RFI No 72012123RFI00002 - New Physical Rehabilitation Activity - FINAL.pdf

4 Igor Sikorsky Street, Kyiv 04112, Ukraine; Phone: +380 (44) 521 5000; Fax: 521-5245; http://ukraine.usaid.gov

Request for Information (RFI) No.: 72012123RFI00002 Issuance Date: May 17, 2023 RFI Response Deadline: June 5, 2023 at 17:00 Ukraine Local Time

SUBJECT: Request for Information (RFI) for New Physical Rehabilitation Activity

The United States Government, represented by the U.S. Agency for International Development (USAID) Mission in Ukraine, is seeking input from interested organizations and individuals who may provide comments, opinions and recommendations in response to the proposed project approach and questions outlined in this RFI.

Specifically, USAID/Ukraine is considering to expand its investment in the physical rehabilitation sector in Ukraine to respond to the increased short- as well as long-term needs of Ukrainians in need, not only as a result of the impacts of Russia’s invasion but also to support persons with disabilities, older persons and any other person that would benefit from access to physical rehabilitation and assistive technology services (AT). This may include additional or future programming related to physical and occupational therapy, prosthetics and orthotics (P&O), wheelchair service providers and AT products (Attachment 1).

USAID/Ukraine is issuing this request for information (RFI) to:

1. Solicit and obtain input, advice, knowledge and best practices for the Ukrainian context from a broader audience that is experienced in supporting physical rehabilitation activities in Ukraine;

2. Obtain feedback that will help to clearly define the problem statement and theory of change for intervention from a health systems lens, in order to guide potential investments to improve access to and availability of sustainable, quality, and patient-centered physical rehabilitation services;

3. Elicit innovative ideas on essential programmatic objectives and approaches in the context of the ongoing war and recovery period; and

4. Obtain information on the capability of organizations to implement physical rehabilitation programming by inviting the submission of a Capability Statement (Attachment 3)

This RFI is issued in accordance with FAR 15.201(e) solely for information and planning purposes and does not constitute a Request for Proposal (RFP) or Notice of Funding Opportunity (NOFO) or a promise to issue a NOFO or RFP in the future. Any information gathered via responses to this RFI is intended to inform and assist in USAID/Ukraine’s design of a possible

USAID/Ukraine New Physical Rehabilitation Activity future RFP (used to solicit proposals toward the award of a contract) or NOFO (used to solicit applications toward the award of a grant or cooperative agreement).

Responses to this RFI are not offers and cannot be accepted by the Government to form a binding contract; only the information requested in this RFI will be reviewed. Further, the Government is not seeking proposals and will not accept unsolicited proposals. Responses to this RFI will not be returned and respondents will not be notified of the result of the review. Respondents are advised the Government will not be responsible for any costs incurred in response to this RFI.

Not responding to this RFI does not preclude participation in any future RFP, if any is issued. If a solicitation is released, it will be synopsized at https://sam.gov. It is the responsibility of the potential offerors to monitor this site for additional information pertaining to this requirement.

Submission is strictly voluntary. USAID will not provide feedback or responses to questions submitted in response to this RFI and no proposals or resumes will be accepted or considered.

Submission Instructions

In order to inform the design and maximize potential program impact, USAID invites responses to a series of questions (Attachment 2). These responses will be taken into consideration in the design of a final activity. In addition, respondents are also requested to complete a Capability Statement (Attachment 3).

All responses must be submitted electronically to the email address point of contact identified below. The submission should be written in English, single-spaced, using Times New Roman, font size 12, on 11x8.5 inch letter paper format and one inch margins, with each page numbered consecutively bottom right.

Send all responses to the RFI via email to the Contracting Officer, Joseph Terrazas at jterrazas@usaid.gov, with a copy to the Acquisition and Assistance Specialist, Jaimy Lewis, at jailewis@usaid.gov with the subject entitled: “Request for Information (RFI): Physical Rehabilitation Activity” no later than the date and time stated above. You may receive electronic confirmation acknowledging receipt of your response, but will not receive feedback. Questions related to this RFI will not be answered. After USAID reviews and considers any responses, a decision will be made regarding whether or how to proceed with the new activity.

Proprietary Information. The submitted documentation and content thereof becomes the property of the U.S. Government and will not be returned. This notice is part of Government market research. Information received as a result of this request will be considered as sensitive and will be protected as such. Any company or industry proprietary information contained in responses should be clearly marked as such, by paragraph, such that publicly releasable and proprietary information are clearly distinguished. The Government will not use proprietary information submitted from any one source to establish the capability and requirements for any future acquisition, so as to inadvertently restrict competition.

http://jterrazas@usaid.gov mailto:jailewis@usaid.gov

Thank you for your interest in USAID programs in Ukraine.

Sincerely, Joseph Terrazas Contracting Officer USAID/Ukraine

ATTACHMENT 1: DRAFT PROGRAM OBJECTIVES

I. Draft Problem Statement

Prior to the Russian invasion, the Ukrainian health system struggled to meet the demand for physical rehabilitation due to a variety of reasons, such as, but not limited to, inadequate workforce and weak regulation of training programs, poor coordination, limited government financing, fragmented services, and limited engagement with the private sector, leading to overall limited access to and availability of patient-centered services. Since the invasion, the need for physical rehabilitation services has exponentially increased, and Ukraine has seen a significant influx of short-term resources and donor programs for acute and post acute services to respond to a growing number of wounded Ukrainians. At the same time, the underlying challenges remain, impacting the Government of Ukraine’s (GoU) ability to respond to growing needs to ensure that Ukrainian war victims, persons with disabilities, older persons and others that would benefit are able to optimize their functioning and participate in community and family life.

II. Context

Before the war, over 2.7 million Ukrainians (5.6 percent of the population) were registered as persons with disabilities (WHO 2019), however this may not provide a comprehensive accounting as this only represents those persons who are registered. According to the newest WHO global estimates 16 percent of the global population “experience a significant disability” (WHO 2022). As a result of the war, increasing prevalence rates of spinal cord and open and closed head injuries, burns, amputations and complex limb trauma are impacting the ability of physical rehabilitation services to respond appropriately and in a timely manner. The need for physical rehabilitation for conditions not directly related to the war, such as existing conditions, noncommunicable diseases, aging or accidents, also continue, particularly in light of disruptions to other routine healthcare services as a result of the war and increasing economic constraints on the population. Additionally, many in Ukraine rely on AT products, such as mobility aids, wheelchairs and self-care products, in order to optimize functioning and engage in activities of daily living and these products may have been damaged or left behind during evacuations, increasing the overall need.

While the Ministry of Health recognizes rehabilitation as a key component of universal health coverage, national and regional capacities to manage the physical rehabilitation sector--including oversight over rehabilitation services, P&O and AT products and financing--remain weak. An action plan on physical rehabilitation was drafted before the war, however no formalized national strategy exists at this time. Physical rehabilitation services remain severely understaffed, with few rehabilitation professionals equipped with the knowledge and skills to handle complex multi-trauma cases and navigate the demands of emergency medical response.

There are also large gaps in provision of P&O and AT products and services. Procurement and supply chain challenges remain considerable barriers with purchasing decisions often defaulting https://apps.who.int/iris/bitstream/handle/10665/349595/9789289056304-eng.pdf?sequence=1&isAllowed=y https://www.who.int/teams/noncommunicable-diseases/sensory-functions-disability-and-rehabilitation/global-report-on-health-equity-for-persons-with-disabilities to the lowest cost option due to budget limitations or inadequate training. The GoU requires capacity strengthening for AT needs forecasting, procurement and stock management to ensure these are available for those in need.

To address these needs, Ukraine’s public and private sectors are mobilizing resources. The Government of Ukraine is elaborating plans to expand rehabilitation services through investment in public facilities, including through partnership with the World Bank’s Health Enhancement and Lifesaving (HEAL) Ukraine project, which subject to availability of funds may support both training and provision of equipment and vehicles to primary and specialized facilities. At the same time, Ukraine’s private sector has significant and growing capacity to meet needs related to physical rehabilitation, including through private, for-profit institutions, as well as non-profit providers that have expanded - often with support from humanitarian agencies or private investors and foundations - since Russia’s full-scale invasion. To date, there has been limited collaboration or partnership between the public and private sectors and limited engagement of private providers in providing state-subsidized services under the Program of Medical Guarantees. As a result, access to private sector services is potentially limited to those with the ability to pay out of pocket or secure other external financing, presenting uncertainty in terms of meeting longer-term needs.

Building sustainable and quality physical rehabilitation services, for all people, within the health system is a significant priority.

III. Illustrative Objectives

USAID has developed an initial set of illustrative objectives under consideration as potential areas of focus for future programming to support the Ukrainian health system in meeting growing physical rehabilitation needs, while complementing the investments of the GoU, the private sector and other donors including the World Bank. While the activity serves to more effectively meet the increasing physical rehabilitation needs among Ukrainians exposed to the war, support is not limited to this demographic and will include persons with disabilities and older persons unrelated to the war. Any assistance to veterans will be structured to ensure it does not constitute assistance to the military.

USAID’s aim is to strengthen physical rehabilitation services that are inclusive of AT to address the physical rehabilitation needs of all Ukrainians in the short and long-term. Building in sustainability is essential to providing these services in the future and complementing the efforts of other donors and stakeholders. USAID programs seek opportunities to engage with a variety of partners such as non-governmental organizations, disabled persons organizations, governmental bodies and the private sector.

Objective 1: Strengthen national, regional and local leadership, management and governance capacity related to the physical rehabilitation sector

Potential Focus Areas:

● Sustainable financing

● Human resource capacity within the GoU

● Cross-sector coordination (Ministry of Social Policy, Ministry of Health, Office of the

President)

● Quality of care standards

● Private sector engagement

● Linkage and referral systems

● Physical rehabilitation standards and guidelines

Objective 2: Increase access to and availability of affordable, quality and sustainable physical rehabilitation services

Potential Focus Areas:

● Patient-centered care, support and engagement across the care continuum

● Physical rehabilitation services at the Primary Health Care (PHC) level

● Physical rehabilitation workforce capacity

● Demand for services

● Linkages to and integration of rehabilitation services with complementary health and social services (mental health and psychosocial support, livelihoods)

● Access to rehabilitation services for war victims and persons/groups in vulnerable situations (such as low-income households, persons with disabilities, older persons)

● Provision of psycho-social support for those persons receiving rehabilitation services

Objective 3: Develop community-level services and promote the inclusion and participation of persons with disabilities and their families

Potential focus areas:

● Communication about services and resources

● Centers of peer-support

● Provision of social services at the local level

● Accessibility of rehabilitation services

● Representation of persons with disabilities and their families in the development of services, decision-making, policy discussions, etc

● Stigma and discrimination reduction against persons with disabilities

USAID seeks to utilize a systems-centered approach, focusing on government ownership in the development of physical rehabilitation services for long-term sustainability, while simultaneously applying a person-centered approach to addressing the individual requirements of persons with rehabilitation needs and the communities that support them.

[End of Attachment 1]

ATTACHMENT 2: QUESTIONS

Respondents may address any or all questions in their response, but are particularly encouraged to address at least the five overarching questions.

Responses to questions should not exceed four (4) pages.

Overarching Questions (5)

● Q1. Are the proposed program objectives clear? Would objectives benefit from further clarification?

● Q2. What are the key gaps, opportunities and threats to strengthening the physical rehabilitation sector in Ukraine that should be considered?

● Q3. What other similar programming in Ukraine should we take into consideration and what are the unmet needs not being addressed by other partners that USAID would be well-positioned to focus on?

● Q4. Are there opportunities for broader partnership between USAID and other donors on this activity?

● Q5. What do you foresee as possible risks in the implementation of physical rehabilitation activities in Ukraine in the current environment? What are some possible risk mitigation measures?

Objective 1: Strengthen national and regional leadership, management and governance capacity related to the physical rehabilitation sector (2)

● 1.1. What are the key considerations for increasing the Government of Ukraine’s capacity to lead and govern the physical rehabilitation sector--and how can we support them?

● 1.2. What are key government system constraints to strengthening physical rehabilitation and AT services?

Objective 2: Increase access to and availability of affordable, quality and sustainable physical rehabilitation services (4)

● 2.1. What are the best opportunities for enhancing pre-service education and continuing professional development (CPD) for physical rehabilitation professionals?

● 2.2. What are opportunities to strengthen the current referral and follow-up pathways to physical rehabilitation and assistive technology services?

● 2.3. How should mental health and/or psychosocial (MHPSS) and other complementary services be integrated into the activity to provide more comprehensive and holistic services?

● 2.4. What are the prospects and best opportunities for engaging the private sector and private philanthropic resources in the proposed activity?

Objective 3: Develop community-level services and promote the inclusion and participation of persons with disabilities and their families (3)

● 3.1 What needs or barriers must be addressed for persons with disabilities and/or civilian victims of war and/or other persons to access physical rehabilitation services, including P&O and AT products and services?

● 3.2 What are the prospects and best opportunities for engaging disabled persons organizations and other key non-governmental stakeholders in the proposed activity?

● 3.3 What opportunities do you see in Ukraine, at this time, for community-based rehabilitation services and rehabilitation services at the primary health care level?

[End of Attachment 2]

ATTACHMENT 3: CAPABILITY STATEMENT

The capability statement should utilize the template below and not exceed three (3) pages.

Name of organization

Nationality of the organization

Address

Website

Point of contact, including phone and email address

Describe your organization’s technical expertise in physical rehabilitation programming (including support to P&O and AT products and services), preferably in Ukraine.

Provide examples(s) that demonstrate your organization’s capacity and ability to respond to the objectives described in Attachment 1.

Provide a description of your current operational capacity in Ukraine and ability to rapidly scale up if required.

If your organization is currently working in Ukraine, how and with whom are you coordinating in the rehabilitation sector?

What is your organization’s experience implementing activities funded by the United States Government or other donors (EU, FCDO, etc.), as a prime awardee, partner or sub-awardee? Provide the following details for up to five awards or sub-awards in the last five years:

● Organization’s status as a prime or sub-award recipient or contractor

● Funding organization

● Start and end date of the award/contract

Relevant projects/activities (up to five). Please list each award separately in the rows below.

● The value of the award/contract or sub-award and date

● Brief description of the award/contract or sub-award, description of the effort, interventions and outcomes (3-4 sentences).

Project/Activity 1

Project/Activity 2

Project/Activity 3

Project/Activity 4

Project/Activity 5

Summary of total annual budget managed, including funding from all sources.

[End of Attachment 3]