C3HP HIV TB RFP_72062121R00002_Draft.pdf

Issuance Date: XXXXXXX Deadline for Questions: XXXXX, at 1700 East Africa Time Deadline for Receipt of Past performance Information and Key Personnel Annex: XXXXX, at 1700 East Africa Time Deadline for Receipt of Proposal: XXXXX, at 0700 East Africa Time

SUBJECT: REQUEST FOR PROPOSALS (RFP) - SOL NO. 72062121R00002

Dear Prospective Offerors:

The United States Agency for International Development (USAID) Mission in Tanzania is seeking proposals from responsible organizations interested in implementing the Tanzania Comprehensive Client-Centered Health Program – HIV and Tuberculosis (C3HP-HIV&TB) activity. The proposed activity is to increase the demand for and use of quality integrated HIV and TB services, particularly by youth and children, leading to improved health outcomes as detailed in Section C of the RFP.

USAID/Tanzania anticipates awarding one Cost-Plus-Fixed-Fee Completion Form contract from this solicitation. The estimated total cost of the contract ranges between $85,000,000 and $100,000,000. Within the total estimated cost, the maximum total amount of possible additional performance-based payment is $1,500,000 over the life of the project. The anticipated period of performance is five years, subject to availability of funds.

This procurement is being conducted through full and open competition, pursuant to Part 15 of the Federal Acquisition Regulation (FAR). All types of organizations are eligible to compete and to submit offers. All organizations responding to this solicitation, must submit their proposal in accordance with Section L of this RFP. Proposals must be submitted electronically to the USAID Tanzania contracting office mailbox at usaidtzco@usaid.gov. Late proposals will be handled in accordance with FAR Part 52.215-1, Alternate I.

The Request for Proposals (RFP), once issued, and subsequent amendments thereto, can be downloaded from https://beta.sam.gov/.

If substantive questions are received which affect the response to the solicitation, or if changes are made to the closing date and time, as well as other aspects of the RFP, this solicitation will be amended. Any amendments to this solicitation will be issued and posted on the beta.sam.gov website. It is the Offeror’s responsibility to check this site periodically for official updates and amendments to the solicitation.

Questions and Answers: The deadline for receiving questions is indicated above. Questions may be submitted to the USAID Tanzania contracting office mailbox at usaidtzco@usaid.gov .

This solicitation in no way obligates USAID to award a contract, nor does it commit USAID to pay any cost incurred in the preparation and submission of the proposal. Furthermore, the mailto:usaidtzco@usaid.gov https://beta.sam.gov/ mailto:usaidtzco@usaid.gov

RFP No. 72062121R00002 – C3HP HIV&TB

pg. 2

Government reserves the right to reject any and all offers, if such action is considered to be in the best interest of the Government.

Thank you for your interest in USAID/Tanzania program activity.

Best Regards, Dennis Foster Contracting Officer

pg. 3

TABLE OF CONTENTS

ACRONYM LIST

SECTION B – SERVICES/PRICES

B.1 PURPOSE

B.2 CONTRACT TYPE AND SERVICES

B.3 ESTIMATED COST-PLUS-FIXED-FEE AND OBLIGATED AMOUNT

B.3.1 COST PLUS FIXED FEE BUDGET

B.4 PAYMENT OF FIXED FEE

B.5 CEILING ON INDIRECT COSTS

B.6 COST REIMBURSEMENT

B.7 ADDITIONAL PERFORMANCE-BASED PAYMENTS

SECTION C – DESCRIPTION/SPECIFICATIONS

C.1 INTRODUCTION

C.2 ACTIVITY BACKGROUND

C.3 RELATIONSHIP TO USAID COUNTRY DEVELOPMENT COOPERATION STRATEGY

RESULTS FRAMEWORK

C.4 PERFORMANCE WORK STATEMENT

C.5 RESULT AREAS

C.6 MONITORING, EVALUATION, AND LEARNING (MEL) PLAN

C.7 CROSS CUTTING ELEMENTS

C.8 GRANTS UNDER CONTRACTS

C.9 GLOBAL HEALTH CRISIS RESPONSE

C.10 ENVIRONMENTAL COMPLIANCE AND CLIMATE CHANGE

SECTION D – PACKAGING AND MARKING

D.1 AIDAR 752.7009 MARKING (JAN 1993)

D.2 BRANDING POLICY

D.3 BRANDING STRATEGY

D.4 BRANDING IMPLEMENTATION PLAN AND MARKING PLAN

SECTION E – INSPECTION AND ACCEPTANCE

E.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE

E.2 INSPECTION AND ACCEPTANCE

SECTION F – DELIVERIES OR PERFORMANCE

F.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE

F.2 PLACE OF PERFORMANCE

F.3 PERIOD OF PERFORMANCE

F.4 REPORTS, DELIVERABLES, AND OUTPUTS

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F.4.1 HIGH FREQUENCY TECHNICAL DATA REPORTING

F.5 TARGETS FOR PEPFAR-FUNDED ACTIVITIES

SECTION G – CONTRACT ADMINISTRATION DATA

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

G.2 CONTRACTING OFFICER’S AUTHORITY

G.3 CONTRACTING OFFICER’S REPRESENTATIVE

G.4 ADMINISTRATIVE CONTRACTING OFFICE

G.5 PAYING OFFICE

G.6 ACCOUNTING AND APPROPRIATION DATA

G.7 TECHNICAL DIRECTIONS/RELATIONSHIP WITH USAID

SECTION H – SPECIAL CONTRACT REQUIREMENTS

H.1 LANGUAGE REQUIREMENTS

H.2 AUTHORIZED GEOGRAPHIC CODE

H.3 KEY PERSONNEL

H.4 (ADS 302.3.5.19) USAID-FINANCED THIRD-PARTY WEB SITES (NOVEMBER 2017)

H.5 GOVERNMENT FURNISHED FACILITIES OR PROPERTY

H.6 (AAPD 17-01 – Revision 2) INSURANCE AND SERVICES

H.7 LOGISTICAL SUPPORT

H.8 ENVIRONMENTAL COMPLIANCE

H.9 (ADS 350 maa) FOREIGN GOVERNMENT DELEGATIONS TO INTERNATIONAL

CONFERENCES (JANUARY 2002)

H.10 ELECTRONIC PAYMENTS SYSTEM

H.11 SALARY APPROVALS FOR LONG-TERM AND SHORT-TERM TECHNICAL

ASSISTANCE

H.12 SUBMISSION OF DATASETS TO THE DEVELOPMENT DATA LIBRARY (DDL) (October 2014) 72

H.13 INFORMATION TECHNOLOGY APPROVAL (APRIL 2018) (DEVIATION NO. M/OAA-

DEV-FAR-18-2c)

H.14 INTERNATIONAL TRAVEL

H.15 CONSENT TO SUBCONTRACT

H.16 CONTRACTOR’S USE OF PROJECT VEHICLES AND LIABILITY

INSURANCE REQUIREMENTS FOR PRIVATELY OWNED VEHICLES

H.17 302.3.5.16(a)(1) CONSCIENCE CLAUSE IMPLEMENTATION (ACQUISITION) –

SOLICITATION PROVISION (FEBRUARY 2012)

H.18 302.3.5.16(a)(3) CONDOMS (ACQUISITION) (SEPTEMBER 2014)

H.19 302.3.5.16(a)(4) PROHIBITION ON THE PROMOTION OR ADVOCACY OF THE

LEGALIZATION OR PRACTICE OF PROSTITUTION OR SEX TRAFFICKING (SEPTEMBER

2014) 77

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H.20 (AAPD-16-02-Rev 2) INFORMATION TECHNOLOGY APPROVAL (APRIL 2018) (DEVIATION NO. M/OAA-DEV-FAR-20-3c) (APRIL 2020)

H.21 (AAPD-16-02-Rev 2) PRIVACY AND SECURITY INFORMATION TECHNOLOGY

SYSTEMS INCIDENT REPORTING (APRIL 2018)

H.22 (AAPD-16-02-Rev 2) SECURITY REQUIREMENTS FOR UNCLASSIFIED INFORMATION

TECHNOLOGY RESOURCES (APRIL 2018)

H.23 AAPD-16-02-Rev2 CLOUD COMPUTING (APRIL 2018)

H.24 GLOBAL HEALTH CRISIS RESPONSE FUND

H.25 TRAFFICKING IN PERSONS (TIP) NOTIFICATION

H.26 PUBLIC EVENTS AND MEDIA ENGAGEMENT

H.27 VALUE ADDED TAX (VAT) REIMBURSEMENT

H.28 PROCUREMENT OF “COVERED MATERIAL”

H.29 GRANTS UNDER CONTACT

H.30 AIDAR 752.222-70 USAID DISABILITY POLICY (DECEMBER 2004)

H.31 TITLE TO AND CARE OF PROPERTY

H.32 FAR PART 4.21 PROHIBITION ON CONTRACTING FOR CERTAIN COVERED

TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT

(SECTION 889) (JANUARY 2021)

SECTION I – CONTRACT CLAUSES

I.1 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

I.2 AIDAR CLAUSES INCORPORATED BY REFERENCE

I.3 FAR 52.203-17 CONTRACTOR EMPLOYEE WHISTLEBLOWER RIGHTS AND

REQUIREMENT TO INFORM EMPLOYEES OF WHISTLEBLOWER RIGHTS (JUN 2020)

I.4 FAR 52.203-19 PROHIBITION ON REQUIRING CERTAIN INTERNAL CONFIDENTIALITY

AGREEMENTS OR STATEMENTS (JAN 2017)

I.5 FAR 52.204-1 APPROVAL OF CONTRACT (DEC 1989)

I.6 FAR 52.222-35 EQUAL OPPORTUNITY FOR VETERANS (OCTOBER 2015)

I.7 FAR 52.222-36 EQUAL OPPORTUNITY FOR WORKERS WITH DISABILITIES (JULY

2014) 108

I.8 AIDAR 752.222-71 NONDISCRIMINATION (JUNE 2012)

I.9 AIDAR 752.225-70 SOURCE AND NATIONALITY REQUIREMENTS (FEB 2012)

I.10 AIDAR 752.228-7 INSURANCE -- LIABILITY TO THIRD PERSONS (JULY 1997)

I.11 AIDAR 752.228-70 MEDICAL EVACUATION (MEDEVAC) SERVICES (JUL

2007) 110

I.12 AIDAR 752.229-71 REPORTING OF FOREIGN TAXES (JULY 2007)

I.13 AIDAR 752.231-71 SALARY SUPPLEMENTS FOR HG EMPLOYEES (MAR 2015)

I.14 752.231-72 CONFERENCE PLANNING AND REQUIRED APPROVAL (AUG 2013)

[DEVIATION (APR 2020)]

I.15(b) FAR 52.245-1 GOVERNMENT PROPERTY (JAN 2017)

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I.16 FAR 52.247-1 -- COMMERCIAL BILL OF LADING NOTATIONS (FEB 2006)

I.17 AIDAR 752.7004 EMERGENCY LOCATOR INFORMATION (JUL 1997)

I.18 AIDAR 752.7005 SUBMISSION REQUIREMENTS FOR DEVELOPMENT EXPERIENCE

DOCUMENTS (SEP 2013)

I.19 AIDAR 752.7007 PERSONNEL COMPENSATION (JUL 2007)

I.20 AIDAR 752.7013 CONTRACTOR-MISSION RELATIONSHIPS (OCT 1989) [DEVIATION

(JUN 2020)]

I.21 AIDAR 752.7027 PERSONNEL (DEC 1990)

I.22 AIDAR 752.7032 INTERNATIONAL TRAVEL APPROVAL AND NOTIFICATION

REQUIREMENTS (APR 2014)

I.23 AIDAR 752.7034 ACKNOWLEDGEMENT AND DISCLAIMER (DEC 1991)

I.24 AIDAR 752.7036 USAID IMPLEMENTING PARTNER NOTICE (IPN) PORTAL FOR

ACQUISITION (JUL 2014)

I.25 AIDAR 752.7038 NONDISCRIMINATION AGAINST END-USERS OF SUPPLIES OR

SERVICES (OCT 2016)

I.26 (AIDAR 752.7101/AAPD 08-01) VOLUNTARY POPULATION PLANNING ACTIVITIES

(JUN 2008)

I.27 FAR 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

SECTION J – LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACHMENTS

SECTION K – REPRESENTATIONS, CERTIFICATIONS, AND OTHER STATEMENTS OF

OFFERORS

K.1 NOTICE LISTING SOLICITATION PROVISIONS INCORPORATED BY REFERENCE

K.2 FAR 52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS (MAR 2020)

K.3 FAR 52.204-20 PREDECESSOR OF OFFEROR (AUG 2020)

K.4 FAR 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (OCT 2020)

K.5 FAR 52.204-26 COVERED TELECOMMUNICATIONS EQUIPMENT OR SERVICES-

REPRESENTATION (OCT 2020)

K. 6 FAR 52.209-5 CERTIFICATION REGARDING RESPONSIBILITY MATTERS (AUG 2020)

K. 7 FAR 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018) 155

K.8 FAR 52.209-12 CERTIFICATION REGARDING TAX MATTERS (OCT 2020)

K.9 FAR 52.209-11 REPRESENTATION BY CORPORATION REGARDING A DELINQUENT

TAX LIABILITY OR A FELONY CRIMINAL (Deviation OAA-DEV-14-02c) CONVICTION (FEB 2016) 157

K.10 FAR 52.209-13 VIOLATION OF ARMS CONTROL TREATIES OR AGREEMENTS-

CERTIFICATION (JUL 2020)

K.11 FAR 52.222-22 PREVIOUS CONTRACTS AND COMPLIANCE REPORTS (FEB 1999)

K.12 FAR 52.222-25 AFFIRMATIVE ACTION COMPLIANCE (FEB 1999)

K.13 FAR 52.230-1 COST ACCOUNTING STANDARDS NOTICES AND CERTIFICATION (JUN

pg. 7

2020) 161

K.14 FAR 52.230-7 PROPOSAL DISCLOSURE COST ACCOUNTING PRACTICE CHANGES

(APR 2005)

K.15 CONTRACTOR PURCHASING SYSTEM REVIEW (CPSR)

K.16 DATA UNIVERSAL NUMBERING SYSTEM (DUNS) NUMBER

K.17 AUTHORIZED NEGOTIATORS

K.18 SIGNATURE

K.19 AIDAR 752.252-70 PROVISIONS AND CLAUSES TO BE COMPLETED BY THE OFFEROR

(MAR 2015)

SECTION L – INSTRUCTIONS, CONDITIONS, AND NOTICES TO OFFERORS

L.1 FAR 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998) 166

L.2 FAR 52.215-1 INSTRUCTIONS TO OFFERORS-COMPETITIVE ACQUISITION (JAN 2017)

L.3 FAR 52.216-1 TYPE OF CONTRACT (APR 1984)

L.4 FAR 52.233-2 SERVICE OF PROTEST (SEP 2006)

L.5 FAR 52.252-5 AUTHORIZED DEVIATIONS IN PROVISIONS (NOV 2020)

L.6 WAIVERS UNDER FAR PART 4.2101 PROHIBITION ON COVERED

TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES AND EQUIPMENT

L.7 GENERAL INSTRUCTIONS TO OFFERORS

L.8 DELIVERY INSTRUCTIONS

L.9 INSTRUCTIONS FOR PREPARATION OF THE TECHNICAL PROPOSAL

L.10 COST PROPOSAL

L.11 SUPPORTING DOCUMENTS

L.12 RFP COST RANGE

L.13 BRANDING IMPLEMENTATION AND MARKING PLAN

L.14 COMPETITIVE RANGE NEGOTIATIONS

L.15 QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)

SECTION M – EVALUATION FACTORS FOR AWARD

M.1 FAR 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998) 194

M.2 GENERAL INFORMATION

M.3 TECHNICAL EVALUATION FACTORS

M.4 COST EVALUATION

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ACRONYM LIST

ADS USAID Automated Directive System AIDAR USAID Acquisition Regulation ANC Antenatal Care ART Antiretroviral therapy AQL Acceptable Quality Level AYFHS Adolescent and Youth Friendly Health Services C3HP Comprehensive Client-Centered Health Program CBH & SWP Community-Based Health & Social Welfare Program CBO Community-Based Organization CECAP Cervical Cancer Prevention CHS Community Health Strategy CHW Community Health Worker CNSSI Committee on National Security System Instruction CO Contracting Officer COR Contracting Officer’s Representative CPFF Cost-Plus-Fixed-Fee CSP Cloud Service Provider CTC Care and Treatment Centre.

CQI Continuous Quality Improvement CDCS Country Development Cooperation Strategy COR Contract Officer’s Representative CSO Civil Society Organization DATIM Data for Accountability, Transparency and Impact Monitoring DEC Development Experience Clearinghouse DFID British Department for International Development DR-TB Drug Resistant Tuberculosis eSRS Electronic Subcontracting Reporting System FAR Federal Acquisition Regulation FBO Faith-Based Organization FEDRAMP Federal Risk and Authorization Management Program FIPS Federal Information Processing Standards FOIA Freedom of Information Act FSRS Federal Funding Accountability and Transparency Act Subaward Reporting

System HFR High Frequency Reporting HFRG High Frequency Reporting Group FP Family Planning G&A General and Administration GBV Gender-Based Violence GFATM Global Fund to Fight AIDS, Tuberculosis and Malaria GIS Geographic Information System GOT Government of Tanzania GOTHOMIS Government of Tanzania Hospital Management Information System

pg. 9

GUC Grants Under Contract HPV Human Papillomavirus HIV/AIDS Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome HRH Human Resources for Health HSSP Health Sector Strategic Plan IA Information Assurance iCCM Integrated Community Case Management IEE Initial Environmental Examination LTTA Long Term Technical Assistance mCPR Modern Contraceptive Prevalence Rate M/CIO USAID Bureau for Management, Office of the Chief Information Officer MDR–TB Multidrug-Resistant Tuberculosis MEL Monitoring, Evaluation and Learning MELP Monitoring, Evaluation and Learning Plan MER Monitoring, Evaluation and Reporting MNH Maternal and Newborn Health MOH Ministry of Health MOHCDGEC Ministry of Health Community development, Gender, Elderly and Children NICRA Negotiated Indirect Cost Agreement NMNAP National Multi-sectoral Nutrition Action Plan NMSF National Multi-sectoral Strategic Framework ODC Other Direct Costs OHA USAID Office of HIV/AIDS OMB Office of Management and Budget OVC Orphans and Vulnerable Children POA & M Plan of Action and Milestone PEPFAR U.S. President’s Emergency Plan for AIDS Relief PMI U.S. President’s Malaria Initiative PMP Performance Monitoring Plan POC Point of Contact PO-RALG President’s Office – Regional Administration and Local Government PPR Performance Plan Report PSC Personal Services Contractor PSNU Priority sub national unit PWS Performance Work Statement QASP Quality Assurance Plan RMNCAH Reproductive, Maternal, Newborn, Child and Adolescent Health SAM System for Award Management SB Small Business SBC Social Behavior Change SDG Sustainable Development Goal SF Standard Form SLA Service Level Agreement STTA Short Term Technical Assistance TB Tuberculosis TBD To be Determined

pg. 10

TDHS Tanzania Demographic Health Survey TIC Trust Internet Connection TOS Terms of Service TraiNet USAID Training Data Management System UNAIDS United Nations Program on HIV/AIDS USAID United States Agency for International Development USG United States Government WHO World Health Organization

SECTION B – SERVICES/PRICES

B.1 PURPOSE

The purpose of this contract is to provide technical assistance services necessary for the successful implementation of the USAID/Tanzania’s Client-Centered Health Program - HIV and Tuberculosis (C3HP-HIV&TB).

B.2 CONTRACT TYPE AND SERVICES

This is a Cost-Plus-Fixed-Fee Completion Form type contract. The contractor shall achieve results and outputs as described under Section C and other requirements of Section F and H in accordance with the performance standards specified herein.

B.3 ESTIMATED COST-PLUS-FIXED-FEE AND OBLIGATED AMOUNT

(a) The total estimated cost-plus-fixed-fee for the performance of this award is [$TBD from Offeror’s cost proposal] (the summaries below represent the budget that will be reflected in the resulting contract. The Contractor shall not be paid any sum in excess of these amounts:

Budget Categories Cost Total Estimated Cost $ Fixed Fee $ Additional Performance-Based Payment $ 1,500,000.00 Total Estimated Contract Cost $

(b) Within the estimated cost-plus-fixed-fee specified in paragraph (a) above, the amount currently obligated and available for reimbursement of allowable costs incurred by the Contractor for performance hereunder is [$TBD at time of Award]. The Contractor shall not exceed the obligated amount unless authorized by the Contracting Officer pursuant to the clause of this contract entitled “Limitation of Funds” (FAR 52.232‐ 22). Any costs incurred that exceed the obligated amount are considered unallowable.

B.3.1 COST PLUS FIXED FEE BUDGET

The following budget table captures the final negotiated cost elements for the performance of the work required hereunder.

CLINS Cost Element Amount 0001 Program Implementation $ 0002 Grants Under Contracts $35,000,000.00 0003 Fixed Fee $ 0004 Additional Performance-Based Payment $ 1,500,000.00 Total Estimated Contract Cost $

B.4 PAYMENT OF FIXED FEE

Pursuant to FAR 52.216-8, Fixed Fee, payment of fixed fee shall be allocated in accordance with the approved Fee Schedule below (TBD from Offeror’s cost proposal). [See illustrative fixed fee schedule in section L].

Deliverable/Output/Outcome Due Date Percentage Fee Amount ($)

TBD TBD TBD

TBD TBD TBD

TBD TBD TBD

TBD TBD TBD

TBD TBD TBD

B.5 CEILING ON INDIRECT COSTS

Reimbursements for allowable indirect costs shall be at final negotiated rates but not in excess of the following ceiling rates: [To be completed by Offeror]

Contractor Overhead

Rate % Overhead Ceiling Rate

G&A Rate % G&A Ceiling Rate %

PRIME

MAJOR

SUBCONTRACTOR

(S)1

NOTE 1: Insert additional indirect rates as needed for prime and major subcontractors in the above table.

(1) The Government will not be obligated to pay any additional amount should the final Indirect cost exceed the negotiated ceiling rates. If the final indirect cost rates are less than the negotiated ceiling rates, the negotiated rates will be reduced to reflect the lower rates.

(2) This understanding shall not change any monetary ceiling, obligation, or specific cost allowance or disallowance. Any changes in classifying or allocating indirect costs require the prior written approval of the Contracting Officer.

B.6 COST REIMBURSEMENT

Allowable costs shall be limited to reasonable, allocable and necessary costs determined in accordance with FAR clause 52.216-7 (Allowable Cost and Payment), FAR clause 52.216-8 (Fixed Fee), and AIDAR clause 752.7003 (Documentation for Payment).

1 “Major subcontractors” are those subcontractors expected to perform at least 20% (as quantified by or calculated by level of effort for staff and/or total estimated direct costs) of the technical effort under the contract being solicited.

B.7 ADDITIONAL PERFORMANCE-BASED PAYMENTS

Separate from the negotiated price and estimated cost-plus-fixed-fee stated in B.3, the Contractor is eligible to earn additional performance-based payments in accordance with the schedule set forth below. The Contracting Officer will determine the Contractor’s eligibility for the additional payments based on the information taken from the PEPFAR DATIM and also based on the USAID’s review of Contractor’s quarterly performance reports and/or annual reports documenting the achievement of applicable performance standards as approved by the Contracting Officer’s Representative (COR).

The additional performance-based payments shall be allocated in accordance with the approved schedule below (TBD from Offeror’s cost proposal and negotiated with USAID). The Contractor must meet the performance standards stipulated on the table to be eligible for the payment. [See illustrative schedule in section L].

EXPECTED OUTCOME PERFORMANCE

STANDARD

AMOUNT MAXIMUM

FREQUENCY

IR 1: Improved Access to Quality, Client-Centered HIV&TB Services

TBD TBD TBD TBD

TBD TBD TBD TBD

TBD TBD TBD TBD

IR 2: Improved Ability of Individuals to Practice Positive Health-Seeking Behaviors

TBD TBD TBD TBD

IR 3: Enhanced Enabling Environment for Quality HIV/TB Service Provision

TBD TBD TBD TBD

TBD TBD TBD TBD

TBD TBD TBD TBD

[END OF SECTION B]

SECTION C – DESCRIPTION/SPECIFICATIONS

Performance Work Statement

C.1 INTRODUCTION

The purpose of this contract is to implement USAID/Tanzania’s Comprehensive Client-Centered Health Program – HIV and Tuberculosis (C3HP-HIV&TB) activity. USAID/Tanzania intends to support the Government of Tanzania’s (GOT) Ministry of Health and Social Welfare, Elderly and Children (MOHCDGEC) and the President’s Office- Regional Administration and Local Government (PORALG) at the central level and in target Mainland regions to deliver high-quality integrated HIV and TB prevention care and treatment services that will improve health outcomes, particularly for youth and children.

The acquisition will increase the demand for and use of quality integrated HIV and Tuberculosis services in target regions by improving access to quality services in both facilities and the surrounding communities, promoting positive health-seeking behaviors among Tanzania’s populace, and enhancing the overall policy environment for HIV&TB service delivery.

C.2 ACTIVITY BACKGROUND

Incidence of HIV infection has declined dramatically in the last decade and access to antiretroviral therapy (ART) has accelerated rapidly. Nevertheless, the world is challenged to achieve the UNAIDS “95-95-95” goal for 2030 (95% of people living with HIV know their HIV status; 95% of people who know their status are on treatment; and 95% of people on treatment have suppressed viral loads). In 2002, the Global Fund to Fight AIDS, TB, and Malaria (GFATM) was formed to accelerate the end of these diseases as epidemics.

These international platforms are complemented by two U.S. government initiatives, the U.S.

President’s Emergency Plan for AIDS Relief (PEPFAR), initiated in 2002 in response to the global HIV/AIDS pandemic, and the U.S. President’s Malaria Initiative (PMI), launched in 2005 to reduce the burden of malaria and help relieve poverty on the African continent. Additionally, in 2018, USAID Administrator announced the USAID Global Accelerator to end Tuberculosis. This initiative catalyzes investments across multiple countries and sectors to end epidemics while building the self-reliance of countries to take action against TB.

Tanzania’s Vision 2025 aims to see the country transform from a least-developed economy to a middle-income economy, which will require high quality human capital and the strengthening of social services, particularly for health and education. In the coming decades, the GOT MOHCDGEC will play an instrumental role in ensuring that healthy individuals, families, and communities are contributing to the country’s broader socio-economic development. To that end, USAID/Tanzania supports and works in close collaboration with these two entities and their respective President’s Office-Regional Administration and Local Government bodies (PO-RALG) and other local government authorities to improve access to and use of quality health care services

– including RMNCAH, malaria case management, TB, and HIV/AIDS – to ensure Tanzania’s citizens are capacitated to live healthy and prosperous lives.

According to the Tanzania HIV Impact Survey (THIS) 2016/2017,2 the prevalence of HIV among adults age 15-64 years in Tanzania is 5%, meaning that some 1.63 million3 adult Tanzanians are living with HIV. The prevalence of HIV among children age 10-14 is less than 1%. Despite the low prevalence, there has been growing treatment coverage gap between adults and children with children having less than 60% treatment coverage as compared to 80% coverage for adults. This necessitated the need to increase focus on improving treatment coverage for children. Projections from the UNAIDS Spectrum 2020 model show that new HIV infections, now estimated at 0.3% for adults, have been declining steadily over the years, as have deaths for people living with HIV.

Tanzania is committed to achieving the global “95-95-95” goals. While still challenged to reach the first “95” (only 61% of people with HIV in Tanzania are aware of their HIV status), the country has made excellent progress toward the second “95” (94% self-reported current use of ART), and the third “95” (viral load suppression among HIV-positive adults is 87%). Hidden behind these figures are the disparities that exist by age group, gender, geographic region, and urban/rural location. For example, only 52.4% of men know their HIV status compared to 65.3% of women, and only 18% of children are virally suppressed compared to 87% of adults.

Heterosexual transmission remains the main mode of transmission of HIV infections in Tanzania.

Comprehensive knowledge of HIV has declined among adolescents and young people. Among women aged 15-19 years and 20-24 years, comprehensive knowledge declined progressively from 39% and 50% in 2003-2004 to 32% and 43%, respectively in THIS 2016-2017. Similarly, among men aged 15-19 years and 20-24 years, there was a decline from 43% and 57% in 2003-2004 to 33% and 41%, respectively in 2016-2017. Just as comprehensive knowledge has declined, unsafe sex behavior has increased in all age groups for both women and men. Among people who had sex in the 12 months prior to THIS survey, 56% of men and 36% of women had sex with a non-cohabiting, non-marital partner in 2016-2017 compared to 46% and 23%, respectively in 2003- 2004. Among women and men, the percentage was highest among teenagers and then declined with age.

TB and drug-resistant TB (DR-TB) are major causes of illness and mortality in Tanzania, which is among the 30 highest-burden countries for TB and TB/HIV coinfection. Approximately 22,000 Tanzanians die every year due to TB. The current treatment coverage for TB is only 44%. Further, of the estimated 1,700 multi-drug-resistant TB (MDR-TB) cases in 2018, less than 25% were started on MDR treatment. Although it is declining, Tanzania also experiences high rates of TB/HIV coinfection, with World Health Organization (WHO) estimating that almost one third of those newly diagnosed with TB are also HIV-positive. In 2019, the coverage of TB preventive treatment (TPT) among people living with HIV who attend antiretroviral treatment (ART) services reached 60%, with a high completion rate of 86.4%. Nevertheless, poor access to effective diagnosis of TB using GeneXpert, coupled with supply chain issues in peripheral health facilities, make further narrowing this gap a challenge. Furthermore, TB contact tracing for both HIV and

2Tanzania HIV Impact Survey (THIS) 2016/2017 https://www.malecircumcision.org/resource/tanzania-hiv-impact-survey-2016%E2%80%922017-final-report 32020 Spectrum estimates, 2019-point estimate https://www.malecircumcision.org/resource/tanzania-hiv-impact-survey-2016%E2%80%922017-final-report https://www.malecircumcision.org/resource/tanzania-hiv-impact-survey-2016%E2%80%922017-final-report

TB infected individuals and for the children of smear positive patients is limited. In 2018 WHO reported that only 22% of under-fives received TPT.

As indicated above, the GOT has made significant progress in addressing health concerns across the country. But much remains to be done to enable all Tanzanians to live healthy, productive lives. There are significant discrepancies between rural and urban health facilities, with rural facilities facing more challenges. Further, new evidence indicates that urban areas also face significant barriers to accessing services, including those related to quality of care. Key constraints include:

● Inadequate human resources for health

● Inadequate budget allocation and disbursement of funds for health

● Shortages of commodities and medical equipment and supplies

● Overall weaknesses in the health system

● Inefficient referral systems and linkages between facilities and communities

● Limited access to health insurance; informal payments at health facilities pose financial barriers to access

● Limited private sector engagement

● Resistance to expanding the role of community-based service delivery

● Limited citizen engagement in promoting public sector transparency and accountability

● Slow adoption of global best practices and newly recommended curative and preventive interventions

● Harmful social and gender norms that affect individuals’ access to and use of services, especially for women, men and youth

● Challenges in reaching facility-based services due to long distances and difficult terrain

● Long waiting times for services at health facilities

● Limited political support for FP provision at the highest level of government

● Inadequate use of data for decision-making and program improvement

To date, inadequate attention has been paid to changing behaviors by addressing factors such as knowledge, attitudes, norms and automatic or unconscious determinants (such as present bias which may affect adherence to ARVs among asymptomatic or younger PLHIV), including communication between health providers and clients, families’ and couples’ communication, and the engagement of community leaders and other influencers in promoting the adoption of healthy behaviors and practices. Arming communities, families, and healthcare workers with the right skills to support self-efficacy and adherence and information is essential to maximizing access to and use of HIV and TB services to save lives and improve health.

In its fourth NMSF for HIV and AIDS, the GOT identified three key priorities: (1) acceleration and intensification of targeted, high impact interventions aimed at preventing new HIV infections and reducing AIDS-related deaths; (2) promoting efficiency and effectiveness, strategic partnerships, and meaningful participation by all stakeholders, in particular communities, in implementation of the national decentralized HIV response; and (3) leveraging the financial, technological, and human resources necessary to sustain implementation of the HIV response.

In Tanzania, to improve the provision of health services at the community level and to help address human resource constraints, the MOHCDGEC developed policy guidelines for Community-Based

Health and Social Welfare Services, 2020, and National Operational Guidelines for Community- Based and Health Care Services, 2020 Guidelines4. These guidelines, which are in line with the national HSSP IV, map an integrated and coordinated national approach to community-based health, and will guide operationalization of community-based health services so that the program overall becomes functional and sustainable in improving community health and social welfare.

Over the past several years, to enhance the effectiveness of its investments and improve health outcomes, USAID/Tanzania’s Health Office moved from a disease-specific and single-service component portfolio to a more comprehensive and integrated portfolio. The Comprehensive Client-Centered Health Program (C3HP) builds on lessons learned from that experience and emphasizes “smart integration” between components and other activities where feasible and possible, strengthens integration and linkages between health facilities and the community, addresses concerns with the enabling environment, and incorporates robust social and behavior change (SBC) interventions at the facility and community levels as a crucial component for success. Critically, C3HP also emphasizes reaching young Tanzanians with health services and health promotion messaging.

C3HP includes three related activities. This current procurement action covers only the two HIV and TB Activities: Client-Centered Health Program HIV and Tuberculosis Activity (HIV&TB) and Local Organization Client-Centered Health Program HIV and Tuberculosis Activity (LOC-

HIV/TB)

● CH3HP- RMNCAH Activity: This award will focus on improving the quality of RMNCAH services at the facility and community level and include community-level SBC interventions.

● CH3HP-HIV&TB Activities: These two awards will focus on the provision of integrated HIV and TB prevention, care, and treatment services, will integrate FP into these services, as appropriate, and include community-level SBC interventions.

These three awards will be complemented by a malaria control program and a national social behavior change technical assistance award (a follow-on to the current USAID-supported Tulonge Afya activity, which ends in 2022). It is envisioned that the three C3HP activities, the malaria control program and Tulonge Afya follow on activities will synergistically collaborate, especially in areas with geographical overlap, to fast track the achievement of the overall goal of improved health outcomes for all Tanzanians.

Regions in which each C3HP award will work are indicated in the table below.

Table 1: C3HP Awards and Regions

Region RMNCH FP Malaria HIV/TB LOCAL

HIV&TB

Geita x x

Simiyu* x x

4 https://drive.google.com/drive/u/0/folders/1ajCu9TH-3y0bH3rRGnfcdLw1R9QkvoZA

Mwanza* x x X

Mara* x x X

Shinyanga x x

Katavi x

Tabora x X (TB only)

Manyara x x x

Dodoma x x x

Tanga x

Dar es Salaam x

Arusha x x

Zanzibar x x X

Pwani

Kigoma

Rukwa

Songwe

Iringa X

Lindi X

Morogoro X

Mtwara X

Njombe X

Ruvuma X

Kilimanjaro x

Singida x

Kagera x

C.3 RELATIONSHIP TO USAID COUNTRY DEVELOPMENT COOPERATION

STRATEGY RESULTS FRAMEWORK

The C3HP-HIV&TB activities are key to achieving USAID/Tanzania’s Country Development Cooperation Strategy (CDCS) for the period 2020-2025. The CDCS focuses on youth and children as the current and future drivers of Tanzania’s long-term development and prosperity. It emphasizes the needs of youth and young adults for quality public and private sector services that build their skills and productivity, while also focusing on the need for local leadership to create the community environment that allows young people to thrive in a way that will accelerate inclusive, broad-based growth.

The CDCS posits that IF Tanzania improves the foundational skills of its youth; empowers and increases the productivity and engagement of young adults; and strengthens the ability of state and non-state actors to benefit future generations, THEN youth will be better positioned to contribute to the long-term prosperity of their country.

Following the CDCS development hypothesis, the C3HP-HIV&TB Activity will support Development Objective on Foundational skills of children below age 15 improved, with intermediate results on household nutrition and health outcomes improved and safe and supportive community structures enhanced by improving availability and access to HIV&TB services through quality improvements and improved health behaviors at facility and community level. It will also support development objective on empowerment, productivity and engagement of Tanzanians aged 15 to 35 increased with intermediate results on health and education outcomes improved by expanding youth access to quality information and supporting youth in taking control of their own health. The other development objective is capacity of state and non-state actors strengthened to benefit future generations with results on capacity of sub national government to lead sustainable development improved, through mentoring, training, supportive supervision and capacity-building at various levels of the health system; and capacity of civil society actors strengthened through strengthening linkages between health facilities and communities.

Figure 1: CDCS 2020/2025 Results Framework

C.4 PERFORMANCE WORK STATEMENT

USAID/Tanzania’s purpose for the C3HP – HIV&TB activity, is increased demand for and use of quality integrated HIV and TB services, particularly by youth and children, leading to improved health outcomes.

To accomplish this, the Contractor must provide technical and material assistance and/or administrative and management support to the GOT-MOHCDGEC and PORALG through local government authorities, at regional and districts level, health facilities and communities to increase their capacity to manage and deliver quality HIV/TB services within public sector and relevant faith based health facilities. The Contractor must also strengthen the provision of community-based health services and improve linkages between communities and health facilities.

All HIV and TB interventions implemented under this activity must be guided by the PEPFAR Country operational plan, TB Road map and MOHCDGEC soon to be released Strategic Plan (HSSP) V (2020-2025), the National Multisectoral Strategic Framework (NMSF) for HIV and AIDS (2018/19-2022/23), the National Strategic Plan V for TB and Leprosy (2015-2020) and its forthcoming successor Plan VI, and the recently launched National Family Planning Costed Implementation Plan (2019-2023).

The goal for the C3HP-HIV&TB Activity and the strategy for achieving results are indicated in the Results Framework (Figure 2) graphic, outlined in the development hypothesis, and discussed in more detail by result and sub-result, below:

Figure 2: C3HP-HIV/TB Activity Results Framework

C3HP-HIV/TB ACTIVITY DEVELOPMENT HYPOTHESIS:

Goal: Household nutrition and health outcomes of Tanzanians improved

Result 1:

Improved access to quality client-centered health services

Sub-Result 1.1

Improved access to quality health services at both facility and community level

Sub-Result 1.2

Strengthen capacity of health work force to deliver client centered services

Result 2:

Improved ability of individuals to practice positive healthy behaviors

Sub-Result 2.1

Improved attitudes and norms related to health-seeking behaviors

Sub-Result 2.2

Increased community support for healthy behaviors

Result 3:

Enhanced enabling environment for quality health service provision

Sub-Result 3.1 Improved availabilty of quality strategies, policies and guidelines to support health service delivery

Sub-Result 3.2

Increased engagement of communities and citizens for quality health delivery

Sub-Result 3.3 Increased engagement and use of system wide reforms and governance structures that impact service provision

Objective: To increase use of quality HIV/TB services, particularly by youth and children

IF: (1) Beneficiaries, particularly children and youth have access to integrated, quality HIV/TB services in facilities and communities; and IF: (2) positive social and gender norms and practices related to health-seeking behaviors are strengthened; and IF: (3) the right policies are in place and clients are engaged in service delivery; THEN Tanzanians, especially youth, will use these services, leading to healthier lives and thriving communities.

Geographic Coverage

1. PEPFAR Tanzania reviewed epidemiologic data and burden of disease at the council level, including population density and total number of PLHIV and unmet needs for ART. Based upon progress made in service delivery and revised PLHIV estimates, key interventions will be prioritized in districts with greatest burden and gap in coverage. The C3HP HIV&TB (1) Activity will operate in five regions - Arusha, Dodoma, Kilimanjaro, Manyara, Singida; and the LOC HIV/TB (2) Activity (restricted to local partners) in six regions - Iringa, Lindi, Morogoro, Mtwara, Njombe and Ruvuma.

To improve health outcomes and ensure that services are client centered, the Contractor will integrate HIV and TB and family planning. The contractor will use PEPFAR funds to provide FP/HIV integration services and FP funds to provide family planning services beyond HIV/FP integration in regions of Dodoma, Manyara and Arusha. Furthermore, as further described in Section VII, the contractor will collaborate with the implementing partners of other USAID-supported health services in the identified regions to maximize activity impact.

C.5 RESULT AREAS

It is anticipated that the C3HP-HIV&TB Activity will contribute to the results framework and indicators as outlined in the following discussion, and to results measured by the following:

1. Epidemic control 95-95-95 (disaggregated by gender/age)

2. MCPR

3. Adolescent pregnancy

4. The number of TB cases detected and notified. (disaggregated by gender/age

5. Number of MDR TB patients detected (disaggregated by gender/age

6. Number of TB patients confirmed with Molecular Diagnostic method (disaggregated by gender/age)

7. Number of patients who completed TB preventive treatment (disaggregated by gender/age)

Intermediate Result 1: Improved access to quality, client-centered HIV&TB services

● Sub IR 1.1 – Improved access to quality health services at both the facility and community level

● Sub IR 1.2 – Strengthen capacity of health work force to deliver client centered services

Poor linkages between health facilities and community-based service delivery structures further impact the continuum of HIV and TB care. Furthermore, harmful social and gender norms in many communities negatively impact health-seeking behavior, often limiting clients’ access to and use of facility and community-based services.

Improved access to and use of quality, client-centered health care at both the facility and community levels is essential to improving health outcomes in Tanzania. The contractor must build capacity at both levels to deliver standardized, evidence-based quality HIV and TB services that are client-centered. The contractor will also strengthen bi-directional linkages and referrals within and between health facilities and the community service delivery structures. Where feasible and possible, the contractor will integrate services to make them more client-centered.

Expected Results for this IR will be measured by the following standard indicators:

Mandatory Result Performance Standard5 Quality Assurance

Surveillance Plan (QASP) Improved coverage of HIV testing services/ Increase number of index positives being identified through index testing modalities

1. HTS-TST (disaggregated by gender/age)

2.HTS_TST_POS

(disaggregated by gender/age)

Plan for monitoring the progress toward meeting performance standards and to be proposed by the Offeror.

5 A full description of all these indicators can be found in PEPFAR Monitoring, Evaluation and Reporting Indicator Reference Guide MER 2.0 Version 2.4 September 2019 -https://www.state.gov/wp-content/uploads/2019/10/PEPFAR-MER-Indicator-Reference-Guide-Version-2.4-FY20.pdf https://www.state.gov/wp-content/uploads/2019/10/PEPFAR-MER-Indicator-Reference-Guide-Version-2.4-FY20.pdf https://www.state.gov/wp-content/uploads/2019/10/PEPFAR-MER-Indicator-Reference-Guide-Version-2.4-FY20.pdf

3.HTS_Index (disaggregated by gender/age)

TBD at time of award

Improved linkages to/and= retention on HIV Care and viral load suppression

4. TX_CURR (disaggregated by gender/age)

5. TX_NEW (disaggregated by gender/age)

6. TX_PVLS (disaggregated by gender/age) (disaggregated by gender/age)

7. PrEP_CURR

8. TX_RTT

Plan for monitoring the progress toward meeting performance standards and to be proposed by the Offeror.

TBD at time of award

Strengthened TB screening through integrated approach and improved TB outcomes

9. TB_PREV (disaggregated by gender/age)

10. TB_STAT (disaggregated by gender/age)

11. TB_ART (disaggregated by gender/age)

12. Proportion of presumptive TB specimen evaluated with molecular testing

13. Drug susceptible (DS) TB treatment success rate

14. Number of clients treated for active TB.

15. Number of MDR TB patients started on second line TB medicines

16. Number of MDR TB patients cured

Plan for monitoring the progress toward meeting performance standards and to be proposed by the Offeror.

TBD at time of award

Strengthen the inclusion of gender -based violence (GBV) screening

17. Gen_GBV Plan for monitoring the progress toward meeting performance standards and to be proposed by the Offeror.

TBD at time of award

Integrated FP services 18. FPINT_SITE

19. Number of clients accepting a modern family planning method (Disaggregated by Sex, Age (10-14, 15-19, 20-24, or 25+), Contraceptive method, Plan for monitoring the progress toward meeting performance standards and to be proposed by the

Type of user (new or continuing) and Type of service (routine or outreach)

Strengthen capacity of health work force to deliver client centered services

20. SC_ARVDISP

21. HRH_CURR

22.HRH_Staff (disaggregated by facility and community staff)

Plan for monitoring the progress toward meeting performance standards and to be proposed by the

Sub IR 1.1 – Improved access to quality health services at both the facility and community- level

Access to quality HIV&TB services is key to meeting beneficiaries' needs, reaching the country’s goal of epidemic control, and helping Tanzanians stay healthy.

To achieve this sub-IR, the Contractor will build capacity to deliver HIV and TB services within all public health facilities in the identified regions, with a focus on improving quality and patient-centered care and treatment.

The Contractor will be expected to improve health services across the HIV cascade. Starting with the first 95, identification of HIV positive people, the contractor will address the broad gaps in coverage across age and sex bands through enhanced, evidence-based implementation of key aspects of client centered HIV prevention, case finding and testing approaches:

● index testing that comply with WHO safe measures

● optimized provider-initiated testing and counseling (PITC)

● Pre exposure prophylaxis (PrEP)

● Self testing

● Gender based violence screening and gender norms

● Client centered targeted community testing, including peer/social network testing (SNT) approaches for priority populations where new diagnoses are occurring.

● scale up TB case detection, prevention and treatment

● targeted SBC activities for demand creation and stigma reduction

Special emphasis will be on the quality of index testing services ensuring these are client-centered, safe, non-coercive, private, and confidential. This will include routine tracing of intimate partner violence and reporting of any related adverse events.

The Contractor will continue to strengthen the collaboration with the Government of Tanzania and OVC service providers to ensure wider scale up of risk screening for HTS especially at medical outpatient department (OPD) and community settings. This will include ensuring the proper use of the validated national risk screening tool.

The Contractor will establish a standardized and coordinated quality assurance (QA) system for HTS; focusing on both QA for Index testing and Optimized PITC performed by HCWs including support of all services for people diagnosed with HIV at those facilities.

For the second and third 95s, the contractor will ensure linkage to treatment, retention and adherence resulting in viral suppression. Technical assistance will be given to facility and community level services to ensure implementation of evidence based care and treatment approaches which include:

• Transition of optimal regimens for both children and adults.

• Integration of TB screening, treatment and preventative therapy, nutrition monitoring, cervical screening and family planning.

• Differentiated service delivery models including multi-month dispensing Use of Orphans and vulnerable children platforms for pediatric HIV case finding, linkage to treatment, and viral suppression.

• Establishment of the memorandum of understanding for improved coordination and implementation between health facilities and the OVC program on data sharing agreements bi-directional referral protocols and index testing of OVC.

Expected Results:

At a minimum, the Contractor must demonstrate improvements in the following indicators in each of the activity’s target health facilities:

Mandatory Result Performance Standard Quality Assurance

Surveillance Plan (QASP) Improved coverage of HIV testing services/ increase the number of index positives being identified through index testing modalities

1. HTS_TST_POS (disaggregated by gender/age)

2. HTS_Index (disaggregated by gender/age) performance standards and to be proposed by the Offeror.

TBD at time of award

Improved linkages to and retention on HIV Care

3. TX_CURR (disaggregated by gender/age)

4. TX_PVLS (disaggregated by gender/age)

5. PrEP_New (disaggregated by gender/age)

Plan for monitoring the progress toward meeting performance standards and to be proposed by the Offeror.

TBD at time of award

Strengthened TB screening with fidelity for case detection through integrated approach to HIV and TB screening.

6. TB_PREV

7. TB_STAT

8. TB_ART

Plan for monitoring the progress toward meeting performance standards and to be proposed by the Offeror.

Strengthen the inclusion of gender -9. Gen_GBV Plan for monitoring the based violence (GBV) screening progress toward meeting performance standards and to be proposed by the Offeror.

TBD at time of award

Integrated FP services 10. FP-INT

11. Number of clients accepting a modern family planning method (Disaggregated by Sex, Age (10-14, 15- 19, 20-24, or 25+), Contraceptive method, Type of user (new or continuing) and Type of service (routine or outreach) performance standards and to be proposed by the

Sub IR 1.2 – Strengthen capacity of health work force to deliver client centered services

When appropriately designed and implemented, community health worker (CHW) programs can play an important role in reducing inequitable access to services by bringing information, services, and supplies to women and men in the communities where they live and work rather than requiring them to visit health facilities.

The Contractor shall collaborate with the established USAID Human Resources for Health (HRH) mechanism in identification of HCWs needed in supported sites using evidence driven approaches and jointly co-manage the contracted facility HCWs with the HRH Mechanism for a performance-based assessment associated with their roles and responsibilities as defined.

The Contractor will directly support Community Health Worker (CHWs) per the national and PEPFAR guidance and will use evidence-based approaches to determine the need, services and location of their placement. The contractor will support both the facility and community HCWs by building the capacity of required skills for these HCWs to provide integrated services not limited to, skills for application of service delivery guidelines, provide supportive supervision, job aides, on-the-job training and additional incentive as required.

Expected Results:

At a minimum, the Contractor must demonstrate improvement in the following indicators in each of the activity’s target health facilities/communities:

Mandatory Result Performance…