RFP-72036724R00005-USAID Nepal Health Surveys.pdf

Issuance Date: May 31, 2024 Closing Date/Time for Questions/Registration for Pre-Proposal Conference: June 07, 2024, 5:00 p.m. (NPT) Pre-Proposal Conference: June 12, 2024 Closing Date/Time for Receipt of Proposals: June 30, 2024, 5:00 p.m. (NPT)

SUBJECT: Request for Proposals (RFP) No: 72036724R00005 USAID Nepal Health Surveys

The United States Government (USG), represented by the U.S. Agency for International Development Mission to Nepal (USAID/Nepal) seeks proposals from Local organizations (as defined in Section 7077 of the FY 2012 Appropriations Act, as carried forward by the FY 2013 Continuing Resolution, and as amended by Section 7028 of the FY 2014 Appropriations Act) operating in Nepal to provide services as detailed in the RFP for USAID Nepal Health Surveys.

USAID/Nepal contemplates awarding a Firm-Fixed-Price (FFP) type contract for a 4 Years period subject to the availability of funds. In accordance with ADS 302.3.4.5(f) and Section 7028 of the FY 2014 Appropriations Act this procurement is limited to Nepali entities and must not exceed a total price of USD 5 million.

Interventions under the USAID Nepal Health Surveys will support the Government of Nepal's (GON) Ministry of Health and Population (MOHP) in designing and implementing two large-scale, nationally representative surveys - the 2025 Nepal Health Facility Survey and the 2026 Nepal Demographic and Health Survey as described in Section C. Proposals will be accepted from eligible Nepali organizations as defined in Section L. The NAICS Code is 541611 – Administrative Management and General Management Consulting Services.

Offerors are requested to submit proposals that are both realistic and reasonable for this effort.

Offerors are directed to pay close attention to Section L – Instructions to Offerors and Section M –Evaluation Factors for Award. Please also pay careful attention to, and complete Section K – Representations, Certifications and Other Statements. All submitted proposals must be signed by an authorized official with the authority to bind the firm represented by the Offeror.

Questions and comments related to this RFP must be submitted electronically to cghimire@usaid.gov, with a copy to me at mtelevantos@usaid.gov by the deadline stated.

Answers to questions received in writing will be made available to all offerors through an amendment to the RFP and posted on www.sam.gov.

It is extremely important that electronic submissions be made by the date and time indicated above. Proposals received after the closing date and time will be processed as late and handled in accordance with FAR 15.208. Pursuant to Block 12 of Standard Form 33 of this RFP, offers U.S. Agency for International Development (USAID) G.P.O. Box 295 U.S. Embassy, Maharajgunj Kathmandu, Nepal Telephone: +977.1.423.4000 Email: usaidnepal@usaid.gov Website: https://www.usaid.gov/nepal mailto:cghimire@usaid.gov mailto:mtelevantos@usaid.gov http://www.sam.gov mailto:usaidnepal@usaid.gov https://www.usaid.gov/nepal must remain valid for 268 days. Please ensure that your company’s registration in the System for Award Management (SAM) is current and up to date. SAM can be accessed at www.sam.gov.

Electronic submissions must be sent to cghimire@usaid.gov with a copy to me at mtelevantos@usaid.gov. No other form of submission will be accepted.

Pre-Proposal Conference: A pre-proposal conference will be held virtually on June 12, 2024. The purpose of the Pre-Proposal Conference is to ensure an understanding of the RFP’s technical objectives and to review the proposal process. The Conference agenda will include a short presentation of the RFP and a question/answer session based on participants’ review of the RFP.

All interested potential Offerors are welcome to attend, but it will be limited to 2 representatives per Offeror and all attendees must register. If you are interested in attending the Pre-Proposal Conference, please send an email to Chetana Ghimire at cghimire@usaid.gov with a copy to Maria Televantos at mtelevantos@usaid.gov by the deadline stated above.

Include the name of your organization and the name(s) of the person(s) who will attend. USAID will respond with an email confirming registration, a google meet link will be shared with the registered offerors along with a confirmed time of the meeting. You must have a registration in order to receive a meeting link for the pre-proposal conference. An amendment to the solicitation will be posted shortly after the conference containing the presentation and questions and answers covered during the conference.

Issuance of this RFP in no way obligates the U.S. Government to award a contract nor does it commit the U.S. Government to pay any costs incurred in the preparation and submission of a proposal. Award of a contract under this RFP is subject to availability of funds and other internal USAID approvals. This RFP can be viewed and downloaded from www.sam.gov. USAID bears no responsibility for data errors resulting from transmission or conversion processes. Further, be aware that amendments to solicitations are occasionally issued and will be posted on the same website from which you downloaded the solicitation. USAID advises to regularly check the above website for amendments.

Thank you for your interest in working with USAID.

Sincerely, /s/ Maria Televantos, Contracting Officer USAID/Nepal mailto:cghimire@usaid.gov mailto:mtelevantos@usaid.gov mailto:cghimire@usaid.gov mailto:mtelevantos@usaid.gov

Table of contents

PART I – THE SCHEDULE 5

SECTION B – SUPPLIES OR SERVICES AND PRICE 5

SECTION C – DESCRIPTION / SPECIFICATIONS/STATEMENT OF WORK 8

SECTION D – PACKAGING AND MARKING 24

SECTION E – INSPECTION AND ACCEPTANCE 28

SECTION F – DELIVERIES OR PERFORMANCE 29

SECTION G – CONTRACT ADMINISTRATION DATA 40

SECTION H – SPECIAL CONTRACT REQUIREMENTS 43

PART II – CONTRACT CLAUSES 69

SECTION I – CONTRACT CLAUSES 69

PART III – LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACHMENTS 73

SECTION J - LIST OF ATTACHMENTS 73

PART IV - REPRESENTATIONS AND INSTRUCTIONS 74

SECTION K – REPRESENTATIONS, CERTIFICATIONS, AND OTHER STATEMENTS 74

SECTION L - INSTRUCTIONS, CONDITIONS, AND NOTICES TO OFFERORS 84

SECTION M - EVALUATION FACTORS FOR AWARD 99

Offeror must download the most recent version of the SF-33 on www.gsa.gov to prepare its offer.

http://www.gsa.gov

PART I – THE SCHEDULE

SECTION B – SUPPLIES OR SERVICES AND PRICE

B.1 PURPOSE

The purpose of this contract is to obtain services as described in Section C - Statement of Work.

B.2 TYPE OF CONTRACT

This is a Firm Fixed Price contract. For the consideration set forth in the contract, the Contractor shall provide the deliverables described in Section C and Section F, and comply with all contract requirements.

B.3 FIXED PRICE

a. The total fixed price for the performance of work required hereunder is $TBD.

b. The amount currently obligated and available for disbursement for performance hereunder is $TBD. The Contractor will not exceed the aforesaid obligated amount in accordance with Availability of Funds clause FAR 52.232-18.

c. Funds obligated hereunder are anticipated to be sufficient through TBD. Additional funds up to the total firm fixed price may be obligated by USAID subject to the availability of funds. USAID is not obligated to reimburse the Contractor for the expenditure of any amount in excess of the total obligated amount.

B.4 CLINS

Item No. Supplies/Services (Description) Amount

0001 Component 1: 2025 Nepal Health Facility Survey TBD

0002 Component 2: 2026 Nepal Demographic and Health Survey TBD

Unless authorized in writing by the Contracting Officer (CO), the Contractor must not be entitled to additional compensation above the total FFP, nor above the price of each individual line item stated in the Payment Schedule. Changes made to the payment schedule of the contract shall be modified accordingly.

B.5 PAYMENT METHOD

Payment will be made in accordance with FAR Clause 52.232-1, Payments (APR 1984).

B.6 PAYMENT SCHEDULE

Payment will be made to the Contractor, in accordance with the payment schedule:

Payment Nos.

Deliverables Payment Amount

CLIN 1 2025 Nepal Health Facility Survey (NHFS) 1 USAID inspection and acceptance of Hiring Key Personnel (Section

F.3-Deliverable #1) 5%

2 USAID inspection and acceptance of Activity Implementation Timeline (Section F.3-Deliverable #2)

1%

3 USAID inspection and acceptance of 2025 NHFS Survey Design Document (Section F.3-Deliverable #9)

4%

4 USAID inspection and acceptance of 2025 NHFS Final questionnaires in English, Nepali and other local languages (Section F.3-Deliverable #12)

5%

5 USAID inspection and acceptance of 2025 NHFS enumerators training report (with annexes on field mobilization plan for data collection and detailed supervision and quality control plan) (Section F.3-Deliverable #13)

5%

6 USAID inspection and acceptance of clean 2025 NHFS data set (Section F.3-Deliverable #15)

15%

7 USAID inspection and acceptance of 2025 NHFS Key Indicators Report (Section F.3-Deliverable #16)

10%

8 USAID inspection and acceptance of 2025 NHFS Final Report tabulation plan (Section F.3-Deliverable #18)

2%

9 USAID inspection and acceptance of 2025 NHFS Final Report and all other dissemination materials (Section F.3-Deliverable #19)

5%

10 USAID inspection and acceptance of the 2025 NHFS Journalist Workshop completion report (Section F.3-Deliverable #21)

1%

11 USAID inspection and acceptance of 2025 NHFS data analysis workshop completion report (Section F.3-Deliverable #22)

1%

12 USAID inspection and acceptance of 2025 NHFS further analysis reports (Section F.3-Deliverable #24 &25)

1%

CLIN 2 2026 Nepal Demographic and Health Survey (NDHS)

13 USAID inspection and acceptance of 2026 NDHS SOW (Section F.3-Deliverable #26)

1%

14 USAID inspection and acceptance of 2026 NDHS final questionnaires in English, Nepali and other local languages (Section F.3-Deliverable #29)

5%

15 USAID inspection and acceptance of 2026 NDHS enumerators training report (with annexes on field mobilization plan for data collection and detailed supervision and quality control plan) (Section F.3-Deliverable #32)

10%

16 USAID inspection and acceptance of clean 2026 NDHS data set (Section F.3-Deliverable #34)

10%

17 USAID inspection and acceptance of 2026 NDHS Key Indicators Report (Section F.3-Deliverable #35)

5%

18 USAID inspection and acceptance of 2026 NDHS Final Report tabulation plan (Section F.3-Deliverable #37)

5%

19 USAID inspection and acceptance of 2026 NDHS Final Report and all other dissemination materials (Section F.3-Deliverable #38)

4%

20 USAID inspection and acceptance of the 2026 NDHS Journalist Workshop completion report (Section F.3-Deliverable #39)

1%

21 USAID inspection and acceptance of 2026 NDHS data analysis workshop completion report (Section F.3-Deliverable #40)

1%

22 USAID inspection and acceptance of 2026 NDHS further analysis reports (Section F.3-Deliverable #42)

1%

23 USAID inspection and acceptance of Activity Completion Report (Section F.3-Deliverable #43)

2%

Total 100%

The Contractor must submit one completed and signed Standard Form (SF) 1034, “Public Voucher for Purchases and Services other than Personal” (http://www.usaid.gov/forms/) along with each payment request after receiving acceptance of the deliverable stated by the Contracting Officer Representative (COR). USAID reserves the right to require the Contractor to provide additional documentation to determine the value of each payment requested and verify work is complete at its sole discretion and at no additional cost.

[END OF SECTION B]

http://www.usaid.gov/forms/

SECTION C – DESCRIPTION / SPECIFICATIONS/STATEMENT OF WORK

C.1 TITLE OF ACTIVITY

The title of this activity is USAID Nepal Health Surveys.

C.2 OBJECTIVE

The goal of “USAID Nepal Health Surveys'' is to support the Government of Nepal's (GON) Ministry of Health and Population (MOHP) in designing and implementing two large-scale, nationally representative surveys - the 2025 Nepal Health Facility Survey and the 2026 Nepal Demographic and Health Survey. These surveys will support the GON's efforts to track the health sector’s progress towards the 2030 United Nations Sustainable Development Goals (SDGs) and the Nepal Health Sector-Strategic Plan (NHS-SP) 2023–2030 goals. These surveys will be key data sources for USAID/Nepal to measure the endline results of the health component of Development Objective (DO) 3 of the Country Development Cooperation Strategy (CDCS) 2020–2025, measure baselines, and set targets for its next CDCS. The survey data will also support policy development and programming for a wide range of stakeholders including national, provincial, and municipal governments and Nepal’s development partners.

USAID Nepal Health Surveys will carry out the following two nationally representative surveys:

1. 2025 Nepal Health Facility Survey (NHFS): The 2025 NHFS will assess the overall availability of specific client services in health facilities (HFs), both public and private, in Nepal. These include the general readiness of HFs to provide client services; the availability of essential drugs; the service-specific readiness of HFs; the quality of services; client perceptions, feedback, and accountability systems; and financial, inventory, and personnel management.

2. 2026 Nepal Demographic and Health Survey (NDHS): The 2026 NDHS will provide data for monitoring the population, health, and nutrition situation in Nepal. Specifically, it provides reliable estimates of fertility, marriage, family planning, breastfeeding practices, nutrition, food insecurity, maternal and child health, childhood mortality, awareness and behavior regarding HIV/AIDS and other sexually transmitted infections (STIs), women’s empowerment, domestic violence, fistula, mental health, accident and injury, disability, and other health-related issues such as smoking, knowledge of tuberculosis, and prevalence of hypertension.

C.3 BACKGROUND

Nepal’s health sector needs accurate, comprehensive, and disaggregated data to gauge its performance, identify inequalities among social groups, geographic and administrative areas, and economic classes, and allocate scarce resources in a meaningful way. In addition to routine information, surveys have been an important source of information for informing planning and policy formulation and for monitoring the health sector’s progress over time. Since 1996, USAID/Nepal has partnered with the MOHP to conduct the NDHS every five years. Each NDHS provides information on mortality, morbidity, nutritional status, disease prevalence, service utilization, and health-seeking practices both at the national and sub-national level. In 2015, USAID/Nepal also partnered with the MOHP to carry out Nepal’s first comprehensive HF-based survey, the NHFS, which was co-funded by the United Kingdom’s Foreign, Commonwealth, and Development Office (FCDO), the United Nations Population Fund (UNFPA), and the World Health Organization (WHO). This survey harmonized the existing HF survey methodologies used globally and in Nepal: the Service Availability and Readiness Assessment (SARA), Service Tracking Surveys (STS), Reproductive Health Commodity Security Survey (RHCSS), and the Service Provision Assessment (SPA). The goal of the NHFS is to provide a comprehensive overview of a country’s health service delivery and is scheduled to be implemented every five-years. The second NHFS was conducted in 2021.

In addition to providing technical support in the design and implementation of these surveys, USAID has also funded capacity-building activities directed at the MOHP, local research organizations, and academia, to strengthen their expertise in: sampling, computer-assisted personal interviews (CAPI) or computer-assisted field interviews (CAFI), basic and advanced statistical analysis, report writing, and the use of geographic information systems. Until now, these surveys have been conducted with support from the USAID/Washington managed Demographic and Health Survey (DHS) Program, managed by a prime organization based in the USA, and the prime organization subcontracted the implementation of the Nepal NDHS and NHFS, to a local Nepali organization.

USAID/Nepal works across several sectors to address Nepal’s development challenges and support USAID/Nepal’s CDCS 2020–2025 goal of "A more self-reliant, prosperous, and inclusive Nepal that delivers improved democratic governance and health and education outcomes."

Addressing the cross-cutting principles of federalism, inclusion, and resilience, USAID/Nepal is working to achieve this goal through a set of four broad Development Objectives (DOs):

DO 1: More Effective, Participatory, and Equitable Democratic Ecosystem DO 2: Broad-Based and Inclusive Economic Growth Fostered DO 3: Inclusive Health & Education Systems Strengthened DO 4: More Equitable and Improved Natural Resources & Disaster Risk Management

USAID/Nepal’s Health Office is focused on achieving DO 3 through the three intermediate results shown in the results framework below. This activity is advancing IR 3.1, 3.2, 3.3 by providing high quality data and information to USAID and MOHP to make data-driven decisions to respond and address the needs within the health system.

Figure 1: USAID/Nepal CDCS 2020-2025 Results Framework

USAID/Nepal continues a long legacy of supporting Nepal’s health sector in the areas of family planning and reproductive health (FP/RH); maternal, neonatal, and child health (MNCH);

nutrition; human immuno-deficeiency virus (HIV); health system strengthening, including supply chain management, health financing, public financial management, and public health research and surveillance; air quality improvement; water, sanitation and hygiene (WASH); physical rehabilitation; and more recently, global health security (GHS). During the coronavirus disease-19 (COVID-19) pandemic, USAID/Nepal quickly mobilized its resources to support the GON’s COVID response. Currently, USAID/Nepal is funding 24 large- and small-scale health activities. USAID/Nepal’s health activities are implemented at the national level and in all seven provinces, covering 66 districts and over 500 municipalities. USAID/Nepal works with more than 900 public HFs and around 900 private sector HFs across the country.

USAID/Nepal recognizes the significant capacity that exists with local research organizations, and to further USAID’s principle of localization, which aims to increase direct funding to local entities in order to build sustainable local capacity and ownership of development programs, USAID/Nepal determined that this contract will be implemented by a local organization. To ensure quality and alignment with the standards of the global DHS Program, USAID/Nepal will also buy into the next round of USAID/Washington’s Global DHS Program (round 9), hereafter referred to as "DHS-9 Global,” to provide technical assistance (TA) to the local contractor, hereafter referred to as “the Contractor,” throughout the statement of work (SOW).

C.4 SCOPE OF WORK

The Contractor must design and implement the large, nationally representative 2025 NHFS and

2026 NDHS in Nepal. Throughout the design and implementation of the surveys, the Contractor must work closely with USAID/Nepal’s Health Office, the DHS-9 Global, the MOHP, the

Department of Health Services (DOHS), the National Planning Commission (NPC), the National

Statistics Office (NSO), Nepal Health Research Council (NHRC), provincial and local governments, the survey Steering Committees and the Technical Working Groups formed by the MOHP for executing these surveys.

C.4.1. 2025 Nepal Health Facility Survey: The 2025 NHFS will collect information from HFs in the country on the delivery of healthcare services and examine the preparedness of HFs to provide quality child health, family planning, maternal and newborn care, HIV, sexually transmitted infections (STIs), non-communicable diseases, and tuberculosis services. The specific objectives are to:

● Assess the availability of basic and essential services in Nepal’s HFs, including maternal and newborn care, child health, family planning and reproductive health, as well as services for non-communicable diseases and certain infectious diseases, including HIV, STIs, malaria, and tuberculosis.

● Assess the preparedness of HFs in Nepal to provide quality services.

● Provide a comprehensive and comparable body of information on the performance of different types of HFs that provide the basic and essential health services.

● Identify differences in service readiness among provinces, ecological regions, HF types, and managing authorities.

● Identify gaps in the support services, resources, and processes used to provide health services that may limit the ability of HFs to provide quality services.

● Describe the processes followed in the provision of basic and essential health care services and the extent to which accepted standards for quality service provision are met.

● Collect relevant data on the preparedness of the HFs to manage health emergencies.

● Advance analysis and synthesis of the NHFS data.

● Improve NHFS data use among stakeholders.

To fulfill the above objectives, the Contractor must provide the services listed below:

C.4.1-1 Survey design and finalization of SOW:

The DHS-9 Global will make an in-country visit (design visit) to Nepal to work with the Contractor to assist during consultations and the development of the SOW and provide TA to develop a sampling frame and finalize the sampling plan. The Contractor must:

● Carry out consultations with the MOHP, DOHS, the NHRC, hospital associations, USAID, health development partners, and other stakeholders as relevant to understand the data needs to be addressed in the 2025 NHFS. This process must harmonize the available resources and avoid duplicative efforts across the health development partners and GON. After the consultations, develop the 2025 NHFS SOW.

● During or immediately after the consultations, work with the MOHP to establish a 2025 NHFS Steering Committee (SC) comprising key GON stakeholders, USAID, health development partners, and other selected members as directed by the MOHP and USAID. The SC will endorse the scope of the survey and the final report.

● During or immediately after the consultations, work with the MOHP to establish a 2025 NHFS Technical Working Group (TWG) comprising key members of the MOHP, DOHS, USAID, health development partners, and other stakeholders. The TWG will be responsible for coordination, oversight, advice, and decision making with respect to all technical aspects of the survey implementation.

● Develop a survey sample frame using a secondary or primary data collection method and submit it to USAID. USAID will provide the final sampling size to the Contractor. The sample size will not change significantly from the 2021 NHFS.

● Obtain endorsement of the SOW for the 2025 NHFS, including the sampling, by both the 2025 NHFS SC and the 2025 NHFS TWG.

● Consult with USAID and procure necessary supplies and equipment at the time of the survey pretest and main survey training that meet the specifications provided by USAID.

C.4.1-2 Questionnaire adaptation, pretest and questionnaire finalization:

The DHS-9 Global will visit Nepal, to assist the Contractor in questionnaire adaptation, pre-test and finalization. The Contractor must:

● Co-create survey questionnaires with a range of stakeholders at the national and sub-national levels. Organize meetings and/or workshops to adapt the DHS-9 SPA core questionnaires, and the 2021 NHFS questionnaires, ensuring the data needs of Nepal’s health sector are met. This includes ensuring data needs of SDG 2030, NHS-SP 2023–2030, including USAID/Nepal CDCS 2020–2025, as applicable, are met in the questionnaires. If the 2025 NHFS is co-funded by other donors or organizations, ensure that their data needs are met.

● Adapt questionnaires in English and translate them into Nepali and other local languages as needed. USAID will provide a computer assisted personal interviews (CAPI) program to the Contractor.

● Recruit a pool of supervisors and train them for the pretest.

● Pretest the questionnaires. The pretest must be completed in an appropriate and adequate number of sites in consultation with the 2025 NHFS TWG.

● Modify the questionnaires incorporating the findings of the pretest. The final questionnaire must be endorsed by the 2025 NHFS SC and/or TWG.

C.4.1-4 Main training of field researchers:

Once the pretest is complete and necessary modifications are incorporated, DHS-9 Global will visit Nepal and participate in the training. The Contractor must:

● Recruit an adequate number of field researchers for data collection, considering the necessary technical qualifications as well as gender, language, geographic origin or residence, and other diverse social characteristics.

● Organize training for field researchers. The training must be of adequate duration, ensuring competency, employing a participatory approach, and should engage the TWG and the MOHP officials as needed.

● Make use of available information, communication, and technology (ICT) to ensure the quality (reliability and validity) of the data collected.

● Develop a field mobilization plan, including supervision and quality control plan for fieldwork. The supervision and quality control plan must ensure engagement of the SC, TWG, and provincial and local governments as relevant.

C.4.1-5 Data collection:

DHS-9 Global will provide remote technical assistance to the Contractor on monitoring data quality according to the DHS-9 Global requirements. The Contractor must:

● Mobilize field researchers for data collection.

● Conduct regular data quality checks and address issues as they arise throughout the data collection cycle. This includes using computer aided interviewing technologies, coupled with internet file streaming to support ongoing data quality review.

● Implement the supervision and quality control plan.

C.4.1-6 Data entry, verification, and cleaning:

Shortly after the fieldwork has started, USAID will provide the Census and Survey Processing System (CSPro) program for data entry to the Contractor. The Contractor must:

● Enter data in the CSPro program provided by USAID. Typically, data entry must be done with 100% verification.

● Use computer-aided interviewing technologies, coupled with internet file streaming, to support ongoing data quality reviews.

● Regularly and frequently, use field check tables to monitor the data collectors’ performance and identify potential issues impacting quality to immediately resolve.

C.4.1-7 2025 NHFS Key Indicators Report finalization and dissemination:

USAID will provide the clean data set to DHS-9 Global. DHS-9 Global will analyze the clean data set provided by USAID, draft the Key Indicators Report remotely, and submit it to USAID. USAID will provide the draft report to the Contractor. The Contractor must:

● Share the 2025 NHFS Key Indicator Report for feedback with the TWG or selected individuals as directed by the MOHP.

● Review the report, collect feedback from the TWG, share it with USAID for feedback, and finalize the report.

● Obtain SC and/or TWG approval for the Key Indicators Report.

● Work with the MOHP to disseminate the Key Indicators Report.

C.4.1-8 Data analysis and Tabulation Plan for 2025 NHFS Final Report:

USAID will provide a standard Tabulation Plan for the Final Report to the Contractor. The Contractor must:

● Share the Tabulation Plan with the TWG for feedback, ensure timely feedback from the TWG, and consolidate the feedback received.

● Coordinate with the MOHP and USAID to finalize the Tabulation Plan, ensuring that key indicators of the MOHP and USAID are included.

C.4.1-9 Report finalization and dissemination:

USAID will provide the final Tabulation Plan to DHS-9 Global. DHS-9 Global will analyze data as per the Tabulation Plan and submit it to USAID. USAID will provide the Tabulation Plan with analyzed data to the Contractor. DHS-9 Global will visit Nepal to participate in the Report Writing Workshop. The Contractor must:

● Work with the TWG to finalize participants for the report-writing workshop and arrange all logistics. Organize and facilitate the report-writing workshop.

● Ensure the report-writing workshop is participatory. After the workshop, submit the draft report to USAID.

● USAID will provide the final report to the Contractor. The Contractor must ensure the Final Report is endorsed by the SC.

Using the English dissemination materials provided by USAID, the Contractor must:

● Develop the necessary dissemination products in Nepali. The dissemination materials typically include a summary report in English, a summary report in Nepali, a flier in Nepali, a flier in English, infographics, and press releases in English and Nepali. Work with the MOHP to develop PowerPoint slides in English and Nepali targeting multiple audiences.

● Work with the MOHP and USAID to organize national- and provincial-level dissemination events. This includes planning, organizing, and facilitating the dissemination event, including logistics; and preparing the schedule and audio-visual materials for dissemination.

● After the DHS-9 Global removes all personally identifiable and other sensitive information from the 2025 NHFS data set, USAID will share it with the contractor to upload in the public domain. The Contractor must submit the data set to the MOHP, and help them upload it to the MOHP data portal as needed.

C.4.1-10 Journalist Workshop:

USAID will provide the resources (powerpoint slides, technical briefs, tentative agenda/schedule, facilitation guides) developed by DHS-9 Global to the Contractor. The Contractor must:

● In coordination with the MOHP, organize a workshop with health journalists to support them in developing media content covering the 2025 NHFS findings. Track DHS media coverage and report to USAID/Nepal.

C.4.1-11 Further analysis and data analysis workshop:

USAID will share the resources developed by DHS-9 Global to the Contractor to organize the Data Analysis workshop with USAID. DHS-9 Global will visit Nepal and assist the Contractor in conducting further analysis workshops. The Contractor must:

● Within 4-6 weeks of the national dissemination event, consult with the MOHP, DOHS, USAID, and other health sector partners to identify potential topics for further analysis.

In consultation with the MOHP and USAID, select 5–6 topics for further analysis.

● Within two months of finalizing the further analysis topics and in coordination with USAID, design, organize, and facilitate at least seven provincial level data analysis workshops for Nepali professionals from the MOHP and other relevant GON offices, health development partners, academia, local research firms, and other local organizations. The selection of the participants must be transparent and based on established criteria.

● Within one month of the completion of the data workshops, identify consultants suitable to conduct further analysis and initiate further analysis in close coordination with the MOHP. Engage the MOHP and interested health development partners in the further analysis process.

● Within 4 months of initiating the further analysis process, finalize all further analysis reports, organize a dissemination event, and ensure the reports are provided to the

MOHP.

C.4.2. 2026 Nepal Demographic and Health Survey (NDHS):

The 2026 NDHS will collect and disseminate accurate, nationally representative data on topics such as fertility, mortality, family planning, maternal and child health, gender, HIV/AIDS, nutrition, basic health services, and other priority topics. Information is collected through interviews with women and men, measurements of height and weight, and the collection of biological samples. The specific objectives are to:

● Collect data that will allow the calculation of demographic rates, particularly rates of fertility and childhood mortality, at the national level and for urban and rural strata of the population.

● Measure the level of contraceptive knowledge and practice, by method, at the national level, by urban/rural strata, three ecological zones (mountain, hill, and terai) and for each of the seven provinces.

● Collect data pertaining to the reproductive health of women (prenatal visits, place of birth, and assistance at delivery) and the health of their children (breastfeeding and supplementary feeding practices, immunizations, and the prevalence and treatment of childhood illnesses).

● Collect data on the knowledge of HIV, other STIs, and HIV/STI prevention behaviors of women and men.

● Collect data pertaining to maternal health and health care utilization.

● Measure hemoglobin levels (for anemia) in women and children.

● Assess the nutritional status (measure weight and height) of women and children.

● Collect data on blood pressure, disability, obstetric fistula, mental health, and uterus prolapse

● Advance analysis and synthesis of the NDHS data.

● Improve facilitation of NDHS data use among stakeholders.

To fulfill the above objectives, the Contractor must provide the services listed below:

C.4.2-1 Survey design and finalization of SOW:

DHS-9 Global will make a visit (design visit) to Nepal to work with the Contractor to assist during consultations and the development of the SOW and provide TA to develop a sampling frame and finalize the sampling plan. The Contractor must:

● Carry out consultations with the MOHP, DOHS, NHRC, NPC, NSO, USAID, health development partners, and other relevant stakeholders as relevant to understand the data needs to be addressed in the 2026 NDHS. This process must harmonize the available resources and avoid duplicative efforts across the health development partners and GON. After the consultations, develop the 2026 NDHS SOW.

● During or immediately after the consultations, work with the MOHP to establish a 2026 NDHS SC comprising key GON stakeholders, USAID, health development partners, and other selected members as directed by the MOHP and USAID. The SC will endorse the scope of the survey and the final report.

● During or immediately after the consultations, work with the MOHP to establish a 2026 NDHS TWG comprising key members of the MOHP, DOHS, USAID, health development partners, and other stakeholders. The TWG will be responsible for coordination, oversight, advice, and decision making with respect to all technical aspects of the survey implementation.

● Coordinate with the MOHP and NSO to identify the survey sample frame enumeration areas to be included in the sample using a secondary or primary data collection method, and submit to USAID. The sample size will be similar to that of the 2022 NDHS. USAID will provide the sampling plan including sample size to the Contractor. Obtain endorsement of the SOW for the 2026 NDHS, including the sampling plan, sample size from the 2026 NDHS SC and/or TWG.

● Consult with USAID and procure necessary supplies and equipment for the survey pretest and main survey training.

C.4.2-2 Questionnaire adaptation and computer assisted personal interviews programming:

USAID will provide the CAPI to the Contractor, and the Contractor must:

● Co-create survey questionnaires with a range of stakeholders at the national and sub-national levels. Organize meetings and/or workshops to adapt the DHS-9 Global core questionnaires and the 2022 NDHS questionnaires, ensuring the data needs of Nepal’s health sector are met. This includes ensuring the data needs of SDG 2030, NHS-SP 2023–2030, and USAID/Nepal CDCS 2020–2025, as applicable, are met in the questionnaires.

● Adapt the questionnaires in English and translate them into Nepali and other local languages, as needed. Develop a new Nepal specific module if there is a need. The questionnaires must be endorsed by the respective 2026 NDHS SC or TWG for field testing.

● DHS-9 Global will develop the CAPI. The Contractor must assist DHS-9 Global to develop the CAPI program for NDHS questionnaires.

C.4.2-3 Household Mapping and Listing:

After DHS-9 Global designs the household mapping and listing, the Contractor must:

● Identify and train a pool of individuals to conduct household mapping and listing.

● Mobilize the trained individuals, visit the sampled clusters, and list and map all households using the standard DHS procedures.

● Use Geo-enabled listing and mapping technology.

C.4.2-4 Pretest and questionnaire finalization:

Following the questionnaire adaptation, DHS-9 Global will visit Nepal to assist the Contractor during pretest of the questionnaires and training. The Contractor must:

● Recruit a pool of supervisors and train them for the pretest.

● Pre-test the questionnaires. The pretest must be completed at an appropriate and adequate number of sites in consultation with the 2026 NDHS TWG, and as per the standard DHS procedures.

● Modify the survey questionnaires incorporating the findings of the pretest. The final questionnaire must be endorsed by the 2026 NDHS SC and/or TWG.

C.4.2-5 Main training of field researchers:

DHS-9 Global will visit Nepal, participate in the training, and develop the Census and Survey Processing System (CSPro) program for data entry which USAID will provide to the Contractor.

Once the pretest is complete and necessary modifications are incorporated, the Contractor must:

● Recruit an adequate number of field researchers for data collection, considering the necessary technical qualifications as well as gender, language, geographic origin or residence, and other diverse social characteristics.

● Organize training for field researchers. The training must be of adequate duration, ensuring competency, employing a participatory approach, and should engage the TWG and the MOHP officials as needed.

● Make use of available information, communication, and technology (ICT) to ensure the quality (reliability and validity) of the data collected.

● Develop a field mobilization plan, including supervision and quality control plan for fieldwork. The supervision and quality control plan must ensure engagement of the SC, TWG, and provincial and local governments as relevant.

C.4.2-6 Data Collection:

After DHS-9 Global provides remote technical assistance to the Contractor on monitoring data quality according to the DHS-9 requirements, the Contractor must:

● Mobilize field researchers for data collection.

● Conduct regular data quality checks and address issues as they arise throughout the data collection cycle. This includes using computer aided interviewing technologies, coupled with internet file streaming to support ongoing data quality review.

● Implement the supervision and quality control plan.

C.4.2-7 Data entry, verification, and cleaning:

DHS-9 Global will provide remote support in monitoring of data processing/cleaning. Shortly after the fieldwork has started, the Contractor must:

● Enter data in a CSPro or other program provided by USAID. Typically, data entry must be done with 100% verification.

● Use computer-aided interviewing technologies, coupled with internet file streaming, to support ongoing data quality reviews.

● Regularly and frequently, use field check tables to monitor the data collectors’ performance and identify potential issues impacting quality to immediately resolve.

C.4.2-8 2026 NDHS Key Indicators Report finalization and dissemination:

After USAID provides the draft Key Indicators Report to the Contractor, the Contractor must:

● Share the 2025 NDHS Key Indicator Report for feedback with the TWG or selected individuals as directed by the MOHP.

● Review the report, collect feedback from the TWG, share it with USAID for finalization of the report.

● Obtain SC and/or TWG approval for the Key Indicators Report.

● Work with the MOHP and USAID to disseminate the Key Indicators Report.

C.4.2-9 Data analysis and Tabulation Plan for 2026 NDHS final report:

USAID will provide the Tabulation Plan for the Final Report, and the Contractor must:

● Share the Tabulation Plan with the TWG for feedback, ensure timely feedback from the TWG, consolidate the feedback received, and provide it to USAID.

● Coordinate with MOHP to finalize the Tabulation Plan, ensuring that key indicators of the MOHP and USAID are included.

C.4.2-10 Report finalization and dissemination:

USAID will provide analyzed data as per the finalized Tabulation Plan. DHS-9 Global will visit Nepal to support the Contractor in organizing the report writing workshop. The Contractor must:

● Work with the TWG to finalize participants for the report-writing workshop and arrange all logistics. Organize and facilitate the report-writing workshop Ensure the report-writing workshop is participatory. After the workshop, continue coordinating with the MOHP and USAID to finalize the Report.

● Ensure the Final Report is endorsed by the SC.

● Work with the TWG to agree on the final dissemination products.The dissemination materials typically include a summary report in English, a summary report in Nepali, a flier in Nepali, a flier in English, infographics, and press releases in English and Nepali.

USAID will provide an English version of all the agreed dissemination products to the Contractor.

The Contractor must:

● Work with the MOHP to develop PowerPoint slides in English and Nepali and translate the relevant dissemination products in Nepali targeting multiple audiences.

● Work with the MOHP and USAID to organize national- and provincial-level dissemination events.

● USAID will provide the final data set removing all personal identifiable and other sensitive information. The Contractor must submit the final NDHS data set to the MOHP, and help them upload it to the MOHP data portal as needed. The Contractor must also assist MHP to upload the NDHS report and other dissemination products in MOHP’s website.

C.4.2-11 Journalist Workshop:

USAID will provide resources for organizing the journalist and DHS-9 Global will provide remote technical assistance in planning the workshop. The Contractor must:

● In coordination with the MOHP, organize a workshop with health journalists to support them in developing media content from the 2026 NDHS findings. Track the media coverage, and report to USAID/Nepal.

C.4.2-12 Further Analysis of 2026 NDHS and Data Analysis Workshop:

The Contractor must:

● Within 4-6 weeks of the national dissemination event, consult with the MOHP, DOHS, USAID, and other health sector partners to identify potential topics for further analysis.

In consultation with the MOHP and USAID, select 5–6 topics for further analysis.

DHS-9 Global will visit Nepal and provide technical assistance to the Contractor in designing and organizing the Data Analysis Workshops. The Contractor must:

● Within two months of finalizing the further analysis topics, design and organize at least seven provincial data analysis workshops for Nepali professionals from the MOHP and other relevant GON offices, health development partners, academia, local research firms, and other local organizations. The selection of the participants must be transparent and based on established criteria. Facilitate the workshop and manage all logistics.

● Within one month of the completion of the data workshop, identify consultants suitable to conduct further analysis and initiate further analysis in close coordination with the MOHP . Engage the MOHP and interested health development partners in the further analysis process.

● Within 4 months of initiating the further analysis process, finalize all further analysis reports, organize a dissemination event, and ensure the reports are provided to the

MOHP.

C.5 SPECIAL REQUIREMENTS

C.5.1 Collaboration with Global Demographic and Health Surveys (DHS) Round 9

The Contractor must collaborate with the Global Demographic and Health Survey Round 9 activity throughout implementation as directed by the COR. All the deliverables submitted by the Contractor must meet DHS-9 requirements.

C.5.2 Gender and Inclusive Development Considerations

USAID activities must comply with USAID gender and inclusive development policies, including, but not limited to, the USAID Disability Policy, the USAID 2023 Gender Equality and Women’s Empowerment Policy, the Youth in Development Policy, the Democracy, Human Rights, and Governance Strategy, the Lesbian, Gay, Bisexual, Transgender (LGBT) Vision for Action, and the Nondiscrimination for Beneficiaries Policy. The USAID 2023 Gender Equality and Women’s Empowerment Policy provides the vision for USAID’s work to advance gender equality and women’s empowerment around the world. The policy establishes the strategic objectives, guiding principles, and driving investments across all operations and programs to achieve these aims. USAID reaffirms that gender equality and women and girls’ empowerment are fundamental to the realization of human rights and key to effective and sustainable development outcomes. For societies to thrive, women and girls, men and boys, and gender-diverse individuals must have the agency, social support, and structures to make their own choices and live free from violence and abuse. They must have equal rights and opportunities, as well as equal and safe access to and control over resources. Achieving gender equality in society will improve the overall quality of life for all people throughout their lives. As such, USAID/Nepal recognizes that gender equality and female empowerment are fundamental to effective and sustainable development outcomes.

Although many gender gaps have narrowed over the years in Nepal, substantial inequalities remain across every health area. The Contractor must provide the data and analysis necessary for understanding gender and other social and economic disparities and trends (i.e., stagnating, regressing, progressing) related to health, including the continuation of data collection on women’s empowerment, age at marriage, domestic violence, women's experience of gender-based violence, skewed sex ratios at birth, men’s health service utilization, including vasectomy, HIV testing and more. In addition, the Contractor must assess access to quality health services, and the clients’ experience of care for men and women of different age, caste, and economic groups, etc. The Contractor will also investigate the collection and utilization of https://www.usaid.gov/inclusivedevelopment/disability-policy#:~:text=USAID%20is%20committed%20to%20the,outreach%20to%20persons%20with%20disabilities.

https://reliefweb.int/report/world/2023-gender-equality-and-womens-empowerment-policy?gad_source=1&gclid=Cj0KCQiAhomtBhDgARIsABcaYym0x9aWC9oez8G64exxosfVTvXYXhOSJzvOudaSdB-B2xCGCGEnDFkaAviQEALw_wcB https://reliefweb.int/report/world/2023-gender-equality-and-womens-empowerment-policy?gad_source=1&gclid=Cj0KCQiAhomtBhDgARIsABcaYym0x9aWC9oez8G64exxosfVTvXYXhOSJzvOudaSdB-B2xCGCGEnDFkaAviQEALw_wcB https://www.usaid.gov/policy/youth https://reliefweb.int/report/world/usaid-strategy-democracy-human-rights-and-governance?gad_source=1&gclid=Cj0KCQiAhomtBhDgARIsABcaYylwjtbAPdV2etLxRgahq2GeqcJdPfvSEAvr6EA788YLQwhPafjJhooaAkowEALw_wcB https://reliefweb.int/report/world/usaid-strategy-democracy-human-rights-and-governance?gad_source=1&gclid=Cj0KCQiAhomtBhDgARIsABcaYylwjtbAPdV2etLxRgahq2GeqcJdPfvSEAvr6EA788YLQwhPafjJhooaAkowEALw_wcB https://pdf.usaid.gov/pdf_docs/pbaaa689.pdff_docs/pbaaa689.pdf https://www.usaid.gov/sites/default/files/2022-05/200mab.pdf https://reliefweb.int/report/world/2023-gender-equality-and-womens-empowerment-policy?gad_source=1&gclid=Cj0KCQiAhomtBhDgARIsABcaYym0x9aWC9oez8G64exxosfVTvXYXhOSJzvOudaSdB-B2xCGCGEnDFkaAviQEALw_wcB https://reliefweb.int/report/world/2023-gender-equality-and-womens-empowerment-policy?gad_source=1&gclid=Cj0KCQiAhomtBhDgARIsABcaYym0x9aWC9oez8G64exxosfVTvXYXhOSJzvOudaSdB-B2xCGCGEnDFkaAviQEALw_wcB new types of data to meet emerging needs. The Contractor must assess gender and inclusive development impacts in both the NHFS and NDHS. Both surveys’ population-level data must include variables to analyze data by social characteristics such as age, sex, caste or ethnicity, wealth quintiles, provinces, and geography, etc., as applicable.

Under the further analysis activities, the Contractor must conduct multivariate and in-depth analyses of data to understand a variety of issues related to gender equality and female empowerment, including, for example, factors influencing gender and caste/ethnicity disparities and their programmatic implications, relationship dynamics that shape health behaviors and access to services, the contribution of gender attitudes and beliefs to health behaviors and service use, and the role of domestic violence in health outcomes.

The Contractor must continue to increase the opportunities and capabilities of women and men equitably, by deliberately training and hiring women to be managers as well as survey fieldwork staff. The Contractor will continue to build the capacity of women and men in Nepal to design and implement surveys, as well as to analyze, disseminate, and use the survey data and findings, especially those related to gender equality and women's empowerment. Finally, the Contractor must adhere to the survey ethical guidelines to recognize gender-based dangers, the need to protect interviewees and interviewers, and to ensure confidentiality.

C.5.3 Diversity, Equity, Inclusion, and Accessibility (DEIA)

The Contractor must consider DEIA in all aspects of this activity. The Contractor must employ DEIA approaches within their organizations and assignments, and with the people and communities they work with, supported by USAID. USAID/Nepal’s working definition of DEIA is as follows: "Diversity is the practice of including many communities, identities, races, ethnicities, backgrounds, abilities, cultures, and beliefs. Equity is the consistent, systematic, fair, just, and impartial treatment of all individuals. Inclusion is the recognition, appreciation, and use of the talents and skills of employees of all backgrounds.