RMNCH_Pre-Solicitation_Conference.pdf

Reproductive, Maternal, Newborn, and Child Health (RMNCH) Project

Pre-solicitation Conference/Webinar

August 11, 2015

10:00 am - 2:00 pm EST

Agenda

• Introductions

• Conference Purpose

• Technical Overview

– Nigeria Background

– RMNCH Project Goals- “What success looks like”

– RMNCH- A Different Approach

– USAID Nigeria Health Objectives

– RMNCH Guiding Principles

– RMNCH Strategic Approach

– RMNCH Intervention Areas

– Illustrative Indicators

Agenda Cont.

• Procurement Overview

– Choice of Instrument Determination

– Procurement Methodology

– RMNCH - Draft Evaluation Criteria

– RMNCH - Draft Evaluation Criteria Order of Importance

– IDIQ Key Personnel – Country Director

– Anticipated TO #1: Offerors Mobilization Plan

– Period of Performance

– Funding/Budget Breakdown

– Procurement Process & Tentative Time-line

• Q&A

Conference Purpose

• Provide industry with USAID Nigeria’s strategic vision;

• Discuss the strategic approach and direction of the

RMNCH project;

• Have an open forum discussion for the RMNCH project;

• Gather industry feedback and incorporate them into the upcoming solicitation.

Nigeria Background

• USAID donor support for health in Nigeria (not including

HIV/PEPFAR) has been over $500M in the past 5 years.

• Nigeria did not achieve Millennium Development Goals 4 and 5, related to improvements in maternal and child health

– Some reductions in child mortality (mostly due to reduction of malaria-related mortality) (201/1000 live births in 2003 to 128/1000 live births in 2013);

– Newborn and maternal mortality rates remain stagnant;

– Family planning use very low;

– Immunization coverage very low.

• The health status of women and children is among the poorest in the world, especially in Northern Nigeria.

Nigeria Background Cont.

• Estimated total population: 170million

• Annual births: 7million

• Maternal mortality ratio: 576/100,000 live births

• Under five mortality rate: 128/1,000 live births

• Newborn mortality rate: 37/1,000 live births

• Fully immunized children: 25.3%

• Use of modern contraception: 10%

Ref: National Population Commission Census projections

2013 Nigeria Demographic and Heath Survey

Progress on service delivery in Nigeria: NDHS1990-2013

Trends in Maternal Health Care

Percent of births in the 5 years before the survey

*Skilled provider includes doctor, nurse, midwife, or auxiliary nurse/midwife.

Households with at least one ITN Children <5 yrars who slept under an

ITN

Pregnant women who slept under an

ITN

2.2% 1.2% 1.3%

8.0%

5.5% 4.8%

41.3%

28.7%

33.5%

49.5%

16.6% 16.5%

ITN Ownership and Use from 2003-2013

DHS 2003 DHS2008 MIS 2010 2013 DHS

Trends in Childhood Mortality

Deaths per 1,000 live births for the 5-year period before each survey

Fertility Regional Comparison TFR for women age 15-49

*Results from preliminary report

Vaccination Coverage Regional Comparison

Percent of children age 12-23 months fully vaccinated

*Preliminary report data

Reproductive, Maternal, Newborn and Child Outcomes: A

Tale of Two Regions

Indicators North South National

Under-five Mortality Rate per 1000 live births 100-185 90-131 128

Fully Immunized Child (%) 9.6-26.9 40.9-51.7 25.3

Skilled Delivery at Birth (%) 12.3-46.5 55.4-82.5 38.1

Stunting among children (%) 29.3-54.8 16.0-22.1 36.8

Currently pregnant (%) 11.7-16.1 7.9-9.0 12.1

Total Fertility Rate (children/woman) 5.3-6.7 4.3-4.7 5.5

Modern contraceptive use (%) 3.6-12.4 11.0-24.9 9.8

Antenatal Care service coverage (%) 41.0-67.0 73.0-90.6 60.6

Neonatal Mortality Rate per 1000 live births 35-44 32-39 37

Fertility By Zone

Total fertility rate

Nigeria

5.5

North East

6.3

North Central

5.3

North West

6.7

South West

4.6 South

East

4.7

South

South

4.3

Under-five Mortality by Zone

Deaths per 1,000 live births for the

10-year period before the survey

North East

North Central

North West

South West

South

East

South

South

Immunization Coverage by Zone

Percent of children age 12-23 months fully vaccinated

Nigeria

25%

North East

14%

North Central

27%

North West

10%

South West

41% South

East

52%

South

South

52%

RMNCH Project Goals- “What success looks like”

• At the end of this project, success is a state government that leads and owns the management of its health systems, to deliver high quality primary health care services, and cover the majority of the target populations.

RMNCH Project Goals- “What success looks like”

• To achieve success, we need the following over the life of the project:

– State level scale-up of high-impact interventions to reduce maternal and child mortality.

– Increased capacity of health systems (public and/or private) to sustainably support quality primary health care services.

– Effective partnership and accountability established between state level government officials and USAID, towards developing Health and Development Plans, build capacity, and promote ownership of interventions, systems, and results.

RMNCH - A Different Approach

• Key indicators did not move due to the following:

– Lack of state ownership;

– Lack of state-tailored technical approach;

– Lack of whole of systems approach;

– Limited direct engagement by USAID with state leadership;

– Lack of adequate checks and balances at the state level

(e.g. subservient legislative arm, limited civil society activities);

– Weak government budget and procurement systems at the state level, leading to leakages and mismanagement of resources.

RMNCH - A Different Approach cont.

• USAID will be at the table with all parties, especially at state level;

• Engage State and LGA officials from design-phase, and throughout implementation;

• Identify budgetary gaps at the state-level for more effective programming and accountability;

• Support State and LGA priorities, where feasible

• Flexible programming depending on the needs of the state and geopolitical context;

• Clear understanding with state leadership that the availability of USAID resources is dependent upon fulfillment of pre-determined benchmarks/milestones;

• USAID will reallocate resources from state(s) where collaboration is failing;

• This project will not be doing direct service delivery.

USAID Nigeria Health Objectives

• Objective 1: Health systems strengthened

– State and local government authorities and private sector transparently and effectively engaged in health programs.

• Objective 2: Demand for quality primary health care services increased

– Community mobilization to increase demand for health services as well as improving quality of those services.

• 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. PMTCT, TB/HIV, etc.).

RMNCH Guiding Principles

• Results: There is an “urgent compulsion” to demonstrate improvements in health outcomes at scale.

• Ownership: Concern that 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. Focus on “real time” awareness of what is working and what is not, and the flexibility to nimbly stop what is not working and take on promising new ideas.

– State specific designs based on evidence and context. Each state will have a unique set of approaches to achieve desired results.

RMNCH Strategic Approach

• Health is a political or, in the private sector, business imperative.

– State- and LGA-level decision makers are driven to tangibly support and invest their resources for increased access to primary health care.

– Private sector actors, such as PPMVs, 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 political imperatives. Stimulating public demand for PHC services is expected to compel state leadership to do more in fulfilling their health needs.

RMNCH Strategic Approach Cont.

• Prioritize early and rapid scale-up of high-impact, easy-to-deliver RMNCH interventions, while co-investing with states to progressively strengthen the health systems in order to expand the range, and sustain interventions beyond the life of project.

– Address key barriers to achieving improved health outcomes in the near-term.

– Identify budgetary gaps at the state-level for more effective programming and accountability.

– Achieve improvements in the core functions of the health systems, promote country ownership and sustainability.

• Fundamental to this theory of change is a strengthened partnership foundation

– Public and/private sector actors;

– 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;

– Shared expectations of each other, mutual accountability, monitoring to see that commitments are being fulfilled and results achieved, and clear provision for course corrections.

• Robust monitoring and evaluation to ensure that the project is on track to achieve results.

– Frequent and granular data to allow for more nimble course corrections, introduction of new ideas and proven innovations.

– In addition to project-level monitoring and evaluation, USAID/Nigeria will support external performance monitoring and validation to track progress and results.

RMNCH Intervention Areas

• Family planning;

• Malaria;

• Routine immunization;

• Nutrition;

• Maternal/newborn health; and,

• Treatment of childhood pneumonia/diarrhea.

Illustrative Indicators

Modern Contraceptive Prevalence Rate

Pentavalent Vaccine 3

Fully immunized children

Pregnant women attending antenatal clinic who received HIV counseling, testing and results

Pregnant women with at least 3 doses of Intermittent preventive treatment

Pregnant women who slept under insecticide treated mosquito net (ITN)

Skilled Delivery at birth

Facility Delivery Rate

Postnatal check for woman (within 2 days of delivery)

Postnatal check for newborn (within 2 days of delivery)

Illustrative Indicators Cont.

Breastfeeding initiation within one hour of birth

Vitamin A supplementation coverage

Children who received minimum acceptable diet

Children under five who slept under insecticide treated mosquito net

Children with diarrhea treated with ORS

Children with diarrhea treated with Zinc

Children with fever tested for malaria

Children with fever treated with ACT

Health facilities reporting on time through the NHMIS

Women who make decisions about their own health care

PROCUREMENT OVERVIEW

Choice of Instrument Determination

• The Contracting Officer has made the determination that the appropriate instrument for this type of project is an acquisition based on the nature of the requirement and the following:

– The RMNCH award is for USAID’s benefit or use, and thus requires a contract;

– RMNCH seeks to procure consulting and professional services to be provided by the USG or on behalf of the USG to a third party;

– RMNCH will require surveys, studies, and research which provide specific information to USAID for its direct activities;

– USAID/Nigeria Intends to exercise a considerable amount of operational control, i.e., performing day-to-day oversight and providing technical direction which would be inappropriate under an assistance instrument.

Choice of Instrument Determination Cont.

• The RMNCH project is anticipated to be awarded as a single award IDIQ based on the following:

– RMNCH has recurring needs – (state by state);

– Program integration and coordination;

– The contractor will be held accountable for deliverables and expected results;

– Task Orders will allow for tailored approach based on local context – (i.e. in budget that more accurately reflects the work to be completed).

Procurement Methodology

• FAR Part 15

• USAID will utilize the trade-off methodology within the best-value continuum.

– Technical is more important than cost

RMNCH - Draft Evaluation Criteria

• The RMNCH IDIQ will be evaluated based on the following:

– Technical Approach: Based on responsiveness to the case studies provided.

– Past Performance: Demonstrated ability to successfully implement projects of similar size, scope, and complexity within the past five years.

• This will include focus within health systems, health service delivery, and demonstrated ability to successfully engage and dialogue with government officials.

– Institutional Capacity & Management Plan: Demonstrated management composition and organizational structure, with the institutional capacity to successfully implement the project.

– TO #1 Mobilization Plan: Demonstrated ability and plan to rapidly scale-up activities and have personnel on the ground.

– Key Personnel: Strength of proposed IDIQ Country Director.

RMNCH - Draft Evaluation Criteria Order of

Importance

• Technical Approach is the most important, while

Past Performance, Institutional Capacity &

Management Plan, TO#1 Mobilization plan, and Key

Personnel are of equal importance. When combined, all non-cost factors are more important than cost.

IDIQ Key Personnel – Country Director

• Resides in Nigeria over the life of the IDIQ;

• Will provide the overall leadership and management to Nigeria RMNCH

IDIQ;

• S/he oversees the project’s strategic planning functions and ensures quality implementation of the project;

• 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.

Anticipated TO #1: Offerors Mobilization Plan

• Timeline of all start-up activities

– Country Director mobilized;

– Abuja Office location identified;

– Staff hired;

– Initial procurement of vehicles and/or equipment; and,

– Any other expenses to be incurred to have a fully functional

Abuja central office.

Note: USAID will monitor the mobilization plan and the first CPARS rating will directly reflect the stated timeline.

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.

– IDIQ Period of Performance: The IDIQ period of performance will be no more than eight (8) years.

– Task Order Period of Performance: TO periods of performance will in no case be longer than five (5) years at any one time.

Funding/Budget Breakdown

Funding for this activity will come from the HPN budget and will include MCH, FP, Malaria and Nutrition funds.

Total estimated cost for implementation will be $225M based on 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%

Procurement Process & Tentative Timeline

Procurement Action Tentative Time-line

Collate and continue to receive inquiries and questions from the public relating to the IDIQ;

August 2015

Prepare and post of solicitation; September 2015

Respond to inquiries and questions via amendment(s); September/October

Past Performance Information will be submitted; October 2015

Receive and acknowledging receipt of the proposals; December 2015

Overseeing evaluation of all proposals received February 2016

Communicate results of the evaluation to the offerors’ or establishment of competitive range, if applicable;

end of May 2016

Conduct responsibility determination of successful offerors’;

June/July 2016

IDIQ and TO#1 award complete July 2016

Conclusion

• Updates posted to FBO.gov (SOL-620-15-000009)

• POC:

Primary Point of Contact: Secondary Point of Contact:

Maryann Asielue Mohib Ahmed

Acquisition & Assistance Specialist OAA Office Deputy Director masielue@usaid.gov Contracting & Agreements Officer mohahmed@usaid.gov mailto:masielue@usaid.gov mailto:mohahmed@usaid.gov

Q&A