ANNEX 2 - PHASE 2 TEMPLATE for FY20 RFA(12.4.2019).docx

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American Schools and Hospitals Abroad Program Worldwide
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72ASHA20RFA00001-PC
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ANNEX 2 – PHASE 2 TECHNICAL APPLICATION - TEMPLATE

ANNEX 2 – PHASE 2 TECHNICAL APPLICATION TEMPLATE

Instructions: Applicants should reproduce and complete the "Annex 2 - Phase 2 Technical Application Template" and return to ASHA for review. All requested information should be submitted.

II. Table of Contents (1 page)

III. Management Approach (not to exceed 9 pages)

Please provide your response to the merit review criterion of Management Approach, in accordance with the instructions in Section E.2.b of this NOFO/RFA. For the monitoring and evaluation factor, Applicants should note the following:

· "F" indicators can be found using this link: https://usaidlearninglab.org/library/standard-foreign-assistance-indicators

· ASHA's two mandatory custom indicators are:

ASHA PD Custom 1: Number of American best practices that improve organizational performance.

ASHA PD Custom 2: Number of American best practices formally disseminated, accepted, or adopted.

Additional information can be found on ASHA's PD Custom Indicators. Additionally, Applicants must use the following table (add rows as needed) as part of the response to monitoring and evaluation and should include both the "F" indicators and the ASHA PD Custom indicators:

Indicator
Result Measured by Indicator
Type of Indicator
Data Source
Frequency
Unit of Measure
Baseline
Endline
Date
Value
Date
Target

[Example 1] Indicator DR.1.5-1 Number of USG-assisted courts with improved case management systems

Improved operations of East Tambou civil courts.
Performance / Standard
Implementing Partner count of courts assisted.
Reported annually.
Number
09/2017
0
09/2022
120

[Example 2] Indicator 3.4.1(a) Neonatal mortality rate (number of deaths of infants during the first 28 days of life per 1,000 live births) in childbirth facilities in the southern region of East Tambou.

Improved child birth outcomes in the southern region of East Tambou.

Performance / Custom
Survey of child birth facility vital registration data.
Reported quarterly.
Number per 1,000
01/2016
55.3
09/2021
40.0

MANDATORY INDICATOR:

ASHA PD Custom Indicator 1: Number of American best practices that improve organizational performance

Performance/ Custom

Reported quarterly.

MANDATORY INDICATOR:

ASHA PD Custom Indicator 2: Number of American best practices formally disseminated, accepted, or adopted

Performance/ Custom

Reported quarterly.

IV. Commodities and/or Construction Approach (not to exceed 9 pages)

Please provide your response to the merit review criterion of Commodities and/or Construction under the appropriate headings below, in accordance with the instructions in Section E.2.b of this NOFO/RFA.

Durable Commodities Information (if applicable), including Procurement Plan

Construction/Renovation Information (if applicable), including Implementation Plan

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