SOL-615-14-000013_Afya_Jijini_ _Pwani.pdf

RFP Issuance Date: November 24, 2014 Questions due date: December 8, 2014, 08:00 AM Nairobi local time RFP Closing date: January 12, 2015, 08:00 AM Nairobi local time

SUBJECT: Request for Proposals (RFP) No. SOL-615-14-000013

Afya Jijini (Nairobi) program and Afya Pwani (Coast) program in Kenya

Dear Potential Offerors:

The United States Government, represented by the U.S Agency for International Development in Kenya (USAID/Kenya), is seeking proposals from qualified companies and organizations for the implementation of the Afya Jijini (Nairobi) program and the Afya Pwani (Coast) program in Kenya as stipulated in the attached solicitation.

This procurement is conducted through full and open competition, under which any type of organization (large or small commercial [for profit] firms, educational institutions, non-profit organizations) is eligible to compete.

Subject to availability of funds, the Government plans to award two separate Cost-Plus-Fixed- Fee (CPFF) completion type contracts - one for the Afya Jijini program and one for the Afya Pwani program - for anticipated base periods of three years with two option periods of one year each.

The maximum overall estimated cost of this procurement is $86-$88 million. The Afya Jijini Program is estimated to be in the range of $34-$35 million (total costs and fee, if any). The Afya Pwani program is estimated to be in the range of $52-53 million (total costs and fee, if any). The Government is in no way obligated to make an award within this range. Revealing the cost range for the contract does not mean that Offerors should strive to meet the maximum amount; rather, Offerors should propose costs that are appropriate, realistic and reasonable, and in accordance with the proposed approach for achieving results. Cost proposals will be evaluated as part of a best value determination.

All amendments to this solicitation will be made available through the Federal Business Opportunities website at http://www.fbo.gov. It is an Offeror’s responsibility to check this site periodically for official updates and amendments to the solicitation.

Any questions regarding the RFP’s requirements must be submitted via e-mail to Camille Hasha at chasha@usaid.gov and Rose Kinuthia at rkinuthia@usaid.gov, by no later than the date and time listed at the top of this letter. Answers to questions from potential Offerors will be published on www.fbo.gov as an amendment to the solicitation.

Proposals must be received electronically on or before the closing date and time stipulated above. Proposals must be sent via e-mail to chasha@usaid.gov and rkinuthia@usaid.gov and http://www.fbo.gov/ mailto:chasha@usaid.gov mailto:rkinuthia@usaid.gov http://www.fbo.gov/ must conform to all requirements outlined herein. Receipt time is when the proposal is received by the USAID internet server. Proposals submitted in response to this solicitation must be valid for 180 calendar days.

This RFP does not obligate the United States Government to award a contract, nor does it commit USAID to pay for any costs incurred in the preparation or submission of proposals.

USAID reserves the right to award this contract without discussions and any resultant contract is subject to the availability of funds.

Sincerely, Linda McElroy Supervisory Contracting Officer

7. ISSUED BY CODE

NOTE: In sealed bid solicitations "offer" and "offeror" mean "bid" and "bidder".

SOLICITATION

9. Sealed offers in original and --- copies for furnishings the supplies or services in the Schedule will be received at the place specified in item 8, or if hand carried, in the depository located in until 8 am local time 01/12/2015

(Hour) (Date) CAUTION - LATE Submissions, Modifications, and Withdrawals: See Section L, Provision No. 52.214-7 or 52.215-1. All offers are subject to all terms and conditions contained in this solicitation.

11. TABLE OF CONTENTS

(X) SEC. DESCRIPTION PAGE(S) (X) SEC. DESCRIPTION PAGE(S)

PART I - THE SCHEDULE PART II - CONTRACT CLAUSES

A SOLICITATION/CONTRACT FORM 3 I CONTRACT CLAUSES 100

B SUPPLIES OR SERVICES AND PRICES/COSTS 8 PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACH.

C DESCRIPTION/SPECS./WORK STATEMENT 11 J LIST OF ATTACHMENTS 112

D PACKAGING AND MARKING 53 PART IV - REPRESENTATIONS AND INSTRUCTIONS

E INSPECTION AND ACCEPTANCE 55

K

REPRESENTATIONS, CERTIFICATIONS AND OTHER

STATEMENTS OF OFFERORS 113

F DELIVERIES OR PERFORMANCE 56

G CONTRACT ADMINISTRATION DATA 73 L INSTRS., CONDS., AND NOTICES TO OFFERORS 128

H SPECIAL CONTRACT REQUIREMENTS 76 M EVALUATION FACTORS FOR AWARD 139

OFFER (Must be fully completed by offeror)

NOTE: Item 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period.

12. In compliance with the above, the undersigned agrees, if this offer is accepted within calendar days (60 calendar days unless a different period is inserted by the offeror) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the set opposite each item, delivered at the designated point(s), within the time specified in the schedule.

13. DISCOUNT FOR PROMPT PAYMENT

(See Section I, Clause No. 52.232-8)

10 CALENDAR DAYS (%) 20 CALENDAR DAYS (%) 30 CALENDAR DAYS (%) CALENDAR DAYS(%)

14. ACKNOWLEDGMENT OF AMENDMENTS

(The offeror acknowledges receipt of amendments to the SOLICITATION for offerors and related documents numbered and dated):

AMENDMENT NO. DATE AMENDMENT NO. DATE

15A. NAME AND

ADDRESS

OF OFFER-

OR

CODE FACILITY 16. NAME AND THE TITLE OF PERSON AUTHORIZED TO SIGN OFFER

(Type or print)

15B. TELEPHONE NUMBER 15C. CHECK IF REMITTANCE ADDRESS IS

DIFFERENT FROM ABOVE - ENTER SUCH

ADDRESS IN SCHEDULE.

17. SIGNATURE 18. OFFER DATE

AREA CODE NUMBER EXT.

AWARD (To be completed by Government)

19. ACCEPTED AS TO ITEMS 20. AMOUNT 21. ACCOUNTING AND APPROPRIATION

See Section G.7: Accounting and Appropriation Data

22. AUTHORITY FOR USING OTHER THAN FULL OPEN COMPETITION:

10 U.S.C. 2304 (c) 41 U.S.C. 253 (c)

23. SUBMIT INVOICES TO ADDRESS SHOWN IN

(4 copies unless otherwise specified)

ITEM

24. ADMINISTERED BY (If other than Item 7) 25. PAYMENT WILL BE MADE BY CODE The Controller, Regional Financial Management Services USAID/East Africa

P. O. Box 629, Village Market, 00621 - Nairobi, Kenya.

Email:nairobirfmspayments@usaid.gov

26. NAME OF CONTRACTING OFFICER (Type or print)

Linda McElroy

27. UNITED STATES OF AMERICA

(Signature of Contracting Officer)

28. AWARD DATE

IMPORTANT - Award will be made on this Form, or on Standard Form 26, or by other authorized official written notice.

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition is unusable

STANDARD FORM 33 (REV,. 9-97)

Prescribed by GSA - Far (48 CFR) 53.214 (c)

SOLICITATION, OFFER AND AWARD 1. THIS CONTRACT IS A RATED ORDER

UNDER DPAS (15 CFR 7900)

RATING PAGE OF PAGES

1 147

2. CONTRACT NUMBER 3. SOLICITATION NUMBER

SOL-615-14-000013

4. TYPE OF SOLICITATION

SEALED BID (IFB)

NEGOTIATED (RFP)

5. DATE ISSUED

11/24/2014

6. REQUISITION/PURCHASE NUMBER

REQ-615-14-000198 &

REQ-615-14-000199

8. ADDRESS OFFER TO (If other than item 7)

10. FOR

INFORMATION

CONTACT:

A. NAME

Rose Kinuthia

B. TELEPHONE (NO COLLECT CALLS) C. E-MAIL ADDRESS

rkinuthia@usaid.gov

AREA CODE

NUMBER

EXT.

(electronically) mailto:rkinuthia@usaid.gov

Request for Proposals # SOL-615-14-000013, Afya Jijini (Nairobi) and Afya Pwani (Coast) programs in Kenya

TABLE OF CONTENTS

PART I – THE SCHEDULE

SECTION B – SUPPLIES OR SERVICES AND PRICE/COSTS

B.1. PURPOSE

B.2. CONTRACT TYPE

B.3. ESTIMATED COST, FIXED FEE AND OBLIGATED AMOUNT

B.4. CONTRACT BUDGET

B.5. INDIRECT COSTS

B.6. CEILING ON INDIRECT COST RATES

B.7. MULTI-YEAR CONTRACT

SECTION C – STATEMENT OF WORK

C.1. PROGRAM TITLE

C.2. LIST OF ACRONYMS AND DEFINITIONS

C.3. OBJECTIVE

C.4. SCOPE AND MISSION

C.5. BACKGROUND

C.6. RATIONALE AND RELATIONSHIP WITH GoK PLANS AND PRIORITIES

C.7. RESULTS FRAMEWORK

C.8. GRANTS UNDER CONTRACT

C.9.a AFYA JIJINI C.9.b AFYA PWANI

C.10. ADAPTABILITY, FLEXIBILITY, AND RESPONSIVENESS

SECTION D – PACKAGING AND MARKING

D.1. AIDAR 752.7009 MARKING (JAN 1993)

D.2. BRANDING POLICY

D.3. BRANDING STRATEGY AND MARKING PLAN

SECTION E – INSPECTION AND ACCEPTANCE

E.1. NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE

E.2. INSPECTION AND ACCEPTANCE

SECTION F – DELIVERIES OR PERFORMANCE

F.1. NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE

F.2. PERIOD OF PERFORMANCE

F.3. PLACE OF PERFORMANCE

F.4. TECHNICAL DIRECTION AND DESIGNATION OF RESPONSIBLE USAID OFFICIALS 56

F.5. KEY PERSONNEL

F.6. REPORTING REQUIREMENTS

F.7. REPORTING FORMAT

F.8. DELIVERABLES (PERFORMANCE TARGETS)

F.9. PERFORMANCE STANDARDS

F.10. AIDAR 752.242-70 PERIODIC PROGRESS REPORTS (OCT 2007)

F.11. AIDAR 752.7005 SUBMISSION REQUIREMENTS FOR DEVELOPMENT EXPERIENCE

DOCUMENTS (SEPTEMBER 2013) (Class Deviation OAA-DEV-13-01c)

SECTION G – CONTRACT ADMINISTRATION DATA

Request for Proposals # SOL-615-14-000013, Afya Jijini (Nairobi) and Afya Pwani (Coast) programs in Kenya

G.1. ADMINISTRATIVE CONTRACTING OFFICE

G.2. CONTRACTING OFFICER’S AUTHORITY

G.3. CONTRACTING OFFICER’S REPRESENTATIVE (COR)

G.4. CONTRACTOR’S PRIMARY POINT OF CONTACT

G.5. PAYING OFFICE

G.6. AIDAR 752.7003 DOCUMENTATION FOR PAYMENT (NOV 1998)

G.7. ACCOUNTING AND APPROPRIATION DATA

SECTION H – SPECIAL CONTRACT REQUIREMENTS

H.1. NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE

H.2. AIDAR 752.7034 – ACKNOWLEDGMENT AND DISCLAIMER (DEC 1991)

H.3. AIDAR 752.225-70 – SOURCE AND NATIONALITY REQUIREMENTS (FEB 2012)

(CLASS DEVIATION NO. OAA-DEV-12-01C)

H.4. LANGUAGE REQUIREMENTS

H.5. GOVERNMENT FURNISHED FACILITIES OR PROPERTY

H.6. CONTRACTOR’S STAFF SUPPORT, AND ADMINISTRATIVE AND LOGISTICS

ARRANGEMENTS

H.7. AUTHORIZED GEOGRAPHIC CODE

H.8. ENVIRONMENTAL COMPLIANCE

H.9. CONFIDENTIALITY AND OWNERSHIP OF INTELLECTUAL PROPERTY

H.10. MOBILIZATION REQUIREMENTS

H.11. AIDAR 752.228-70 MEDICAL EVAUCATION (MEDEVAC) SERVICES (JULY 2007)

H.12. AUTHORIZED WORK WEEK

H.13. AIDAR 752.231-71 – SALARY SUPPLEMENTS FOR HG EMPLOYEES (OCT 1998)

H.14. ADS 302.3.5.5 – REPORTING OF FOREIGN TAXES (JUL 2007)

H.15. NONDISCRIMINATION (JUNE 2012)

H.16. USAID DISABILITY POLICY – ACQUISITION (DEC 2004)

H.17. HOMELAND SECURITY PRESIDENTIAL DIRECTIVE – 12

H.18. STANDARDS OF CONDUCT – IMPROPER BUSINESS PRACTICES

H.19. PROHIBITION ON THE PROMOTION OR ADVOCACY OF THE LEGALIZATION OR

PRACTICE OF PROSTITUTION OR SEX TRAFFICKING (SEPTEMBER 2014)

H.20. AIDAR 752.7025 APPROVALS (APR 1984)

H.21. AIDAR 752.7032 INTERNATIONAL TRAVEL APPROVAL AND NOTIFICATION

REQUIREMENTS (APR 2014) (Class Deviation OAA-DEV-14-01c)

H.22. CONTRACTOR’S USE OF PROJECT VEHICLES AND LIABILITY INSURANCE

REQUIREMENTS FOR PRIVATELY OWNED VEHICLES

H.23. DISCLOSURE OF INFORMATION

H.24. COMPLIANCE WITH THE TRAFFICKING VICTIMS PROTECTION

REAUTHORIZATION ACT

H.25. AIDAR 752.245-71 TITLE TO AND CARE OF PROPERTY (APRIL 1984)

H.26. AIDAR 752.7007 PERSONNEL COMPENSATION (JULY 2007)

H.27. SUBCONTRACTING

H.28. CONDOMS (ACQUISITION) (SEPTEMBER 2014)

H.29. CONSCIENCE CLAUSE IMPLEMENTATION (ACQUISITION) – SOLICITATION

PROVISION (FEBRUARY 2012)

H.30. 752.7004 EMERGENCY LOCATOR INFORMATION (JUL 1997)

H.31. 752.7001 BIOGRAPHICAL DATA (JULY 1997)

H.32. INSURANCE AND SERVICES

H.33. FOREIGN GOVERNMENT DELEGATIONS TO INTERNATIONAL CONFERENCES

(JAN 2002)

Request for Proposals # SOL-615-14-000013, Afya Jijini (Nairobi) and Afya Pwani (Coast) programs in Kenya

H.34. 752.7101 VOLUNTARY POPULATION PLANNING ACTIVITIES (JUN 2008)

H.35. GOVERNMENT OF KENYA LABOR MARKET POLICY (FOR WORK WITHIN

KENYA)

H.36. AIDAR 722.170 EMPLOYMENT OF THIRD COUNTRY NATIONALS (TCN’S) AND

COOPERATING COUNTRY NATIONALS (CCN’S)

H.37. ELECTRONIC PAYMENTS SYSTEM

H.38. CONFERENCE PLANNING AND REQUIRED APPROVALS (August 2013)

H.39. USAID IMPLEMENTATION OF SECTION 508 OF THE REHABILITATION ACT OF 1973

AND FEDERAL ACQUISITION CIRCULAR (FAC) 97-27 "ELECTRONIC AND

INFORMATION TECHNOLOGY ACCESSIBILITY

H.40. PROHIBITION OF ASSISTANCE TO DRUG TRAFFICKERS

H.41. GENDER CONSIDERATION

H.42. GRANTS UNDER CONTRACT

H.43. LIMITATION ON SUBCONTRACTING TO NON-LOCAL ENTITIES (JULY 2014)

H.44. 302.3.5.21 USAID IMPLEMENTING PARTNER NOTICES (IPN) PORTAL FOR

ACQUISITION (JULY 2014)

H.45. REPRESENTATION BY CORPORATION REGARDING A DELINQUENT TAX LIABILITY

OR A FELONY CRIMINAL CONVICTION (Deviation OAA-DEV-14-02c) (August 2014)

PART II ‐ CONTRACT CLAUSES

SECTION I – CONTRACT CLAUSES

I.1. NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE

I.2. 52.252‐2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

I.3. 52.204-1 APPROVAL OF CONTRACT (DEC 1989)

I.4. 52.203‐13 CONTRACTOR CODE OF BUSINESS ETHICS AND CONDUCT (APR 2010) .. 103

I.5. 52.209‐9 UPDATES OF PUBLICLY AVAILABLE INFORMATION REGARDING

RESPONSIBILITY MATTERS (JULY 2013)

I.6. 52.232-40 PROVIDING ACCELERATED PAYMENTS TO SMALL BUSINESS

SUBCONTRACTORS (DEC 2013)

I.7. 52.232-22 LIMITATION OF FUNDS (APR 1984)

I.8. 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

I.9. 52.215-20 – REQUIREMENTS FOR CERTIFIED COST OR PRICING DATA AND DATA

OTHER THAN CERTIFIED COST OR PRICING DATA (OCT 2010)

I.10. 52.247-67 SUBMISSION OF TRANSPORTATION DOCUMENTS FOR AUDIT

(FEB 2006)

I.11. 752.219-70 USAID MENTOR- PROTÉGÉ PROGRAM (JUL 2007)

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

SECTION J – LIST OF DOCUMENTS EXHIBITS AND OTHER ATTACHMENTS

PART IV – REPRESENTATIONS AND INSTRUCTIONS

SECTION K – REPRESENTATIONS, CERTIFICATIONS AND OTHER STATEMENTS OF

OFFERORS OR RESPONDENTS

K.1. NOTICE LISTING SOLICITATION PROVISIONS INCORPORATED BY REFERENCE ... 113

Request for Proposals # SOL-615-14-000013, Afya Jijini (Nairobi) and Afya Pwani (Coast) programs in Kenya

K.2. 52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS (NOV 2014)

K.3. INSURANCE - IMMUNITY FROM TORT LIABILITY

K.4. AGREEMENT ON, OR EXCEPTIONS TO, TERMS AND CONDITIONS

K.5. 52.209-5 CERTIFICATION REGARDING RESPONSIBILITY MATTERS (APR 2010)

K.6. 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (JUL 2013)

K.7. 52.215-6 PLACE OF PERFORMANCE (OCT 1997)

K.8. 52.219-22 SMALL DISADVANTAGED BUSINESS STATUS (OCT 1999)

K.9. 52.222-22 PREVIOUS CONTRACTS AND COMPLIANCE REPORTS (FEB 1999)

K.10. 52.222-25 AFFIRMATIVE ACTION COMPLIANCE (APR 1984)

K.11. 52.225-25 PROHIBITION ON CONTRACTING WITH ENTITIES ENGAGING IN

SANCTIONED ACTIVITIES RELATING TO IRAN--REPRESENTATION AND

CERTIFICATION (DEC 2012)

K.12. 52.227-15 REPRESENTATION OF LIMITED RIGHTS DATA AND RESTRICTED

COMPUTER SOFTWARE (DEC 2007)

K.13. 52.230-1 COST ACCOUNTING STANDARDS NOTICES AND CERTIFICATION

(MAY 2012)

K.14. 52.230-7 PROPOSAL DISCLOSURE – COST ACCOUNTING PRACTICE CHANGES

(APR 2005)

K.15. AIDAR 752.226-1 – DISADVANTAGED ENTERPRISE REPRESENTATION (APR 1991) 126

K.16. SIGNATURE

K.17. AGREEMENT ON OR EXCEPTIONS TO, TERMS AND CONDITIONS

SECTION L – INSTRUCTIONS, CONDITIONS, AND NOTICES TO OFFERORS

L.1. NOTICE LISTING SOLICITATION PROVISIONS INCORPORATED BY REFERENCE ... 128

L.2. 52.216-1 – TYPE OF CONTRACT (APR 1984)

L.3. 52.233-2 – SERVICE OF PROTEST (SEPT 2006)

L.4. GENERAL INSTRUCTIONS TO OFFERORS

L.5. SUBMISSION/DELIVERY INSTRUCTIONS

L.6. INSTRUCTIONS FOR PREPARATION OF THE TECHNICAL PROPOSAL

L.7. INSTRUCTIONS FOR PREPARATION AND SUBMISSION OF THE COST PROPOSAL . 135

L.8. BRANDING AND MARKING PLAN

SECTION M – EVALUATION FACTORS FOR AWARD

M.1. GENERAL INFORMATION

M.2. TECHNICAL EVALUATION CRITERIA

M.3. COST EVALUATION

M.4. 52.217-5 EVALUATION OF OPTIONS (JULY 1990)

M.5. PAST PERFORMANCE INFORMATION

M.6. DETERMINATION OF COMPETITIVE RANGE

M.7. SOURCE SELECTION

ATTACHMENTS

Request for Proposals # SOL-615-14-000013, Afya Jijini (Nairobi) and Afya Pwani (Coast) Programs in Kenya

PART I – THE SCHEDULE

SECTION B – SUPPLIES OR SERVICES AND PRICE/COSTS

B.1. PURPOSE

The purpose of the [Afya Jijini or Afya Pwani] program is to improve and increase access and utilization of quality health services in Kenya through strengthened service delivery and institutional capacity of county health systems, as described in detail in Section C, the Statement of Work.

B.2. CONTRACT TYPE

This is a Cost-Plus-Fixed-Fee (CPFF) completion type contract. For the consideration set forth below, the Contractor must achieve the performance objectives and deliverables or outputs described in Sections C and F, and otherwise comply with all contract requirements.

B.3. ESTIMATED COST, FIXED FEE AND OBLIGATED AMOUNT

(a) The estimated cost for the performance of the work required hereunder, exclusive of fixed fee, if any, is $TBD. The fixed fee, if any, is $TBD. The estimated cost plus fixed fee, if any, is $TBD.

(b) Within the estimated cost plus fixed fee amount specified in paragraph (a) above, the amount currently obligated and available for reimbursement of allowable costs incurred by the Contractor (and payment of fee, if any) for performance of the contract period hereunder is $TBD. The Contractor must not exceed the aforesaid obligated amount unless authorized by the Contracting Officer pursuant to the clause of this contract entitled “Limitation of Funds” (FAR 52.232‐22).

See Section I of this contract.

(c) Funds obligated hereunder are anticipated to be sufficient through TBD.

B.4. CONTRACT BUDGET

The Contract Line Item Number (CLIN) budget is below:

Contract Line Item

Description Total

CLIN 0001 AFYA [Jijini or Pwani] Program - Base Period (Years 1-3) CLIN 0001a Direct Costs $TBD CLIN 0001b Grants under Contracts $TBD CLIN 0001c Indirect Costs $TBD CLIN 0001d Total Fixed Fee $TBD

CLIN 0001 Total:

(Total of CLIN 0001a-d)

$TBD

Description Total

CLIN 0002 AFYA [Jijini or Pwani] - Option Period 1 (Year 4)

Request for Proposals # SOL-615-14-000013, Afya Jijini (Nairobi) and Afya Pwani (Coast) Programs in Kenya

CLIN 0002a Direct Costs $TBD CLIN 0002b Grants under Contracts $TBD CLIN 0002c Indirect Costs $TBD CLIN 0002d Total Fixed Fee $TBD

CLIN 0002 Total:

(Total of CLIN 0002a-d)

Description Total

CLIN 0003 AFYA [Jijini or Pwani] - Option Period 2 (Year 5) CLIN 0003a Direct Costs $TBD CLIN 0003b Grants under Contracts $TBD CLIN 0003c Indirect Costs $TBD CLIN 0003d Total Fixed Fee $TBD

CLIN 0003 Total:

(Total of CLIN 0003a-d)

Total Estimated Cost: $TBD

B.5. INDIRECT COSTS

Pending establishment of revised provisional or final indirect cost rates, allowable indirect costs must be reimbursed on the basis of the following negotiated provisional or predetermined rates and the appropriate bases:

Description Rate Base Type Period

TBD TBD 1/ 1/ 1/

TBD TBD 2/ 2/ 2/

1/Base of Application:

Type of Rate:

Period:

Source:

2/Base of Application:

Type of Rate:

Period:

Source:

[To be determined]

Note: The Contractor is allowed to recover applicable indirect costs (i.e., overhead, G&A, etc.) consistent with FAR Part 31 and its approved Negotiated Indirect Cost Rate Agreement (NICRA).

Request for Proposals # SOL-615-14-000013, Afya Jijini (Nairobi) and Afya Pwani (Coast) Programs in Kenya

B.6. CEILING ON INDIRECT COST RATES

(a) Reimbursement for allowable indirect costs will be at the lower of the negotiated final predetermined rates or the following ceiling rates::

Description Rate Base Type Period

TBD TBD 1/ 1/ 1/

TBD TBD 2/ 2/ 2/

[To be determined]

(b) The Government will not be obligated to pay any additional amount should the final indirect cost rates exceed the negotiated ceiling rates. If the final indirect cost rates are less than the negotiated ceiling rates, the negotiated rates will be reduced to conform to the lower rates.

(c) This understanding will not change any monetary ceiling, obligation, or specific cost allowance or disallowance. Any changes in classifying or allocating indirect costs require the prior written approval of the Contracting Officer.

B.7. MULTI-YEAR CONTRACT

This is a CPFF completion type contract under which the Contractor is authorized to be reimbursed for all costs which are allowable in accordance with FAR 52.216-7, “Allowable Costs and Payment.”

Furthermore, this is a multi-year contract as defined in FAR 17.103. Therefore, the Contractor must not incur any costs which would have been amortized over the life of the contract should the contract be cancelled in accordance with FAR 52.217-2.

This contract is subject to the requirements of FAR 17.106 and has the following cancellation dates and ceilings:

Contract Year: Cancellation Ceiling:

(Not to Exceed) Cancellation Date:

Base Period Year 2: $[TBD] [TBD]

Base Period Year 3: $[TBD] [TBD]

[END OF SECTION B]

Request for Proposals # SOL-615-14-000013, Afya Jijini (Nairobi) and Afya Pwani (Coast) Programs in Kenya

SECTION C – STATEMENT OF WORK

C.1. PROGRAM TITLE

AFYA JIJINI (Nairobi) and AFYA PWANI (Coast)

Improved and Increased Access and Utilization of Quality Health Services through Strengthened Service Delivery and Institutional Capacity of County Health Systems

C.2. LIST OF ACRONYMS AND DEFINITIONS

AAD Activity Approval Document AFP Acute Flaccid Paralysis AIDS Acquired Immune Deficiency Syndrome AMSTL Active Management of the Third Stage of Labor ANC Antenatal Care APH Antepartum Hemorrhage APHIA AIDS, Population and Health Integrated Assistance APHIAplus AIDS, Population and Health Integrated Assistance Plus APR Annual Performance Report ARI Acute Respiratory Infection ART Antiretroviral Therapy ARV Antiretroviral BCC Behavior Change and Communication BS Branding Strategy CACC Constituency AIDS Control Council CBHIS Community Based Health Information System CBO Community Based Organization CCC Comprehensive Care Center CD4 Cluster of Differentiation 4 CDC Center for Disease Control and Prevention CDCS Country Development Cooperation Strategy CHAP Community Health Action Plan CHC Community Health Committee CHEW Community Health Extension Worker CHMT County Health Management Team CHS Community Health Strategy CHU Community Health Unit CHW Community Health Worker CIPK Council of Imams and Preachers of Kenya CLTS Community Led Total Sanitation CME Continuing Medical Education COP Chief of Party COR Contracting Officer Representative CPR Contraceptive Prevalence Rate CR Country Representative CTX Cotrimoxazole CSW Commercial Sex Worker DCOP Deputy Chief of Party DFH Division of Family Health DHS Demographic Health Survey

Request for Proposals # SOL-615-14-000013, Afya Jijini (Nairobi) and Afya Pwani (Coast) Programs in Kenya

DOD Department of Defense DOT Directly Observed Therapy EBI Evidence Based Interventions EID Early infant diagnosis EMTCT Elimination of Mother to Child Transmission EMONC Emergency Obstetric and Newborn Care FBO Faith Based Organization FIC Full Immunization Coverage FP Family Planning FSW Female Sex Worker GBV Gender-Based Violence GFATM-GF Global Fund to Fight AIDS, Tuberculosis, and Malaria GoK Government of Kenya GUC Grants Under Contracts HCSM Health Commodities and Services Management HINI High Impact Nutrition Interventions HIV Human Immunodeficiency Virus HTC HIV Testing and Counseling IDU Injection Drug User IEE Initial Environmental Examination IPT Isoniazid Preventive Therapy IR Intermediate Result ITN Insecticide Treated Net KAIS Kenya AIDS Indicator Survey KEMSA Kenya Medical Supplies Agency KSPA Kenya Service Providers Assessment LGBT Lesbian, Gay, Bisexual, and Transgender LOE Level of Effort MARP Most-At-Risk Population MCSP Maternal and Child Survival Program MDG Millennium Development Goal M&E Monitoring & Evaluation MNCH Maternal, Newborn and Child Health MoH Ministry of Health MP Marketing Plan MSM Men Who Have Sex with Men NACC National AIDS Control Commission NACS Nutritional Assessment, Counseling and Support NASCOP National AIDS and STI Control Programme NGO Nongovernmental Organization NHP+ Nutrition and HIV Program plus NSP National Strategic Plan OGAC Office of the Global AIDS Coordinator OPH Office of Population and Health ORS Oral Rehydration Solution OVC Orphans and Vulnerable Children PEPFAR President’s Emergency Plan for AIDS Relief PF Partnership Framework PHPD Positive Health Dignity and Prevention PITC Provider Initiated Testing and Counseling PLHIV People Living with HIV

Request for Proposals # SOL-615-14-000013, Afya Jijini (Nairobi) and Afya Pwani (Coast) Programs in Kenya

PMP Performance Monitoring Plan PPD Purified Protein Derivative PR Principal Recipient RFP Request for Proposals SAPR Semi Annual Performance Report SI Strategic Information SOW Statement of Work SRH Sexual and Reproductive Health SIA Supplemental Immunization Activity SW Sex Workers STIs Sexually-transmitted Infections SO Strategic Objective TA Technical Assistance TB Tuberculosis TFR Total Fertility Rate TO Task Order TST Tuberculin Skin Test UNAIDS Joint United Nations Programme on HIV/AIDS UNFPA United Nations Population Fund UNGASS United Nations Global AIDS Special Session UNODC United Nations Office of Drugs and Crime USAID United States Agency for International Development USG United States Government VCT Voluntary Counseling and Testing WASH Water, Sanitation and Hygiene WHO World Health Organization YLHIV Youth Living with HIV

For the purpose of this SOW, the following definitions are used:

Men who have sex with men (MSM) [1] Men who have sex with other men whether occasionally or frequently; some, who may not regard themselves as homosexual or bisexual in any way, may also have sex with women and are very often married..

Sex Workers (SW) [2] Sex workers include female, male and transgender persons who receive money or goods in exchange for sexual services, either regularly or occasionally.

People Living with HIV (PLHIV) [3] This refers to those who have been diagnosed and are living with HIV. An infected person may continue to live well and productively for many years.

Key Populations [4] This refers to groups of people that are at higher risk of being infected or affected by HIV and play a key role in how HIV spreads, and whose involvement is vital for an effective and sustainable response to HIV. Key populations vary according to the local context, but include vulnerable and marginalized groups such as migrants and displaced people, mobile populations and prisoners.

Most-At-Risk Population [5] Refers to groups engaged in risky sexual behaviors for HIV transmission including sex workers, Request for Proposals # SOL-615-14-000013, Afya Jijini (Nairobi) and Afya Pwani (Coast) Programs in Kenya transgender women, men who have sex with men and people who use drugs, but may also include (depending on the context) people in HIV-discordant relationships, among others. These populations are often highly stigmatized and there is reluctance to invest in them.

C.3. OBJECTIVE

The objective of this program is to contribute to the USAID/Kenya Country Development Cooperation Strategy (CDCS) Development Objective (DO) 2 “Health and Human Capacity Strengthened”, Intermediate Result (IR) 2.2 “Increased use of quality health services”.

The activities will build on experiences and lessons learned from the previous integrated health service delivery activities, including the current AIDS, Population and Health Integrated Assistance Plus (APHIAplus) Nairobi/Coast program, and ensure coordination and communication among development counterparts.

The goal is to contribute to CDCS Sub-Intermediate Result 2.2.2 “Improved county-level accountability, institutional capacity, leadership, and management of health service delivery”.

The purpose of the program is improved and increased access and utilization of quality health services through strengthened service delivery and institutional capacity of county health systems. The goal, purpose, three sub-purposes and output areas for both activities are illustrated in the results framework.

The three sub-purposes and output areas for the activity are:

Sub-purpose 1: Increased Access and Utilization of Quality HIV Services

Output 1.1: Elimination of Mother-to-Child Transmission (eMTCT) Output 1.2: HIV Care and Support Services Output 1.3: HIV Treatment Services Output 1.4: HIV Prevention, HIV Testing and Counseling (HTC), and Voluntary Medical Male Circumcision (VMMC) Output 1.5: Tuberculosis (TB) / HIV Co-infection Services

Sub-purpose 2: Increased Access and Utilization of focused Maternal, Newborn, and Child Health (MNCH), Family Planning (FP), Water, Sanitation and Hygiene (WASH), and Nutrition Services

Output 2.1: Maternal and Newborn Health (MNH) Services Output 2.2: Child Health Services Output 2.3: Family Planning Services Output 2.4: Water, Sanitation and Hygiene (WASH) Services Output 2.5: Nutrition Services

Sub-purpose 3: Strengthened and Functional County Health Systems

Output 3.1: Partnerships for Governance and Strategic Planning Output 3.2: Human Resources for Health (HRH) Output 3.3: Health Products and Technologies (HPT) Output 3.4: Strategic Monitoring and Evaluation Systems Output 3.5: Quality Improvement Systems

Request for Proposals # SOL-615-14-000013, Afya Jijini (Nairobi) and Afya Pwani (Coast) Programs in Kenya

C.4. SCOPE AND MISSION

Through the contractor, the USAID/Kenya Office of Population and Health (OPH) will support county-led health service delivery and systems strengthening. The program will build upon existing strengths and opportunities and expand on the scope of the current USAID APHIAplus activity, scheduled to end April 30, 2015, and earlier APHIA activities. The selection of tasks is based on consultations with county government, priorities identified in the County Health Strategic and Investment Plans of each county, a health indicator analysis, the President’s Emergency Plan for AIDS Relief (PEPFAR) Blueprint, Agency prioritization of ending preventable maternal and child deaths, and available resources. The contractor will work at the county level to support health systems strengthening and at sub-county, health facility and community levels to support service delivery.

The contractor will support the county government, in particular the County Health Team, to implement the County Health Strategic and Investment Plan and will strategically communicate, coordinate and collaborate within and across development and implementing partners, including all USG and non-USG partners, especially those implementing national and other service delivery mechanisms.

C.5. BACKGROUND

National Context

The 2010 Kenya census estimates the population to be about 40 million, 22% of which is an ever increasing urban population. The most populous regions are the Rift Valley (10 million inhabitants), Eastern (6.1 million), and Nyanza (5.7 million). Life expectancy is 52 years for men and 55 for women.

Kenya’s health profile varies across counties and includes vast disparities for rural versus urban populations and across income quintiles. To address these challenges, Kenya Vision 2030 provides a roadmap in meeting Kenya’s health sector goal of “providing equitable and affordable quality health services to all Kenyans in order to continue to reverse negative health trends”. In March 2013, Kenya moved to a devolved system of government that transitioned fiscal, planning, and oversight autonomy from central authorities to 47 new counties. Health is one of the most devolved sectors and the U.S.

government, including USAID, is deeply involved in supporting the Government of Kenya (GoK) to implement and sustain the new structure. In June 2013, as part of the GoK’s focus on the achievement of Millennium Development Goals (MDGs) 4 and 5, all public sector maternity services and those for children under five years were deemed to be free of charge to the client, adding to the challenge of maintaining quality services during this transition period to a devolved government.

Under-five and infant mortality are much higher in Nyanza, Western, North Eastern, and Coast while newborn mortality is highest in Nyanza, Nairobi, and Coast. Findings from the 2012 Kenya AIDS Indicator Survey (KAIS) estimated HIV prevalence to be highest in Nyanza (15.1%) and lowest in the North Eastern region at 2.1%. Substantial decreases in prevalence from the prior KAIS were noted in Nairobi (4.9% down from 8.8%), and Coast (4.3% down from 8.1%). Modes of transmission are markedly different in these regions and specific challenges exist for informal settlements (urban slums) and transportation corridors as well as “hard-to-reach” remote and rural areas. Persons living in poverty have a myriad of poor health indicators compounded by financial barriers and non-financial barriers such as marginalization, geography and social disempowerment.

The changing roles and responsibilities of the national and county governments under devolution have great potential to improve service reach, especially for poor and underserved populations, and to enhance local leadership and accountability for overseeing service delivery. Yet critical challenges remain in the

Request for Proposals # SOL-615-14-000013, Afya Jijini (Nairobi) and Afya Pwani (Coast) Programs in Kenya delivery of health services. While county governments have been assigned the role of provision of health care, the transfer of this function has not been adequately matched with the required resources and there is a danger of the health sector being under-funded in county budgets. Expansion of service provision is also threatened by the lack of adequate human resources for health. Kenya’s health care system continues to face critical human resources for health (HRH) demands, i.e., shortages of essential cadres, problems in attracting and retaining staff, inequitable distribution of health workers affecting rural areas, poor working conditions and other performance management issues. There is varying capacity among counties to effectively plan, manage and finance these health workforce gaps and access to essential health commodities under the devolved system remain a challenge. Funds for procurement were devolved to counties at a time when commodity management systems and capacity at the facility/county levels were limited, including storage, inventory management and reporting usage of commodities to facilitate procurement. All of the above, combined with challenges in financing and governance, could compromise quality service delivery in the near term and erode the health gains made under the former centralized system.

Kenya has made incredible progress in reducing child deaths, with a 30% decline in under-five mortality (from 115 to 74 per 1,000 live births) between the 2003 and 2008/9 Kenya Demographic Health Surveys (DHS). Infant mortality dropped from 77 to 52 per 1,000 live births during the same period. These decreases are largely attributable to increased immunization coverage: the percentage of children that are fully vaccinated rose from 57% to 77% between 2003 and 2008/9, and are now 93%. A second major factor is the success of malaria interventions, with ownership of insecticide treated nets (ITNs) in endemic areas rising dramatically. The nutritional status of children under five, however, improved only slightly between 2003 and 2008/9 and 35 % of children under five are stunted. Among children aged 1 to 59 months, the major causes of death are diarrhea (21%), pneumonia (16%), malaria (11%) and HIV/AIDS (5%).

Progress in neonatal and maternal mortality has been slower or stagnant. Neonatal mortality was 31 per 1,000 live births in 2008/9, only a slight decrease from 33 per 1,000 in 2003. Newborn deaths comprise 60% of infant and 40% of overall under-five mortality, underscoring the fact that newborn health must be addressed in order to achieve MDG 4 for child health. The major causes of neonatal deaths are asphyxia (29%), pre-term birth (28%) and infection (27%). Maternal mortality is estimated at 488 per 100,000 live births, a statistically insignificant change from the rate of 414 per 100,000 live births in 2003 and translates to at least 7,000 Kenyan women dying each year from pregnancy-related complications. Hemorrhage and pre-eclampsia/eclampsia account for over 50% of all maternal deaths in Kenya. Other direct causes are hypertension, sepsis, and complications from unsafe abortions. Major indirect causes are severe anemia, malaria, tuberculosis and HIV.

According to the 2008/9 DHS, the contraceptive prevalence rate (CPR) has risen from 7% in the late 1970s to 46%. The total fertility (TFR) rate is 4.7 and the unmet need for family planning is 25%.

Recent efforts towards meeting 70% of the unmet need are showing positive results but will be confirmed with the 2014 DHS. Children under the age of 15 make up 43% of Kenya’s population and youth between the ages of 15 and 34 years constitute another third. Kenya has a limited, but promising, window of opportunity to reap the advantages of the demographic dividend over the next two decades as birth rates decline and Kenyans of the current large “youth bulge” move into their working years.

HIV prevalence among adults aged 15 to 64 years decreased nationally from 7.2%, as measured in KAIS 2007 to 5.6% in 2012. Prevalence among adults varied by region, with the highest prevalence in Nyanza (15%) and lowest prevalence in the Eastern and Rift Valley regions (both 3.7%). While most regions showed a decreased prevalence from 2007, substantial drops were identified in the Coast, Nairobi and Rift Valley regions. Although HIV prevalence decline was observed for both females and males, prevalence among young women aged 15 – 24 remained higher than the national prevalence (6.9%) and

Request for Proposals # SOL-615-14-000013, Afya Jijini (Nairobi) and Afya Pwani (Coast) Programs in Kenya their male counterparts (4.4%). Levels of HIV testing have increased with 72% of adults aged 15 to 64 years in KAIS 2012 reporting ever having been tested for HIV, a significant increase from 34% in 2007.

Despite the increase in HIV testing levels, 53% of survey participants found to be infected during KAIS 2012 were not aware of their HIV infection. However, this was a substantial improvement from 2007 where over 80% of HIV-infected persons did not know they were infected. The proportion of men who were circumcised increased nationally from 85% in 2007 to 91% in 2012. Low levels of consistent condom use were observed among both women and men aged 15 to 64 years who reported a sexual partner of discordant or unknown HIV status.

The HIV epidemic in Kenya is concentrated among the key populations (sex workers, men who have sex with men and injecting drug users) and generalized among the general population. According to KAIS 2012, sex workers (male and female) comprise approximately 4% of the total HIV-infected individuals while people who inject drugs comprise less than one percent (0.1%). Although there is lack of similar data on men who have sex with men, previous surveillance studies show HIV prevalence among MSM in Nairobi to be 18.2%. Sustained efforts to prevent HIV transmission among key populations and other vulnerable population are paramount to reduction of new HIV infections.

The GoK has subscribed to the virtual elimination of mother-to-child-transmission (eMTCT) as part of its expansion of comprehensive antenatal services. Sustained scale up of HIV care has ensured provision of services to people living with HIV (PLHIV) in Kenya. By September 2013, 831,000 (86,000 children) were receiving care while 630,000 (62,000 children) were receiving antiretroviral therapy (ART). Kenya has reached about 70% of PLHIV with care services, based on the KAIS 2012 estimate of 1.2 million PLHIV nationally. 58% of HIV-infected persons aged 15-64 years were eligible for ART for HIV infection based on a CD4+ T-cell count of 350 cells/μl or less or reported history of current tuberculosis treatment. Of those, 63% were currently on ART. Among those on ART, 78% achieved viral suppression. However, viral suppression among all HIV-infected persons, regardless of awareness of HIV status and ART use was low, at 40%.

KAIS 2012 found 47% of PLHIV aged 15-64 years were aware of their HIV status, an increase from KAIS 2007 which found that only 16% were aware. Of the 47% aware of their positive HIV status, 89% were currently on cotrimoxazole (CTX) compared to 76% from KAIS 2007. The KAIS 2012, the first national survey in Kenya to estimate the burden of HIV in children, estimated the prevalence of HIV among children aged 18 months to 14 years as 0.9%, approximately 104,000 children.

Widespread HIV/TB co-infection challenges efforts to combat both diseases—an estimated 44% of new TB patients are HIV-positive. Kenya ranks 13th on the list of 22 high-burden TB countries in the world and has the fifth highest burden in Africa. Preliminary TB/HIV surveillance data indicates ART coverage only reached 83% in 2013. Through improved integration, supportive supervision, and continued surveillance, Kenya aims to reach 85% in FY14, 90% in FY15 and to treat 450,000 PLHIV with Isoniazid Preventive Therapy (IPT). Kenya achieved WHO targets of 70 % case detection and 85% for treatment success in 2005 and 2007 respectively, and both indicators have risen in recent years.

One in three Kenyan children suffers from chronic under nutrition, and while it contributes to one in three child deaths every year, remains a neglected issue. The effects of under nutrition go beyond survival; the stunting of cognitive development associated with under nutrition causes poorer educational attainment and perpetuates the cycle of poverty in Kenya. Under nutrition persists despite economic and agricultural growth, and millions of dollars of food donated each year. Effective programs and platforms exist – both in the emergency and development realm – but they must be maximized to address nutrition using a preventive approach.

Kenya faces considerable challenges in meeting the basic water supply and sanitation needs of its

Request for Proposals # SOL-615-14-000013, Afya Jijini (Nairobi) and Afya Pwani (Coast) Programs in Kenya population. The 2013 UNICEF/WHO Joint Monitoring Program’s (JMP) Progress on Drinking Water and Sanitation report indicates that Kenya is not on track to meet its MDG targets for either drinking water or sanitation by 2015. The report estimates that in 2011 (the most recently available estimate) only 61% of Kenyans had improved drinking water access and only 29% had access to improved sanitation. Rural areas have much lower coverage than urban areas for water supply (54% rural versus 83% urban). In both contexts, sanitation coverage lags far behind water service coverage. The impact of inadequate WASH services on the well-being and productivity of Kenya’s growing population is profound. Diarrheal diseases remain the third leading cause of under-five mortality. There is increasing evidence of the effect of poor water supply, sanitation access, hygiene behaviors and malnutrition in children. Over a third of children under five are stunted in Kenya. These malnutrition rates are unlikely to improve until WASH conditions improve.

USG, GoK and Other Efforts to Date

The USG, GoK and other development partners have long supported the expansion of HIV care and treatment in Kenya. ART coverage among adults and children in Kenya has increased over the past decade with number of individuals on ART increasing from 538,667 in 2011 to 631,503 in 2013.

Children under 15 years of age account for 11% of the total number of people on ART. Despite these achievements, only 38% of children in need of ART receive it, compared to 83% of adults. The GoK is strategically increasing the coverage of ART with the hope of achieving universal coverage by 2015.

In Kenya, PEPFAR is implemented through a number of U.S. Government Departments and Agencies, including USAID, the Centers for Disease Control (CDC), the Department of Defense (DOD) and Peace Corps. Through its national partners, USAID has also continued to support health system strengthening in strategic information, commodity supply chain systems, and improving quality of integrated programming.

USAID/Kenya’s investments in FP, MNCH, WASH and nutrition have in the past operated in an integrated fashion with malaria and HIV/AIDS, increasing impact. This has enhanced support for expanding family planning services within an integrated service model, increasing demand for antenatal and maternity care, and improving infant and child feeding practices. Through a community platform, behavior change initiatives have supported improved household hygiene and sanitation practices, reduction of diarrhea among young children, and increased knowledge of and demand for family planning and maternal and child health services. At the national level, in combination with PEFPAR funds, these health resources have supported health systems strengthening, including leadership and management capacity building, policy development, health information systems, enhanced efficiency of supply chains and skills building among health providers.

Future programming, particularly for PEPFAR, will be more focused on identifying individuals most likely to be infected with HIV and those in greatest need for care and/or treatment. MCH/FP and nutrition resources will therefore be targeted to a smaller geographic area for greater effect.

Kenya’s health system is fully devolved, and most of the Ministry of Health’s (MoH) functions are now being undertaken by the new county governments. These include but are not limited to: HRH, supply chain and commodity procurement, and strategic planning and budgeting. USAID supports strengthening of supply chain and distribution of commodities through Kenya PHARMA, HCSM and KEMSA. The national level CAPACITY Bridge project continues to contract staff for health facilities across the country and strengthening human resources for health development while Funzo Kenya supports HRH training. Other USAID supported projects such as USAID’s NHP and MCSP have focused on the provision of central technical assistance to the MoH in the areas of reproductive health, child health, and nutrition. This has been in the areas of policy and guidelines development as well as designing related

Request for Proposals # SOL-615-14-000013, Afya Jijini (Nairobi) and Afya Pwani (Coast) Programs in Kenya materials and job aids jointly with the MoH. Through its Health Policy Project, a lead partner providing support to health sector devolution processes, USAID is also assisting the MoH to shape policy and legislation and strengthen inter-governmental dialogue on key health issues while building capacity to utilize financial data as an input to more effective and efficient strategic planning and longer term sustainable financing.

C.6. RATIONALE AND RELATIONSHIP WITH GoK PLANS AND PRIORITIES

Alignment with the devolved government structure, GoK health plans and priorities

Local governments are now in charge of devolved county health systems and such reforms will need several years before all capabilities and resources required to run the devolved system are firmly in place. Based on county consultations with civil society, health service providers and County Health Executives, the counties are in a good position to articulate their needs and can reach out to partners to request where support is most needed. In consultation with USAID/Kenya, the contractor is expected to support these needs to the extent which resources will allow.

The GoK’s free maternity services and child health services policy has highlighted the urgency to achieve MDGs 4 and 5 and indicated current health sector priorities. Increasing access to skilled birth attendants and preventing communicable diseases in children under five are critical components of the health sector. In order to achieve MDG 4, efforts to address neonatal causes of death must be accelerated. The GoK is also committed to curbing the main killers of under-fives which include diarrheal diseases, malaria (in endemic zones), pneumonia and pediatric HIV. The contractor will be expected to support these efforts as per the priorities of the county.

Kenya has made gains in steering a multi-sectoral HIV/AIDS control program towards its intended objectives. Recent data (KAIS 2012) indicate that HIV prevalence continues on a downward trend and prevalence rates in Nairobi point to progress in achieving positive outcomes due to a comprehensive package of prevention, care and treatment interventions. The contractor will continue the sustainability driven and systems strengthening approach begun by APHIAplus with the public sector and civil society.

Vision 2030, the Second Mid Term Plan, the third National Health Sector Strategic Investment Plan, and the County Health Investment Plans all call for consolidation of what has been achieved so far through strategic partnerships and greater innovation.

With final approval from the USAID COR, tasks under this program will be guided by the Kenya Health Sector Strategic and Investment Plan 2012-2017 and priorities outlined in the County Health Strategic and Investment Plans. The contractor will ensure technical alignment with GoK’s strategies including: the National Road Map for Accelerating the Attainment of the MDGs related to Maternal and Newborn Health; the Child Survival and Development Strategy 2008 – 2015; the new Kenya AIDS Strategic Framework and the Kenya National Nutrition Plan of Action. The activities will support Kenya’s National Health Policy Framework 2012-2030 goal of: “attaining the highest possible health standards in a manner responsive to the population needs by supporting equitable and quality health and related services delivery”.

Alignment with USG strategies

As stated earlier, tasks under this program will support USAID/Kenya’s CDCS Development Objective 2.

USAID/Kenya is also committed to accomplishing global priorities including achieving an AIDS Free Generation and Ending Preventable Maternal and Child Deaths (EPCMD). USAID will work with the

Request for Proposals # SOL-615-14-000013, Afya Jijini (Nairobi) and Afya Pwani (Coast) Programs in Kenya contractor to develop a Monitoring and Evaluation (M&E) Plan with a set of performance and outcome indicators in addition to the required USG Global Health Initiative (GHI) and PEPFAR indicators. Technical interventions must follow state of the art, globally supported and GoK endorsed guidelines. In addition, the contractor will adequately address several key areas, including gender, sustainability and USAID Forward, in accordance with USAID guidelines.

Tasks under this program are intended to align with the newly devolved structure of the GoK, contribute to CDCS Sub IR-2.2.2…