FHM APS - Round 1.pdf

Issue Date March 24, 2021

Questions Due March 31, 2021 05:00 PM (EDT)

Closing Date & Time of Concept Papers April 14, 2021 05:00 PM (EDT)

Subject Frontier Health Markets (FHM), Annual

Program Statement (APS)

No.7200AA21APS00005

Opportunity Title Frontier Health Markets Round 1: Global

Technical Assistance (FHM Round G1)

Catalog of Federal Domestic Assistance 98.001, Foreign Assistance for Programs

Overseas

To: All Interested Respondents/Parties

Pursuant to the Foreign Assistance Act of 1961, as amended, the United States Government, represented by the U.S. Agency for International Development (USAID), Bureau for Global

Health (GH), Office of Population and Reproductive Health (PRH) invites interested

Applicants to submit a Concept Paper that focuses on strengthening health market systems and increasing private sector contributions to voluntary family planning (FP), maternal, newborn and child health (MNCH), malaria, tuberculosis (TB), HIV/AIDS, and other health outcomes through targeted technical assistance and capacity building activities.

The Frontier Health Markets Round 1: Global Technical Assistance (FHM Round G1) is not a

Request for Application (RFA) but rather a request for Concept Paper(s) in response to this

Round published under the Frontier Health Markets Annual Program Statement (FHM APS). To be competitive, the Concept Paper submission must be fully responsive to all directions under this Round and FHM APS. Based on the submitted Concept Paper, USAID will determine whether to request a Full Application from an eligible organization. Issuance of this Round does not constitute an award or commitment on the part of the U.S. Government, nor does it commit the U.S. Government to pay for costs incurred in the preparation and submission of Concept

Paper(s) or Application(s). Issuance of award is subject to the availability of funds and the interest and requirements of USAID as well as the viability of eventual Full Application(s) received.

To be eligible for award, the Applicant must provide all information as required and meet eligibility standards of this APS Round. This funding opportunity is posted on www.grants.gov, and may be amended. It is the responsibility of the Applicant to ensure that the APS Round has been downloaded from www.grants.gov in its entirety as USAID bears no responsibility for data errors resulting from transmission or conversion process. In case of difficulty registering on www.grants.gov or accessing the APS Round, please contact the grants.gov Helpdesk at 1-800-

518-4726 or via email at support@grants.gov for technical assistance.

Please send any questions by the due date listed above to Ms. Jacquelin Bell at jacbell@usaid.gov. Responses to questions received prior to the deadline will be furnished to all potential Applicants through www.grants.gov.

Thank you for your interest in USAID programs.

Sincerely, Alisa J. Dunn

Agreement Officer

Office of Acquisition and Assistance

M/OAA/GH/POP

http://www.grants.gov/ http://www.grants.gov/ http://www.grants.gov/ http://www.grants.gov/ http://www.grants.gov/ http://www.grants.gov/ http://www.grants.gov/ mailto:jacbell@usaid.gov

TABLE OF CONTENTS

SECTION I: FUNDING OPPORTUNITY DESCRIPTION 1

A. Background 1

B. Description 2

C. Expected Results 6

SECTION II: AWARD INFORMATION 15

A. Funding 15

B. Substantial Involvement 15

SECTION III: ELIGIBILITY INFORMATION 17

SECTION IV: CONCEPT PAPER SUBMISSION INFORMATION 17

A. Concept Paper Content and Format 17

B. Concept Paper Submission 19

SECTION V. APPLICATION REVIEW INFORMATION 21

A. Review of Concept Papers and Full Applications 21

B. Full Application Review Process 21

C. Merit Review Criteria and Considerations 22

SECTION I: FUNDING OPPORTUNITY DESCRIPTION

The U.S. Agency for International Development’s Global Health Bureau is pleased to issue

Global Technical Assistance Round (Round G11) under the Frontier Health Markets Annual

Program Statement (APS). FHM Round G1 is focused on advancing voluntary family planning

(FP), maternal, newborn and child health (MNCH), malaria, tuberculosis (TB), HIV/AIDS, and other health outcomes by strengthening the functioning and supporting the growth of local health markets. FHM Round G1 will facilitate strategic and substantive engagement with a wide range of private sector actors to meet the growing needs and shifting demands of healthcare consumers.

A. Background

USAID aims to support the strategic development of effective, efficient, and equitable health markets and a robust and capacitated local private sector which systematically contributes to advancing health outcomes while reducing pressure on the healthcare delivery systems in low-and middle-income countries. By strengthening local health markets, FHM Round G1 aims to strategically advance health outcomes and improve the access, and equitable use of quality health products, services, and information in voluntary family planning, maternal, newborn and child health, malaria, tuberculosis, HIV/AIDS, and other health programs.

As described in the Frontier Health Markets Annual Program Statement (FHM APS), USAID has a long-standing history of private sector programming at the country and local level and has funded a number of global health programs that focus on private sector models to advance family planning and other health outcomes, and improve the enabling environment to address health policy, financing, and other functions of the health systems. While FHM Round G1 will build upon and incorporate the lessons, knowledge, and insights from past investments, the design of this Round reflects the evolution in USAID’s private sector programming with a greater emphasis on strengthening health market systems. A health market is broadly defined as a system of supply, demand, rules, and supporting functions in which a variety of actors contribute to health outcomes. FHM Round G1 will prioritize market improvements (access, quality, equity, efficiency) that result in better health outcomes for consumers in the private sector. A more detailed definition of a health market system and related development approaches are included in the FHM APS.

FHM Round G1 will also focus on building the technical capacity, sustainability, and resilience of local market actors, while leveraging the expertise of established, new, and local partners to scale-up evidence-based approaches and interventions. FHM Round G1 builds on the work of previous private sector projects by providing global technical leadership, supporting innovation, generating and disseminating evidence, and ensuring the linkages between knowledge generation, global dialogue, and country action to achieve global health goals.

1 FHM APS rounds will be issued as Global (G) or Mission (M) rounds.

The private sector can be an important enabler and supporting player to: advancements and innovation in health supply chains and distribution of commodities and supplies; digital technology and mobile health solutions; telemedicine; health data and information for providers and clients; training and support to the healthcare workforce; financing; research; marketing; as well as manufacturing of health commodities and supplies. As one of the fastest growing components of healthcare systems, private healthcare providers and facilities are an increasingly important source of care and provide services to individuals across socioeconomic segments in both rural and urban areas. Given the size, scope, and potential of the private sector, FHM Round

G1 will facilitate effective public-private engagement across health system functions and support lasting partnership models to expand access to high-quality, affordable FP and other health products, services, and information for a wide range of clients who use the private sector.

FHM Round G1’s central focus will be on strengthening the functioning of local health markets and harnessing the potential of the private sector to improve health outcomes. Approaches that incorporate broader health systems strengthening and support capacity building of governments’ health delivery systems are necessary. These approaches should account for differences in the maturity of the health markets, the size, capacity and organization of market actors, and private sector incentives and participation in the local health markets, which vary greatly by country.

More detailed background on the private health sector can be found in the FHM APS.

B. Description

The purpose of FHM Round G1 is to accelerate improvements in family planning (FP), maternal, newborn and child health (MNCH), malaria, HIV/AIDS, tuberculosis (TB), and other health outcomes by strengthening the functioning of local health markets and facilitating strategic engagement with a wide range of private sector actors. These efforts are necessary to meet the growing needs and shifting demands of healthcare consumers for high-quality, consumer-driven products and services in the private sector in a sustainable manner.

Country Support

FHM Round G1 will provide targeted technical assistance to facilitate health market development and private sector engagement in USAID-supported countries. Round G1 will provide coordinated and strategic health market development expertise and assistance. Round G1 will also enhance and supplement mission health programs with systemic, innovative, and lasting private sector engagement and partnership approaches that are tailored to the local contexts in each country. In addition to the provision of technical assistance, FHM Round G1 will strengthen the management and leadership capacity of national and local governments to steward FP and other health markets, as well as the development of engagement platforms to facilitate strategic dialogue and partnership with a wide range of private sector actors. This mechanism will also strengthen the business capabilities of local and regional private health sector actors to build sustainable, long-term engagement in the health system.

FHM Round G1 will require primary expertise in health market development and private sector engagement, along with knowledge and expertise of broader health systems strengthening and of the key global health areas of FP/RH, MNCH, malaria, TB, and HIV/AIDS. A successful mixed health system depends upon both effective government stewardship of health markets as well as the capacity of the health market stakeholders including national, sub-regional, and regional private sector platforms and federations. As FHM Round G1 focuses on market systems and private sector engagement approaches, it will be expected to work synergistically with other

USAID central and bilateral private sector and system strengthening mechanisms that focus on expanding healthcare delivery in the private sector.

Learning Agenda

FHM Round G1 seeks to advance global learning and state of the art research on market development and systemic private sector engagement approaches to advancing voluntary FP, MNCH, malaria, TB, HIV/AIDS, and other health outcomes. FHM Round G1 will invest in understanding and addressing the root causes and systemic barriers and facilitators to greater private sector engagement by health and non-health actors that unlock the potential of market development approaches to improving health outcomes. FHM Round G1 will guide the development and implementation of a comprehensive research and learning agenda that will inform global health investments and country and regional-level programming focused on:

strengthening the stewardship of health markets; improving market conditions for greater private sector participation in the delivery of health outcomes; creating or growing health markets to increase sustainable uptake of high-quality, affordable consumer-driven health products, services, and information; creating or growing ancillary markets that lead to increased access and availability of financing, training, research, data, evidence on effective delivery approaches, and related business services. The continual review and interpretation of monitoring data for programmatic decision-making will be critical to advancing the global learning agenda. FHM

Round G1 will use Collaborating, Learning, and Adapting (CLA) approaches to foster both more adaptive health systems and more effective approaches to USAID global health programming.

FHM Round G1 will include a specific focus on enhancing health outcomes through systematic local private sector engagement and will promote local leadership, seek bold and innovative engagement approaches, and identify new sources of funding to sustain partnerships and scale impact. FHM Round G1 will support the engagement of local private sector partners and build the capacity of local private sector and mixed health system entities. FHM Round G1 will work to: remove barriers to market entry and to enhance market efficiency; build the capacity of the government to effectively play their health market stewardship role; and enhance the private sector’s capacity and incentives to participate in the health market, ultimately leading to https://usaidlearninglab.org/qrg/understanding-cla-0 improved health outcomes. FHM Round G1 will build local ownership and sustainability, engage the local private sector, and capture innovations of previously underutilized partners.

FHM Round G1 & Related USAID Global Health Awards

Several projects/awards from the Global Health Bureau also support private sector health programming and FHM Round G1 is expected to strategically collaborate around key market systems and private sector engagement aspects. These projects/awards include:

● Sustaining Health Outcomes through the Private Sector (SHOPS) Plus (2015-2021):

Managed by the Office of Population and Reproductive Health (PRH), SHOPS Plus is

USAID’s flagship initiative in private sector health and supports the achievement of U.S.

government health priorities and improves the equity and quality of the total health system. The project seeks to harness the full potential of the private sector and catalyze public-private engagement to improve health outcomes in voluntary FP, MNCH, malaria, TB, HIV/AIDS, and other health areas.

● MOMENTUM Private Healthcare Delivery (MPHD) (2020-2025): Managed by the

Office of Population and Reproductive Health (PRH), MPHD is a service delivery focused award seeking to expand access to and use of evidence-based, quality

MNCH/FP/RH information, products, and services through private providers by: (1) ensuring increased availability of and demand for evidence-based, quality voluntary family planning and MNCH information, services, and supplies through private providers; and (2) expanding public and private partnerships to ensure a total market approach for improved healthcare access and coverage. While MPHD focuses primarily on service delivery, FHM Round G1 will focus on systemic health market development approaches, including improving the market environment for private healthcare, systematically engaging the private sector, and supporting local health sector businesses.

● Scale for Impact (2016-2020): Managed by GH’s Center for Innovation and Impact (CII), Scale for Impact aims to accelerate and magnify the impact of priority global health innovations by leveraging the most successful private sector principles and practices. The objective is the rapid development and diffusion of innovations by ensuring timely and appropriate planning for and introduction of priority global health products and technologies. Scale for Impact focuses on magnifying innovations in health products at a global level while FHM Round G1 will support implementation and operationalization of private sector engagement strategies at the country level by building and strengthening health markets.

● Market Access and Innovative Finance (MAIF) (2020-2023): Managed by GH’s Center for Innovation and Impact (CII), the MAIF contract vehicle was established to assist GH and Missions to apply business-minded approaches to accelerate global health and support local ownership and sustainability. The award enables USAID to acquire support services and technical assistance from a variety of firms, organizations, and/or consultants on a range of diverse market access activities, which could include strategic planning for introduction and scale, market shaping, innovative financing, private sector engagement, and/or human-centered design. MAIF focuses on support services and technical assistance that will benefit and complement the work of FHM to develop health markets at the country level.

● NPI EXPAND: New Partners for Better Health (2019-2024): Managed by the Office of

Country Support (OCS), NPI EXPAND supports missions and organizations to scale up innovative interventions by strengthening the capacity of New and Underutilized Partners

(NUPs), including the private sector. This program will help reach USAID's goal of increasing access to, and the uptake of, high-quality healthcare across priority areas through sub-awards to local organizations, along with mentoring and technical support to strengthen their capacity. NPI EXPAND’s focus on capacity building of local organizations is significantly different from, and complementary to, FHM Round G1’s focus on developing health markets.

● Integrated Health Systems IDIQ (2018-2023) and TO 1 “Local Health System

Sustainability” (2019-2024): Managed by the Office of Health Systems (OHS), LHSS supports partner countries and USAID operating units to plan and implement health system strengthening (HSS) solutions with the overall goal of improving health and transitioning capacity to local partners. The mechanism focuses on overall country health systems strengthening including a mix of public and private interventions.

Complementary to this focus, FHM will focus on supporting the private sector through market development approaches in family planning and other specific health/disease areas.

● Health Policy Plus (HP+) (2015-2022): Health Policy Plus (HP+) strengthens and advances health policy priorities at global, national, and subnational levels. The project aims to improve the enabling environment for equitable and sustainable health services, supplies, and delivery systems through policy design, implementation, and financing. The project emphasizes voluntary, rights-based health programs, and cross cutting principles such as gender equality, equity, capacity development, and sustainability. HP+ also strengthens in-country partners' capacity to navigate complex environments for effective policy design, implementation, and financing aligned to country priorities.

Complementary to HP+, FHM will focus on health market rules and regulations that support FP market growth and enable effective engagement with private sector actors across health system functions.

In addition, there are several other GH Bureau mechanisms that have private healthcare components, but do not focus on the private health sector. In focusing on market development for health, FHM Round G1 will bring a unique and differentiated private sector perspective that takes a health systems approach to improving the integration of public and private health sectors to achieve health outcomes.

C. Expected Results

FHM Round G1 is an evolution in USAID’s thinking to embrace a system-wide, market development approach that addresses the root causes of market inefficiencies that limit the ability of the private sector to deliver quality, affordable, and appropriate health information, products, and services to a range of clients across different market segments. These root causes are often associated with the financing, regulation, and supporting functions of health markets and could be improved by interventions aimed at increased access to financing, balanced application and enforcement of health policy, increased availability and use of health market data, improved donor coordination, and broader platforms for systematic engagement between governments and private sector organizations.

The key elements of the design are detailed below, and it is expected that each sub-result will not work in isolation. Rather, the applicant should propose well integrated approaches to ensure all sub-results and the related activities are complementary and outcomes directly contribute to achieving the project’s overall purpose and ultimately the project’s strategic goal. Applicants must propose a theory of change that is based on best practice and is responsive to the purpose and results of the FHM.

Goal: Contribute to the Agency’s priorities of preventing child and maternal deaths, controlling the HIV/AIDS epidemic, combating infectious diseases, and strengthening countries’ healthcare markets.

Purpose: Increase private health sector contributions to advance voluntary family planning (FP), maternal, newborn and child health (MNCH), malaria, tuberculosis (TB), HIV/AIDS, and other health outcomes.

With this goal and purpose, FHM Round G1 aims to invest in achieving its results through:

● targeted technical assistance in market development approaches;

● strategic partnership, engagement, and technical capacity-building of local market actors;

● state of the art research and learning on critical gaps/challenges; and

● at scale implementation of best practices and market-based approaches that help grow the health market, address health challenges, and achieve health outcomes.

By leveraging private sector delivery channels and infrastructure, harnessing their expertise and innovation, and addressing market failures that create inefficiencies, FHM Round G1 will contribute to sustainable supply and increased use of health products, information, and quality services in an equitable manner.

Result 1: Improved market environment for greater private sector participation in the delivery of high-quality FP and other health products, services, and information.

Sustainably improving health outcomes requires the engagement of both the public and private sectors. In most health markets in low- and middle-income countries (LMICs), the private sector is not well organized, coordinated, regulated, or positioned adequately to respond systematically to healthcare needs. The current growth in demand for modern contraceptives and other health products and services places considerable strain on the public healthcare sector, while also presenting an opportunity for the private sector to play a larger role in providing this care and achieving greater client access to quality services.

Under this result, FHM Round G1 will invest in market development approaches and facilitate systematic public-private engagement and collaboration for FP and other health outcomes. FHM

Round G1 will scale up the application and adoption of market-based approaches for FP and other health products, services, and information and will focus on improving the functioning of local health markets to enhance countries’ ability to fortify and diversify their healthcare delivery. FHM Round G1 will provide global technical and thought leadership to advance health market development approaches, including generating evidence, learning, and innovation to improve the understanding of local health markets and strategies to address market failures.

This will be achieved through four intermediate results:

● IR 1.1: Strengthened and supported effective public sector stewardship of FP and other health markets and engagement with the private sector

● IR 1.2: Mobilized and leveraged financial and non-financial resources and incentives to improve private sector capacity, responsiveness, and financial sustainability

● IR 1.3: Improved institutional norms, rules and regulations, and private sector organizational capabilities to support overall market growth

● IR 1.4: Increased effective collection, integration, and utilization of private sector data and market intelligence for informed public and private sector decision-making

IR 1.1: Strengthened and supported effective public sector stewardship of FP and other health markets and engagement with the private sector

FHM Round G1 will directly address constraints to private sector engagement and involvement in health by playing a critical facilitative, supportive, and intermediary role. FHM Round G1 will convene stakeholders to address barriers related to policy and regulatory issues, efficiency of resource allocation, access to finance, and other issues identified in consultation with local public and private sector stakeholders. FHM Round G1 aims to provide contextually appropriate, tailored market facilitation and capacity building, as well as strategic, market systems strengthening support to enable the public sector to become a more effective steward of health markets. This may include technical support to establish or strengthen health market development platforms to facilitate and sustain strategic engagement among market actors for improved relationships and networking, market analytics, coordination of policy, program, and investment priorities, and strategic collaboration. FHM Round G1 will diagnose root causes and design, implement, and evaluate health market systems strengthening interventions. The medium to long term goal is to help strengthen government actors’ health market stewardship capacities to better leverage private sector resources for maximum health outcomes.

IR 1.2: Mobilized and leveraged financial and non-financial resources and incentives to improve private sector capacity, responsiveness, and financial sustainability

In mixed-system health markets, private provision of health information, products, and services are financed by various sources, including: consumers who pay out of pocket (OOP);

governments procuring for strategic health priorities; government social insurance/social protection programs; development partners financing project specific objectives; banks and investors providing loans and capital; and private or publicly funded insurers.

The private commercial health sector is often overly reliant on OOP payments while the non-profit private sector relies heavily on donor support. Governments play an important health financing role that can include social protection programs and/or strategic purchasing of private sector goods and services. However, the private sector is often excluded from government strategic purchasing and insurance schemes due to scarcity of resources or high barriers to meet requirements. If they do participate, the reimbursement rates are often low and/or payments on claims are delayed. In addition, private providers can face challenges in accessing non-financial resources from government and development partners such as subsidized commodities, staff development, continuous medical education, supply and procurement information, and other types of technical assistance and support.

In order to grow a sustainable health market, and incentivize and increase private sector participation, FHM Round G1 will invest in identifying, piloting, and scaling up the best practices and evidence-based approaches that address supply and demand-side health financing challenges and equal access to resources, such as, but not limited to:

● Blended financing to strategically leverage government and donor resources to increase private sector interest and participation in mixed-system healthcare delivery;

● Support for government initiatives to contract private sector healthcare providers, facilities, supply chain companies, and other relevant actors to increase health products, information, and service coverage, availability, affordability, and quality;

● Strategic allocation of non-financial resources by governments and development partners to support and incentivize private sector capacity and service expansion;

● Facilitation of access to private capital and business support services for a range of regional and local private sector actors, including health businesses, social enterprises, nonprofits, and the informal sector;

● Demand side financing strategies to help grow the market base by increasing affordability and removing financial barriers that inhibit consumer uptake of healthcare.

IR 1.3: Improved institutional norms, rules and regulations, and private sector organizational capabilities to support the overall market growth

Health markets require clear rules and regulations to function effectively. Regulatory bodies have an important role of setting and enforcing health product importation, registration, testing, quality assurance, surveillance, marketing, and assessment, as well as providing service oversight, compliance with international quality standards and regulations, and other functions.

These necessary controls protect consumers from poor quality and high prices. When optimized to ensure they are well defined and implemented, these regulatory tools can help make health markets more competitive and efficient in providing consumers with a range of quality, affordable options from which to choose.

In contrast, cumbersome regulations, lack of clear expectations, and variable punitive enforcement focused on collecting fees are disincentives for registered health businesses and providers of quality health products and services to expand their operations. In addition, these issues create an opportunity for open, informal, and unregulated health markets to flourish.

Applicants may want to consider that both formal and informal health market actors need to be strategically engaged in diagnosing the root causes, setting strategic priorities, and identifying market-based solutions and investment priorities to improve quality and access to healthcare across both sectors. While policy and regulatory oversight is a core government function, involvement of both formal and informal private sector actors in developing the policies and regulations that impact them often improves adherence and outcomes.

FHM Round G1 will provide technical assistance to a wide range of health market actors and support reforms to improve organizational capabilities, institutional norms, health market rules, and regulations. These efforts will often support greater private sector representation, accountability, and participation in healthcare delivery at both the national and sub-national levels. Applicants should propose approaches that include working with local private sector organizations and provide capacity building and other support to assess the impact of policies and engage in dialogue with the government. These initiatives will lead to better policy, investment, and partnership opportunities to advance mixed health systems in countries where

USAID works.

IR 1.4: Increased effective collection, integration, and utilization of private sector data and market intelligence for informed public and private sector decision-making

Readily accessible data about the market, specifically market intelligence, that is transparent and available to all market actors is extremely important. These data include information on the depth, breadth, scope, and location of service providers and product suppliers, mapping of the regulatory processes and requirements, demand forecasting, consumer insights, and price and procurement data. Stakeholders can use this information to understand key bottlenecks and possible solutions, as well as identify key market investment opportunities. Greater access to market intelligence improves the efficiency of health markets benefiting everyone from consumers to service providers, product suppliers, financiers, regulators, and stewards. FHM

Round G1 will support sustainable market intelligence platforms that are complementary to and/or integrated with existing national health information systems. Some of the opportunities and solutions include:

● Sustainable health market data platforms aimed at improving the understanding of local health markets through routine and cost-effective collection and analysis of market data such as supplier/provider landscape, demand forecasting, consumer insights, market segmentation, pricing analysis, procurement plans, service delivery information, and other relevant data;

● Systemic solutions for private sector data, including interactive and user-friendly market analytics platforms that maximize the use of available health, demographic, policy, economic, and other private sector data in order to help government stewards diagnose market failures and assess potential opportunities to improve health market growth, efficiency, and/or sustainability;

● Creation and/or strengthening of digital health information markets, such as mHealth technology for rapid distribution of health knowledge and information to a wide range of consumers; electronic health records solutions to support advanced health information systems; AI-based solutions for health analytics, demand forecasting, and related market trend analysis; innovative solutions that support availability of “real-time data” in a sustainable way;

● Improving the integration and interoperability of existing public and private sector health information systems and facilitating data access agreements among key market stakeholders.

Result 2: Improved equal access to, and uptake of, high-quality consumer-driven FP and other health products, services, and information.

FHM Round G1 recognizes the important role of the private sector across the health value chain and aims to support interventions that increase demand for and sustainable supply of quality FP and other health products, services, and information in the private sector while ensuring equity of access. By improving the client-centered nature of these interventions, FHM Round G1 will help achieve a greater demand for and utilization of private sector health interventions. FHM will address barriers to access and use of quality health products, services, and information through market-based approaches and increase the resources available to, and the capacity of, the local private sector by:

● Scaling up user/client-centered, high-impact, and evidence-informed practices with a focus on improving overall quality and affordability of FP and other health products, services, and information in the private sector;

● Creating greater demand for and matching it with sustainable supply of consumer-driven

FP and other health products, services, and information in the private sector to better ensure access, choice, equity, and sustained uptake.

This will be achieved through three intermediate results:

● IR 2.1: Improved quality of care and user/client-centered focus of FP and other health products, services, and information in the private sector

● IR 2.2: Enhanced, sustainable supply of quality, affordable FP and other health products, services, and information in the private sector

● IR 2.3: Increased client-driven demand for priority, quality FP and other health products, services, and information in the private sector

IR 2.1: Improved quality of care and user/client-centered focus of FP and other health products, services, and information in the private sector

FHM Round G1 will scale up user-centered, high-impact, and evidence-informed practices with a focus on improving overall quality of care in the private sector. While private providers are an increasingly important source of healthcare for individuals in LMICs, there are frequently gaps in the quality of healthcare products, services, and information in the private sector. Importantly, many private providers receive insufficient in-service training and clinical policy updates. FHM

Round G1 will advance the learning agenda for private sector quality improvement, while working directly with in-country programs to improve the quality of products and services among networked and non-networked private sector providers and facilities. In addition to quality, healthcare should be tailored to the unique needs of different population groups and market segments. Key aspects of improving quality and client centeredness of care within FHM

Round G1 can include, but should not be limited to:

● Improving service readiness to provide quality FP and other health products, services, and information while also improving practices in healthcare delivery by private providers;

● Coordinating, facilitating, and supporting interventions aimed at institutionalizing quality assurance and quality improvement systems for the private sector, including effective and efficient accreditation models of private providers;

● Development and/or adaptation of learning curricula, training materials, on-the-job tools, digital applications, and other resources based on provider insights and inputs;

● Development of innovative models of supportive supervision, including digital health, coaching, and other models of supportive supervision, including gender-transformative approaches;

● Human-centered design approaches to better tailor private sector products and services to client needs, wants, and aspirations, leveraging digital platforms where appropriate;

● Engaging a wide range of local market stakeholders, community, and private sector organizations (i.e., business associations, professional associations, and health NGOs) in the improvement of quality of products, services, and information in the private sector.

IR 2.2: Enhanced sustainable supply of quality, affordable FP and other health products, FHM Round G1 will improve the supply of quality, affordable FP and other health products, services, and information by leveraging private sector engagement platforms to co-create sustainable solutions; partnership opportunities that harness the capacity, infrastructure, skills, innovation, and other local private sector resources; and facilitating the systemic improvements that address the root causes of health market supply inefficiencies. Private supply chain and distribution channels, digital innovators, social entrepreneurs, and health service providers are important sources of care, information, and services in many LMICs. FHM Round G1 will continue to learn and address the local private sector capacity, willingness, and motivation to offer quality products, services, and information, as well as client’s awareness, ability, and willingness to accept and use FP and other health products and services.

FHM Round G1 will incorporate key supply-side considerations, such as, but not limited to the following:

● Scale up of market-based approaches that are co-created with key public-private stakeholders and supported with state-of-the-art technical, business, and market segmentation analysis, and other relevant services to ensure sustainable and equitable access to FP and/or other health products, services, and information;

● Expansion of product and service offerings by local private sector actors, including networked and non-networked service providers, pharmacy, drug shops, and other retailers by facilitating access to affordable finance, capacity building, quality improvement, and other opportunities in order to increase availability and accessibility of high-quality FP and/or other health products, services, and information;

● Strategic marketing, sales, and distribution support to increase uptake of FP and other health products, services, and information by specific population segments;

● Approaches that facilitate strategic collaboration between digital health innovators, local entrepreneurs, and funders to support design and application of digital health solutions for consumers, providers, and other market stakeholders.

IR 2.3: Increased client-driven demand for priority, quality FP and other health products, FHM Round G1 will increase the uptake of priority, quality FP and other health products, services, and information using the state of the art as well as new and innovative client-driven demand creation and behavior change strategies and approaches that are evidence-based, informed by consumer insights and market research, and leverage the potential of digital platforms. FHM Round G1 will address barriers to client uptake of priority health products and services both through improved product, service, and information delivery and improved social and behavior change interventions to increase uptake. FHM Round G1 will work synergistically with other efforts in FHM Round G1 countries to increase demand, change social norms, and improve community support for uptake of key health products and services. Where those efforts are carried out by other organizations, FHM Round G1 will ensure collaboration.

Key approaches that FHM Round G1 may use to increase client-driven demand for health products and services can include, but should not be limited to:

● Consumer and marketing research to inform comprehensive demand generation strategies to support the growth of a health market and promote private sector products, services, and information;

● Marketing and communications support to private sector partners to help expand their brand offerings, increase sales, and leverage digital platforms;

● Promotion of the adoption of healthy behaviors through social, provider, community, and consumer behavior change interventions supported by research and using human-centered design principles;

● Use of insights from behavioral economics (e.g., nudges, incentives) to support demand creation, health behaviors, and habit formation.

Illustrative set of indicators of market performance (not comprehensive):

FHM Round G1 will request an Activity Monitoring, Evaluation, and Learning Plan (AMELP) from the successful applicants, which would be developed in consultation with USAID and include milestones, indicators for programmatic monitoring, and performance targets for the efficient response and management of any programmatic or technical issues. Applicants may propose additional illustrative indicators and proposed measurements of market performance and should consider the following:

● Changes in total volume and total value distributed across public and private sectors of quality FP and other health products, services, and information;

● Trends in reported use, affordability, and accessibility of FP and other health products, services, and information across private and public sectors and in relation to the overall market;

● Progress against standards in market diversification and equity of access in terms of brands, price, coverage, and availability;

● Measures of market sustainability in terms of optimum subsidy and funding diversity

(donor, domestic, commercial) at the micro/macro levels;

● Measures of quality of care and client satisfaction;

● Number of local private sector health and non-health actors engaged and actively contributing to the growth of local FP and other health markets;

● Value of private capital or grants distributed to the private health sector and number of private providers participating in health insurance/risk pooling schemes.

Cross-cutting principles:

Applicants are requested to incorporate fundamental cross-cutting principles underlying each of the expected results above. These principles are:

● Implementing evidence-based approaches and interventions;

● Improving the quality of care provided across the continuum from household to facility;

● Promoting client-centered care by engaging and responding to the preferences of individuals, families, and communities;

● Applying market systems thinking as a more sustainable way to engage, support, and increase the role of the private sector in the delivery of FP and other healthcare;

● Developing local capacity to improve health outcomes by increasing local ownership and sustainability, as well as partnerships with local private sector actors and organizations, government, and other stakeholders;

● Building and bolstering the resilience2 of populations and communities, thereby encouraging sustainability, and leveraging the work of other U.S. government agencies and donors;

● Promoting dignity, respect, and equity in FP and other health services;

● Addressing the role of social norms, both as barriers and contributors, to achieving health and development outcomes;

● Advancing workplace diversity, equity, and inclusion within the award’s management structures, staffing, and award implementation plans;

● Fostering gender equality by increasing use of approaches designed to empower vulnerable populations including women and couples, and engage men more fully in FP and other health areas; fostering iterative, continuous learning, and adaptive management;

● Coordinating a research, monitoring, and evaluation agenda across FHM investments for strategic alignment, learning, and information exchange; and

● When involving digital platforms, adhering to the principles of the USAID Digital

Strategy and Digital Health Vision, e.g. inclusivity and equitable access, mitigating cyber harm, utilizing a systems based approach, and leveraging global goods.

2 USAID defines resilience as “the ability of people, households, communities, countries and systems to mitigate, adapt to, and recover from shocks and stresses in a manner that reduces chronic vulnerability and facilitates inclusive growth” (USAID, 2012) https://www.usaid.gov/usaid-digital-strategy https://www.usaid.gov/usaid-digital-strategy https://www.usaid.gov/digital-health-vision

SECTION II: AWARD INFORMATION

Please see the Frontier Health Markets APS for award information. Additional information pertinent to FHM Round G1 only is provided below.

A. Funding

Subject to the availability of funds, under FHM Round G1, USAID anticipates supporting approximately one new Cooperative Agreement of up to $135 million over a period of performance of five years. Under that total estimated cost and over the period of performance, USAID anticipates approximately 20% of funding to be core (Global Health Bureau, various health offices) funds and 80% to come from USAID Missions and other Operating Units.

Estimated core funding levels by health area, subject to availability of funds:

Estimated core funding levels by health area

Family planning/reproductive health 75%

Maternal, child health, nutrition 15%

Infectious disease (TB, malaria, HIV, other) 10%

For the award resulting from FHM Round G1, USAID anticipates a significant number of sub-awards and transition awards. USAID strongly encourages substantive collaboration and partnerships with a wide range of local private sector actors and institutions for service delivery, technical assistance, innovation, and other relevant skills and expertise. FHM Round G1 should seek to issue performance-based, capacity-building, and/or innovation sub-awards and sub-grants to local organizations which may become transition awards. All sub-awards to local organizations should connect to specific national priorities with clear, achievable, and measurable outcomes mapped to priority health indicators.

B. Substantial Involvement

USAID substantial involvement is envisioned in, but not limited to, the following areas:

● Approval of implementation and monitoring plans;

● Approval of key personnel;

● Review and approval of one stage of work before work can begin on a subsequent stage;

● Review and approval of substantive provisions of proposed subawards or subcontracts;

● Ability to immediately halt an activity if the recipient does not meet detailed performance specifications;

● Collaboration or joint participation with the recipient, such as when the recipient’s successful accomplishment of program objectives would benefit from USAID’s technical knowledge; and

● Monitoring to permit specific kinds of direction or redirection of the work because of the interrelationships with other projects or activities.

SECTION III: ELIGIBILITY INFORMATION

Please see the Frontier Health Markets (FHM) APS for eligibility information.

SECTION IV: CONCEPT PAPER SUBMISSION INFORMATION

Concept Paper Instructions

For questions on this Round G1 document, please submit all questions via email to Alisa Dunn

(adunn@usaid.gov) and Jacquelin Bell (jacbell@usaid.gov) by the deadline specified on the

Cover Page.

Applicants should submit Round G1 concept papers that present their proposed approach to achieving the two, inter-related results of FHM Round G1. Applicants must address all IRs under the Expected Results. Organizations may submit more than one concept paper if submitting as both an individual organization and as part of a consortium.

For FHM Round G1, interested applicants should submit a concept paper via email to both Alisa

Dunn (adunn@usaid.gov) and Jacquelin Bell (jacbell@usaid.gov). Under 5CFR 1320, the

Paperwork Reduction Action, only electronic copies of concept papers will be accepted. The concept papers must be received by the deadline on the cover page of this document for Round

G1 (demonstrated by the timestamp on the email when received by USAID).

When emailing a concept paper, each applicant must include the FHM APS number and FHM

Round G1 number in the subject line of the email and attachment/file name(s). USAID’s email server cannot handle more than 25 MBs of attachments per email. If the applicant must divide the submission into more than one email, please number the emails in the subject line and indicate in the email’s subject line the desired sequence of emails (Email 1 of 3 etc.). It is the applicant’s responsibility to ensure that all necessary documentation is completed and received on time. In the event of technical difficulties, please contact Alisa Dunn (adunn@usaid.gov) and

Jacquelin Bell (jacbell@usaid.gov).

A. Concept Paper Content and Format

This section presents guidance for the structure of the concept paper. Organizations that wish to be considered for funding under FHM Round G1 must submit a concept paper via email. To facilitate the competitive review of the concept papers, USAID will only consider those concept papers that conform to the format prescribed below.

The concept paper must be written in English and must adhere to a page limit of no more than ten (10) pages for the Technical Section (includes Technical Approach, Staffing and

Management, and Organizational Capability).