LON Addendum 03 Indonesia - Health Communication Campaign for TPT.pdf

U.S. AGENCY FOR INTERNATIONAL DEVELOPMENT

ANNOUNCEMENT

CALL FOR CONCEPT PAPERS

HEALTH COMMUNICATION CAMPAIGN

FOR TB PREVENTIVE TREATMENT (TPT) IN INDONESIA

ADDENDUM 03

Under Existing

TB LOCAL ORGANIZATIONS NETWORK (LON)

ANNUAL PROGRAM STATEMENT APS No.: 7200AA19APS00001

CATALOG OF FEDERAL DOMESTIC ASSISTANCE (CFDA) NUMBER: 98.001

ISSUANCE DATE: November 19, 2021 CLOSING DATE OF QUESTIONS: December 3, 2021 (COB Jakarta time)

CLOSING DATE OF

CONCEPT PAPERS SUBMISSION: December 22, 2021 (COB Jakarta time)

PLEASE NOTE: This is an Addendum to an existing announcement. All interested organizations should carefully review both this addendum AND the full announcement, which can be found here: Important information contained in the full umbrella APS is not repeated in this specific Addendum.

This program is authorized in accordance with Foreign Assistance Act of 1961, as amended.

Through this Addendum to the TB Local organization Network Project (LON) Annual Program Statement (APS) No. 7200AA19APS00001, the U.S. Agency for International Development (USAID) seeks to capitalize on the expertise, ingenuity, and passion of local organizations working in Indonesia on Health Communication Campaign for TB Preventive Treatment (TPT).

USAID/Indonesia anticipates one (1) Cooperative Agreement with a total estimated ceiling up to $5,000,000, for a five-year period of performance, subject to pending approvals. Actual funding amounts are subject to availability of funds. Publishing this Addendum does not commit USAID to make any awards. USAID also reserves the right not to create a co-creation process and request full application from the applicants successful at concept paper stage. Unless otherwise stated herein, all terms and conditions of the LON APS apply.

https://www.grants.gov/web/grants/search-grants.html?keywords=Local%20organizations%20network

I. Problem Statement and Country Context

Problem statement:

The End TB Strategy envisions zero death, zero suffering and zero disease due to TB by 2035.

This goal serves as an impetus to expand testing and treatment services for individuals with TB.

However, to move forward to the ultimate TB elimination goal, more rapid progress beyond detecting and assuring quality treatment for TB patients is essential. All efforts and utilization of resources in diagnostic and treatment strategies need to be put in place, but more efforts should also be made in reducing new TB infections.

After setting an ambitious target of 68% TB Preventive Treatment (TPT) initiation among household contacts by the end of 2024, Indonesia needs to expedite its efforts in finding and delivering TPT among TB contacts. The National TB Program through Global Fund support has been mobilizing contact investigation in districts with the highest TB cases in Indonesia; however, TB prevention efforts specifically aimed at promoting the delivery of TPT are still limited despite their proven effectiveness. USAID envisions that reaching the UN high-level meeting targets requires collective efforts in preventive intervention through promoting TPT at scale. As part of this effort, health providers and the community need to have better access to both information on the importance and benefits of treating Latent TB Infection (LTBI), and about the nature of TPT itself.

Country context:

Prior to COVID-19, tuberculosis (TB) was the greatest killer worldwide due to a single infectious agent. In the first UN high-level meeting on TB held in 2018, world leaders agreed and reaffirmed the Sustainable Development Goals (SDGs) target to reduce the death rate from tuberculosis by 90% and reduce the incidence rate of tuberculosis by up to 80% by 2030. The global strategy towards achieving this goal, namely the End TB strategy, builds on pillars where preventive treatment of people at risk of TB has become a critical component of an integrated and patient-centered TB care model. Heads of State have pledged to ensure access to TB Preventive Treatment (TPT) to 24 million people who have close contact with TB patients and 6 million people living with HIV (PLHIV) by 2022. WHO TB modelling argues that the End TB target can only be achieved by combining treatment and prevention through TPT to individuals with Latent TB Infection (LTBI). Robust evidence suggests that treatment of latent TB reduces the risk of TB activation by 60% - 90%. However, even with proven effectiveness and decades of inclusion in global TB policy, TPT interventions have not yet been widely adopted in high TB burden settings. Globally, only 4.1 million people were put on TPT in 2019.

With an estimated 845,000 new TB cases per year, Indonesia continues to bear the second largest burden of TB cases globally. While continuing to make remarkable progress in reducing TB morbidity in the country, significant challenges toward eliminating the disease persist. In 2019, only 69% of the estimated TB patients were reported to the National TB program (NTP); the rest remained either unnotified or undetected and untreated hence continuing the spread of infection in the population. An estimated 24,000 people developed drug resistant TB nationwide, yet less than 50% were successfully diagnosed.

Indonesia has recognized the value of TPT to reduce TB incidence. TPT in Indonesia’s TB program was formally introduced in 2016 and targeted two key populations: children under the age of five who live in close proximity to TB patients, and PLHIV. However, over five years since the policy was introduced, the TPT uptake remains extremely low. In 2020, only 9.9% of eligible child contacts under 5 years old and only 12% of PLHIV were put on TPT.1 Based on various studies, the underlying factors that explain the poor implementation include: (1) the lack of community awareness on TPT; (2) the lack of capacity in diagnosing latent TB and providing TPT;

and (3) limited awareness and knowledge on TB,2 which fuels stigma and discrimination and further limits health seeking behaviors.

TB is still seen as shameful and fearful so that families hide the TB patient and refuse attempts to screen other family members. Evidence suggests that low acceptability of TPT among primary caregivers is associated with a low-risk perception of TB disease, low social influence of the caregiver, and insufficient knowledge on TB in general and TPT in particular. Even when caregivers have sufficient knowledge about TB as a disease, their understanding of TB prevention remains lacking. Many families who have TB patients in their household do not believe that their children are at risk for TB. TPT is recommended for asymptomatic children who have been in contact with TB patients, but this raises fear of rising drug resistance and low acceptability of TPT treatment among the primary caregivers and healthcare staff.3 The importance of ongoing treatment for a healthy child is difficult to emphasize to caregivers as they tend to not believe the health staff when being informed that the treatment was necessary.4 From the facility side, health workers often provide thorough information on TB to caregivers but explain less about TPT because of their lack of knowledge or because of the limited time to serve many patients at the same time.5 The importance of administering TPT is also difficult for beneficiaries and health workers to grasp without a firm understanding of its potential benefit.

The Indonesian 2020-2024 National TB Strategic Plan has defined priority elements to address the main barriers for TPT uptake in Indonesia, which include strategic communication, coordination with relevant stakeholders, inducing demand creation from beneficiaries, the rollout of shorter regimens and intensifying case finding.6 The MOH also developed a plan to improve TPT coverage by conducting a mapping and needs assessment, encouraging District Health Offices (DHOs) and Community Health Centers (Puskesmas) to leverage community cadres’ roles in identifying TB contacts and promoting TPT in the community, listing TPT as one of the key performance indicators in the national TB program, and investing in effective communication to better educate the public on the benefits of TPT. However, the plans have not been fully executed and have been further impeded by the prolonged COVID-19 outbreak. The MOH has adopted global recommendations for administration of the latest TPT regimens, using once in a week fixed

1 https://cdn-auth-cms.who.int/media/docs/default-source/hq-tuberculosis/global-tuberculosis-report-2020/country-profile-2020-finale0393ed2f22a44bc8a6da606fb46df72.pdf 2 Kementerian Kesehatan Republik Indonesia. Petunjuk Teknis Penanganan Infeksi Laten Tuberkulosis (ILTB). 2020 3 Hill P C, RutherfordME, Audas R, van Crevel R, Graham SM. Preventive therapy in children exposed to Mycobacterium tuberculosis:

problems and solutions. Tropical Medicine and International Health, volume 17 no 10 pp 1264–1273 october 2012.

4 Alperstein G, Morgan KR, Mills K & Daniels L (1998) Compliance with anti-tuberculosis preventive therapy among 6-year-old children.

Australian and New Zealand Journal of Public Health 22, 210–213.

5 Triasih, R, Padmawati R. S., Duke , Robertson, C. §Sawyer S. M., Graham S. M. A mixed-methods evaluation of adherence to preventive treatment among child tuberculosis contacts in Indonesia.INT J TUBERC LUNG DIS 20(8):1078–1083, 2016 6 Indonesia National TB Strategic Plan 2020-2024 dose combinations for 3 months (3HP and 3HR), but it is still using daily Isoniazid (INH) pills of 6 months as the main regimen nationwide.

II. Purpose

In publishing this Addendum, USAID is seeking Concept Papers from eligible local organizations in Indonesia to address the challenges described in section I above. Information provided in the Concept Paper should address the objectives and Activity description presented in this section.

A. Activity Description

Although global recommendations on TB preventive treatment (TPT) have long been adopted in Indonesia’s national TB response, the actual implementation of the TPT program to prevent progression to active TB among individuals with latent TB infection remains suboptimal. The lack of knowledge and unsupportive attitude of community and health providers are strong predictors of insufficient delivery of TPT. Of TB contacts who enrolled on treatment, low adherence correlated with a person's lack of knowledge and incorrect beliefs about the disease and the benefits of medication.7

Efforts aimed at changing knowledge, attitude and behavior, however, are complex and need to address interlocking factors such as individual perceptions and beliefs, interpersonal factors, social norms, and numerous structural factors (policies, economic status of the country, politics and law enforcement). Thus, such efforts require an intense engagement of both the government and community. This health communication activity seeks to persuade communities to engage in certain behaviors through adequate access to information so as to facilitate positive knowledge and attitudes.

This activity will complement and leverage the current TB efforts underway by NTP, which is providing an enabling environment for TB prevention programs through the enactment of the policy on TPT and securing TPT commodities in TB sites in Indonesia. This activity should employ a systematic process that is described in the following activity objectives and illustrative intermediate results (IRs):

Objective 1. Increased access to reliable information about TPT

IR 1.1 Enabling factors and key barriers that inhibit TPT uptake identified

The activity should provide support in conducting a formative study to identify and analyze the underlying factors that impact the performance of TPT service in the selected areas, as well as mapping opportunities to introduce health communication to address the gaps. In addition, the assessment should also review recent trends in available grassroots activities, strategies, and best practices in TB prevention issues. The information gathered from the analysis will serve as a basis for developing the best model for a health communication campaign to improve the TPT program

7 Jin J, Sklar G E, Min Sen Oh V, Chuen Li S. Factors affecting therapeutic compliance: a review from the patient’s perspective. Ther Clin Risk Manag 2008; 4: 269–286.

in the selected areas and provide a baseline measurement to allow a later assessment of progress and of the outcomes of the intervention at the end of the activity. Given the limited learning available for effective health communication implementation in a large country such as Indonesia, the Activity should focus in specific geographic areas but with the perspective that the proposed approach would be feasible to be extended in diverse areas across Indonesia. Geographic priority is given to USAID focus provinces (South Sulawesi, East Java, West Kalimantan, North Sumatra, DKI Jakarta, East Nusa Tenggara, Banten, Papua) and areas where the largest activities on implementing active case finding and contact investigations are currently being carried out by a coalition of local organizations: Penabulu Foundation and Stop TB Partnership Indonesia (with support from the Global Fund) to facilitate potential large-scale collaborations for intervention that targeting similar subpopulations. This should allow the health communication approach of this project to complement the TPT implementation approach of these existing efforts.

IR 1.2 Strategic health communication plan developed

This initiative will complement the MOH efforts in optimizing the TPT program by deploying effective communication strategies that specifically target subpopulations at risk for TB and their health providers.

In order to achieve the defined IR, the Activity should develop an innovative health communication strategy to improve access to and uptake of TPT based on proven theories/models, aiming at the primary community and provider audiences as mentioned earlier, develop and use clear messages and materials that have been previously tested, and utilize the most effective yet feasible channels to convey the messages. This could be in the form of mass media, interpersonal channels and events, grassroots outreach, digital campaign, etc., or a combination of various channels. Health messages should be developed with the aim of raising awareness of how TPT contributes to preventing progression to active TB and moving target audiences toward behaviors that result in improved uptake of TPT. Upon selection of channels in the communication strategy, the Activity should also outline a plan to ensure the optimal frequency and timely exposure of the messages to the primary targets. Further, the Activity should also explore any vision to integrate the campaign activity/contents into a more sustained platform or trusted channel to plan for sustainability of delivering the messages in the long run.

Objective 2. Improved perceptions, knowledge and attitude on how TPT contributes to the prevention of TB

IR 2.1 Strategic health communication plan activated

Upon approval of USAID/Indonesia, the Activity will be responsible for implementing the strategic plan designed to engage primary target audiences and spark their interest and motivation in taking steps for preventing TB through promoting TPT in the focus areas. In implementing the plan, the activity should explore opportunities to partner with the existing effort underway by the Global Fund’s principal recipient, particularly in Active Case Finding (ACF) and contact investigation, to bring massive and collective efforts of health communication in the focus areas.

The implementation of the strategy should cultivate relationships with any existing local activity/events in a way that will deliver more access to the primary targets of the campaign.

IR 2.2 Coordination and collaboration with stakeholders and other key implementers established

To build sustainability, this activity must work with Government counterparts at national and sub national levels. Coordination with the Ministry of Health’s Directorate of Health Promotion (Promkes) should be established at the start of the Activity, particularly when designing the message contents and the health communication strategy and exploring the possibility to sustain the intervention upon successful implementation; with the MOH NTP for technical context of TB and TPT messaging; and with the relevant DHOs in planning, coordination and overseeing the ground implementation of the intervention. To avoid a project-specific approach that is only applicable in a certain context, the activity must identify opportunities to sustain the approach by fostering collaboration with already existing community platform(s) and the relevant government institutions to build local stewardship of the designed health communication approach, and where applicable, across different health campaign activities supported by other donors/government bodies/implementing groups.

Objective 3. Generate an evidence-based approach to facilitate adoption and adaptation of strategic health communication to improve TPT uptake in Indonesia

This objective aims to test whether the introduced approach can be taken up and used in a variety of distinct contexts, given the wide variety of district characteristics in Indonesia. A well-documented process should be followed throughout the course of the activity, with active dissemination of challenges, good practices and successes, thus complementing the continued TB prevention measures by the government.

IR 3.1 Monitoring and evaluation framework developed

Interventions under this activity should be based on the results framework/theory of change and use SMART (Specific, Measurable, Achievable, Relevant, Timely) indicators to quantify results.

The Activity should provide illustrative activities under each objective in their Activity Monitoring, Evaluation and Learning Plan (AMELP), as well as input, output, and outcome indicators to measure progress towards the objectives.

Performance indicators should measure the results for each activity component and establish baseline measurements and targets to assess the impact of proposed interventions. Moreover, the Activity should also document the unintended consequences that arise as a result of the activity implementation. The proposed AMELP should also include an explanation of how data and information will be collected, analyzed, and used for both internal activity management purposes as well as external dissemination. The activity is expected to establish an internal data system that is able to generate rigorous data to provide learnings and context beyond the single defined TPT indicator in the national TB surveillance system.

IR 3.2 The ongoing learning process documented

This objective focuses on the documentation of the health communication activity, which comprises the planning process, the ongoing learning across the lifespan of the activity, and the process to disseminate good practices to other districts beyond the focus districts. To meet the need for learning and adjusting the approach while simultaneously implementing the activity, the activity should include the following activities:

1. Include operational research in the design and implementation phase of M&E activities to understand the reasons driving or inhibiting success; also for fostering identification, testing, evaluation, delivery models, tools and approaches that are evidence-based, effective and feasible to be adopted and transitioned to the health system, and most importantly, acceptable to the national TB program and other end users.

2. Provide periodic updates to USAID on the progress of the activity toward the agreed targets, any challenges, and the suggestions for overcoming the bottlenecks encountered during implementation

3. Periodic review meetings with the government counterparts such as MOH Dirjen Promkes and NTP to ensure communication of progress to date, challenges, and suggestions for course correction.

4. Periodic meetings with the relevant District Health Offices and Provincial Health Offices to communicate progress to date, challenges, and suggestions for course correction.

IR 3.3 Evidence to scale up the health communication strategy and to inform policy needs generated

The activity will include a detailed plan of action to disseminate the lessons gained from the health communication intervention in improving TPT uptake, how to replicate and tailor the strategy in larger areas, and the required efforts to engage potential key actors that will sustain the efforts once the project ends. Options and recommendations for the GOI to expand the intervention will be based on the documented practices and experience in the geographical focus area(s). When proposing recommendations to the GoI for transitioning the approach into the broader public health system, the Activity is expected to advise on the suggested geographical strategy, the proposed approach to engage and involve different key institutions in the expansion process, the expected impact on the program budget, the recommended resource allocation, any necessary policy alignment, and the projected impact on community health seeking behavior and the demand for TB care.

IR 3.4 Impact Evaluation

In addition to performance monitoring for management, accountability and learning, and programmatic output(s), this activity will be included in the planned Mission-wide impact evaluation. The impact evaluation will be carried out by a third party contracted by USAID/Indonesia (please refer to https://www.usaid.gov/evaluation/policy and USAID ADS 201:

https://www.usaid.gov/ads/policy/200/201 for specifics on impact evaluations at USAID).

The Implementing Partner (IP) for the LON-Health Communication Campaign for TPT will fully engage and coordinate with the selected contractor and engage in a co-design process for the impact evaluation prior to the start of implementation of the LON-Health Communication Campaign for TPT. This co-design process includes the joint determination by USAID, the impact evaluation experts and the USAID LON-Health Communication Campaign for TPT of a treatment (activity sites) and a comparison group. The site selection will also include inputs from relevant Government of Indonesia’s institutions. The USAID LON-Health Communication Campaign for https://www.usaid.gov/evaluation/policy https://www.usaid.gov/ads/policy/200/201

TPT work plan will support the successful implementation of the impact evaluation design. For example, most impact evaluation designs require the collection of baseline data before the activity is rolled out and before site selection is announced publicly. Another example is that the agreed-upon site selection will need to be respected throughout the life of the activity, unless changes are jointly agreed upon.

Because the success of both the activity implementation and the impact evaluation rests on public and stakeholder buy-in, the USAID LON-Health Communication Campaign for TPT will also coordinate its communication strategy with the third-party evaluation partner as well as USAID.

Additionally, the LON-Health Communication Campaign for TPT will be expected to share all performance monitoring data, project documents and key informant information with the third-party evaluation partner.

B. Guiding Principles

The following principles will guide USAID’s investments under this activity:

(1) Support the National TB program to improve the coverage of TPT through provision of evidence that complements the definition of existing problems, potential solutions, outcomes and impact measurements, and the need for policy alignment as deemed necessary. Hence, the Activity should not create stand-alone interventions but rather offer and test models that serve as potential solutions to address persistent barriers to increasing TPT uptake in Indonesia and that reflect the potential roles played by various actors in the existing public health system, as well as the feasibility for scaling up the approach across the country.

(2) Partnership, coalition, and collaboration. The Activity should leverage the use of the available resources and contribute in building institutional relationships that last beyond USAID assistance. This includes building strategic partnership with interdisciplinary initiatives alongside the government, community, other development activities, private sector, etc.

(3) Work towards sustainability. The activity should be aligned in a way that leads to sustainable results, focusing on essential efforts to achieve the ultimate objectives of TPT uptake and TB outcomes. The strategic intervention should be replicable in larger geographical areas with diverse socio-cultural contexts in Indonesia.

C. Anticipated Results and Indicators

Performance indicators should measure the results for each activity component and establish baseline measurements and targets to assess the impact of proposed interventions. This will require a mixture of ongoing data collection and periodic surveys. To better capture the progress of the interventions, the Activity may include process indicators in addition to the other Key Performance Indicators (KPIs) that reflect the direct outputs of the intervention. The process and output indicators ideally should cover the entire Knowledge, Attitudes, and Practices (KAP) continuum, and reflect metrics to measure progress on different levels of intervention throughout the project cycle, such as (but not limited to) below:

● Number of people exposed to/reached by TPT campaign

● Number of people who are able to recall the TPT communication content(s)

● % of people with positive perception on the accuracy and credibility of the TPT message(s)

● % of people who perceived that the TPT message(s) is relevant

● Number of people agreeing with the message(s) delivered through the TPT communication materials

● Number of people reporting increased skills and knowledge gained from TPT communication materials

● Number of people taking action to collect more information on TPT

● Number of people with sufficient understanding on the benefit of TPT

● Number of people with a plan made to access TPT

At minimum the Activity should also list, monitor and report on the following USAID standard indicators:

● DT-3: TB notifications in the control and intervention areas

● CI-1: CI coverage rates in the control and intervention areas

● PT-1: TB Preventive Treatment Coverage

● PT-6: Percent household contacts initiated on TPT

● PT-9: Percent of household contacts completed TPT

● PV-1: Number of individuals screened for TB disease and TBI outside of health facilities by community health worker or other qualified person (according to national screening protocols) during the specified reporting period

● PV-2: Number of contacts of bacteriologically confirmed pulmonary TB cases who were screened for TB infection (and/or tested for TBI) according to national screening protocols during the specified reporting period

(details on USAID standard indicators can be found at this link:

https://www.usaid.gov/sites/default/files/documents/Navigating_TB_Indicators_- _A_Guide_for_TB_Programs_MS-21-197_TB.pdf).

III. Eligibility Information

Local non-governmental entities in Indonesia are eligible to submit a concept paper. USAID welcomes concept papers from organizations which have not previously received financial assistance from USAID as well as from local non-governmental organizations which have received USAID funding.

Only local organizations as defined below are eligible for the award. USAID defines a “local entity” as a corporation, a nonprofit organization, or another body of persons that:

(1) Is legally organized under the laws of; and

(2) Has as its principal place of business or operations in; and https://www.usaid.gov/sites/default/files/documents/Navigating_TB_Indicators_-_A_Guide_for_TB_Programs_MS-21-197_TB.pdf https://www.usaid.gov/sites/default/files/documents/Navigating_TB_Indicators_-_A_Guide_for_TB_Programs_MS-21-197_TB.pdf

(3) Is majority owned by individuals who are citizens or lawful permanent residents of; and

(4) Is managed by a governing body the majority of who are citizens or lawful permanent residents of the country receiving assistance.

For purposes of this section, ‘majority owned’ and ‘managed by’ include, without limitation, beneficiary interests and the power, either directly or indirectly, whether exercised or exercisable, to control the election, appointment, or tenure of the organization’s managers or a majority of the organization’s governing body by any means.

The recipients must be responsible entities and must have the necessary organizational experience, accounting, operational controls and technical skills, or ability to obtain them in order to achieve the objectives of the project and comply with the terms and conditions of the award.

Concept papers from organizations that do not meet the above eligibility criteria will not be reviewed and evaluated. Individuals are not eligible to apply for this APS.

USAID strongly encourages concept papers from potential new partners to the US government who meet the above eligibility requirements. Such organizations are advised that they will be required to undergo a Pre-Award Responsibility Determination - a pre-award survey to determine fiscal responsibility (i.e. whether the prospective recipient has the necessary organization, experience, accounting and operational controls, and technical skills – or ability to obtain them – in order to achieve the objectives of the project and comply with the terms and conditions of the award).

IV. Additional Considerations

Prior to submitting a Concept Paper, applicants should ensure that submissions are in line with the US Government Global TB Strategy (follow this link to find the details:

https://www.usaid.gov/sites/default/files/documents/1864/Reach-Cure-Prevent-2015-2019- TBStrategy.pdf) . Successful Concept Papers will also align closely with the broader priorities of

USAID.

USAID is especially interested in promoting new partnerships or projects, as well as existing partnerships that have not been funded by USAID previously.

V. Concept Paper Template and Submission

USAID/Indonesia is responsible for the review process and management of any awards issued under this Addendum.

Concept Papers, Full Applications, and management of any awards issued under this Addendum will be managed in accordance with the process described in the umbrella LON APS announcement.

https://www.usaid.gov/sites/default/files/documents/1864/Reach-Cure-Prevent-2015-2019-TBStrategy.pdf https://www.usaid.gov/sites/default/files/documents/1864/Reach-Cure-Prevent-2015-2019-TBStrategy.pdf

a. Concept Paper Content and Template

● The Concept Paper must be specific, complete, presented concisely and written in English.

The Concept Paper must demonstrate the Applicant’s capabilities and expertise with respect to achieving the objectives.

● Based on the activities proposed by the Applicant, the proposed award size and duration must be specified in the Concept Paper. Proposed award duration must be five (5) years.

● The concept paper must follow the template provided below. Excluding the cover page, the Concept Paper must not exceed five (5) pages, using Times New Roman 12-point font, on standard A4 paper size, and single spaced with no less than one-inch margins and pages numbered consecutively. 10-point font can be used for graphs and charts. Any pages submitted beyond the five-page limit will not be evaluated.

● Additional documentation, such as annexes, charts and graphs that exceed the five pages will not be reviewed. USAID will not review any information provided in links in the Concept Paper.

● The Concept Paper must be submitted in PDF format.

USAID TB LON CONCEPT PAPER TEMPLATE

A. Cover Page – Applicants must complete the following questions below:

[Note that no.1-9 shall be submitted as a cover page, and they are not included in the five-page limit for the Concept Paper.]

1. Proposed Activity Name/Title: __________________________________________

2. Proposed Period of Performance (i.e., start date and end date): _________________

3. Overall Estimate of Funding Requested (in USDs, in the range of $1million - $5million):

4. Applicant Organization Name: __________________________________________

5. Applicant Contact Person (name, title, phone, email): ________________________

6. Full Address for Applicant Organization: _________________________________

7. Type of Organization (e.g., non-US, multilateral, private, for-profit, non-profit, date of incorporation, etc.): ________________________________________________________

8. Name(s) of Partner(s) (Applicants that are Implementing Partners will name Resource Partner(s), if any, here): ____________________________________________________

9. DUNS number and SAM registration status:

Note: USAID may not award to an applicant unless the applicant has complied with all applicable unique entity identifiers (DUNS number) and System for Award Management (SAM) requirements.

The applicant is required to:

1. Provide a valid DUNS number for the applicant.

2. Be registered in SAM before the Cooperative Agreement is awarded.

The registration process may take many weeks to complete. If your organization does not have DUNS or is not registered in SAM when submitting a concept paper, the applicants are encouraged to begin the process early. If an applicant has not fully complied with the requirements above by the time USAID is ready to make an award, USAID may determine that the applicant is not qualified to receive an award and use that determination as a basis for making an award to another applicant. Please refer to the umbrella LON APS for more comprehensive information on establishing a DUNS number and SAM registration.

B. Concept Introduction: (approximately ½ page) Identify the TB problem you will address, linking it to all of the USAID Intermediate Results in Section II, and briefly describe your intervention for tackling this problem. Describe why there is a strategic need for your concept, how it differs from alternatives and any relevant gender-specific considerations for the problem or solution.

C. Beneficiaries: (approximately ½ page) Describe the types of benefits the intervention will produce and the types and range of people who will benefit from this intervention. Was the concept designed with end user input? Has it or can it be adapted to reach both women and men? How can the concept be scaled up to reach more people?

D. Geographic Location: (approximately ½ page) In what location(s) (e.g., province, district, city) are you proposing to operate under this proposed partnership, and reaching approximately what total population? Describe key elements of and actors in the value chain or intervention in the geographic location(s) in which you propose to work. What are the biggest challenges and opportunities?

E. Intervention approach: (approximately 1½ pages) Building on the introduction, propose a Theory of Change for how this intervention will produce the desired impact in the focus area(s) identified. Briefly describe critical barrier(s) or problem(s), related to your focus area(s) that your concept addresses. Be sure to include information describing why the approach is creative or innovative, how it is potentially scalable, and evidence to support it as a tested solution or as an intervention likely to have a significant development impact, and how it will be sustained. The analysis should consider population demographics, disease burden, geography, and present a reasonable theory of change. The concept paper should demonstrate current knowledge of the primary challenges related to TB implementation within the relevant context, and a strong understanding of the opportunities for and barriers to achieving the project purpose.

F. Intervention results: (approximately 1 page) As specifically as possible, describe the anticipated outputs, outcomes, results and/or impact of the proposed intervention. What are the key, quantifiable metrics related to your project’s performance or expected performance? What is the scale needed to achieve results sufficient to address the problem? What are the baselines that you will measure before the project begins?

G. Partner roles: (approximately ½ page) If applicable, describe and define the role of any other entities in the partnership. This must include a description of how roles will be divided and managed efficiently.

H. Applicant capacity: (approximately ½ page) Describe organizational capacity – technical, managerial, financial, etc. – to carry out the proposed intervention.

b. Concept Paper Submission

● All Concept Papers must be submitted by the closing date listed on page 1 of this Addendum. Submissions received after the specified closing date will not be eligible for review.

● The subject line of concept paper email submissions must indicate:

"[APS number], [Addendum Title], and [Organization Name]".

● Concept Papers must be submitted by email to applications-indonesia@usaid.gov with copy to ychristanti@usaid.gov and LON@usaid.gov .

VI. Merit Review Process for Concept Papers

All concept papers received by the deadline stated on page 1 of the Addendum will be reviewed for eligibility and compliance with the instructions for submission prior to evaluation against the merit review criteria listed in this section. Those concept papers that are complete and comply with the instructions for submission will be forwarded to the Selection Committee (SC). The SC will then conduct a merit review of the concept papers.

mailto:applications-indonesia@usaid.gov mailto:ychristanti@usaid.gov mailto:LON@usaid.gov

The final selection of successful concept papers will be determined by the AO. A concept paper is determined to be successful if it receives a “Pass” based on the merit review criteria specified in this section.

The following criteria will be considered when reviewing concept papers, and are weighted equally:

a. The degree to which the concept paper proposes a strategic vision to achieve quantifiable results related to all objectives in the Activity Description and the proposed intermediate results (IRs) and demonstrates a strong understanding of challenges and opportunities related to implementation of the TB Preventive Treatment program in Indonesia.

b. The degree to which the proposed activity is evidence-based, technically sound, feasible with regards to cost and capacity, engages the appropriate stakeholders and contributes to building and strengthening institutional relationships that last beyond USAID support.

c. The degree to which the concept paper clearly exhibits innovative, practical, culturally appropriate, scalable and sustainable strategies.

d. The degree to which the concept paper demonstrates institutional capability, technical and financial management capacity, and relevant technical expertise needed to achieve the proposed results

Note: This Addendum serves primarily to outline the goals and priorities of USAID in making an award under the LON APS. More comprehensive information regarding the application and review processes (including Concept Paper submission, co-creation, Full Application, and Evaluation stages) can be found in the umbrella LON APS, located here.

Applicants are advised to refer extensively to both documents in preparing Concept Papers.

VII. Questions and Further Assistance

Questions regarding the substance and objectives of this Addendum should be directed to applications-indonesia@usaid.gov with copy to ychristanti@usaid.gov and LON@usaid.gov

Questions regarding the substance and terms of the LON APS umbrella should be directed to LON@usaid.gov using the subject line “Question - LON APS Umbrella”.

[END OF ADDENDUM TO LON APS]

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