 COST EVALUATION 105

M.4 DETERMINATION OF THE COMPETITVE RANGE AND CONTRACT

AWARD 107

M.5 CONTRACTING WITH SMALL BUSINESS CONCERNS AND

DISADVANTAGED ENTERPRISES 107

M.6 SOURCE SELECTION 107

ATTACHMENT J.1 109

ATTACHMENT J.2 110

ATTACHMENT J.3 111

ATTACHMENT J.4 115

ATTACHMENT J.5 116

ATTACHMENT J.6 117

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PART I - THE SCHEDULE

SECTION B - SUPPLIES OR SERVICES AND PRICE/COSTS

B.1 PURPOSE

The purpose of this contract is to secure technical services for the implementation of the entitled Benin Private Sector health Partnership Activity. The contractor will be responsible for providing all services and activities described throughout this contract document.

B.2 CONTRACT TYPE AND SERVICES (CPFF)

This is a performance-based completion-type Cost-Plus-Fixed-Fee (CPFF) contract. For the consideration set forth in the contract, the contractor shall provide the deliverables or outputs described in Section C and comply with all contract requirements.

B.3 ESTIMATED COST, FIXED FEE, AND OBLIGATED AMOUNT

(a) The estimated cost for the performance of the work required hereunder, exclusive of fixed fee, if any, is TBD. The fixed fee, if any, is TBD. The estimated cost plus fixed fee, if any, is

TBD.

(b) Within the estimated cost plus fixed fee (if any) specified in paragraph (a) above, the amount currently obligated and available for reimbursement of allowable costs incurred by the contractor (and payment of fee, if any) for performance hereunder is TBD. The contractor must not exceed the aforesaid obligated amount.

(c) Funds obligated hereunder are anticipated to be sufficient through TBD.

B.4 BUDGET AND CEILING PRICE

Contract Period (Years 1 – 5)

For Workdays (LOE) Ordered $ TBD For Other Direct Costs $ TBD Indirect Costs (includes overhead, G&A $ TBD and MHO) Fixed Fee $ TBD Cost Plus Fixed Fee Ceiling Price $ TBD

The contractor will not be paid any sum in excess of the ceiling price. Individual subcontractors should include the same cost element breakdowns in their budgets as applicable.

B.5 COST REIMBURSABLE

The U.S. dollar costs allowable must be limited to reasonable, allocable and necessary costs

P a g e | 6 determined in accordance with FAR 52.216-7, Allowable Cost and Payment, FAR 52.216-8, Fixed Fee, if applicable, and AIDAR 752.7003, Documentation for Payment.

FAR 52.232-20 Limitation of Cost (applies while the contract is fully funded). FAR 52.232-22 Limitation of Funds (applies while the contract is funded in an amount less than the total estimated cost).

B.6 INDIRECT COST

For prime Contractor:

Pending establishment of revised provisional or final indirect cost rates, allowable indirect costs must be reimbursed on the basis of the following negotiated provisional or predetermined rates and the appropriate bases:

Description Rate Base Type Period [Description] [Rate] 1/[___] 1/[___] 1/[____] [Description] [Rate] 2/[___] 2/[___] 2/[____] [Description] [Rate] 3/[___] 3/[___] 3/[____]

1/Base of Application: [_____] Type of Rate: [_____] Period: [_____] Source: [_____]

2/Base of Application: [____] Type of Rate: [____] Period: [_____] Source: [_____]

3/Base of Application: [____] Type of Rate: [____] Period: [____] Source: [____]

B.7 ADVANCE UNDERSTANDING ON CEILING ON INDIRECT COST RATES

AND FINAL REIMBURSEMENT FOR INDIRECT COSTS

[This clause may be added if a ceiling for indirect cost rate is negotiated with the successful offeror]

(a) For each of the contractor's accounting periods during the term of this contract, the parties agree as follows:

(1) The distribution base for establishment of final overhead rates is

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(2) The distribution base for establishment of final G&A rates is

(b) The contractor will make no change in its established method of classifying or allocating indirect costs without the prior written approval of the contracting officer.

(c) Reimbursement for indirect costs shall be at final negotiated rates, but not in excess of the following ceiling rates:

Indirect Cost FY [XX] FY [XX] FY [XX] FY [XX]

[Reference respective accounting periods specified in Section B, Indirect Costs.]

(d) The government shall not be obligated to pay any additional amount on account of indirect costs above the ceiling rates established in the contract. This advance understanding shall not change any monetary ceiling, cost limitation, or obligation established in the contract.

B.8 PAYMENT OF FIXED FEE

Payment of fixed fee will be in accordance with FAR 52.216-8. Pursuant to FAR 16.306.(d), the fixed fee payable under this contract will be tied to the execution of tasks and achievement of results per objective outlined in Section C, subject to inspection and acceptance by USAID and in compliance with the terms of the contract. Upon acceptance by USAID and receipt of approval from the Contracting Officer, the Contractor must submit an invoice for the amount of the fee associated with the deliverable and approved fee schedule detailed below:

Deliverable Due Date % Fee $ Amount of Fee Objective 1 TBD TBD TBD

Outcome/Result 1.1 (TBD) TBD TBD TBD Outcome/Result 1.2 (TBD) TBD TBD TBD Outcome/Result 1.3 (TBD) TBD TBD TBD Objective 2 TBD TBD TBD

Outcome/Result 2.1 (TBD) TBD TBD TBD Outcome/Result 2.2 (TBD) TBD TBD TBD Objective 3 TBD TBD TBD

Outcome/Result 3.1 (TBD) TBD TBD TBD Outcome/Result 3.2 (TBD) TBD TBD TBD

Objective 4 TBD TBD TBD Outcome/Result 4.1 (TBD) TBD TBD TBD

(Note: This is an illustrative table. A fee schedule will be negotiated with the offeror as described in Section L.8)

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B.9 CANCELLATION CEILING

This contract is considered non-severable, and is therefore a multi-year contract as defined in FAR 17.103. Therefore, this contract is subject to the requirements of FAR 17.106. In the event that the Government cancels requirements for services in subsequent program years under this contract, the following conditions will apply: [Amount and dates to be filled in at time of award]

Cancellation Dates:

Contract Year 2: DATE TBD, 2019 Cancellation Ceiling: TBD Contract Year 3: DATE TBD, 2020 Cancellation Ceiling: TBD Contract Year 4: DATE TBD, 2021 Cancellation Ceiling: TBD Contract Year 5: DATE TBD, 2022 Cancellation Ceiling: TBD

This is a CPFF type contract where the contractor is authorized to be reimbursed for all costs which are allowable in accordance with FAR 52.216-7, “Allowable Costs and Payment”.

Therefore, the contractor will not incur any costs which would have been amortized over the life of the contract should the contract be cancelled in accordance with FAR 52.217-2. Therefore, the cancellation ceiling for each cancellation date is stated above.

[END OF SECTION B]

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SECTION C – PERFORMANCE WORK STATEMENT

C.1. Introduction

The overall purpose of this activity is to contribute to the reduction of preventable deaths among vulnerable populations1 by increasing the use of high impact health services and healthy behaviors at the community level in all health zones in Benin (see Attachment J.8).

Targeted technical assistance to key public and private institutions in order to strengthen Beninese capacity to effectively manage the provision of services is one of the approaches USAID applies to achieve its development objectives in Benin. Such assistance may help to unlock the significant potential of the private sector, which is currently unorganized, highly informal, and yet provides half of the health services in Benin. The activity is linked to the new USAID/Benin Results Framework, specifically supporting Sub-IR1.1: “Improved access to High-Impact Health Services (HIHS)” of IR1: “Expanded delivery of high impact health services”. As described in IR1 and Sub-IR1.1 of the Results Framework, this Framework envisions additional support to private institutions, which provide half of all health services in Benin, to expand the formalization of operators through registration, by better connecting them to the national health information reporting system, and through policy engagement to address the overly restrictive regulatory environment. Private sector pharmacies will also be involved in an effort to make them more efficient and promote changes to government regulations to enable service to clients.

C.2. Background

Country Context

Despite improvements, Benin’s health indicators remain unsatisfactory. Maternal, under-five, and infant mortality rates are estimated at 405 maternal deaths per 100,000 live births, 115 child deaths per 1,000 live births, and 66 infant deaths per 1,000 live births, respectively. While child mortality has fallen dramatically (from 166/1000) since 2006, the proportion of under-five mortality during the neonatal period rose from 23 percent in 2006 to 33 percent in 2011-12 (DHS 2011-2012). Endemic malaria threatens the entire population and is the leading cause of morbidity and mortality. Malaria prevalence remains high with 28 percent of children carrying malaria parasites. Despite progress in improving access to basic services, achieving the Sustainable Development Goals (SDGs) will remain a significant challenge, unless the current trend of improvement is sharply accelerated.

During the five-year period of 2015 – 2020, USAID’s Benin Health Project (BHP) aims to reduce preventable deaths among vulnerable populations through increased use of high-impact health services and healthy behaviors at the community level. This goal will be achieved through programming in three areas: 1) delivery of an integrated package of high-impact health services

1 Vulnerable populations is defined in the USAID Benin Strategic framework 2017 -2021 as student girls, girls in school, women and Benin’s most marginalized groups, including the extremely poor and at-risk populations. These marginalized groups include the extreme poor -- found in Benin’s larger cities and remote parts of the country -- as well as key populations most affected by HIV/AIDS

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2) improved preventative and care seeking behavior in communities and 3) improved performance of key health systems.

Key national-level results projected under the BHP include:

● Reduce maternal mortality by 5 percent from 405 to 385 deaths per 100,000 live births

● Reduce under-five mortality by 20 percent from 115 to 92 per 1000 children

● Reduce infant mortality by 15 percent from 60 to 51 per 1000 infants

● Increase modern method contraceptive prevalence rate by 7.6 percentage points from 12.4 percent to 20 percent

● Reduce the prevalence of stunted children under five by 10 percent from 47 percent to 37 percent

The major differences between the current Benin Health Project and the previous one include a change in focus from “families” to “vulnerable populations,” more emphasis on strengthening key health systems and developing strategic partnerships, and better programmatic integration with a greater emphasis on private sector work. This new approach will better serve the Beninese who first seek healthcare from the private sector while also addressing the varying quality of services in the private sector.

National Policy Context

One of the causes of Benin’s low performance on health indicators is the health system’s weak performance. Poor quality healthcare remains a problem in both public and private healthcare sectors. Today, over half of private health providers are unlicensed and less than a quarter of the over 3,000 private health facilities are registered. Moreover, only one-third of the registered providers receive supervision, and few providers regularly report health statistics in the national Health Management Information System (HMIS). (See Attachment J.10)

While standards and norms for service delivery are required to be used by public sector providers, they are not consistently used by private providers. However, the private sector faces additional burden in that the Government of Benin (GOB) is unable to provide effective oversight due to the complexity of regulations that make management difficult but do not contribute to increased quality of services. In addition, there are restrictions on advertising of services and products for health facilities and pharmacies. Prices are set by professional associations rather than health managers of private facilities. These prices are not market-based and do not take into consideration socioeconomic and geographic differences, which restrict competition and the availability of quality services and products.

There is anecdotal evidence that informal drug channels provide the bulk of the country’s pharmaceuticals. For example the 2014 ACT Watch study found that 70 percent of all antimalarial product sales took place in the private sector, of which two-thirds were sold in the informal sector. Little is documented about the structure and content of the pharmaceutical market, drug flows, private sector supply chains and logistics. This lack of market information and data impedes decision-making on how to strengthen private markets and encourage private investment, which would increase access to quality medicines.

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The National Association of Pharmacists places restrictions on where pharmacies can be established, and intentionally avoids placing new pharmacies near existing ones, limiting competition. The availability of key pharmaceuticals and healthcare products vary; many pharmacies do not carry oral contraceptive pills or malaria rapid test kits, and around half carry diarrhea treatments, including oral rehydration solution with zinc. Pharmacies cite a shortage of equipment and pharmaceuticals as a barrier to improving business. The highly controlled and centralized decision-making process within the Government of Benin (GOB) for product registration hinders product availability and limits both the competition for and availability of key products in the marketplace.

The Government, as opposed to markets, determines whether specific products are needed in the market. The market authorization review process denies registration to products similar to those already available on the market, thus limiting patient choice. Central GOB authorities set margins for wholesalers, limiting percentage spread at the wholesale level. There are strict rate controls for markups and margins. The rate controls – especially on non-generic medicines – are so strict that wholesalers are often unable to cover their direct costs. In short, the current regulatory practices hamper the ability of the private sector to sustainably make available a full range of product choices to consumers at different price points to competitively serve all population segments, including the poor and vulnerable, which subsequently limits the availability of high impact products and services.

The World Bank’s performance-based financing project which recently ended used financial incentives to increase access to quality high impact services among poor and vulnerable populations in both public and private sectors in select zones.

USAID Benin’s Investment in the Private Sector

USAID Benin has a long history of strengthening Benin’s private health sector. Over the last decade, USAID Benin has supported private sector family planning (FP) and maternal and child (MCH) service delivery, commodity security as well as malaria prevention. Recent studies commissioned by USAID indicate the private health sector is growing in importance and has substantial potential. In light of this situation, USAID Benin is prioritizing strengthening private sector health care services and access to quality affordable healthcare products.

The USAID private sector work to date includes supporting the development of ABMS (Association Béninoise pour le Marketing Social et la communication pour la santé), established in 1994 and revitalized in 2009, which in conjunction with the ProFam healthcare network has strengthened the provision and quality of private provider services through over 50 clinics nationwide.

Recent studies including the 2013 Benin Private Health Sector Assessment (PSA) and the 2014 Benin Private Sector Census indicate a need to focus on scaling up private sector work beyond these established initiatives. These studies led to several interventions, including the private sector components of the Advancing Newborn, Child, and Reproductive Health 2014-2018 (ANCRE) and Accelerating Reductions in Malaria Morbidity and Mortality 2011-2018 (ARM3)

P a g e | 12 as well as the creation of the Private Sector Health Platform (referred to hereinafter as “The Platform”). ANCRE aims to respond to the PSA’s recommendations around services including scaling up the high impact health services, and developing an accreditation process and fast-tracking the registration of facilities. ARM3 focuses on private sector malaria services and improving access to affordable, quality malaria commodities in the private sector. (See Attachment J.16)

The Platform provides private providers a platform for collective advocacy with the GOB and civil society. The Platform is exclusively private, apolitical, and represents a broad cross sector of the private health sector. The Platform’s first strategic plan is underway, covering the period of 2015-2019. It is legally registered and has established a legal convention with the GOB by 2017. The creation of the Platform and increased interest among private providers and associations to reform the private health sector provides a national solution to barriers facing the private sector, as well as one that has potential to be sustainable and scalable. However, as a newly created organization, the Platform needs to build capacity to interface objectively and effectively with the GOB.

C.3 Project, Purpose and Objectives

The purpose of this activity is to increase the use of high impact RMNCH2 services and products delivered by the private sector nationwide.

There are four objectives of the activity, including the following:

Objective 1: Expand volume of quality, high-impact RMNCH services delivered by private sector providers

Objective 2: Increase availability of affordable and quality and health products through private sector channels

Objective 3: Strengthen public-private engagement to promote universal RMNCH outcomes

Objective 4: Innovative, successful, private sector models are identified, tested, and applied

[Intentionally left blank]

2 Please see definition of RMNCH services and Products in the Attachment J.13

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The activity links to USAID/Benin Strategic Framework, The activity’s link to Health PAD Logical Framework

Narrative Summary

M an ag ea bl e

In te re st

If P ur po se th en

G oa l Goal: Reduced deaths among vulnerable populations

Project Purpose: Increased use of high-impact health services and healthy behaviors

If O ut pu ts , t he n

(S ub

Pu rp os e, Sub-Purpose 1: Improved delivery of integrated high-impact health services

Sub-Purpose 2: Improved preventive and care seeking behavior of empowered communities.

Sub-Purpose 3: Improved Performance of Key Health Systems

C.4. Scope

4.1. Geographic Scope and Focus

The activity will be headquartered in Cotonou with activities covering all 34 health zones in Benin.

4.2 Technical Focus

SubIR 1.2: Increased adoption of healthier behavior among Beninese population

The activity

SubIR 2.3: Reduced corruption and impunity of health sector

IR 1: Expanded delivery of high impact health services

IR2: Strengthened governance of health sector services

IR3: Improved protection of vulnerable populations

SubIR 1.1: Improved access to quality high impact health services

SubIR 2.1: Improved management of health sector resources

SubIR 2.2: Increased participation if decision-making and financing of health resources

SubIR 3.1: Gender-based violence response and prevention services d d

SubIR3.2: Improved access to services for marginalized groups

Strategic Objective: Benin more capable of fostering healthier, more inclusive society

Activity

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The contractor will primarily utilize a technical assistance approach to reform Benin’s regulatory systems, strengthen healthcare administration, and advocate. This activity will be market-based and patient-centered and will be informed by analyses of pharmaceutical market data, policy, innovative best practices in the private sector, gender, and consultation with the Government of Benin, Benin private sector organizations and associations, U.S. Government agencies, civil society, research institutions, donors and other stakeholders.

The contractor must strengthen the private sector’s delivery of high-impact RMNCH services and products by strengthening the GOB’s management of the private sector, including using professional market data to monitor and evaluate regulatory policy and availability of drugs in the private sector. At the same time, the contractor must strengthen the private sector’s administrative capacity to provide high-impact services, and conduct public-private engagement and advocacy work. The contractor must provide assistance to roll out service delivery systems where they may be lacking and strengthen existing service delivery platforms.

The Reproductive, Maternal, Newborn and Child Health (RMNCH) high-impact services include family planning, malaria in pregnancy, antenatal and postnatal care, safe deliveries, vaccinations, exclusive breastfeeding, water sanitation and hygiene, and integrated management of common childhood illnesses of diarrhea, acute lower respiratory infections, malnutrition and malaria.

Key RMNCH products include rapid diagnostic tests for malaria (RDTs), artemisinin-based combination therapy (ACT), injectable artesunate for hospitalized malaria patients, long lasting insecticide treated nets (LLINs), male and female condoms, hormonal and non-hormonal oral contraceptives, injectable contraceptives including Sayana Press, implants, intrauterine devices (IUDs), emergency contraception, vaccines, oral rehydration solution (ORS) with zinc, and water purification tablets. The contractor is expected to adapt package based on the Government of Benin’s policies and norms.

4.3 The Activity Tasks and Performance Standards

The contractor must implement the following tasks to achieve the objectives and outcomes of the activity. Under the tasks are USAID proposed standards. [Offerors may propose additional standards and relevant quality assurance and surveillance based on their approaches.]

Objective 1: Expand volume of quality, high-impact RMNCH services delivered by private sector providers

By 2022, it is expected that Benin’s private sector will deliver high-impact RMNCH services to approximately six million people. Per the 2014 SHOPS census report, there were an estimated 3,174 unregistered clinics and only approximately 50 percent of the 2,486 private sector providers were licensed to practice (excluding medical aides, laboratory technicians, radiology technicians, health logisticians, first aid responders, and “other” providers, who would not be expected to be licensed).

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The contractor must build the capacity of providers in the private sector, prioritizing general practitioners, pediatricians, pharmacists and pharmacy workers, and nurses and midwives, to deliver the complete package of quality, high-impact services reaching poor and vulnerable populations. The contractor must also support private facilities to complete the recently established national accreditation process.

Key stakeholders such as the GOB, the Platform, donors, and other private sector actors are working to strengthen private sector healthcare and public-private partnerships in Benin. The contractor must strengthen the capacity of the members of the Platform and collaborate with the Platform and the GOB and other key stakeholders to obtain nationwide coverage.

A dearth of technical assistance or continuing medical education has resulted in few private providers having up-to-date skills of high-impact services. The contractor must support professional associations to provide technical assistance and training for quality assurance to facilitate and promote the scale-up of high-impact health programs (i.e. malaria, family planning, vaccinations, antenatal and postnatal care, etc.) in the private sector and ensure continuous improvement.

The contractor must provide technical and material assistance to the GOB and private professional associations to reform regulatory standards, conduct training, and increase the registrations of private facilities and licensing of private providers as well scale up neonatal services.

Outcome 1.1. Significantly increased number of registered private facilities and licensed providers

The contractor must:

Task 1.1.1. Convene the GOB, professional healthcare associations, and private providers to review and simplify the process for registration for the private sector facilities and providers.

Task 1.1.2. Provide technical assistance to the Ministry of Health’s (MoH) Direction of Public Health to officially deregulate processes for licensing private providers and registering private facilities, focusing on patient and consumer needs.

Task 1.1.3. Determine the feasibility of putting in place a system of quality norms led by a non-governmental organization (NGO) that could also help providers understand their rights in the registration process.

Task 1.1.4. Identify at least three innovative financing strategies accessible to private sector health facilities.

Task 1.1.5. Provide technical assistance through selected organization(s) to provide registration support services.

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Task 1.1.6. Provide training in service delivery, administration, and business strategy and management via professional associations.

Performance Standards for Outcome 1.1:

Performance Standard Acceptable Quality Level

Quality Assurance Plan

Method of Surveillance

At least three innovative strategies are identified for financing private health facilities

At least three strategies are known to private facility managers

-Written strategies -Communication from financing sources

100% COR

review and approval of written strategies

800 newly registered private facilities

Minus 10 percent variation

Verified registration number posted at HF

Periodic COR inspection

750 health facilities receiving training in service delivery, administration and business strategy and management by professional associations

Minus 5 percent variation

-Training plan -Training participant list -Training evaluations

Quarterly reports contain:

- Annex with a list of trained health facilities

- Synopsize results of training evaluation

Support 700 private health providers to obtain a license

Minus 10 percent variation

Verified license numbers posted at Health Facility (HF)

Five deregulation meetings are organized with GOB and stakeholders

No variation unless approved in advance by the COR

Meeting notes Quarterly reports contain:

- Meeting outcomes

- List of participants

Outcome 1.2. At least 35 percent of registered health facilities are RMNCH accredited

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Task 1.2.1. Provide technical assistance to the Platform to implement the accreditation of private facilities, focusing on patient and consumer needs and provide accreditation support services.

Task 1.2.2. Convene the MoH, professional healthcare associations, and private providers to establish standards and norms for quality for the private sector.

Task 1.2.3. Support on-the-job training in high-impact RMNCH services as well as improving providers’ and pharmacists’ understanding of government standards and norms.

Performance Standards for Outcome 1.2:

Quality Assurance Plan

Method of Surveillance

70 percent of registered, non-accredited HFs receive quarterly accreditation visits

No variation unless approved in advance by the COR

-Completed checklist -Quarterly report by Accreditor(s)

Quarterly report

35 percent of registered private facilities are accredited (after completion of 2 years of visits)

No variation unless approved in advance by the COR

Verified certificate of accreditation posted at HF

1500 providers reached by the on-the-job training in high impact RMNCH services, leveraging professional associations

Minus 10 percent variation

Trainees certificates

Quarterly reports:

- Annex provides a list of trained health facilities

- Synopsize results of training evaluation

Outcome 1.3. 50 percent of registered health facilities routinely reporting on high impact RMNCH services into the national HMIS

Task 1.3.1. Develop systems with the MoH to ensure that registered, private facilities are covered by routine MoH data management supervision at the health zone level. This will require innovative models for supervision in high-density private sector areas in the Porto Novo, Cotonou, and Calavi corridor.

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Task 1.3.2. Connect at least 50 percent of registered private clinics to HMIS.

Performance Standards for Outcome 1.3:

Quality Assurance Plan

Method of Surveillance

50 percent of private facilities were supervised at least once by the MoH in past six months

No variation unless approved in advance by the COR

Integrated supervision checklist

Quarterly report

50 percent of registered private clinics reporting to HMIS on quarterly basis

No variation unless approved in advance by the COR

DHIS2 Quarterly report

Objective 2: Increase availability of affordable and quality health products through private sector channels

The contractor must strengthen the capacity of pharmacies, pharmacists, and wholesalers to import and distribute quality drugs and health care products, especially drugs and products supporting high-impact health services, as well as increase their availability and build a simple but routine approach to monitor the market. Routine data will be used to monitor regulatory reform, health care programming and encourage private investment. The contractor must support a shift in mindset in all sectors and legal framework governing the pharmaceutical supply environment to allow the private sector to reach its potential in supplying quality drugs.

Outcome 2.1. Increased volume (i.e., gross unit sales) of quality key RMNCH products in the private sector at the department level

Studies on health care products are sometimes done by market or health care players, which create a conflict of interest or less than optimal results. The contractor must use a third-party, expert pharmaceutical market data vendor to analyze the structure of the private sector supply chain, highlighting potential synergies with the public sector supply chain system. The third party vendor must also collect and analyze market data on a routinely basis for key products for private and public sector use.

Task 2.1.1. Manage an expert, “conflict-of-interest-free” sub-contractor to conduct in-depth study of flow, logistics and quality testing of key RMNCH products from manufacturer to end-user.

Task 2.1.2. Manage an expert, “conflict-of-interest-free” sub-contractor to collect routine pharmaceutical market data based on existing panels (such as QuintilesIMS or Nielson) and

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Task 2.1.3. Ensure semi-annual routine analysis of key RMNCH product data by expert, “conflict-of-interest-free” sub-contractor measuring change in players (e.g., Central Medical Store (CMS), manufacturers and distributors), volume, products and pricing of key RMNCH products in total market.

Task 2.1.4. Assist the GOB and private sector actors to interpret and use market data analysis findings to inform quantification, drug quality testing, and regulatory reforms.

Performance Standards for Outcomes 2.1:

Performance Standard

Acceptable Quality Level

Quality Assurance Plan

Method of Surveillance

Complete mapping of key RMNCH product availability in private sector from manufacturer to end users, including product quality testing status, nationwide

No variation unless approved in advance by the

COR

Map indicating all tracer products flows from manufacturer to end-users and quality testing status

-100% COR

inspection of protocol

- First work plan and first quarterly report

Semi-annual market data of tracer products collected by approved subcontractor

Minus 10 percent variation (timeliness, completeness and exactitude)

Contractor will provide quarterly updates on the status of the data collection process

-Quarterly reports and final report -Meetings with contractor

35 percent increased unit volume of tracer

RNMCH

Minus 10 percent variation

Verified from routine market data collection

- Report on a semi-annual basis in the quarterly reports

Evidence that the GOB has used market data for quantification, budget, policy and/or program monitoring exercises at least 4 times annually

Minus 25 percent variation

Quarterly review of GOB documents with the MoH

Quarterly reports

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Outcome 2.2. Improved regulatory environment for key RMNCH products

Task 2.2.1. Identify regulatory articles needed for reform to increase availability of pharmaceuticals, especially the key RMNCH products, and improve ease of networking of pharmacies.

Task 2.2.2. Develop a business case for policy makers for the liberalization of product prices using pharmacoeconomics or Health Technology Assessment analyses.

Task 2.2.3. Working with MoH and private sector players including the Platform, streamline the pharmaceutical registration process and harmonize with regional regulatory bodies.

Task 2.2.4. Develop and present a business case to policy makers on the public health benefits and limits of advertising of pharmaceutical products.

Task 2.2.5. Strengthen collaboration between the Platform and universal health care insurance providers.

Performance Standards for Outcomes 2.2:

Quality Assurance Plan

Method of Surveillance

Provide evidence to policy makers of liberalization of product prices using pharmacoeconomics or HTA analysis

100 percent of standard

Policy document and stakeholder/policy maker presentation

Quarterly reports

One registered pharmacy or registered depot by “arrondissement”

No variation unless approved in advance by the

COR

Records of registered pharmacies and registered depots

-Periodic COR inspection of approach -Quarterly reports

Present a business case to policy makers on the importance of networking/franchising and advertising on pharmaceuticals

100 percent of Standard

Business analysis completed and presented to policy makers and stakeholders

-Periodic COR inspection of approach -Quarterly reports

Present a business case to the policy makers on the

100 percent of Standard

Business case developed and

-Periodic COR inspection of

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Performance Standard Acceptable Quality Level

Quality Assurance Plan

Method of Surveillance public health benefits and limits of advertising on pharmaceutical products presented to policy makers and stakeholders approach -Quarterly reports

Objective 3: Strengthen public-private engagement to promote universal RMNCH outcomes

The contractor must contribute to a strengthened enabling environment for the private health sector and public-private engagement to promote universal health outcomes. The contractor must strengthen the capacity of the Platform, as well as reduce the conflicts of interest among the Platform members, professional orders, and private sector association.

Outcome 3.1. Increased leadership, management and governance capacity of the Platform

Task 3.1.1. Identify gaps in the Platform’s membership base and establish written strategies to grow the membership.

Task 3.1.2. Support the Platform to develop and carry out a resource mobilization plan to strengthen its financial base.

Task 3.1.3. Establish a functional mechanism to mitigate conflicts of interest between individual members and associations within the Platform. Develop specific approaches to address conflicts of interest with professional associations, new applicants to their professional associations, and the Platform, establishing an inclusive environment for informal providers and expanding pharmacy networks and chains.

Task 3.1.4. Provide technical assistance to the Platform to establish an advocacy agenda and implement an advocacy action plan, including quarterly meetings with the Ministry of Health, to enhance the Platform’s influence on health policy issues.

Task 3.1.5. Provide actuarial technical expertise through the Platform to support the GOB with costing terms to enable the private sector to participate in national health insurance and other health sector reforms.

[Intentionally left blank]

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Performance Standards for Outcome 3.1:

Acceptable Quality Level

Quality Assurance Plan

Method of Surveillance

Resource mobilization plan in place and increased resource based by 50 percent over the life of the activity

No variation unless approved in advance by the

COR

Membership receipts;

documentation of financing sources;

verified bank accounts

Contractor and the Platform financial reports

Membership growth plan established and at least ten additional associations joined

No variation unless approved in advance by the

COR

Membership ledger Contractor and the Platform reports

Functional mechanism in place to mitigate conflicts of interest between members and associations within the private sector

100 percent of

Charter or similar document

Quarterly reports

Advocacy agenda established and advocacy action plan implemented

No variation unless approved in advance by the

COR

COR invitation to meetings

Quarterly reports

Advocacy meetings between MoH and the Platform held quarterly

No variation unless approved in advance by the

COR

Verified meeting notes; verified participants’ list

Quarterly reports

Outcome 3.2. Annual landscape of Benin’s private health care regulations produced

Task 3.2.1. Working closely with PSSP, other private sector associations and the MoH, the contractor must produce a landscape of Benin’s private health care regulation on an annual basis.

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Performance Standard

Acceptable Quality Level

Quality Assurance Plan

Method of Surveillance

Annual documentation of Benin’s regulatory landscape developed

No variation unless approved in advance by the

COR

Landscape document

Annual reports

Objective 4: Innovative, successful, private sector models are identified, piloted and applied.

The contractor must contribute to integrating existing innovative models and disseminating and applying them in Benin. To this end, the contractor must review the innovative, successful models in other regions/continents and incorporate them intoBenin’s private sector, with funding mobilized through the Resource Mobilization Plan (Task 3.1.2) from organizations including but not limited tothe West Africa Private Health Federation and Africa Private Health Federation.

Outcome 4.1. At least one innovative, successful private sector model applied

Task 4.1.1. Identify at least four possible innovative, successful private sector models.

Task 4.1.2. Pilot one of the innovative, successful private sector models, and disseminate results to stakeholders.

Task 4.1.3. In collaboration with the Platform and GOB, apply at least one model.

Performance Standards for Outcome 4:

Acceptable Quality Level

Quality Assurance Plan

Method of Surveillance

At least one tested, innovative, and emerging private sector model applied

100 percent of Standard

Project results verified by COR during site visits

-Quarterly and Annual reports

C.5 ADDITIONAL CONSIDERATIONS

1. Coordination with Other Initiatives and Implementing Partners

In addition to reducing preventable deaths among vulnerable populations by increasing the use of high-impact health services and healthy behaviors at the community level in all health zones in

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Benin, the contractor will coordinate with other U.S. Government initiatives. These include but are not limited to: Creating an AIDS-free Generation; Ending Preventable Child and Maternal Deaths (EPCMD) as USAID-supported initiatives such as WHO Eliminating Malaria Strategy;

Ouagadougou Initiative and FP2020.

The contractor must promote country ownership of high-impact RMNCH strategies and programs that are consistent with health sector priorities. The contractor must adapt and utilize, where possible, available capacity-building tools and resources that have been developed through other global, regional, and Beninese health activities. The contractor must abide by the Benin government’s standards and guidelines during the provision of all technical assistance and direct service delivery.

2. Gender

Gender refers to the socially-constructed roles, behaviors, activities, and attributes that a given society considers appropriate for men and women. USAID is committed to promoting gender equality and female empowerment, and seeks to improve the lives of citizens around the world by advancing equality and empowering women and girls to participate fully in and benefit from securing better lives for themselves, their families and their communities.

Gender-based violence (GBV) is one of the most serious problems facing women and girls in Benin. Common forms of GBV include domestic violence, sexual gender-based violence, molestation of students by teachers, and harmful traditional practices such as early and forced marriage. About 75% of women report having experienced physical violence during their lifetime, and a third of women report having experienced sexual violence.