DFOP0017890_Advancing_Global_Health_APS_Round_2a_QA.pdf

“Advancing Global Health” APS, Round 2a Q&A

Formatting Clarifications The Department of State has received numerous questions regarding formatting requirements for Statements of Interest (SOIs). The following clarifications are provided to ensure consistent interpretation of the instructions outlined in Section D: Application Contents and Format of the

APS.

• Page Limit and Narrative Content As stated in the APS, SOI submissions should be no more than five (5) pages in length for the narrative portion. This page limit applies to the core narrative content only.

Submissions will only be reviewed up to the specified page limit and no further.

• Table of Critical Details (Cover Page) The required “Table Listing of Critical Details” (Section D.1.a) does not count toward the five-page narrative limit. Applicants must include this table as a cover page to their submission.

• Tables, Charts, and Visual Elements As specified in the APS, tables and charts are not included in the five-page narrative limit. Applicants may include relevant tables and charts either within the narrative or as annexes. For the purposes of this guidance, diagrams, conceptual frameworks, and other visual representations may be treated as charts and are therefore also excluded from the page limit. Given the nature of tables and charts, font sizes as small as 10-point are acceptable for these elements.

• Annexes Applicants may include annexes containing supporting tables, charts, or other visual materials. To ensure a fair and efficient review process, the Department will review up to four (4) annexes per submission, and each annex should be no more than one

(1) page. Annexes should be used to supplement, not replace, the narrative. Reviewers will primarily evaluate the five-page narrative submission in accordance with the APS review criteria.

• General Guidance Applicants are encouraged to present information clearly and concisely within the five-page narrative, using annexes only where they add value or clarity.

Process and Timeline Clarifications The Department of State has received a number of questions regarding the anticipated timeline for review, selection, and award under the Advancing Global Health APS. The following clarifications are provided to outline the general process while preserving necessary flexibility.

• Review Timing and Process All SOIs submitted within a given quarterly window are reviewed after the submission deadline for that window has passed. Following the close of the submission window, the Department conducts a multi-step review process, including:

ο Technical Eligibility Review ο Merit Review Panel evaluation ο Internal clearance and selection decision-making

The Department aims to complete and communicate results of the Technical Eligibility Review in a timely manner following the close of the window. However, timelines may vary based on the volume of submissions and operational considerations.

• Notification of Results Organizations who have submitted an SOI will be notified of one of the following outcomes, consistent with the APS:

ο Not selected for continued review ο Recommended for consultative program design ο Recommended to proceed to Phase 2 (full application)

Due to the anticipated volume of submissions, the Department does not anticipate being able to provide individualized feedback to unsuccessful applicants.

• Consultative Program Design (if applicable) For organizations selected for consultative program design, this stage is intended to be a structured, time-bound process to refine proposed concepts in collaboration with the Department of State. In general, this process is expected to occur over a defined and relatively short period and may include virtual, in-person, or hybrid engagement. As this is a new approach being implemented on a pilot basis, the Department retains flexibility in how consultative program design is conducted.

• Phase 2 (Full Application) and Awards Organizations invited to submit a full application will receive additional guidance, including submission requirements and timelines, at that stage. The timing of full application review and award issuance will depend on a range of factors, including:

ο Complexity of proposed programs ο Availability of funding ο Completion of required reviews and approvals

• General Guidance The Department of State is committed to conducting a fair, transparent, and efficient review process. At the same time, applicants should anticipate that the full process (from SOI submission to potential award) may take several months. Organizations are encouraged to plan accordingly and monitor official communications for updates.

Submission Platform Clarifications (Grants.gov and MyGrants) The Department of State has received a number of questions regarding submission requirements across Grants.gov and MyGrants, particularly related to required forms at the SOI stage.

• SOI Submission Requirements As stated in the APS, the only required submission at Phase 1 is the SOI. Standard federal assistance forms (e.g., SF-424, SF-424A, SF-424B) are not required at the SOI stage and are not part of the merit review. SOIs will be accepted on grants.gov (now requires an active sam.gov registration to apply) or MyGrants (does not require an active sam.gov registration to apply).

• Grants.gov System Requirements The Department is aware that, due to Grants.gov system functionality, certain forms (including the SF-424) may appear as required fields in order to complete a submission through that platform. At this time, these system requirements cannot be modified or bypassed. Applicants who choose to submit via Grants.gov may therefore complete and upload the required forms for the purpose of satisfying system submission requirements only.

• Review Process

Any SF-424 or related forms submitted as part of a Grants.gov package at the SOI stage will not be reviewed or evaluated. The Department will assess only the SOI document in accordance with the evaluation criteria outlined in the APS.

• Alternative Submission Platform Applicants may also submit SOIs via MyGrants, which does not require completion of these forms at the SOI stage.

• Troubleshooting Help Desk o For assistance with Grants.gov accounts and technical issues related to using the system, please call the Contact Center at +1 (800) 518-4726 or email support@grants.gov. The Contact Center is available 24 hours a day, seven days a week, except federal holidays.

o For assistance with MyGrants accounts and technical issues related to the system, please contact the ILMS help desk by phone at +1 (888) 313-4567 (toll charges apply for international callers) or through the Self Service online portal that can be accessed from https://afsitsm.servicenowservices.com/ilms. Customer support is available 24/7.

MOU Alignment and Country Priorities Clarifications The Department of State received several questions regarding how applicants should align proposed activities with bilateral Memoranda of Understanding (MOUs) and whether these documents are publicly available. As stated in the APS, bilateral MOUs are a central element of the America First Global Health Strategy (AFGHS) and serve as a framework for partnership, reinforcing shared commitments between the U.S. government and recipient governments to sustain health gains and advance health systems performance and integration. The overarching goals are to save lives, strengthen health systems, and advance U.S. interests by fostering country self-reliance, reducing dependency on U.S. funding, and improving global health security to protect U.S. and global populations.

MOUs will be implemented through multiple mechanisms, including government-to-government (G2G) agreements and APS-funded activities. The APS is designed to support projects that support the implementation of the MOUs as well projects that complement the MOUs. For example, some APS addenda will be for specific countries and will be used to implement MOU priorities with MOU funding. Other APS addendum will be for specific services that could compliment MOUs and would be funded with non-MOU funding.

SOIs should be responsive to the priorities outlined in the specific Addendum to which they are applying. For general context on U.S. global health priorities and the strategic framework underpinning this APS, applicants may refer to the publicly available U.S. Department of State America First Global Health Strategy: https://www.state.gov/america-first-global-health-strategy/. This resource provides high-level information on the goals of the strategy.

Organizations should focus on developing clear, feasible, and impactful concepts that respond directly to Addendum priorities. Detailed knowledge of specific MOUs is not required to submit a competitive SOI.

mailto:support@grants.gov https://afsitsm.servicenowservices.com/ilms https://www.state.gov/america-first-global-health-strategy/ https://www.state.gov/america-first-global-health-strategy/

Addendum D: Nigeria Q&A

1. Under Objective 4, may applicants propose electronic medical record migration and interoperability support scoped to priority states or a defined subset of facilities, with national coverage of the approximately 4,000 facilities achieved across multiple awards, or does the Department expect individual awards to propose national coverage?

Organizations may propose approaches that are national or sub-national in scope, provided the proposed scope is responsive to the objectives outlined in the Addendum and is appropriately justified. The Department does not expect every individual SOI to achieve national coverage on its own. Organizations should clearly describe the proposed geographic and facility scope, the rationale for that scope, and how the proposed approach would contribute to broader Government of Nigeria ownership, interoperability, sustainability, and achievement of the Addendum objectives.

2. Is there any preference regarding geographic focus (national versus sub-national implementation), or are applicants encouraged to propose target states based on epidemiological and programmatic considerations?

Organizations may propose national or sub-national approaches, provided the proposed scope is responsive to the objectives outlined in the Addendum and is appropriately justified. Organizations should clearly describe the proposed geographic scope and explain how the proposed approach will contribute to achievement of the Addendum objectives.

3. Are applicants encouraged to propose integrated approaches spanning multiple disease areas and health system functions, or should interventions be aligned to specific priority areas?

Organizations are encouraged to propose approaches that are responsive to the objectives outlined in the Addendum. Consistent with the Addendum's emphasis on integrated health systems and service delivery, organizations may propose activities that address multiple disease areas and health system functions where appropriate.

Organizations should clearly explain how the proposed approach contributes to achievement of the selected objective(s).

4. Are consortium applications encouraged, and if so, are there any limitations regarding the number or types of consortium partners?

Applicants may propose consortium, partnership, or other collaborative implementation arrangements where appropriate to achieve the objectives described in the Addendum.

The APS does not establish a specific limit on the number or types of consortium partners. Organizations should clearly describe the roles and responsibilities of proposed partners and demonstrate how the consortium structure supports successful implementation of the proposed approach.

5. Scope fit under Objective 4: Under Addendum D for Nigeria, would a digital health safety, pharmacovigilance, risk communication, adverse-event reporting awareness, and stakeholder engagement platform be considered responsive under Objective 4 if it supports interoperability, analytics, cybersecurity, data-driven decision-making, and transition to Government of Nigeria ownership?

Organizations should review the objectives and scope described in Addendum D and determine whether their proposed concept is responsive to one or more of those objectives. The Department will evaluate SOIs based on the extent to which they address the priorities and objectives identified in the Addendum. Organizations are encouraged to clearly explain how proposed activities support interoperability, evidence-based decision-making, government ownership, sustainability, and achievement of the selected objective(s).

6. Relationship to Objectives 3 and 6: If a digital health safety platform also supports outbreak-related risk communication, medicine safety alerts, post-market surveillance awareness, or diagnostic product safety communication, should the SOI identify alignment only with Objective 4 or also with Objective 3 and/or Objective 6?

Organizations may propose concepts that support one or multiple objectives where appropriate. Applicants should clearly identify the objective(s) addressed by the proposed concept and explain how proposed activities contribute to achievement of those objectives. The Department recognizes that some activities may support multiple objectives within the Addendum.

7. Pharmacovigilance and medicine-safety scope: Does GHSD consider pharmacovigilance, adverse-event reporting awareness, post-market medicine safety communication, counterfeit/substandard medicine alerts, and regulator-led stakeholder engagement to be within scope when linked to integrated digital health systems, health security, or data-driven decision-making?

Organizations are encouraged to propose approaches that are responsive to the objectives outlined in the Addendum. Consistent with the Addendum's emphasis on integrated health systems and service delivery, organizations may propose activities that address multiple disease areas and health system functions where appropriate.

Organizations should clearly explain how the proposed approach contributes to achievement of the selected objective(s).

8. Government of Nigeria counterpart: For Objective 4 digital health and safety-surveillance concepts, which Government of Nigeria institutions should applicants prioritize for alignment and ownership, such as the Federal Ministry of Health, NCDC, NAFDAC, NHMIS leadership, or other national digital health governance bodies?

The SOI should provide sufficient information for reviewers to understand the proposed concept and implementation approach. The Addendum does not prioritize specific Government of Nigeria institutions. Organizations proposing digital health or information systems activities should demonstrate awareness of relevant governance, security, privacy, and sustainability considerations appropriate to the proposed concept.

9. Interoperability expectations: For Objective 4, does GHSD expect proposed digital platforms to integrate directly with named systems such as SORMAS, LIMS, NHMIS, mSupply, and EMR platforms, or may applicants propose complementary systems that exchange data, provide analytics, support stakeholder engagement, and strengthen government-owned digital health workflows?

The SOI should provide sufficient information for reviewers to understand the proposed concept and implementation approach. Detailed technical specifications are not required at the SOI stage. Organizations proposing digital health or information systems activities should demonstrate awareness of relevant governance, security, privacy, and sustainability considerations appropriate to the proposed concept.

10. Data governance and cybersecurity expectations: What level of detail should an SOI provide regarding hosting environment, data sovereignty, Nigerian data protection compliance, role-based access controls, audit logging, security audits, network monitoring, privacy safeguards, mobile device management, and incident response?

The SOI should provide sufficient information for reviewers to understand the proposed concept and implementation approach. Detailed technical specifications are not required at the SOI stage. Organizations proposing digital health or information systems activities should demonstrate awareness of relevant governance, security, privacy, and sustainability considerations appropriate to the proposed concept.

11. Allowable digital health costs: Are software configuration or development, cloud infrastructure, hardware and digital devices, networking equipment, cybersecurity tools, interoperability/API development, analytics dashboards, helpdesk support, user training, and platform maintenance allowable activities under Objective 4 when tied to government ownership and sustainability?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. Organizations should explain in the SOIs how their proposed work will achieve the objectives outlined in the Addendum. Applicants should refer to 2 CFR 200. Subpart E – Cost Principles to determine allowable costs. Under 2 CFR 200.403, costs must be necessary and reasonable for the performance of the award, allocable to the award, and conform to any limitations and exclusions in 2 CFR 200 and the terms and conditions of the award.

12. Prime applicant and consortium structure: May a U.S.-based for-profit small business serve as the prime applicant under Nigeria Addendum D if it proposes a strong consortium with Nigerian public-sector, academic, professional association, faith/community-based, or technology partners? Are there circumstances where GHSD would prefer such a firm to participate as a subrecipient or technical partner instead of prime?

Eligibility requirements are described in the APS. Eligible organizations may apply as prime recipients or participate as consortium members, subrecipients, or partners. The Department has not established a preferred organizational type or consortium structure.

Applications will be evaluated based on the merit of the proposed concept, organizational capacity, and ability to achieve the stated objectives.

13. Local partner expectations at SOI stage: At the SOI stage, how important is it to name Nigerian partners or include letters of support from Nigerian government institutions, universities, professional associations, faith/community-based providers, or local organizations? What level of partner commitment is expected at Phase 1?

Organizations are not required to submit letters of support at the SOI stage. Applicants should describe relevant partnerships and implementation arrangements to the extent known at the time of submission. Organizations should clearly explain how proposed partnerships contribute to successful implementation, sustainability, local ownership, and achievement of the Addendum objectives.

14. Phased pilot-to-scale approach: Are phased approaches acceptable under Addendum D where the project begins with selected federal institutions, pilot states, teaching hospitals, professional associations, or community networks, then scales nationally based on measurable adoption, interoperability, data quality, sustainability, and transition milestones?

Organizations may propose phased approaches where appropriate to achieve the objectives outlined in the Addendum. Applicants should clearly describe the proposed implementation strategy, rationale, anticipated milestones, and how the approach supports sustainability, government ownership, and achievement of the intended outcomes.

15. Performance indicators: For digital health and surveillance-related SOIs, what types of outcome indicators are most important to GHSD, such as number of facilities/users connected, interoperability milestones, data quality, reporting timeliness, safety alert dissemination speed, cybersecurity maturity, adoption by government users, use of dashboards for decision-making, or government cost absorption?

The Department has not prescribed specific indicators at the SOI stage. Organizations are encouraged to describe anticipated results and how progress and success would be measured. Proposed indicators should be appropriate to the concept and demonstrate how the proposed approach contributes to the objectives of the Addendum, including sustainability, government ownership, and measurable outcomes.

16. Sustainability and transition requirements: What level of detail should an SOI provide on transition to Government of Nigeria ownership, including data ownership, platform governance, recurrent cost absorption, local staffing, service contracts, technology licensing, source-code/configuration ownership, and long-term financing?

Organizations should provide sufficient information to demonstrate how the proposed approach supports sustainability and long-term Government of Nigeria ownership.

Detailed transition plans are not required at the SOI stage. However, applicants are encouraged to describe key assumptions, governance approaches, capacity-building strategies, and other factors that would support sustainable implementation beyond the period of U.S. government support.

17. One integrated SOI versus separate SOIs: If a proposed concept addresses both Objective 3 and Objective 4, would GHSD prefer one integrated SOI that clearly identifies multiple objectives, or separate SOIs for the health security/surveillance and digital health/interoperability components?

Organizations may submit multiple SOIs under a given Addendum and may participate in multiple submissions as a prime applicant, subrecipient, or consortium member.

However, applicants are encouraged to submit their most competitive and responsive concept(s) rather than multiple variations of similar approaches. In many cases, a single well-developed SOI that presents an integrated and comprehensive approach to the Addendum objectives may be more effective than multiple narrowly focused or overlapping submissions. Applicants should carefully consider whether related concepts can be presented within a single SOI.

18. Can a foreign based (non-Nigerian) entity (NGO) be part of the Nigerian consortium?

Eligible organizations may participate in a consortium, partnership, or other collaborative implementation arrangement as a prime recipient, subrecipient, or consortium member, consistent with the eligibility requirements described in the APS.

Applicants should clearly describe the roles and responsibilities of all proposed partners.

19. Is it allowed for a non-Nigerian NGO to lead a consortium with Nigerian based local NGOs?

Eligible organizations may serve as the prime recipient and propose implementation arrangements that include local, national, regional, or international partners.

Applications will be evaluated based on the merit of the proposed concept, organizational capacity, and ability to achieve the objectives described in the Addendum.

20. Objective 2 – Health Insurance Expansion: The addendum references support for premium payments through NHIA mechanisms. Could you please clarify whether grant funds may be used directly to finance health insurance premium subscriptions/enrolment costs for beneficiaries, or whether funding is restricted to technical assistance, systems strengthening, and implementation support activities related to health insurance expansion

Applicants should reference 2 CFR 200 Subpart E – Cost Principles to determine allowable costs. Additionally, organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum.

21. Objective 8 – Health Workforce Financing and E-Learning Platforms: The addendum mentions maintaining e-learning platforms to support health workforce mentoring. Could you clarify whether applicants are expected to leverage and strengthen existing local e-learning platforms, or whether the development of new e-learning platforms is permissible and/or encouraged where existing platforms do not adequately meet project needs?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. Organizations should explain in the SOIs how their proposed work will achieve the objectives outlined in the Addendum.

22. Geographic Scope and State Coverage: Could you provide guidance on the expected geographic scope of proposed interventions? Specifically, are applicants expected to propose activities across all 36 states and the FCT, or may proposals focus on a subset of states based on demonstrated need and alignment with the selected objectives

Organizations may propose approaches that are national or sub-national in scope, provided the proposed scope is responsive to the objectives outlined in the Addendum and is appropriately justified. The Department does not expect every individual SOI to achieve national coverage on its own. Organizations should clearly describe the proposed geographic and facility scope, the rationale for that scope, and how the proposed approach would contribute to broader Government of Nigeria ownership, interoperability, sustainability, and achievement of the Addendum objectives.

23. Budget Ceiling and Funding Allocation: The addendum indicates an estimated total funding envelope of up to $200 million and up to 20 anticipated awards. Is there an indicative funding ceiling per award, or should applicants determine the budget based on the scale, number of objectives to be implemented, geographic coverage, and technical requirements necessary to achieve the proposed objectives and outcomes?

At the SOI stage, organizations are not required to submit a detailed budget.

Organizations should propose concepts that are appropriately scoped to achieve the objectives described in the Addendum. The number, size, and scope of awards will depend on the quality of submissions received, Department and U.S. Embassy priorities, and availability of funding.

24. How many objectives may a single organization apply for under this funding opportunity?

Organizations may propose concepts addressing one or multiple objectives. Applicants should clearly identify the objective(s) addressed and explain how the proposed activities contribute to achievement of those objectives.

25. Is an applicant permitted to serve as a prime recipient for one or more objectives while simultaneously participating as a sub-recipient under another prime applicant for different objectives?

Organizations may participate in multiple submissions as a prime applicant, subrecipient, or consortium member, consistent with the eligibility requirements described in the APS.

26. Are there any restrictions on the number of applications in which an organization may participate as either a prime applicant or a sub-recipient?

Organizations may submit multiple SOIs under a given Addendum and may participate in multiple submissions as a prime applicant, subrecipient, or consortium member.

However, applicants are encouraged to submit their most competitive and responsive concept(s) rather than multiple variations of similar approaches. In many cases, a single well-developed SOI that presents an integrated and comprehensive approach to the Addendum objectives may be more effective than multiple narrowly focused or overlapping submissions. Applicants should carefully consider whether related concepts can be presented within a single SOI.

27. Is there a limit to the number of states that a single organization can propose to cover under an objective?

No specific limit has been established. Organizations should propose a geographic scope that is appropriate, feasible, and responsive to the selected objective(s), and clearly explain the rationale for the proposed coverage area.

28. Has the donor identified priority states, regions, or geographic areas for implementation under this APS? If so, could these be specified?

GHSD has not identified priority states, regions, or geographic areas for this Addendum.

Organizations may propose approaches that are national or sub-national in scope, provided the proposed scope is responsive to the objectives outlined in the Addendum and is appropriately justified.

29. If applicants may select specific objectives, will proposals be evaluated independently by objective, or as part of an integrated package?

SOIs will be evaluated against the APS evaluation criteria and the extent to which the proposed concept responds to the objectives described in the Addendum. The Department recognizes that some concepts may address a single objective while others may address multiple objectives through an integrated approach.

30. What is the anticipated budget ceiling or funding range for each objective?

The Department has not established a specific budget ceiling or funding range for individual objectives. The number, size, and scope of awards will depend on the quality of submissions received, GHSD and Embassy priorities, and availability of funding.

31. Is there a maximum award amount that an organization may request if applying for multiple objectives?

At the SOI stage, organizations are not required to submit a detailed budget. The Department has not established a maximum award amount associated with a particular number of objectives. Applicants should propose concepts that are appropriately scoped to achieve the intended results.

32. Could DOS please clarify the intended geographic scope of this Addendum? Or is it up to the applicant to specify the locations?

Organizations may propose approaches that are national or sub-national in scope, provided the proposed scope is responsive to the objectives outlined in the Addendum and is appropriately justified. The Department does not expect every individual SOI to achieve national coverage on its own. Organizations should clearly describe the proposed geographic scope, the rationale for that scope, and how the proposed approach would contribute to broader Government of Nigeria ownership, sustainability, and achievement of the Addendum objectives.

33. Cross-addendum concept: Would a secure, consent-based patient/family records and understanding layer that digitizes paper records, photos, and PDFs be considered responsive where it complements, rather than replaces, national EMR/HMIS systems

Applicants should explain in their SOI how their proposed work will achieve the objectives outlined in the addendum. SOIs will be evaluated against the APS evaluation criteria and the extent to which the proposed concept responds to the objectives described in the Addendum.

34. Nigeria Addendum D: Under Objective 4, would patient/family-facing records continuity tools be considered allowable if they improve data visibility, referral continuity, and interoperability across public, private, faith-based, and community-based settings

Applicants should explain in their SOI how their proposed work will achieve the objectives outlined in the addendum. SOIs will be evaluated against the APS evaluation criteria and the extent to which the proposed concept responds to the objectives described in the Addendum.

35. Consortium model: Would a model be responsive where a local health-system, faith/community, or government-aligned partner leads implementation and a technology partner provides the secure records/scannable-paper/interoperability layer?

Applicants may propose consortium or partnership arrangements that they believe are best suited to achieve the objectives of the Addendum. The Department has not prescribed a preferred consortium structure. Organizations should clearly describe partner roles and explain how the proposed arrangement supports successful implementation, sustainability, local ownership, and achievement of the intended outcomes.

36. Is there a preference for applications that speak to multiple objectives as discrete pieces of work as they are presented in the Addendum, or that combine objectives into a more holistic, integrated design?

The Department welcomes both integrated and more narrowly focused approaches, provided they are responsive to the objectives described in the Addendum. Applicants should clearly explain how the proposed activities contribute to the selected objective(s) and why the proposed design is appropriate to achieve the intended outcomes. The Department recognizes that integrated approaches may be appropriate where objectives are interrelated.

37. If all components/objectives are required to be addressed in the SOI and to ensure comprehensive partnership involvement, will GHSD fund all components at start of budget period or likely to designate one or more components as 'approved but unfunded'?

Applicants are not required to address all objectives. The number, size, scope, and funding structure of any awards will depend on the quality of submissions received, GHSD and U.S Embassy priorities, availability of funding, and completion of required reviews and approvals. Additional guidance will be provided to applicants invited to proceed to a subsequent phase.

38. Can we assume a budget summary is not required at the SOI stage, and that a total estimated budget amount will suffice in this SOI submission?

At the SOI stage, organizations are not required to submit a detailed budget. Applicants should provide sufficient information to describe the proposed concept, anticipated scale, and general resource needs. Additional budget guidance will be provided to applicants invited to proceed to a subsequent phase.

39. In the APS, GHSD has indicated award range from a minimum of USD 500,000 - $250 M.

For this addendum D, GHSD anticipates 20 awards with a total estimated funding of up to USD $200 M (subject to availability). Can we assume the maximum ceiling per award is estimated at $10M? otherwise, what is anticipated maximum ceiling per award?

Applicants should not assume that the estimated total funding amount will be divided equally among anticipated awards. The number, size, and scope of awards will depend on the quality of submissions received, Department and Embassy priorities, proposed scope, and availability of funding.

40. GHSD has indicated in the APS that addenda "will complement, extend or fill identified gaps in the implementation of bilateral MOUs…Detailed knowledge of specific MOUs is not required to submit a competitive SOI”. Furthermore, in addendum D, GHSD indicates that applicants should ensure alignments with MOU priorities. Will GHSD at anytime in the future share MOU objectives and activities to help applicants avoid duplicative efforts and ensure they furnish gap-filling tailored activities that complement MOUs?

SOIs should be responsive to the priorities outlined in the Addendum to which they are applying. Detailed knowledge of specific MOUs is not required to submit a competitive SOI. For general context on U.S. global health priorities and the strategic framework underpinning this APS, applicants may refer to the publicly available AFGHS.

Additional information may be provided during subsequent phases, if applicable.

41. Objective 1 clearly states that service for Government supported facilities and clinics are excluded and included in other sections of the MoU implementation plan. Can more information be shared on the services that may be required for these government supported facilities?

Applicants are encouraged to submit SOIs for any work that is responsive to the objectives outlined in the Addendum. Objectives 2-8 address services in government supported facilities where relevant. SOIs will be evaluated against the APS evaluation criteria and the extent to which the proposed concept responds to the objectives described in the Addendum. Additional information may be provided during subsequent phases, if applicable.

42. Does GHSD anticipate single-organisation applications or does it expect consortium-led implementation?

The Department has not prescribed a specific implementation model. Applicants may submit SOIs as single organizations or as part of a consortium, partnership, or other collaborative implementation arrangement. The proposed structure should be appropriate to the scope and objectives of the concept.

43. If a consortium is allowed, is there a preferred minimum proportion of organisations within a consortium?

The APS does not establish a required minimum or preferred proportion of organizations within a consortium. Applicants should propose a partnership structure that is appropriate to the proposed concept and clearly describe the roles and responsibilities of proposed partners.

44. If a consortium is allowed, can a consortium be led by a local Nigerian organisation with or without an international partner?

Eligible organizations, including eligible local organizations, may serve as prime applicants. Applicants may propose partnership arrangements with or without international partners, provided the proposed structure supports successful implementation of the proposed concept.

45. Does GHSD anticipate any advantage or preference for local organizations serving as prime recipients?

The Department has not established a separate evaluation preference based solely on whether an applicant is local or international; however, as per the guiding principles stated within Addendum D, there should be a priority placed on engaging local Nigerian organizations with a strong emphasis on faith-based and community-based providers to deliver services, strengthen local systems, and ensure culturally appropriate, sustainable, and accountable implementation at national and sub-national levels. SOIs will be evaluated in accordance with the APS evaluation criteria and the priorities outlined in the Addendum.

46. If an organisation appears in multiple consortiums, will that affect competitiveness?

Organizations may participate in multiple submissions as a prime applicant, subrecipient, or consortium member. However, applicants are encouraged to submit and participate in their most competitive and responsive concept(s) rather than multiple overlapping or duplicative submissions. The Department will consider the merits of each SOI based on the APS evaluation criteria.

47. Does GHSD have an expected or preferred consortium structure?

The Department has not prescribed a preferred consortium structure. Applicants should clearly describe proposed partner roles, responsibilities, and management arrangements, and explain how the structure supports successful implementation, sustainability, and achievement of the Addendum objectives.

48. Are faith-based organizations expected to be implementation partners, subrecipients, or beneficiaries?

The Department has not prescribed a required role for faith-based organizations. Faith-based organizations may serve as prime applicants, subrecipients, consortium members, implementation partners, or beneficiaries, as appropriate to the proposed concept and consistent with applicable eligibility and program requirements.

49. Will GHSD make separate awards for each objective, or are integrated multi-objective proposals preferred?

The Department has not predetermined whether awards will be made by objective or through integrated multi-objective approaches. Applicants may propose concepts addressing one or multiple objectives. The proposed approach should be clearly justified and responsive to the Addendum.

50. Is addressing more objectives viewed more favorably?

SOIs will be evaluated based on the APS evaluation criteria, including the quality, feasibility, responsiveness, and likely impact of the proposed concept. A focused SOI that addresses fewer objectives in a strong and feasible way may be competitive.

51. How will proposals covering different numbers of objectives be compared?

SOIs will be evaluated in accordance with the APS evaluation criteria and the extent to which the proposed concept responds to the objectives identified by the applicant. The Department recognizes that some SOIs may address a single objective while others may address multiple objectives through an integrated approach.

52. Are some objectives considered higher priority than others?

All objectives identified in the Addendum are priorities. The Department has not established a public ranking of objectives. Applicants should propose concepts that are responsive to one or more objectives and clearly explain how the proposed activities will achieve meaningful results.

53. Is there a preferred combination of objectives?

The Department has not prescribed a preferred combination of objectives. Applicants may propose the combination of objectives that best reflects their technical approach, capacity, partnerships, and proposed results.

54. If a proposal addresses fewer objectives, what level of depth is expected?

Applicants should provide sufficient detail to demonstrate that the proposed concept is technically sound, feasible, responsive to the selected objective(s), and capable of achieving meaningful results. A focused SOI should clearly explain the rationale for the selected scope and how the proposed activities will contribute to the Addendum objectives.

55. Is there an expected minimum or maximum budget range per award?

The Department has not established a specific minimum or maximum budget range per award beyond the information provided in the APS and Addendum. The number, size, and scope of awards will depend on the quality of submissions received, Department and Embassy priorities, proposed scope, and availability of funding.

56. Does GHSD expect national-scale implementation from Year 1 or phased geographic expansion?

Organizations may propose approaches that are national or sub-national in scope, provided the proposed scope is responsive to the objectives outlined in the Addendum and is appropriately justified. The Department does not expect every individual SOI to achieve national coverage on its own. Organizations should clearly describe the proposed geographic scope, the rationale for that scope, and how the proposed approach would contribute to broader Government of Nigeria ownership, sustainability, and achievement of the Addendum objectives.

57. What specific evidence of "country ownership" will be most heavily weighted during merit review?

SOIs will be evaluated based on APS evaluation criteria, including the quality, feasibility, responsiveness, and likely impact of the concept. Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. Organizations should explain in the SOIs how their proposed work will achieve the objectives outlined in the Addendum.

58. How will GHSD assess sustainability for interventions that require ongoing operational funding?

SOIs will be evaluated based on APS evaluation criteria, including the quality, feasibility, responsiveness, and likely impact of the concept. Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. Organizations should explain in the SOIs how their proposed work will achieve the objectives outlined in the Addendum.

59. Does GHSD have priority faith-based networks it expects applicants to engage?

Eligible organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. The Addendum does not prescribe any priority faith-based networks.

60. What is the definition of Community-based facilities and Faith-based facilities?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. Organizations should explain in the SOIs how their proposed work will achieve the objectives outlined in the Addendum.

61. Are Primary Healthcare facilities and Comprehensive Healthcare facilities considered as Community-based facilities?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. Organizations should explain in the SOIs how their proposed work will achieve the objectives outlined in the Addendum.

62. What proportion of service delivery is expected to occur through faith-based facilities versus community-based platforms?

The Addendum does not specify expectations for proportion of service delivery.

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. Organizations should explain in the SOIs how their proposed work will achieve the objectives outlined in the Addendum.

63. Is GHSD interested primarily in service integration at the facility level or integrated referral systems across facilities and communities?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. Organizations should explain in the SOIs how their proposed work will achieve the objectives outlined in the Addendum.

64. For surveillance and outbreak response, are there priority states or geopolitical zones? The Addendum did not identify priority states or geopolitical zones.

The Addendum does not identify priority states or geopolitical zones. Organizations may propose activities in any state(s) or geopolitical zone in Nigeria.

65. Does GHSD have preferred approaches for strengthening PHEOCs such as infrastructure investment, incident management strengthening or workforce development?

GHSD does not have predetermined expectations beyond the stated objectives in the Addendum. Organizations should explain in their SOIs how their proposed approach will achieve the objectives outlined in the Addendum.

66. What Government of Nigeria-owned EMR platform(s) does GHSD envision as the destination for migration?

The Department does not have any preferred EMR platforms for migration.

67. How will GHSD define success for interoperability?

Organizations should explain in their SOIs how their proposed work will achieve the objectives outlined in the Addendum. The scope and nature of any post-SOI engagement will depend on the results of the review process and the needs of the proposed concept. Additional guidance, if applicable, will be provided to selected organizations at a later stage.

68. Does GHSD anticipate that applicants directly support salaries during transition, or only provide technical assistance?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. Organizations should explain how proposed workforce-related activities support the objectives outlined.

69. Has GHSD identified workforce categories that should be prioritized for transition: Clinical staff, Laboratory scientists, or community health workers?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. Organizations should explain how proposed workforce-related activities support the objectives outlined.

70. What evidence will be required to demonstrate successful workforce transition?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. Organizations should explain how proposed workforce-related activities support the objectives outlined.

71. Objectives 2 and 7 appeared to be currently implemented by government of Nigerian agencies. Is the APS requesting a takeover of this roles from the government or approaches to provision of technical assistance to the government to continue to do what they are doing?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. Organizations should explain how their proposed approach supports the objectives outlined in the Addendum.

72. Can GHSD clarify the operational definition of "community-based health facilities", whether this includes private for-profit facilities, community pharmacies, patent medicine vendors, and community health platforms?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. Organizations should explain how their proposed approach supports the objectives outlined in the Addendum.

73. Under Objective 4, applicants are asked to support migration of U.S.-supported EMR systems to Government of Nigeria-owned platforms across 4,000 facilities, including hardware, cloud infrastructure, and networking. Could DoS clarify whether this objective is intended to finance significant capital/IT procurement at scale, or whether the emphasis is primarily on technical assistance, interoperability, and transition planning?

Organizations are encouraged to submit SOIs for any work that falls within the scope outlined in the Addendum. Organizations should explain how their proposed approach supports the objectives outlined in the Addendum.

74. Objective 8: The Addendum states “Recipients will provide support for salaries, stipends, non-monetary compensation, and travel for persons delivering frontline health services.”

Can the department of State clarify that “recipients” means recipients of Objective 8 funding or is it referencing the Addendum or other DOS award recipients?

“Recipients” is defined in 2 CFR 200.1. It means an entity that receives a Federal award directly from a Federal agency to carry out an activity under a Federal program. The term recipient does not include subrecipients or individuals that are participants or beneficiaries of the award.

75. If Objective 8 is expected to directly provide salaries and other compensation for healthcare workers, can the Department of State provide a plug number for this expense for budget purposes?

The Department has not established a specific minimum or maximum budget range per award beyond the information provided in the APS and Addendum. The number, size, and scope of awards will depend on the quality of submissions received, GHSD and U.S. Embassy priorities, proposed scope availability of funding, and compliance with regulation and Department policy.

76. Objective 8: Can the Department of State provide more information on who these frontline health care workers are: Do they work in the public, community-based, faith-based, not-for-profit or private sectors? Are they working at the primary, secondary or tertiary level?

(as this will impact the transition strategy). Where are they located geographically?

Organizations may propose approaches…