Annex 1 72030625RFA00001_Q&A.pdf

Integrated Health Initiative (IHI) Activity

Notice of Funding Opportunity Number (NOFO):

72030625RFA00001

Consolidated Questions and Answers

Amendment no. 1

December 24, 2024

1. Section 9 of the RFA indicates that a security plan may be required, while Attachment

8 (A.17.1) suggests that it should be submitted with the application. Could USAID please clarify whether offerors are required to submit a security plan with their application?

USAID Response: Applicants are not required to submit a security plan with the application.

2. Page 18 of the RFA states, "The IHI Activity should not directly hire staff for health facilities to deliver services or provide salary top-ups or similar incentives." To build on previous investment, can USAID please clarify if the awardee can directly support service delivery in other ways (e.g., through contracting with health facilities)?

USAID Response: Awardees can “support service delivery” through activities that improve the quality of care. Awardees shall not pay salaries or top-ups for staff through any mechanism (direct payment or contracting with facilities).

3. Section C.8 on page 22 states that 5% of planned funds is expected to be available for shock response interventions. Can USAID please confirm that the budget should include a line item for the shock response interventions?

USAID Response: USAID confirms that the budget should include a line item for the shock response interventions.

4. Section D.1 on page 25 notes that each sheet of data applicants wish to restrict should have “the following legend:” but does not provide the language required. Could USAID please provide the requested language?

USAID Response: The language regarding the non-disclosure of the applicant’s data is:

“Use or disclosure of data contained on this sheet is subject to the restriction on the title page of this application.”

Annex 1 72030625RFA00001_Q&A

5. Section D.4.f on page 25 states requirements for obtaining approval of subawards at time of award. If the applicant has an approved purchasing system, are these documents still required?

USAID Response: The reference D.4.f is not located on page 25; it can be found on page 33 of the NOFO under the section titled "Approval of Subawards." This requirement applies even if the applicant has an approved purchasing system.

6. Section D.4 on page 34 describes the required "history of performance" information, but the Past Performance Information form included as an attachment does not align with these requirements. Could USAID please clarify whether applicants should follow the form as is or provide additional information? If additional details are needed, could USAID specify the expected format or content?

USAID Response: The applicant must submit all information specified in Attachment No.

4 of the NOFO, titled "Past Performance Information.

7. If the current government of Afghanistan does not recognize the bilateral agreement allowing for the exemption of foreign taxes, will taxes incurred by implementing partners be considered an allowable cost in accordance with FAR 31.205 (b)(3)?

USAID Response: As this is an assistance opportunity, the Federal Acquisition Regulation (FAR) does not apply. Instead, the allowability of costs will be governed by the cost principles outlined in 2 CFR 200, Subpart E. These costs will be assessed in accordance with ADS 303.3.30 and ADS Chapter 303maw. In certain cases, allowability may also be determined on a case-by-case basis, depending on the specific circumstances.

8. Regarding the January 24, 2025, deadline, would USAID kindly consider issuing a deadline extension?

USAID Response: USAID is unable to extend the submission deadline.

9. Regarding section D.2 (d) - (g), Technical Application format (p. 26), would USAID kindly consider removing the page limits within the 25-page maximum for the technical proposal to allow applicants to present the technical approach, management approach, institutional capacity and executive summary in a more flexible manner?

USAID Response: USAID agrees to remove the page limits on the sub-sections of the Technical Application. The total page limit of 25 pages remains for the overall Technical Application, inclusive of the executive summary, technical approach, management approach and institutional capacity sub-sections.

10. Regarding section D.4.(g), History of Performance (p. 34): The fields requested in the history of performance section of the solicitation vary from those included in

Attachment 4: Past Performance Information/References. Could USAID kindly confirm that it wishes for applicants to use the past performance information template rather than the content requested in the solicitation?

USAID Response: See USAID’s response to question no. 6 above.

11. Could USAID please provide the Afghanistan Local Compensation Plan (FSN) to better assist applicants in reviewing and evaluating sub-recipient proposed salaries?

USAID Response: We do not share Local Compensation Plans (LCP). Applicants must include their own LCP in their proposals, prepared in accordance with their established policies, procedures, and practices.

12. Given the Christmas and New Years holidays, would USAID extend the submission deadline to accommodate for holiday time off?

USAID Response: See USAID’s response to question no. 8 above

13. Because local organizations are critical to many aspects of this program, would USAID consider requiring local organizations (e.g., social marketing organizations, TB service providers, etc.) to be non-exclusive in order to ensure that the IHI Activity has access to (and can strengthen the capacities of) the strongest, most appropriate local organizations regardless of which prime is selected?

USAID Response: USAID agrees that local organizations should be non-exclusive.

14. On page 7, the NOFO states, “The IHI Activity will need to support a range of different health facilities such as specialty, regional and district hospitals; comprehensive and basic health centers; health posts; and private health facilities”. Could USAID indicate if provincial hospitals and sub-health centers are also included? Can USAID clarify what specialty hospitals the IHI Activity will envision to support?

USAID Response: Specialty hospitals that provide services that align with USAID's priority thematic areas may be included. Applicants may assess whether inclusion of provincial hospitals is appropriate to meet IHI objectives. USAID does not anticipate supporting sub-health centers due to the low volume of services that they usually provide, but Applicants may include these with adequate justification.

15. Section C Program Description, 7. Inter-Office Collaboration and Partnership within

USAID/Afghanistan, page 11, states: The IHI Activity will seek opportunities to layer health investments in communities where education and WASH programming is happening so as to increase the collective impact of these programs. Can USAID identify the communities where education and WASH programming is happening?

USAID Response: Two education programs overlap geographically with the IHI Activity.

Accessible and Quality Basic Education (AQBE) and Afghanistan Integrated Youth

Activity (AIYA) are both working in Kabul, Balkh, and Nangarhar provinces. Specific districts and communities are not identified yet.

Applicants do not need to specify the exact locations to be supported at this time. Site selection in collaboration with other USAID-supported activities can occur at the time of preparation of the year one work plan.

16. Section C Program Description, 4. Theory of Change, page 12, highlights mental health screening and counseling as areas of expected improved outcomes. Could USAID clarify whether the IHI Activity is also expected to incorporate and track the referral and treatment of mental health conditions within the existing care continuum?

USAID Response: USAID does not anticipate tracking the referral and treatment for mental health conditions.

17. The NOFO (page 14) mentions limited availability of essential medical supplies, including medicines, as a factor interfering with access to and quality of services. Is procurement of essential medical supplies allowable under this activity? If so, would USAID consider providing a budget estimate for these procurements?

USAID Response: The procurement of essential medical supplies necessary to support the priority health areas is allowable. USAID will not provide a budget estimate for such procurements.

18. On page 18, the NOFO states that, “The IHI Activity should not directly hire staff for health facilities to deliver services or provide salary top-ups or similar incentives.”

Does this include Community Health Workers (CHWs), as this has been a common practice in the urban areas? Does this include provision of incentives to health workers engaged in TB case finding as per TB Strategic Plan?

USAID Response: Payments to CHWs to cover expenses (transportation, attendance at meetings) are allowable. Regular/recurrent payments that resemble salaries or salary top-ups are not allowed. Incentives recommended under the national TB policy to support the community DOTS program are allowed.

19. On page 21, the NOFO lists as illustrative activities: “Promote and support the use of telecommunication technology, mass media, and mobile messaging to reach more women and girls, particularly those with low literacy and in rural areas.” The use of mass media by ongoing projects was halted given the risk of legitimizing the Taliban.

Does this statement indicate a change in USAID’s position on the use of mass media by its IPs?

USAID Response: USAID does not have any restrictions on using mass media.

20. Would USAID clarify whether the IHI Activity will be permitted to engage at the national level with the Ministry of Public Health, alongside Activity-supported sites and regional authorities, to support collaborative efforts (e.g., analysis of maternal/neonatal death audit data) or will the Activity be limited to only Activity-Supported sites and provinces?

USAID Response: Technical engagement with staff at the Ministry of Public Health, at both national and provincial levels, will be permitted. Certain types of engagement will require prior approval from USAID.

21. Is it possible to share the tools adapted to Afghanistan and used by present USAID investments? These include the uCHW guide for implementation (UHI), Patient Equity Support Assessment Tool (PESAT) adapted to Afghanistan (LHSS), and HQIP assessment tool (AFIAT).

USAID Response: USAID is unable to provide these tools.

22. Section C Program Description, 9. Collaborating, Learning and Adapting, page 23, states: Since USAID does not currently have an in-country footprint in Afghanistan, IPs and local stakeholders play a central role in USAID/Afghanistan becoming a more effective learning organization through developing and supporting learning resources and efforts. Can USAID make available any recent evaluations of health programs in Afghanistan?

USAID Response: USAID has recently conducted an evaluation of the AFIAT activity.

The report will be shared when it is finalized, likely in early January. No other evaluations have been done.

23. On page 25, USAID provides standard language to indicate on the cover page that an application includes proprietary information. It then states that each sheet containing proprietary information should be marked “with the following legend,” but does not include the required language. Please confirm that applicants should use the language provided on p. 35-36.

USAID Response: Please see response to Question 4.

24. For Key Personnel candidates, does USAID wish to impose any minimum education and/or experience requirements for these positions?

USAID Response: USAID will not define the minimum education and/or experience requirements for Key Personnel candidates.

25. On page 27, USAID includes “Finance Director” as one of the required Key Personnel.

Is it acceptable if this position has a broader title and responsibilities: for example, “Finance and Administration Director”?

Response: As it says on page 27, the Applicant may make changes to the proposed Key Personnel positions: The Applicant may propose additional Key Personnel positions deemed essential for the effective implementation of the Applicant’s proposed approach and describe the anticipated roles and responsibilities, as well as the qualifications of these key personnel positions. Descriptions of any proposed additional key personnel position must be included in the five-page Management and Staffing Approach section.

The applicant is limited to proposing no more than five positions (including the Chief of Party position).

26. For Annex 3 (page 28), is the 3-page limit per resume inclusive of the letter of commitment, or can the annex include a 3-page resume plus a 1-page letter for each proposed candidate?

USAID Response: The 3-page limit applies only to the resume. The letter of commitment is not included in that limit. The letter of commitment should not exceed one page.

27. Page 30 of the RFA requires applicants to "summarize the proposed budget of the

Activity by Intermediate Results and year". Could USAID confirm if: a) Only a summary budget is needed for this purpose, and; b) A summary of the proposed budget by 3 objectives and year is sufficient?

USAID Response: For the budget submission, please refer to Attachment No. 2, titled 'Excel Budget Sheet,' in the NOFO USAID confirms that a summary budget by Objective (rather than Intermediate Results) and by year is required. Applicants are asked to adapt the provided template (Attachment No. 2) to reflect this format.

28. On page 35 the NOFO says that “Construction will not be authorized under this award.” Would USAID consider revising this language to allow for minor construction to facilitate improved access to and/or quality of services (e.g., adapting existing structures to comply with rule on strict separation of male and female patients in waiting areas and consultation areas of health facilities)?

USAID Response: No. Construction is not eligible for reimbursement under this award.

However, USAID may allow minor structural changes if necessary to support programming or service delivery.

29. The NOFO (page 40) states that the Merit Review Criteria are listed in descending order of importance. Should applicants assume that the sub-factors listed within each criterion are of equal importance, or would USAID rank their relative importance?

USAID Response: The sub-factors within each criterion are of equal importance.

30. Could USAID please confirm that applicants may use their own budget template as long as the summary budget follows the format provided on page 51 of the solicitation?

USAID Response: The applicant is required to use the budget template provided as Attachment 2 of the NOFO.