SOL-620-15-000009_-_Integrated_Health_-_RMNCH.pdf

SOL-620-15-000009

USAID Integrated Health Program

ACRONYMS

ANC Antenatal Care BIP Branding Implementation Plan CCN Cooperating Country National CDCS Country Development Cooperation Strategy CDR Ceiling Daily Rate COR Contracting Officer’s Representative CPFF Cost-Plus-Fixed-Fee CPIF Cost-Plus-Incentive-Fee CST Contractor Salary Threshold EODCC Expanded Object Class Code FAR Federal Acquisition Regulation FFP Firm-Fixed-Price FP Family Planning GH Global health GON Government of Nigeria GUCs Grants Under Contracts HPN Health Population and Nutrition Office IDIQ Indefinite Delivery, Indefinite Quantity Contract IPTp Intermittent Preventive Treatment in pregnancy ITN Insecticide Treated Net KPI Key Performance Indicator LGA Local Government Area MCH Maternal and Child Health MP Marking Plan NAICS Northern American Industry Classification System NGO Non-governmental organization ODCs Other Direct Costs PMI President’s Malaria Initiative PMP Performance Monitoring Plan PPMV Patent Proprietary Medicine Vendors QA Quality Assurance RFP Request for Proposal RFTOP Request for Task Order Proposal RH Reproductive Health RMNCH Reproductive Maternal Newborn and Child Health SOO Statement of Objective SOW Scope of Work SSR Summary Subcontracting Report STTA Short Term Technical Assistance PMTCT Prevention of Maternal to Child Transmission PMVs Patent Medical Vendors PWS Performance Work Statement

TO Task Order TOCOR Task Order Contracting Officer’s Representative USAID United States Agency for International Development USG United States Government WHO World Health Organization

PART I - THE SCHEDULE

SECTION B - SUPPLIES OR SERVICES AND PRICE/COSTS

B.1 PURPOSE

The purpose of this Contract is to provide services that fall within the Statement of Work (SOW) specified in Section C for the USAID Integrated Health Program. USAID/Nigeria Task Order Contracting Officers (TOCOs) will request additional work through the issuance of subsequent TOs during the ordering period as specified in Section F of the Contract.

B.2 CONTRACT TYPE AND SERVICES

This is a Single Award Indefinite Delivery Indefinite Quantity Contract (IDIQ) utilizing individual TOs to provide technical services. The Government will issue TOs that are Cost-Plus- Fixed-Fee (CPFF) (term or completion), Cost-Plus-Incentive-Fee (CPIF), Cost-Plus-Award-Fee (CPAF) or Firm-Fixed-Price (FFP) or a combination thereof.

B.3 MINIMUM ORDER GUARANTEE

The minimum order guarantee for this Contract is $25,000. USAID/Nigeria is required to order and the contractor is required to furnish the minimum order amount of services. The initial obligation is expected to be applied towards the first TO issued along with the award of the basic Contract.

Following this initial obligation, individual TOs will obligate funds to cover the work required under each TO.

B.4 MAXIMUM CONTRACT CEILING

This is a Single Award IDIQ with an overall ceiling not to exceed $225,000,000.00. The maximum aggregate dollar value of the TOs awarded cannot exceed this Contract ceiling.

B.5 FIXED FEE CEILING (Cost-Plus- Fixed-Fee Task Orders Only)

(a) For each cost-reimbursement TO issued under this IDIQ, the TOCO and Contractor agree to negotiate a set dollar amount for fixed fee. In negotiating the fixed dollar amount for fee, the TOCO must consider the policies and factors for establishing fee in FAR 15.404-4 as well as any applicable USAID policy on establishing a fixed fee amount and any additional considerations received to include a Letter of Credit. In no event, however, may the amount of fixed fee in any individual TO exceed TBD percent of the task order’s estimated cost, excluding fee.

This fee ceiling is not applicable to Grants under Contracts (GUCs), if any, or other costs that have a separate fee ceiling established in the contract. The fixed fee ceiling applies to the prime contract and all cost reimbursement subcontracts.

Fees for CPIF or CPAF task order types will be negotiated by the TOCO at the time of task order award.

(b) The ceiling on fixed fee does not apply to Firm-Fixed-Price (FFP) TOs.

(c) No fee on fee is authorized. Primes that are represented in Joint Ventures and are also proposed as subcontractors are authorized to propose fixed fee under either the prime Contract or the subcontract, not both.

(d) Fixed Fee Payment. For any TO issued under this Contract, at the time of each payment of allowable costs to the contractor, the USAID paying office ordinarily pays the contractor a percentage of fixed fee that directly corresponds to the percentage of allowable costs being paid.

Two exceptions to paying fixed fee in this manner apply:

(1) If the TOCO determines that this method results in paying a disproportionately higher ratio of fixed fee than the percentage of work that the contractor has completed, then the TOCO may suspend further payment of any fixed fee until the contractor has made sufficient progress to justify further payment, up to the agreed percentage.

(2) In accordance with "Allowable Cost and Payment" (FAR 52.216-7) and "Fixed

Fee" (FAR 52.216-8), the terms and conditions of these clauses apply after total payments of fixed fee reach eighty-five percent (85%) of the total fixed fee.

(e) Separate Fixed Fee Ceiling Applicable To Grants Under Contracts (GUCs)

(1) In no event may the amount of fixed fee (if any) applicable to GUCs in any individual TO exceed TBD percent of the TO GUC cost. -Or-

(2) If a Letter of Credit has been issued to the Contractor for GUC expenditures only, in no event may the amount of fixed fee (if any) applicable to GUCs in any individual TO exceed TBD percent of the TO GUC cost.

B.6 INCENTIVE FEE AND AWARD FEE

(a) For each CPIF TO issued under this IDIQ, the TOCO and Contractor agree to negotiate the target cost, target fee, and fee adjustment formula. The Government also reserves the right to utilize non-monetary incentives.

(b) For each CPAF TO, issued under this IDIQ, the TOCO and Contractor agree to negotiate an estimated cost, base fee, an award fee, a maximum fee (the sum of the base and award fee amounts), and a fee payment plan. Award fee determinations will be made unilaterally by the CO, in accordance with an approved evaluation plan, and such determinations will not be subject to appeal under the Disputes clause of the contract.

B.7 CONTRACT LINE ITEMS (CLINs)

CLINs will be established based on requirements in the respective TOs.

B.8 LABOR (Only applicable to cost reimbursement type task orders)

(a) Central management costs will be handled through the following method:

Contractors will be authorized to bill USAID directly for IDIQ management costs as specified in a TO to be issued under a separate solicitation.

(b) Unburdened Ceiling Daily Rates (CDR)

(1) The TO rates must not exceed the CDRs set forth in the table in Section B.11 below.

Each CDR for personnel listed below is “unburdened” and must only include salary costs or consulting rates of the individual providing the services.

The CDR for employees must not include the following:

(i) Payroll costs (fringe benefits, FICA, allowances, differentials, etc.);

(ii) Indirect Costs applicable to labor; and,

(iii) Profit or fee, if any.

The CDRs set forth in Section B.11 are fixed for the contract period and is for a productive eight (8) hour day, and apply to all subcontractors set forth in clause 52.244-2 in Section I. If a new subcontractor is proposed for a specific TO on other than a fixed-price basis, the CDRs set forth in Section B.11 below will apply, and the subcontract is subject to consent by the TOCO in accordance with FAR Part 44.

Actual salaries for all personnel will be negotiated under task orders and final approval is provided by the TOCO. The ceiling rates presented below do not constitute approval of final salary rates above the Contractor Salary Threshold (CST) (see ADS 302).

(2) The single unburdened ceiling daily rate for each labor category/group below represents the mid-level and senior level rate in each category/grouping. One unburdened ceiling daily rate for each labor category/grouping is included in the contract to provide more flexibility under task orders. If junior-level personnel are required under task orders, they must be proposed at rates below the unburdened ceiling daily rate.

(c) Minimum Qualifications

In order to perform the SOW set forth in Section C, the Contractor must provide personnel that meet the minimum education and experience requirements set forth below. These minimum qualifications correspond to the labor matrix in Section B.11.

Language fluency, relevant regional experience, and international development experience requirements will be specified in individual task orders.

*Highest degree obtained should be related to work being performed.

** Experience should be related to the work being performed.

***Relevant Work Experience is required for the levels indicated.

**** Applies to Non US academic qualification equivalence.

(d) Subcontractor Rates

The following provides guidance for various subcontracting arrangements:

Education + Experience Requirements OR

Experience Requirements (Substitution of Relevant Work Experience in Lieu of a Degree)

Level Academic Degree*

AND Years of Relevant Work Experience**

Years of Relevant Work Experience***

Junior Level

BS/BA

Less than

BS/BA****

0-4 10

Mid

Ph.D. 4

JD/ABD 5

MS/MA/MB 6

BS/BA 8

Less than

BS/BA**** 10

Senior

Ph.D. 8

JD/ABD 10

MS/MA/MB 12

BS/BA 15

Less than

BS/BA**** 20

(1) The Prime subcontracts with an approved subcontractor from the original IDIQ competition.

The unburdened CDR’s for the prime Contract apply to the subcontractor.

(2) The Prime contracts with a new subcontractor not yet approved

The unburdened CDR’s for the prime Contract apply to the new subcontractor.

(3) Prime subcontracts with a new subcontractor not yet approved and may or may not have a different cost accounting system that only processes fully burdened rates. Further, subcontractor proposes rates that are “above” the prime IDIQ rates.

The Prime may then include in its TO proposal, (i) the fully burdened rate proposed to the Prime by the Subcontractor, (ii) allocation of the Prime’s indirect costs in accordance with established accounting practices, and (iii) a reasonable profit. If the rates proposed to USAID, inclusive of the Prime’s allocable indirect costs and a reasonable profit are above the Prime’s unburdened CDRs , the Prime must disclose the amount of the indirect costs, and the amount of the proposed profit that were added to the Subcontractor’s proposed rates. A reasonable profit will be negotiated by the TOCO for the specific TO. The CDRs of the subcontractor must not exceed the prime’s CDRs in the IDIQ Contract.

B.9 LABOR (UNBURDENED CDR) RATE CHANGES

The labor rates are fixed for all Contract years as described within this Contract; however, the Contractor may submit a proposal reducing the labor rates and/or indirect rates at any time during the life of this Contract. The Government will review these proposals and determine if the revised rates are realistic and in the best interests of the Government. If the rates are accepted, the Government will modify the Contract by incorporating the new rates into the Contract.

B.10 STTA BURDENED RATE

Certain TOs may require Short Term Technical Assistance (STTA); whereby, the contractor may propose daily (8 hours of productive work) fully burdened rates. No additional fee, overhead, G&A, or other costs may be added to the fully burdened rates.

B.11 LABOR MATRIX

The labor rates below are fixed for the life of the Contract unless amended in accordance with B.9:

Labor Level Yr 1 Yr 2 Yr 3 Yr 4 Yr 5 Yr 6 Yr 7

LABOR CATEGORIES

(UNBURDENED)

Jr/Mid/Snr Daily Rate

Daily Rate

Daily Rate

Daily Rate

Daily Rate

Daily Rate

Daily Rate

TBD

TBD

TBD

LTTA (UNBURDENED)

TBD

TBD

TBD

STTA (FULLY

BURDENED)

TBD

Note 1: The Unburdened Ceiling Daily Rates apply to any task order(s) that are awarded under this contract.

Note 2: The Unburdened Ceiling Daily Rates apply to all labor (the prime contractor, subcontractor, TCNs, CCN’s, and consultant salaries). CCN and TCN labor are also governed by the local compensation plan limitations as further provided in note 3 below.

Note 3: Locally Hired National Personnel or Other Non-U.S. Expatriate Rates: All locally hired national personnel and other non-U.S. expatriates must be paid in accordance with AIDAR 722.170.

Salaries for individual locally-hired personnel and other non-U.S. expatriates under this contract and any resulting subcontract must be in accordance with AIDAR 752.7007, Personnel Compensation (July 2007), and should be based upon a combination of factors including the prevailing compensation paid to personnel performing comparable work in the cooperating country as determined by USAID and consideration of the individual's education, work experience and recent relevant salary history.

Unless otherwise authorized by USAID, the compensation for CCN and TCN labor must not exceed the prevailing compensation paid to personnel performing comparable work in the cooperating country as determined by USAID and must be paid in the currency of the cooperating country.

Note 4: The Unburdened Ceiling Daily Rates above do not apply to Fixed-priced Task Orders.

B.12 INDIRECT COSTS (Applicable to cost reimbursement TOs)

Pending establishment of revised provisional or final indirect cost rates, allowable indirect costs will be reimbursed on the basis of the following negotiated provisional or predetermined rates and the appropriate bases for prime contractors and their subcontractors.

Contractor Fringe Rate

Overhead Rate %

Overhead Ceiling Rate%

G&A Rate %

G&A Ceiling Rate %

PRIME (insert) Type of Rate (insert) Base of Application (insert) Source: (insert) Period: (insert)

SUBCONTRACTOR(S)

(insert)

Type of Rate Base of Application (insert) Source: (insert) Period: (insert)

NOTE: Ceiling Rates only applicable to other than small business contractors.

NOTE: Insert additional indirect rates as needed for all primes and subcontractors in the above table.

NOTE: The un-shaded columns in the indirect cost table are the current approved indirect cost rates for the prime and subcontractor(s).

NOTE: For Fixed-priced Task Orders, the overhead ceilings serve as the basis for negotiation only.

NOTE: Contractors are allowed to recoup indirect costs (OH, G&A, etc.) as other direct costs if it is part of the contractor’s usual accounting procedures, consistent with FAR 31 and the contactor’s NICRA.

The Contractor will make no change in its established method of classifying or allocating indirect costs without the prior written approval of the Contracting Officer.

Reimbursement for indirect costs shall be at final negotiated rates, but not in excess of ceiling rates specified above.

The Government will not be obligated to pay any additional amount associated with indirect costs above the ceiling rates established in the Contract. This advance understanding shall not change any monetary ceiling, cost limitation, or obligation established in the Contract.

B.13 COST REIMBURSABLE

(Applicable to cost reimbursement TOs)

The U.S. dollar costs allowable must be limited to reasonable, allocable, and allowable costs determined in accordance with FAR 52.216-7, Allowable Cost and Payment, and FAR 52.216-8, Fixed Fee, if applicable: AIDAR 752.7003, Documentation for Payment; OMB Circular 1-21, Cost Principles for Educational Institutions and OMB Circular A-122, Cost Principles for Non-profit organizations.

[END OF SECTION B]

SECTION C- STATEMENT OF WORK

C.1 INTRODUCTION

USAID/Nigeria envisions an integrated health program with an expanded effort with the Government of Nigeria (GON) 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 childhood pneumonia/diarrhea.

This program 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. USAID expects this program to be a full partnership between the implementer, USAID, the GON and selected states. 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.

C.2 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 did not improve 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 (ANC) visit 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 children 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 ANC, with a more than 34% drop-out rate between the first and second IPTp doses. (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.)

There have been some improvements between 2008 and 2013. Under-five mortality has decreased from 157 per 1000 live births in 2008 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 Reproductive Maternal Newborn and Child Health (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.1

C.3 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” (e.g. use of government resources) to adequately invest in health to accelerate sustainable reductions in child and maternal mortality. The GON at the all levels must embrace and own the goal of improving Reproductive, Maternal, Newborn and Child Health outcomes as its own, and make substantive parallel GON investments to assure success.

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. Innovative thinking is needed in how feedback occurs.

C.4 CONCEPTUAL FRAMEWORK

By the end of this program, USAID expects participating states to have strengthened health systems that deliver evidence-based high impact RMNCH interventions resulting in improved maternal and child health status. The conceptual framework includes demonstration of state commitment to prioritizing maternal and child health through costed health plans and increased share of state and LGA budgets for health.

Rapid scale-up of family planning, malaria, routine immunization, nutrition, maternal/newborn health, and treatment of major child illnesses (e.g., pneumonia and diarrhea) will require GON health systems support and GON health systems strengthening, focused on the key barriers to achieving improved health outcomes in the near-term, whether through public and/or private sector delivery. Community (or consumer) demand, when channeled through effective advocacy (or market-place choices), and informed by what is possible in health, can drive imperatives.

Service delivery and health systems strengthening interventions will require close coordination with communities, LGAs, states, private sector actors, and other stakeholders. Stakeholders and decision-makers will be encouraged by improved maternal and child outcomes. This in turn will create an atmosphere where health is viewed as a political imperative, whereby state and local level decision makers are committed to improved investment and shared accountability for sustained improvement of primary health care.

Improved investment and accountability will be supported by a strengthened partnership foundation with public and/private sector actors. These actors will collaborate in all aspects of the program to create shared expectations and mutual accountability as well as monitor commitments and results achieved.

Finally, robust monitoring and evaluation will provide the basis for sustained change.

Standardized data at multiple levels will be collected frequently to support all program components to allow for timely course corrections, and the introduction of new ideas and proven innovations.

The conceptual framework is aimed at a situation when health becomes a political imperative in the public sector and a business imperative in the private sector. 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 Proprietary Medicine Vendors (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 imperatives. USAID/Nigeria’s conceptual framework 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 at an affordable cost.

The early and rapid scale-up of primary health interventions will require some level of systems strengthening, focused on the key barriers to achieving improved health outcomes in the near-term. Activities will focus on critical inputs to achieve improvements in the core functions of the health system, and promote country ownership and sustainability. USAID anticipates that health systems strengthening, covering the six WHO-defined building blocks [The “health systems” here refers to the six system building blocks defined under the World Health Organization (WHO) Health Systems Framework http://www.wpro.who.int/health_services/health_systems_framework/en/.], as a percentage of overall Project effort, will increase over the life of program. As measurable improvements in health outcomes at state-level are demonstrated, the imperative grows for the states and LGAs to invest more in their health systems. More importantly, not all six building blocks will be implemented with the same level of effort by the Project in all the states. Health systems http://www.wpro.who.int/health_services/health_systems_framework/en/ priorities will be evidence-based, and be determined in partnership with the state government and in consultation with USAID.

Some examples of the Federal Ministry of Health systems strengthening strategic focus relevant to this Project are:

• The Government of Nigeria’s vision, as enunciated in December 2015, is to have at least one functional Primary Health Care Facility in every political ward.

• The government’s focus on health financing is in part to improve access to health for the most vulnerable groups. Additional Government and non-government sources for financing health in Nigeria include, but are not limited to: the World Bank Performance for Results (P4R) mechanism, the National Health Act, the Global Fund for HIV/AIDS, Tuberculosis and Malaria, and potentially, the Global Financing Facility.

USAID will apply several mechanisms to measure the commitments of the states under this award to include monitoring of the proportion of its budget allocated, released and disbursed to the health sector. USAID recognizes that states may need assistance to track funds flow through the health sector to ensure that funds budgeted are released, disbursed and expended efficiently for optimum performance.

Fundamental to the conceptual framework is a much strengthened partnership foundation with public and private sector actors, beginning in the early design phase of this program, where partners co-create, co-design, co-invest, and collaborate throughout implementation. Pre-award, USAID will manage the interaction with government and non-government actors. Following award of TOs, USAID will still be involved in more direct engagement with the government actors at state and LGA level. There will be shared expectations, mutual accountability, and joint monitoring to see that commitments are being fulfilled and results achieved, with clear provision for course corrections.

Lastly, the conceptual framework requires a robust monitoring and evaluation to ensure that the program is on track to achieve results. Frequent and granular data is needed to support the partnership foundation and all other components of the conceptual framework to allow for more nimble course corrections, introduction of new ideas, and proven innovations.. In addition to program-level monitoring and evaluation, USAID/Nigeria will support external performance monitoring and evaluation to track progress and results.

C.5 ALIGNMENT WITH USAID GOALS AND HPN STRATEGIC FRAMEWORK

Contribution to Mission Country Development Cooperation Strategy (CDCS) and Health, Population, and Nutrition Program

The goal of the USAID/Nigeria CDCS is to “reduce extreme poverty in a more stable, democratic Nigeria” (Figure 1). By improving Reproductive, Maternal, Newborn and Child

Health, this activity will contribute to the reduction of extreme poverty and the achievement of the Health, Population, and Nutrition (HPN) development goal of “a healthier population in targeted states” (Figure 1). This activity will contribute to HPN Intermediate Results (IR) “Utilization of quality health services in target areas and population groups increased” through:

(a) Strengthening Governance of Health systems;

(b) Increasing Demand for Primary Health Care services; and

(c) Improving access to quality services.

Figure 1: HPN and HIV/AIDS Results Framework

C.6 USAID INTEGRATED HEALTH PROGRAM OBJECTIVES AND SUB-

OBJECTIVES

Objective:

This program 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:

Through more transparent mechanisms, State and local government authorities will be efficiently and effectively engaged in health programs. They 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 to quality primary health care services at facility and community level, including integrate services with other technical areas in order to improve access (e.g.

Prevention of Maternal to Child Transmission of HIV/AIDS (PMTCT), tuberculosis, HIV, etc.).

The USAID Integrated Health Program will improve quality and coverage in the following technical areas, with an ultimate goal of state-level reductions in maternal and child mortality:

• Family planning;

• Malaria prevention and treatment;

• Routine immunization;

• Nutrition;

• Maternal/newborn health; and,

• Treatment of childhood pneumonia/diarrhea.

This program will also coordinate closely with other Mission funded health activities (such as other RMNCH-related and malaria activities, where they overlap) in order to maximize impact towards state-level reductions in under-five mortality and maternal mortality.

The USAID Integrated Health Program will expand efforts with states and LGAs to identify and support the optimal service delivery points for rapid scale-up of proven interventions. Areas of intervention may be at the health facility and/or within the community (this could 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 program should build on existing research and evidence of proven approaches, and conduct additional formative research to inform program design as needed.

Promoting state leadership of programs in the health sector is a major objective of this activity.

USAID also plans to fund other complementary development projects within the selected states apart from this program. The Mission leadership will engage actively with state leadership to ensure and articulate a shared vision for and commitment to strengthening health systems and improving health outcomes.

The USAID Integrated Health Program and the new Governance program currently in design will work closely to improve the enabling environment for health and leverage resources from the state government. While the USAID Integrated Health Program will work to strengthen the institutions within the health sector, the Governance activity will primarily engage with players outside the health sector that affect health.

C.7 FUNDING

Funding for this activity will come from USAID Nigeria’s 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 58% 30% 11% 1% 100% Year 2 58% 30% 11% 1% 100% Year 3 58% 30% 11% 1% 100% Year 4 58% 30% 11% 1% 100% Year 5 58% 30% 11% 1% 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 range of technical interventions to be supported in each selected state will therefore be determined before the state-specific TOs are issued. TO 01 for Mobilization and Personnel Recruitment will be issued concurrently with the IDIQ Contract.

C.8 GENDER CONSIDERATION

The Contractor must ensure the USAID policies and strategies including the Gender Equality and Female Empowerment Policy are incorporated and applied during implementation of the IDIQ and all TOs as guided in ADS 205. The Contractor must possess the technical expertise necessary to address gender issues and promote equity in implementing the USAID Integrated Health Program.

C.9 SECURITY CONSIDERATIONS

Nigeria has been designated a high threat post and the Contractor is expected to take steps to be responsive to this shifting environment. Offerors are advised that there are occasional reports of robberies and car-jacks, some involving armed gunmen, on Nigeria's urban and rural road network. The U.S. State Department travel advisory for Nigeria regularly issues information regarding risks of travel to some states in Nigeria because of the risks of kidnapping, robbery, and other armed attacks in these areas. The advisory also informs that throughout the country, violent crime committed by individuals and gangs, as well as by persons wearing police and military uniforms, remains a problem.

The Contractor is encouraged to establish a comprehensive and dynamic safety and security plan pertaining to all aspects of its activities and the activities of its employees in the performance of all work related to this Contract as well as the off-duty activities of its employees, as those activities relate to performance of Contract work, serving in Nigeria. The Contractor must also work closely with and establish working relationships with all authorized and appropriate safety and security organizations and entities for the protection and safety of its operations and employees.

The Contractor will be responsible for its own security under this Contract and will employ a security profile that is cost-effective. The Contractor is responsible for maintaining the security of its personnel, materials, and equipment commensurate with the circumstances involved. All employees of the Contractor must meet the requirements of their work-site which may include background checks, security/restricted area clearance, drug-free workplace, safety training and/or other inspections/requirements.

C.10 MANAGEMENT OF GRANTS UNDER CONTRACT (GUCs)

Funds will be made available in some TOs for the award and administration of grants. GUC must be utilized under this IDIQ to promote local ownership and capacity building of local partners. A grants manual will be required. All grants must comply with branding and marking requirements set forth in the approved Contractor’s approved branding and marking Plan as well as comply with environmental requirements.

The contractor must coordinate with the TOCOR with the grants management tasks that include the following for working with local organizations throughout each phase of the award process:

(a) Pre-Solicitation Phase: Develop the solicitation;

(b) Solicitation Phase: Issue/advertise opportunity, hold solicitation conferences;

(c) Evaluation Phase: Screen potential grantee partners, evaluate proposals consistent with USAID policies at ADS 303 and procedures and document the proposed awardee selection. The TOCO must first approve grants unless otherwise stated in the task order. The process for approving grants will be specified in individual TOs;

(d) Award Phase: Establish grants in accordance with USAID policies; and,

(e) Post-Award Phase: Monitor implementation and deliverables and grant close-out as directed in the task order.

GUCs will be solicited, negotiated, and administered following provisions in Section H.29 of the IDIQ contract.

C.11 HIGH LEVEL/ KEY PERFORMANCE INDICATORS

At the end of the USAID Integrated Health Program, success will primarily be assessed at the state level whereby a state government leads and owns the management of its health systems, delivers high quality primary health care services, and covers the majority of the target populations through:

• 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; and,

• 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.

The USAID Integrated Health Program is expected to produce results at the state level, against which performance will be assessed. Specific indicators and targets for each state will be included in the TOs.

This program 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.

Illustrative IDIQ indicators include the following:

Sub-objective 1: Health systems strengthened:

• Percent of state and LGA budget allocations to the health sector.

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

• Percentage of women who make decisions about their own health care;

• Percentage of women with at least 2 doses of intermittent preventive treatment for malaria during pregnancy; and,

• Percentage of children under five who slept under insecticide treated mosquito net the night before the survey.

Sub-objective 3: Access to quality services improved:

• Percentage of facilities offering integrated package of RMNCH services;

• Percentage of deliveries attended by skilled providers; and,

• Modern contraceptive prevalence rate.

C.12 TASK ORDER 01 REQUEST FOR TASK ORDER PROPOSAL (RFTOP)

Task Order 01 – Mobilization and Personnel Recruitment is provided in the RFTOP as Attachment J.1 to this solicitation.

[END OF SECTION C]

SECTION D – PACKAGING AND MARKING

D.1 AIDAR 752.7009 MARKING (JAN 1993)

(a) It is USAID policy that USAID-financed commodities and shipping containers, and program construction sites and other program locations be suitably marked with the USAID emblem. Shipping containers are also to be marked with the last five digits of the USAID financing document number. As a general rule, marking is not required for raw materials shipped in bulk (such as coal, grain, etc.), or for semi-finished products which are not packaged.

(b) Specific guidance on marking requirements should be obtained prior to procurement of commodities to be shipped, and as early as possible for program construction sites and other program locations. This guidance will be provided through the cognizant technical office indicated on the cover page of this Contract, or by the Mission Director in the cooperating country to which commodities are being shipped, or in which the program site is located.

(c) Authority to waive marking requirements is vested with the Regional Assistant Administrators, and with Mission Directors.

(d) A copy of any specific marking instructions or waivers from marking requirements is to be sent to the Contracting Officer; the original should be retained by the Contractor.

D.2 BRANDING AND MARKING POLICY

(a) In accordance with ADS 320 “Branding and Marking”, this IDIQ incorporates USAID’s policy directives and required procedures on branding and marking of USAID-funded programs, projects, activities, public communications, and commodities with the USAID identity.

Markings under this Contract must comply with the USAID “Graphic Standards Manual" available at www.usaid.gov/branding or any successor branding policy.

(b) The Contractor must develop a Branding Implementation Plan (BIP) and Marking Plan (MP) for the IDIQ to describe how program deliverables shall be branded. The BIP will implement USAID branding strategy for the USAID Integrated Health Program IDIQ:

Program Name: USAID Integrated Health Program

Branding Strategy: The branding shall incorporate the message that the assistance is “From the American People and through USAID”

Desired level of visibility: USAID identity must be prominently displayed in commodities of equipment; infrastructure projects; printed, audio. Visual or electronic public communications; studies, reports, publications, websites, and promotional and informational products; and events.

http://www.usaid.gov/branding

Organization to Be acknowledged: The branding may acknowledge other organizations deemed as partners of an event or deliverable.

The Marking Plan must enumerate all of public communications, commodities, infrastructure projects, program materials, events, deliverables, and other items that shall be marked with the USAID identity or brand.

(c) Each Request for Task Order Proposals (RFTOP) under this IDIQ will request a program-specific Branding Implementation Plan (BIP) and Marking Plan (MP). For each TO, the contractor must develop a detailed Branding Implementation Plan (BIP) and Marking Plan (MP) specific to the TO.

The Marking Plan may include requests for exceptions to marking requirements for programmatic reasons, to be approved by the Contracting Officer. Waivers, as defined by ADS 320, may be necessary for compelling political, safety or security concerns, or if the marking will have an adverse effect in the host country. Marking and attribution for physical structures may need to be visible as soon as work commences. Contract deliverables to be marked with the USAID identity must follow design guidance for color, type, and layout in the Graphic Standards Manual, available at www.usaid.gov/branding , and all successor branding policies (if any).

D.3 BRANDING STRATEGY, IMPLEMENTATION PLAN AND MARKING PLAN

The Contractor must comply with the requirements of the policy directives and required procedures outlined in USAID Automated Directive System (ADS) 320.3.2 “Branding and Marking in USAID Direct Contracts” (effective date: 01/08/2007) at https://www.usaid.gov/sites/default/files/documents/1868/320.pdf, and USAID “Graphic Standards Manual” available at www.usaid.gov/branding, or any successor branding policy.

The Contractor must submit a Branding Implementation Plan and Marking Plan consistent with the instructions of each TO. The Contractor will follow the approved plan during implementation of each task order unless a waiver is requested and approved by the contracting officer.

[END OF SECTION D]

http://www.usaid.gov/branding https://www.usaid.gov/sites/default/files/documents/1868/320.pdf

SECTION E – INSPECTION AND ACCEPTANCE

E.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE

The following Contract clauses pertinent to this section are hereby incorporated by reference (by Citation Number, Title, and Date) in accordance with the clause at FAR 52.252-2 "CLAUSES INCORPORATED BY REFERENCE" in Section I of this Contract. Full text of the FAR clauses is available at https://www.acquisition.gov/far/ and full text of the AIDAR clauses is available at http://www.usaid.gov/ads/policy/300/aidar-http://www.usaid.gov/ads/policy/300/300.

NUMBER TITLE DATE

FEDERAL ACQUISITION REGULATION (48 CFR Chapter 1)

52.246-4 INSPECTION OF SERVICES—FIXED PRICE AUG 1996

52.246-5 INSPECTION OF SERVICES—COST REIMBURSEMENT APR 1984

52.246-15 CERTIFICATE OF CONFORMANCE APR 1984

52.246-16 RESPONSIBILITY FOR SUPPLIES APR 1984

E.2 INSPECTION AND ACCEPTANCE

USAID inspection and acceptance of services, reports and other required deliverables or outputs shall be subject to the performance standards set forth in Sections C and F. Inspection and acceptance shall take place at:

USAID/Nigeria 1075 Diplomatic Drive

Central Business District P.M.B. 519 Garki, Abuja or at any other location where the services are performed and reports and deliverables or outputs are produced or submitted. Inspection of all deliverables required hereunder will be made by the Contracting Officer’s Representative (COR), designated in Section G, who has been delegated authority to inspect and accept all services, reports and other required deliverables. Acceptance of services, reports and other deliverables by the COR will form the basis for payments to the Contractor.

E.3 RESPONSIBLE OFFICIAL

In accordance with the clauses of this Contract entitled ―Inspection – Cost Reimbursement, (FAR 52.246-5) and ―Inspection – Fixed Price, (FAR 52.246-4), inspection of results or other deliverables required by each TO issued hereunder will be made by the cognizant COR for that TO. Acceptance of goods/services and reports or other deliverables by the cognizant COR for that TO will form the basis for payments to the contractor, and will form the basis of the contractor‘s permanent performance record with regard to this Contract.

[END OF SECTION E]

http://www.usaid.gov/ads/policy/300/300

SECTION F - DELIVERIES OR PERFORMANCE

F.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE

The following Contract clauses pertinent to this section are hereby incorporated by reference (by Citation Number, Title, and Date) in accordance with the clause at FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE" in Section I of this Contract. See FAR 52.252-2 for an internet address (if specified) for electronic access to the full text of a clause.

NUMBER TITLE DATE

FEDERAL ACQUISITION REGULATION (48 CFR Chapter 1)

52.242-15 STOP-WORK ORDER AUG 1989

52.242-15 STOP-WORK ORDER ALTERNATE I APR 1984

52.242-17 GOVERNMENT DELAY OF WORK APR 1984

F.2 PERIOD OF PERFORMANCE

(a) 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.

(b) 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 seven (7) years, consisting of the five (5) year IDIQ ordering period, followed by up to two (2) years ending when the last TO expires. Clauses, terms, and conditions that are located in the IDIQ and govern TOs continue to be valid and in-force, and able to be modified if necessary, throughout the IDIQ period of performance.

(c) Task Order Period of Performance: TO periods of performance will in no case be longer than five (5) years at any one time. A TO period of performance may extend by for up to two (2) years past the end of the IDIQ Ordering Period.

(d) If in the rare circumstance the IDIQ period is extended in accordance with FAR part 6, the corresponding dates for paragraphs (a) – (c) above will be provided in the IDIQ modification.

F.3 PLACE OF PERFORMANCE

The place of performance under this Contract is Nigeria.

F.4 PERFORMANCE STANDARDS

(a) Evaluation of the contractor's performance must be conducted for each TO in accordance with the performance standards set forth in the TO, if any, the Contractor's overall performance toward achievement of the objectives in Section C and provision of deliverables in Section F of the TO, and the Contractor's compliance with all other terms and conditions of the IDIQ and TO

(b) Contractor Performance Reports: On an annual basis, the TOCOR will complete a Contractor Performance Assessment Report (CPAR) for the IDIQ Contract and each TO issued hereunder. Each evaluation will be conducted jointly by the TOCOR and the TOCO, and must form the basis of the contractor's permanent performance record with regard to this Contract and task orders as required in FAR Part 42.15 and AIDAR 742.15. Contractor’s performance will be evaluated utilizing at minimum, the following factors:

(1) Technical (quality of product or service).

(2) Cost control (not applicable for firm-fixed-price or fixed-price with economic price adjustment arrangements).

(3) Schedule/timeliness.

(4) Management or business relations.

(5) Small business subcontracting (as applicable).

(6) Other (as applicable) (e.g., late or nonpayment to subcontractors, trafficking violations, tax delinquency, failure to report in accordance with Contract terms and conditions, defective cost or pricing data, terminations, suspension and debarments).

Evaluations will be tailored to the TO type, size, content, and complexity of the requirement.

(c) USAID reserves the right to conduct, and the Contractor must expect and be prepared for, a management and/or financial audit by USAID at any time to ensure systems (management, administration, finance, procurement, and program) are in place as per the Contract. Such audit(s) will focus on program management and performance, including such factors as cost, timeliness, and accountability; and will include field and home office records pertaining to operations and program activities. The Contractor must cooperate with and contribute to a final management and financial review conducted by USAID prior to program closeout.

(d) USAID may also conduct a mid-term evaluation of the program consistent with the Agency Evaluation Policy and program performance reviews as required. The Contractor must cooperate with and contribute to these reviews and evaluations.

F.5 REPORTS AND DELIVERABLES OR OUTPUTS

(a) All reports and deliverables must be in the English language, unless otherwise specified in the respective TOs.

(b) Distribution of TOs to IDIQ COR: An electronic copy of each new TO issued under this IDIQ must be forwarded to the IDIQ COR within one week of receipt by the contractor.

(c) The cover page of all deliverables must include the USAID Identity prominently displayed, the IDIQ and TO Contract number, contractor name, the publication or issuance date of the document, document title, author name(s), and program title. Descriptive information is required whether contractor-furnished products are submitted in paper or electronic form.