ANNEX 2b - PHASE 2 TEMPLATE for FY22 RFA CORRECTED.docx
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US Agency for International Development
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Annex 2b
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American Schools and Hospitals Abroad Initiative Solicitation No.: 720DD122RFA00002
ANNEX 2b – PHASE 2 TECHNICAL APPLICATION - TEMPLATE
American Schools and Hospitals Abroad Initiative Solicitation No.: 720DD122RFA00002 ANNEX 2b – 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.
I. Table of Contents (1 page)
II. Management Approach (not to exceed 6 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.
(a) Operational Approach.
(b) Sustainability and OSI Strengthening.
(c) Monitoring and Evaluation (M&E) Approach.
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 implemented with the intent to improve organizational performance.
ASHA PD Custom 2: Number of individuals made aware of American best practices by partner institutions.
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 childbirth outcomes in the southern region of East Tambou.
| Performance / Custom |
| Survey of childbirth 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 implemented with the intent to improve organizational performance
Performance/ Custom
| Reported quarterly. |
| Number |
MANDATORY INDICATOR:
ASHA PD Custom Indicator 2: Number of individuals made aware of American best practices by partner institutions
Performance/ Custom
| Reported quarterly. |
| Number |
(d) Gender integration:
III. Commodities and/or Construction Approach (not to exceed 6 pages for either and 9 pages for both[footnoteRef:1]) [1: If submitting for Commodity Only, 6 pages are allowed. If submitting for Construction/Renovation Only, 6 pages are allowed. If submitting for both Commodity and Construction/Renovation then 9 pages total are allowed.]
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.
Commodities Information (if applicable), Construction/Renovation Information (if applicable), Environmental Capability: By responding to Annex 3
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