FBO_Announcement.pdf

{Inesrt USAID or USAID Mission Logo}

TO: Prospective Offerors

DATE: July 17, 2015

SUBJECT: Pre-solicitation Conference Webinar for the Reproductive, Maternal, Newborn, and Child Health (RMNCH) Project in Nigeria (SOL-620-15-000009), to be held on August 11, 2015.

Dear Prospective Offerors:

The U.S. Agency for International Development (USAID) Mission to Nigeria seeks to carry out a five-year project to support improvements in reproductive, maternal, newborn, and child health

(RMNCH) outcomes in Nigeria. USAID/Nigeria envisions a project with focus on six intervention areas namely: family planning, malaria, routine immunization, nutrition, maternal/newborn health, and treatment of pneumonia/diarrhea.

The project is envisioned to be a single award Indefinite Delivery Indefinite Quantity (IDIQ)

Contract. USAID anticipates that the maximum ordering limitation of the contract resulting from the solicitation will be $225,000,000.00 ($225 Million) over a five-year ordering period.

The project will work closely with state-level government officials to support established state-level Health and Development Plans, build capacity, and promote ownership of interventions, systems, and results. Specific interventions will need to be tailored to local contexts and will be fully developed at state and Local Government Area (LGA) levels.

USAID will conduct a pre-solicitation conference via webinar on August 11, 2015. USAID appreciates this opportunity to gather industry feedback and comments. Details for the webinar are as follows:

Title: Nigeria RMNCH Bilateral Webinar (Pre-Solicitation Bidders Conference)

When: Tuesday, August 11, 2015, 10 am – 2 pm EST

Logistical Details:

You will need four hours of uninterrupted time, a computer with internet, and a phone

(in case back-up audio is needed).

If back-up audio is needed, you can conference in at 1-866-844-9419. Dial the participant code 16762785# when prompted.

Important Log-In Information:

tel:1-866-844-9419

To join the Nigeria RMNCH Bilateral Webinar, navigate to the following URL by 10:00 am

EST on August 11 th

: https://ghpod.adobeconnect.com/Nigeria RMNCH Bilateral Type in your name and click the “Enter Room” button to join the webinar. We advise you to begin logging in 10-15 minutes before the meeting, in case you run into any technical difficulties.

If you have issues connecting to the meeting, email Mike Myers at mmyers@socialimpact.com

If you have never attended an Adobe Connect meeting, we strongly encourage you to test your connection beforehand to ensure your computer will be able to connect. If prompted to update your Flash Player or install an Add-in, we suggest you do so: https://ghpod.adobeconnect.com/common/help/en/support/meeting_test.htm

USAID/Nigeria intends to issue a Request for Proposal (RFP) following this pre-solicitation notice. Offerrors are advised that this pre-solicitation notice is not a RFP, and in no way obligates USAID/Nigeria to issue a RFP or to award a contract. The information contained in this pre-solicitation notice is released to the public for informational purposes only and is subject to change.

USAID/Nigeria encourages interested parties to register for updates on this activity via www.fbo.gov. All inquiries concerning this notice must be directed via email to Maryann

Asielue, Acquisition & Assistance Specialist, at masielue@usaid.gov with a copy to Mohib

Ahmed at mohahmed@usaid.gov. Phone inquiries will not be entertained.

Best regards, Mohib Ahmed

Contracting Officer

ATTACHMENTS:

1. Draft Statement of Objectives (SOO)

2. Draft Case Studies for RMNCH Solicitation https://ghpod.adobeconnect.com/____?______ mailto:mmyers@socialimpact.com https://ghpod.adobeconnect.com/common/help/en/support/meeting_test.htm http://www.fbo.gov/ mailto:masielue@usaid.gov mailto:mohahmed@usaid.gov

ATTACHMENT 1: DRAFT STATEMENT OF OBJECTIVES

USAID/Nigeria Reproductive, Maternal, Newborn, and Child Health (RMNCH)

The U.S. Agency for International Development (USAID) Nigeria seeks assistance to carry out a five-year project to support improvements in reproductive, maternal, newborn, and child health

(RMNCH) outcomes in Nigeria.

I. INTRODUCTION

a.) Vision

USAID/Nigeria envisions a project with an expanded effort to identify and support rapid scale-up of proven interventions through improvement of service delivery and strengthening of health systems. The activity will focus its support for service delivery in six intervention areas: family planning, malaria, routine immunization, nutrition, maternal/newborn health, and treatment of pneumonia/diarrhea.

This project will also need to work closely with state level government officials to support established state level Health and Development Plans, build capacity, and promote ownership of interventions, systems, and results. Specific interventions will need to be tailored to local contexts and will be fully developed at state and Local Government Area (LGA) levels.

The Mission will consult widely, both internally and externally, before selecting the eventual states for implementation. However, it should be noted that the Mission also reserves the right to stop further investments in a selected state, at any time during the implementation period, if the

Mission determines that the states are not providing the expected leadership, collaboration and commitment.

b.) Background

Nigeria did not achieve the Millennium Development Goals related to maternal and child health and the health status of women and children in the country is among the poorest in the world.

While there has been some progress in the reduction of under-five mortality, maternal and newborn mortality had not improved between 2008 and 2013 nationwide based on the findings of the Nigeria Demographic and Health Surveys. Coverage of key interventions that contribute to these outcomes has also stagnated. For example, only a quarter of Nigerian children are fully immunized and less than 40% of deliveries are attended by skilled providers. More than half of women (61%) received at least one antenatal care visit (ANC) from a skilled provider, with 51% of women receiving the recommended four or more visits. Use of modern contraception is only practiced by 10% of currently married women of reproductive age and fertility rate has remained at 5.5 per woman. Although Nigeria has scaled up malaria control interventions with the proportion of households owning one or more insecticide treated nets (ITNs) increasing from just

8% in 2008 to 50% in 2013, ITN use is still very low. The proportion of children under-five reported to have slept under an ITN the night before the survey only increased from 6% in 2008 to 17% in 2013. In addition, only 15% of women reported receiving two or more doses of

Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) during antenatal care (ANC), with a more than 34% drop-out rate between the first and second IPTp doses.

There have been some improvements between 2008 and 2013. Under-five mortality has decreased from 201 per 1000 live births in 2003 to 128 per 1000 live births in 2013. States in the

South-south and South-west regions have seen the greatest declines, as well as those families with higher educational and wealth statuses. In addition, 38% of children 12-23 months received a third dose of DPT, a 9% increase from 2008 and an 81% increase from 2003.

While the national performance shows clearly that Nigeria is not making adequate progress across the RMNCH continuum, importantly, health outcomes are worse in northern Nigeria. In the North-east and North-west regions of Nigeria, less than 20% of deliveries take place in health facilities, less than 4% of women use modern contraception, and under-five mortality rates are double those of the best performing regions in the same country. Similarly, immunization rates in the North-east and North-west are very low, with less than 15% of all children getting all the required vaccinations.

c.) Guiding Principles

Three principles guide the activity:

Results: The 2013 NDHS results, while showing some areas of improvement, have generally been received with disappointment. There is an “urgent compulsion” to show that achievements in health outcomes at scale are possible.

Ownership: There is an equally widespread worry that in a health system as decentralized as

Nigeria’s, States and LGAs are not “stepping up to the plate” in ways that will accelerate sustainable reductions in child and maternal mortality.

Flexibility: This is the time to take risks. There is no shortage of ideas. One challenge is taking to scale those approaches that have been proven in smaller-scale pilots, having more “real time” awareness of what is working and what is not in the scaling up, and the flexibility to nimbly stop what is not working and take on promising new ideas.

National Population Commission (NPC) [Nigeria] and ICF International. 2014. Nigeria Demographic and Health

Survey 2013. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF International.

d.) Theory of Change:

Our theory of change is aimed at a state when health is a political imperative in the public sector and a business imperative in the private sector (see figure above). That is, when State-and LGA-level decision makers are driven to tangibly support and invest their resources for increased access to primary health care, or when private sector actors, such as patent medical vendors (PMVs), see the business case to provide primary health care services. Community (or consumer) demand, when channeled through effective advocacy (or market-place choices), and informed by what is possible in health, can drive imperatives. Our theory of change thus places a primacy on early and rapid scale-up of service delivery of proven high-impact

RMNCH interventions and demand generation, to demonstrate not only to communities, but also LGAs, States, private sector actors, etc., that it is possible to increase access to life-saving interventions and improve health outcomes.

The early and rapid scale-up of primary health interventions will require some level of health systems support and health systems strengthening, focused on the key barriers to achieving improved health outcomes in the near-term. Health systems support activities will be phased and focus on critical inputs to the health system, e.g. infrastructure and commodities, required to realize rapid gains in health care service delivery. Health systems strengthening activities are designed to achieve improvements in the core functions of the health system, promote country ownership and sustainability. We anticipate that health systems strengthening (covering the six

WHO-defined building blocks ), as a percentage of overall program effort, will increase over time as results in health outcomes are demonstrated, the imperatives grow for partners to invest more in their health systems.

The WHO Health Systems Framework http://www.wpro.who.int/health_services/health_systems_framework/en/

Health as a Political / Business Imperative C o m m u n it y D em an d an d

A d vo ca cy

Partnership Foundation

Monitoring and Evaluation

Service Delivery by Implementing Partner

Health Systems Strengthening

Fundamental to our theory of change is a much strengthened partnership foundation with public and/private sector actors, beginning in the early design phase of this project, where partners co-create, co-design, co-invest, and collaborate throughout implementation. Pre-award, USAID will manage the engagement with government and non-government actors. Following award, USAID will be involved in more direct engagement with the government actors at state and LGA level. There will be shared expectations of each other, mutual accountability, monitoring to see that commitments are being fulfilled and results achieved, and clear provision for course corrections. The offeror is expected to describe an approach to engaging states in a partnership to identify priorities, develop comprehensive state budgets for primary health care that prioritize interventions that are feasible for states to finance and state sustainability plan for these interventions. The offeror will also develop a set of benchmarks that measure state and project progress.

Lastly, our theory of change requires much stronger monitoring and evaluation to ensure that the project is on track to achieve results. More frequent and granular data is needed, and reachable, to support the partnership foundation and all other components of our theory of change to allow for more nimble course corrections, introduction of new ideas and proven innovations, etc. In addition to project-level monitoring and evaluation, USAID/Nigeria will support external performance monitoring and validation to track progress and results.

II. OBJECTIVE AND SUB-OBJECTIVES

Objective:

This project is intended to contribute to State-level reductions in under-five mortality and maternal mortality, and to increase the capacity of health systems (public and/or private) to sustainably support quality primary health care services:

Sub-objective 1: Health systems strengthened:

State and local government authorities will be transparently and effectively engaged in health programs and will systematically engage the private sector.

Sub-objective 2: Demand for quality primary health care services increased:

Community mobilization to expand health services by increasing community demand for health services as well as improving quality of those services.

Sub-objective 3: Access to quality services improved:

Improve access and availability of quality primary health care services at facility and community level, as well as integrate services with other technical areas (e.g. Prevention of Maternal to Child Transmission of HIV/AIDS (PMTCT), tuberculosis , HIV, etc.).

In selected states, USAID will overlay this project with other Mission programming to improve state government budget allocation, financial management and procurement systems to ensure transparency and accountability for resources to the health and education sectors. The other programming will work through State Assemblies, the governor’s ministerial advisors, the commissioners of finance, health and local government area. Concurrently, the other project will also build transparency and accountability at the local government areas structures to ensure that constituents have access to information and decision-making about the resources available, how they are used, and the results.

The achievement of the first sub-objective (health systems strengthened) would therefore be a joint effort between this RMNCH award and the USAID-funded governance activity.

Various configurations and sequences of activities in these areas may result in equivalent lives saved. Specific pathways will need to be tailored to local contexts and will be fully developed at

State and LGA levels.

There will be an expanded effort to identify and support the optimal service delivery points for rapid scale-up of proven interventions. Areas of intervention may be at either the health facility or within the community (this would include house-to-house, non-traditional service delivery points, women’s groups, cooperatives etc.) and could be in the public sector or the private sector.

The project should build on existing research and evidence of proven approaches, and conduct additional formative research to inform project design as needed.

II. IDIQ KEY PERSONNEL:

IDIQ Country Director: The IDIQ Country Director, envisioned to reside in Nigeria over the life of the IDIQ, will provide the overall leadership and management to Nigeria RMNCH IDIQ.

S/he will provide overall strategic guidance, vision and leadership to the project staff. The IDIQ

Country Director works closely with Task Order Key Personnel and supervises project staff and ensures the strategic and functional integration of all technical areas as well as strong collaboration with donors, other implementers, and local counterparts. S/he oversees the project’s strategic planning functions and ensures quality implementation of the project. The

Country Director will be responsible for meeting contractual obligations, producing deliverables and targets, and achieving project results as specified by USAID/Nigeria and each Task Order.

S/he oversees project planning, provides technical direction and support and ensures implementation, with a focus on results, and financial accountability for all project activities. The

Country Director should have at least a post-graduate degree in International Health, Social

Sciences, Management or related discipline. S/he will have demonstrated progressive relevant professional experience working on a project of similar size and complexity. S/he must demonstrate strong management capacity and ability to oversee multiple projects simultaneously.

III. PLACE OF PERFORMANCE

The activity will be implemented in all the LGAs of targeted states. In the first year, this activity will be implemented in a North-east and a North-west state, with other states to be determined by the USAID Nigeria Mission for implementation in subsequent years. The criteria for selecting the additional state(s) will be based on burden of maternal and child mortalities, feasibility of partnering with state government, as well as others factors to be determined.

IV. PERIOD OF PERFORMANCE:

For this Indefinite Delivery/Indefinite Quantity (“IDIQ”) contract, the following determines the periods of performance for the IDIQ and Task Orders (“TOs”):

IDIQ Ordering Period: The IDIQ ordering period is five (5) years from the effective date of the

IDIQ. TOs may be issued at any time during the IDIQ ordering period. Once the IDIQ ordering period ends, no new TOs may be issued.

IDIQ Period of Performance: The IDIQ period of performance begins on the effective date of the IDIQ, until the last TO expires. The IDIQ period of performance will be no more than eight

(8) years, consisting of the five (5) year IDIQ ordering period, followed by up to three (3) years ending when the last TO expires. Clauses, terms, and conditions that are located in the IDIQ and govern task orders continue to be valid and in-force, and able to be modified if necessary, throughout the IDIQ period of performance.

Task Order Period of Performance: TO periods of performance will in no case be longer than five (5) years at any one time. A task order period of performance may extend by for up to three

(3) years past the end of the IDIQ Ordering Period.

V. FUNDING:

Funding for this activity will come from HPN budget and will include MCH, FP, Malaria and

Nutrition funds, starting with FY2014 funds. Total estimated cost for implementing activities at the national level and in targeted states is up to $225m in the following projected proportions:

MCH FP Malaria Nutrition TOTAL

Year 1 50% 25% 11% 14% 100%

Year 2 50% 25% 11% 14% 100%

Year 3 50% 25% 11% 14% 100%

Year 4 50% 25% 11% 14% 100%

Year 5 50% 25% 11% 14% 100%

Total 50% 25% 11% 14% 100%

Some level of variation in the type of funding is expected for each state’s activity based on the

Mission’s specific focus in such states. The level of effort for each technical area will therefore be provided for each selected state before the state-specific Task Orders are issued.

ATTACHMENT 2: DRAFT CASE STUDIES FOR RMNCH AWARD

USAID anticipates that each offeror will be requested to respond to the following case studies to demonstrate their technical approach and understanding to the requirement. We appreciate any feedback on the following outline:

The RMNCH Project will aim at improving the coverage of interventions in the following technical areas:

Family planning, Malaria prevention and treatment, Routine immunization, Nutrition, Maternal/newborn health, and

Treatment of childhood pneumonia/diarrhea.

Using the questions outlined below, each offeror will describe how they would support the scale-up and sustainability of the use of high-impact interventions in each technical area in order to achieve state-level improvements in child and maternal mortality in:

Case Study One: A Nigerian North-east State

Case Study Two: A Nigerian North-west State

Case Study Three: A Nigerian South-south State

Therefore, a total of three (3) case studies will be submitted and evaluated.

Questions:

1. What state-specific baseline data, analyses, formative research, and prior experience

(yours and others) will you use to inform program design and implementation?

2. How will you engage with state- and LGA-level leadership, communities, and other stakeholders in developing, implementing and evaluating the project?

3. Identify and justify for each state and technical area:

a. The high-impact interventions to scale-up to improve child and maternal mortality,

b. The state- and/or other context-specific adaptations of the interventions that may be needed,

c. The service delivery channels to focus on for the most effective scale-up and sustainability of the interventions (e.g., public, NGO, faith-based, commercial;

community-, facility-based), and

d. The needed system support and strengthening for those service delivery channels.

4. What are your plans for monitoring, evaluation, research and learning?

a. How would you use the existing information systems?

b. How would you promote using data for decision-making at facility, LGA, and state levels?

c. How would mid-course corrections be identified and implemented?

5. How will you ensure sustainability of project-supported improvements after the five years of implementation? What social accountability mechanisms (access to information, collective voice and action, state responsiveness) would be most appropriate to strengthen in each state?