Uganda CDC-RFA-JG-25-0047 Final NOFO for Publication.pdf

Division of Global HIV and Tuberculosis

Notice of Funding Opportunity

Application due February 18, 2025

Strengthening and modernizing sustainable public health systems and workforce in Uganda for data science, informatics, surveys, and surveillance for timely, accurate, and integrated data for action under PEPFAR Opportunity number: CDC-RFA-JG-25-0047

Contents Before you begin 3

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 8

Program description 10

Step 2: Get Ready to Apply 34

Get registered 35

Questions 36

Step 3: Prepare Your Application 37

Application contents and format 38

Step 4: Learn About Review and Award 49

Application review 50

Award notices 57

Step 5: Submit Your Application 58

Application submission and deadlines 59

Application checklist 61

Step 6: Learn What Happens After Award 63

Post-award requirements and administration 64

Contacts and Support 71

Contents 2

Before you begin If you believe you are a good candidate for this funding opportunity, secure your SAM.gov and Grants.gov registrations now. If you are already registered, make sure your registrations are active and up-to-date.

SAM.gov registration (this can take several weeks) You must have an active account with SAM.gov. This includes having a Unique Entity Identifier (UEI).

See Step 2: Get Ready to Apply

Grants.gov registration (this can take several days) You must have an active Grants.gov registration. Doing so requires a Login.gov registration as well.

See Step 2: Get Ready to Apply

Apply by the application due date Applications are due by 11:59 p.m. Eastern Time on February 18, 2025.

To help you find what you need, this NOFO uses internal links. In Adobe Reader, you can go back to where you were by pressing Alt + Left Arrow (Windows) or Command + Left Arrow (Mac) on your keyboard.

Before you begin 3 https://sam.gov/ https://grants.gov/

Jump to a step

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1:

Review the Opportunity

In this step

Basic information 5

Eligibility 8

Program description 10

Basic information U.S. Centers for Disease Control and Prevention (CDC)

Global Health Center

Division of Global HIV and Tuberculosis

Reducing HIV and TB incidence and mortality in global settings through data-driven programs and strengthened public health systems

Have questions?

See Contacts and Support.

Key facts

Opportunity name:

Strengthening and modernizing sustainable public health systems and workforce in Uganda for data science, informatics, surveys, and surveillance for timely, accurate, and integrated data for action under

PEPFAR

Opportunity number:

CDC-RFA-JG-25-0047

Announcement type:

New

Assistance listing: 93.067 Global AIDS Program

Key dates

Application deadline:

February 18, 2025

Expected award and start date: September 30, 2025.

We will inform you of your application status by the end of August 2025.

See other submissions for other time frames that may apply to this

NOFO.

Summary This NOFO focuses on working with the Government of Uganda (GOU) and the Ministry of Health (MOH) as a primary partner to strengthen and modernize data systems and workforce, enabling more timely and integrated data for high-quality, data-driven decision-making.

This NOFO will also focus on building capacity and data infrastructure to provide timely epidemic intelligence for critical decision-making for HIV and related health programs in Uganda. Data will be collected through general or targeted surveys, clinical surveillance, disease surveillance, and other data-collection activities to address data or knowledge gaps. Note: this NOFO will not fund research activities.

Funding details Type: Cooperative agreement

Expected total NOFO funding for Year 1: $20,000,000 This is the expected total Year 1 funding for all awards made under this

NOFO.

Expected number of awards: 1 to 2 The number of awards is subject to available funds and program priorities.

Exact amounts for each award under this NOFO will be determined upon award.

We plan to award projects for five 12-month budget periods for a five-year period of performance.

Step 1: Review the Opportunity 5

Funding strategy

Funding amounts We encourage you to apply for the expected total NOFO funding for Year 1.

You may not request more than this amount.

Funding amounts for years two through five will be set at continuation. We will continue funding based on:

• Availability of funds.

• Evidence of satisfactory progress, as documented in your required reports.

• The determination that continued funding is in the best interest of the federal government.

Component funding

Overview

We fund all President’s Emergency Plan for AIDS Relief (PEPFAR) cooperative agreements using component funding.

Component funding allows us to provide funding as it becomes available. To do so, we fund sets of activities by quarter and project.

CDC may fund one or more of your components to start the budget period, and then consider other components based on available funding later.

Setting up components

You must set up your components in your application. While preparing your application:

• Review the expectations for year one activities in the strategies and activities section.

• Group your activities under the following anticipated components. Only include the activities planned for year one.

◦ Component 1: COP Q1 Targets and Activities.

◦ Component 2: COP Q2 Targets and Activities.

◦ Component 3: COP Q3 Targets and Activities.

◦ Component 4: COP Q4 Targets and Activities.

◦ Component 5: COP Additional Targets and Activities.

◦ Component 6: Emerging Public Health Priorities (buffer component if needed).

Step 1: Review the Opportunity 6

For information on how to incorporate component funding into your application, see the following sections:

• Budget narrative

• Component funding instructions for SF-424A

PEPFAR Local partner funding preference This NOFO includes a funding preference for local partners. Your organization will receive 30 extra points during the selection process if you provide sufficient documentation demonstrating you meet the PEPFAR local partner definition.

Step 1: Review the Opportunity 7

Eligibility Statutory authority This program is authorized under:

• The United States Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003, Public Law 108-25 (22 U.S.C. 7601, et seq.).

• The Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008, Public Law 110-293.

• The PEPFAR Stewardship and Oversight Act of 2013, Public Law 113-56.

• Public Health Service Act (42 U.S.C. 242I).

Eligible applicants This is a fully competitive NOFO, and eligibility is unrestricted. Any and all types of organizations are eligible and encouraged to apply, including but not limited to those listed.

• State governments.

• County governments.

• City or township governments.

• Special district governments.

• Independent school districts.

• Public and state-controlled institutions of higher education.

• Native American tribal governments (federally recognized).

• Public housing authorities and Indian housing authorities.

• Native American tribal organizations, other than federally recognized tribal governments.

• Nonprofits having a 501(c)(3) status, other than institutions of higher education.

• Nonprofits without 501(c)(3) status, other than institutions of higher education.

• Private institutions of higher education.

• For-profit organizations other than small businesses.

• Small businesses.

• Foreign or non-U.S. based entities.

Step 1: Review the Opportunity 8

Other required qualifying factors

Delivery location While any type of organization may apply, you must conduct the project in Uganda.

Responsiveness criteria We will review your application to make sure it meets these requirements.

These are the basic requirements you must meet to move forward in the competition. We won’t consider an application that:

• Is from an organization that doesn’t meet eligibility criteria. See requirements in eligibility.

• Is submitted after the deadline.

• Proposes research activities. See 45 CFR 75.2 for the definition of research.

• Requests more funding than the expected total NOFO funding for Year 1.

• Exceeds the 20-page limit for the project narrative (see the project narrative section for what counts toward the page limit).

• Is not in English.

• Includes a budget or budget narrative that uses a currency other than U.S. dollars.

• Does not respond to and is outside the scope of this NOFO.

See the application checklist to understand your application requirements.

Application limits We do not limit the number of applications an organization may submit.

Cost sharing and matching funds This program has no cost-sharing or matching funds requirement. We will not consider cost-sharing fund contributions during your application review.

However, if you submit voluntary cost-sharing funds and we fund your project, we will require you to report on these funds.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 9 https://www.ecfr.gov/current/title-45/part-75#p-75.2(Research)

Program description Background overview and related work The state of the HIV epidemic in Uganda Uganda continues to accelerate reductions in new HIV infections and deaths among people living with HIV, despite challenges like acute infectious disease outbreaks, health system stressors, and economic fragility.

Since 2016, there has been substantial progress toward the Joint United Nations Programme on HIV and AIDS (UNAIDS) global 95-95-95 targets of finding, diagnosing, and successfully treating people living with HIV.

Epidemiological data shows that:

• 92% of Ugandans living with HIV know their status.

• 83% of people living with HIV are linked to lifesaving antiretroviral therapy (ART).

• 79% of people on ART are virally suppressed.

Progress and challenges in HIV data collection and systems Yet, there are still gaps in identifying HIV-positive individuals, particularly among younger populations, key populations (female sex workers, men who have sex with men, and people who inject drugs), and men. Also, challenges with data availability, quality, integration, and timely access make it difficult to use data for planning and decision-making.

Uganda has been increasing investments and advances in its data systems, with 93% of PEPFAR-supported ART sites using electronic medical record (EMR) systems. Currently, the following activities are underway:

• A few sites are going digital, with data captured at the point of care.

• MOH is implementing EMR platforms (eAFYA and Clinicmaster) and discouraging disease-specific information systems. Instead, it’s promoting the full integration of other partners’ systems into the wider national health information system (HIS) ecosystem.

Step 1: Review the Opportunity 10

Modernizing Uganda’s public health data systems However, further support is needed to expand public health data science and informatics (DSI) capabilities through modernization, workforce development, and HIS infrastructure development, including:

• Use of state-of-the-art technologies to build data capture platforms and reduce parallel and manual paper-based data capture.

• Implementation of a digital-first approach to data capture, system interoperability, data integration and warehousing.

• Establishment of shared data analytic and visualization platforms to improve data access and use.

• Prioritization, development, implementation, and enforcement of legal, procedural, and policy frameworks around data science.

Helping GOU and MOH advance sustainable data systems that collect, manage, and use high-quality data through systems of service delivery and disease surveillance for HIV and related public health threats is central to advancing a modern and sustainable public health system. Modernizing data systems will help support:

• Preventing infections and disease outbreaks through a population that is better informed on how to reduce risk.

• Nationwide real-time monitoring, reporting, and investigation of public health threats.

• Faster detection of common public health threats and outbreaks.

• Improved insights into disease conditions and trends to inform program planning and implementation.

• Faster information sharing with stakeholders so that they can use data to make decisions.

More specifically, to improve HIV control, HIV surveillance and survey methods must be strengthened for:

• Case finding.

• Incidence and prevalence measurements.

• Viral load suppression monitoring.

• Treatment adherence.

• Identification of new infections and emerging risks.

Recent infection surveillance, case-based surveillance, and bio-behavioral surveillance can all be strengthened to monitor and inform the HIV response.

Surveillance of causes of death, infectious diseases, and non-communicable

Step 1: Review the Opportunity 11 diseases must also be strengthened and integrated under national mechanisms to improve efficiency, performance, and data use.

Expectations and key outcomes This NOFO builds on previous successes and lessons learned from efforts to strengthen monitoring and evaluation (M&E), disease surveillance, and HIS.

We expect you to support MOH to:

• Strengthen and modernize data systems.

• Develop sustainable public health surveillance systems and responses at all levels.

• Develop institutional structures for health governance.

• Identify and implement behavioral and other studies to inform program interventions.

• Strengthen the public health workforce.

To ensure sustainability and impact, we expect strategies and activities to be guided by and implemented within GOU governance structures.

Key outcomes will include:

• Increased MOH capacity to manage HIS at national and sub-national levels.

• Improved HIS infrastructure, tools availability, and storage capabilities in line with data modernization initiatives to effectively manage and analyze more data.

• Enhanced analytics for disease control and outbreak prevention, detection, and response to maintain and advance gains in the HIV epidemic while strengthening data science capabilities in the public health sector.

• Strengthened workforce capacity for improved surveillance and analytics of disease epidemiology, control, and outbreak response for HIV and related public health threats at all levels.

• Improved availability and use of behavioral data.

Step 1: Review the Opportunity 12

Purpose The purpose of this NOFO is to:

• Help GOU and the MOH implement strategies efficiently and effectively, resulting in more timely, actionable insights for decision-making at all levels of public health.

• Work with MOH to strengthen data systems and workforce capacity for DSI, surveillance, and use of data for decision-making.

• Support the GOU to institutionalize robust data systems for disease surveillance and health management and information to support data-driven decision-making at various levels to manage and monitor response, disease detection, and outbreak control for HIV and related public health threats.

Approach Program logic model The following logic model includes the expected strategies under this NOFO.

The logic model also includes the program’s expected outcomes. Outcomes are the results that you intend to achieve and usually show the intended direction of change, such as increase or decrease.

The asterisked ( * ) outcomes are those we expect you to achieve or substantially contribute to during the five-year period of performance. You must report on these outcomes.

Not all outcomes apply to all strategies. You will use these outcomes as a guide for developing performance measures.

Table: Strategies and outcomes

Strategies Short-term outcomes Intermediate outcomes Long-term outcomes

Strategy 1: Support MOH to strengthen data collection and review processes by increasing automation, improving data capture, and

• Improved infrastructure, management, and operations of HIS at national and sub-national levels.*

• Increased deployment and use of patient-level, laboratory, and surveillance systems.*

• Improved MOH ownership to increase resource allocation and maintain technical expertise and data systems solutions.*

Step 1: Review the Opportunity 13

Strategies Short-term outcomes Intermediate outcomes Long-term outcomes strengthening data quality management.

Strategy 2: Support MOH to create and implement sustainable systems and processes that enable seamless data exchange among disparate systems.

Strategy 3: Support MOH to strengthen tools, systems, and capacity for data analysis, dissemination, and use at national, regional, and health facility levels.

Strategy 4:

Strengthen MOH capacity to lead and implement survey, surveillance, and scientific projects for evidence-based decision-making, policy formulation, and epidemic control.

Strategy 5: Expand the capacity of public health workforce in DSI priority areas, including field epidemiology and informatics.

• Increased access to and availability of timely and high-quality data.*

• Improved data functionalities, interoperability, and integration between public

HIS.*

• Improved data analytics skills of MOH workforce, and availability and use of data analytic tools.*

• Improved availability and use of behavioral scientific data.*

• Increased use of data for forecasting, program planning, and decision-making at all levels.*

• Improved data sharing and dissemination of best practices as identified from data analysis and reviews.*

• Improved quality of health care and patient outcomes.

• Improved targeted program interventions and resource allocation.

• Increased workforce and health systems capacity to prevent, detect, and control HIV, TB, and related public health threats.*

• Sustained MOH and workforce capacity to detect, investigate, and respond to HIV, TB, and related public health threats.*

• Reduced mortality and morbidity.

Step 1: Review the Opportunity 14

Strategies and activities This section elaborates on the strategies described in the logic model by providing expected activities and details about how you expect to implement your program.

The following are strategies and the required activities under this NOFO. You may also propose additional related strategies and activities to achieve the expected outcomes.

Strategy 1: Support MOH to strengthen data collection and review processes by increasing automation, improving data capture, and strengthening data quality management.

Required activities:

• Standardize data collection methods in MOH systems and increase automation through comprehensive, robust, scalable, and secure information systems and applications.

• Establish strong data collection and quality management processes in support of MOH, U.S. Government (USG), and other stakeholders’ efforts to collect, review, clean, and validate program and other data (such as continuous quality improvement (CQI)).

• Develop and implement GOU policies and procedures for data governance, including metadata management, access controls, security measures, privacy considerations, and compliance with relevant regulations.

• Build systems to get regular feedback from data system end users.

• Develop a team of informatics staff at the Regional Referral Hospital and district levels to mentor site-level staff in improving electronic and paper-based data capture.

• Work with key stakeholders to secure and sustain investments in information technology (IT) infrastructure and power solutions.

• Work with MOH, USG, and other stakeholders to develop MOH M&E and other national strategies and frameworks for programs at the national, subnational, and site levels.

Step 1: Review the Opportunity 15

Strategy 2: Support MOH to create and implement sustainable systems and processes that enable seamless data exchange among disparate systems.

Required activities:

• Work with partners to empower MOH to independently establish and maintain centralized health data systems using a project management system.

• Support MOH in the setup, enhancement, and maintenance of scalable and efficient infrastructure needed to centralize and integrate health data.

• Help MOH implement a comprehensive system for unique patient identification, to help ensure high levels of information security, privacy, and confidentiality.

• Help MOH build a team of experts who work with partners to enhance HIS, ensuring continuous improvement and knowledge transfer throughout the system’s lifespan and across all levels.

• Integrate HIV/TB-related service delivery and systems-level HIS with other national health data systems, creating a unified and comprehensive health data ecosystem across care domains.

• Implement Extract, Transform, and Load (ETL) pipelines for the national data warehouse, along with necessary documentation (such as technical or workflow manual), data governance frameworks, and robust security measures for sensitive data.

• Work with MOH to develop a detailed sustainability plan outlining financial, technical, and human resource strategies needed to maintain

HIS.

• Aid MOH in working with national and international partners to facilitate a coordinated approach to implementing internationally approved solutions and standards.

Step 1: Review the Opportunity 16

Strategy 3: Support MOH to strengthen tools, systems, and capacity for data analysis, dissemination, and use at national, regional, and health facility levels.

Required activities:

• Ensure adherence to MOH data governance guidelines to manage sensitive health information.

• Build the technical capacity of MOH staff and partners at all levels to effectively use systems and new technologies for data analysis and forecasting from multiple sources, including routine monitoring, surveillance, surveys, CQI, and other studies.

• Use advanced data science methods for triangulation, modeling, and projections to estimate disease trends and inform interventions, program planning, and policies.

• Partner with MOH, USG, and other stakeholders to develop and use data and analytic tools (such as data visualizations and dashboards) to respond to requests and inform decision-making processes at the national, regional, and district levels.

• Analyze and summarize routine program data, CQI, and other data as requested by MOH, USG, and other key stakeholders.

• Create collaboration platforms between teams working on data analysis to regularly share and review data from routine monitoring, surveillance systems, surveys, and other studies with multiple stakeholders and decision-makers.

• Work with MOH, USG, and other stakeholders to develop program and strategic evaluation questions and analytic tools to address data and knowledge gaps.

Step 1: Review the Opportunity 17

Strategy 4: Strengthen MOH capacity to lead and implement survey, surveillance, and scientific projects for evidence-based decision-making, policy formulation, and epidemic control.

Required activities:

• Strengthen MOH institutional capacity at national, regional, and district levels to track, detect, and investigate health events and outbreaks to better respond to public health emergencies and global health threats.

• Build capacity in new surveillance approaches, including digital disease detection, syndromic, event-based, genomic, and environmental surveillance.

• Implement surveillance for key (female sex workers, men who have sex with men, and people who inject drugs) and selected populations (such as fisherfolk) of public health importance.

• Support the development of a sustainable National Integrated Surveillance System (NISS) for real-time data transmission to a national surveillance database, in partnership with MOH.

• Work with MOH and partners to develop a platform for continuous public health surveillance.

• Create and implement integrated analytics for routine surveillance and survey data, and establish robust platforms for regularly sharing and using data.

• Work with MOH and stakeholders to develop and implement a scientific strategy that addresses priority questions and rapidly informs programs and decision-making.

Step 1: Review the Opportunity 18

Strategy 5: Expand the capacity of public health workforce in DSI priority areas, including field epidemiology and informatics.

Required activities:

• Promote development of new pre-service and in-service programs for data science, epidemiology and public health informatics, including standard curricula.

• Implement in-service programs, including mentorship programs, in field epidemiology, public health informatics, and other DSI-related areas.

• Implement advanced degree capacity development programs in field epidemiology, public health informatics, and other DSI-related areas.

• Develop and strengthen partnerships to coordinate and implement sustainable workforce development in Uganda, including stronger partnerships between the World Health Organization (WHO), Africa Centres for Disease Control and Prevention (Africa CDC), Ugandan academic institutions, MOH, other service delivery institutions (such as faith-based organizations), and other key partners.

To support the purpose of this NOFO, you are expected to provide copies of and/or access to all data, software, tools, training materials, guidelines, and systems developed under this NOFO to Ministry of Health and other relevant stakeholders, including HHS/CDC, for appropriate use consistent with underlying authorities.

Epidemic control activities In coordination with the Global Health Security and Diplomacy (GHSD) Bureau at the U.S. Department of State, and as part of PEPFAR, CDC works with host country governments and other partners. Together, we assess the needs of each country and design a plan for assistance that fits within the host nation’s strategic plan.

Step 1: Review the Opportunity 19

We consider a national HIV epidemic to be under control when:

• The number of HIV-related deaths is declining, and

• The number of new infections is less than the number of deaths.

Controlling the epidemic does not mean that HIV will be eliminated. Instead, it means that the number of people with HIV in the population is decreasing. If new infections or death rates increase, this means the epidemic is no longer under control.

Our work doesn’t end when we reach epidemic control; we must sustain the gains. During your award we may ask you to conduct additional activities to reach and maintain epidemic control, consistent with the scope of this NOFO and the related policies. This may include:

• Improving prevention, testing, and treatment efforts for HIV/AIDS, TB, sexually transmitted infections (STI), and related opportunistic infections, especially among vulnerable, key, and priority populations as defined in PEPFAR’s annual Country/Regional Operational Plan (COP/ROP) Guidance.

• Promoting sustainable, country-led approaches to managing HIV/AIDS and TB and empowering national and local partners to take the lead in designing and conducting high-quality and cost-effective programs. This could involve forming new partnerships with private, public, local, and multisector entities that can complement and expand the reach of existing programs.

• Improving and expanding laboratory, surveillance, and information systems and using the PEPFAR platform for broader disease surveillance and public health programs in ways that align with PEPFAR goals and initiatives.

• Enhancing efforts to prevent, detect, respond to, and treat other diseases affecting people living with or at risk of HIV.

Related policies If awarded, any activities you conduct must follow the directions in:

• Reimagining PEPFAR’s Strategic Direction: Fulfilling America’s Promise to End the HIV/AIDS Pandemic by 2030.

• PEPFAR’s annual COP/ROP Guidance and approved COPs/ROPs.

• Similar forthcoming strategy, guidance, or planning documents that are consistent with relevant laws.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 20 https://www.state.gov/reports-pepfar/ https://www.state.gov/wp-content/uploads/2022/09/PEPFAR-Strategic-Direction_FINAL.pdf https://www.state.gov/wp-content/uploads/2022/09/PEPFAR-Strategic-Direction_FINAL.pdf https://www.state.gov/reports-pepfar/

Geographic focus The geographic focus of this program may change during the period of performance, based on the burden of disease and changing program and PEPFAR priorities.

Outcomes We expect you to achieve or substantially contribute to the outcomes asterisked (*) in the logic model by the end of the five-year period of performance. You will be expected to report on these outcomes.

Focus populations The focus populations for this NOFO include:

• GOU.

• MOH institutions and divisions.

• Regional referral hospitals.

• District-level health offices.

• Health facilities.

• Public health professionals.

• Collaborating partners.

For capacity-building activities, focus populations include:

• MOH and other staff.

• Health workforce, such as:

◦ Data clerks.

◦ Biostatisticians.

◦ Epidemiologists.

◦ Field epidemiologists.

◦ M&E specialists.

◦ Data managers.

◦ Health workers.

◦ Health managers.

◦ Laboratorians.

◦ Health management information systems personnel working on HIS systems or surveillance at facilities and institutions.

Step 1: Review the Opportunity 21

Equal opportunities This NOFO, including funding and eligibility, is not limited based on, and does not discriminate on the basis of:

• Race.

• Color.

• National origin.

• Disability.

• Age.

• Sex (including gender identity, sexual orientation, and pregnancy).

• Other constitutionally protected statuses.

Health disparities The goal of health equity is for everyone to have a fair and just opportunity to be as healthy as possible. Health disparities are often caused by social determinants of health. Social determinants of health are conditions in the environments where people are born, live, learn, work, play, worship, and age.

These determinants affect a wide range of health, functioning, and quality-of-life outcomes and risks. They also influence which populations are most affected by health conditions.

A health disparity is a difference in health burdens between groups of people with differing social determinants of health.

We expect all proposed activities to affirm and advance health equity and an equitable, diverse, and inclusive workforce as core principles. In addition to the strategies and activities listed above, during your award, we may ask you to conduct activities consistent with local laws to:

• Address health disparities in access to and use of HIV and TB services.

• Reduce HIV and TB stigma and discrimination.

• Promote civil and human rights to improve health outcomes of people living with or at risk of HIV and TB.

• Make the workforce more inclusive.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 22 https://www.cdc.gov/about/priorities/why-is-addressing-sdoh-important.html?CDC_AAref_Val=https://www.cdc.gov/about/sdoh/index.html

Organizational capacity You must include a heading in your Project Narrative titled Organizational Capacity, under which you should include a brief description of your organizational capacity to carry out these strategies and activities.

You must also provide supporting documentation in your attachments. See the attachments section for full instructions.

Collaborations If funded, we will expect you to collaborate with:

• MOH divisions and departments and EMR contractors:

◦ Division of Health Information.

◦ Epidemiology and Surveillance Division.

◦ National TB and Leprosy Program.

◦ Uganda National Institute of Public Health.

◦ Uganda National Health Laboratory and Diagnostic Services.

◦ AIDS Control Program.

◦ Pharmacy Division.

◦ Community Division.

◦ Uganda AIDS Commission.

◦ Uganda Virus Research Institute.

• Other GOU ministries, agencies, and departments:

◦ Ministry of Information, Communications Technology, and National Guidance.

◦ Uganda Bureau of Statistics.

◦ National Identification & Registration Authority.

◦ National Information Technology Authority-Uganda.

◦ Ministry of Gender, Labor, and Social Development.

◦ Ministry of Energy and Mineral Development.

• Key MOH partners and collaborators in HIS, surveys and surveillance, and M&E, both locally and internationally.

• Multilaterals: UNICEF, WHO, Global Fund, Africa CDC, and other technical partners.

• Other CDC divisions that provide technical assistance and support for complementary activities such as:

Step 1: Review the Opportunity 23

◦ Division of Parasitic Diseases and Malaria.

◦ Division of Viral Hepatitis.

◦ Division of Global Health Protection.

◦ Center for Chronic Disease Prevention and Health Promotion.

◦ Division of Violence Prevention.

◦ Other CDC programs and activities in the areas of laboratory, surveillance, M&E, and health systems strengthening activities.

• CDC HIS or DSI subject matter experts and contractors.

• U.S. Agency for International Development (USAID), CDC, and Department of Defense (DoD)-funded regional partners.

• USAID, CDC, and DoD above site partners or mechanisms who work at multiple levels (such as district, regional, and national).

• Other service delivery institutions (such as faith-based organizations).

We will periodically update the list of collaborators to reflect the reality on the ground. The aim of these collaborations is to ensure that work with the MOH is jointly implemented and coordinated to strengthen and maintain data systems and processes, as well as to prevent and mitigate potential future disease outbreaks in Uganda efficiently and effectively.

Through the PEPFAR program, CDC works with partners to help prevent HIV infection, provide life-saving treatment to people living with HIV, and reduce HIV-related deaths. We encourage our partners to collaborate with local organizations, U.S.-based organizations, and international partners. The goal of this collaboration is to complement efforts to lower costs, make programs more effective, sustain the gains, and accelerate progress towards the three UNAIDS 95-95-95 targets:

• At least 95% of people living with HIV know their HIV status.

• At least 95% of people who know their HIV status are on treatment.

• At least 95% of people on treatment have a suppressed viral load.

If you work with key populations as defined in PEPFAR’s annual COP/ROP Guidance, we will expect you to collaborate with them when designing, delivering, and monitoring HIV services.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 24

Data, monitoring, and evaluation CDC expectations CDC expects you to review, clean, and use routine performance data for program management. As a result, you should hold regular review meetings to discuss performance and use data to inform program quality improvement activities.

In your application budget, you should allocate at least 2% of funds for monitoring activities and 3% for evaluation activities. We will discuss these percentages and finalize them at or after award. These are estimates for the total funding over the 5-year project.

Required performance measures

Overview This program includes two types of indicators. These include:

• PEPFAR’s Monitoring, Evaluation, and Reporting (MER) indicators common to all awards. You can find additional information regarding MER reporting in the MER Guidance and resource materials, available at DATIM’s MER Indicator Reference Guides.

• Custom indicators that either we or you create. These monitor achievement of outcomes not directly measured by MER indicators.

These include process and outcome measures that directly correlate with the logic model.

The indicators shown may change before award or in future years. For example, any gaps or unmet needs not fulfilled in the first year may affect the targets in later years.

MER indicators There are currently no MER indicators applicable for this NOFO, but that may change in future project years.

Custom indicators In the following list, we show some anticipated custom indicators, targets, and reporting frequencies for the first year. You may also propose custom indicators across the selected program areas, such as system deployment, capacity building, data use, infrastructure support, and implementation of sustainability initiatives for HIS to address the needs of the MOH.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 25 https://help.datim.org/hc/en-us/articles/360000084446-MER-Indicator-Reference-Guides

• Proportion of planned system enhancements on EMR, data warehouse, and other applications that are completed in a timely manner with minimal errors (as per approved workplan). [Target: 100%; Reporting Frequency: Quarterly]

• Proportion of HIS solutions transmitting data to the national data warehouse with less than 5% of errors. [Target: <5% errors; Reporting Frequency: Annual]

• Percentage of sites using EMR for surveillance of priority diseases.

[Target: >90%; Reporting Frequency: Quarterly]

• Number of individuals trained in field epidemiology, public health informatics, and/or other DSI-related areas. [Target: 5-10 per year;

Reporting Frequency: Annual]

• Percentage of technical staff at MOH demonstrating knowledge of and competency in digital health systems for clinical, surveillance, and programmatic processes. [Target: 50% successfully knowledgeable and competent by end of Year 1; Reporting Frequency: Bi-Annual]

• Percentage of targeted facilities successfully replaced with new integrated systems and sharing data for aggregation with national repositories. [Target: 25% successfully replaced with new integrated systems and sharing data for aggregation by end of Year 1; Reporting Frequency: Bi-Annual]

• Number of innovative data analytics solutions implemented at scale.

[Target: 2-5 solutions; Reporting Frequency: Annual]

• Proportion of districts timely (within a week of initial report) detecting, investigating, and responding to outbreaks and global health threats.

[Target: >95% districts with timely response; Reporting Frequency: Bi- Annual]

• Number of surveys designed, implemented, and disseminated by MOH.

[Target: 1 survey designed by end of Year 1; Reporting Frequency:

Annual]

Data sources for MER and custom indicators Data sources may include registers, tally sheets, electronic and paper patient records, quarterly progress reports, surveillance and survey reports, and other program monitoring tools.

Step 1: Review the Opportunity 26

Evaluation Here, we include examples of evaluation topics that we may expect you to answer through process, outcome, or economic evaluation. In your application, include at least one, but no more than three potential evaluation questions. We will expect you to conduct an end-term evaluation.

• The extent to which the project activities and outputs resulted in improved ownership and leadership by MOH structures at all levels towards sustainable DSI and surveillance systems and capacity: outcome evaluation.

Evaluation data sources Data sources may include registers, tally sheets, electronic and paper patient records, recipient progress reports, focus groups, in-depth interviews, surveys, and other program monitoring tools.

Dissemination of evaluation results Dissemination channels could include:

• MOH, USG, and partner meetings/platforms.

• Local and international conferences and forum abstract presentations.

• Conference poster displays.

• Manuscripts.

• Bulletins.

• Reports.

• Presentations to technical working groups and stakeholder meetings.

• Other approved products in print and electronic media.

The primary intended users of evaluation results and findings will be the wider program stakeholders.

CDC and stakeholders will use overall evaluation findings during the five-year project period to share and implement key recommendations to strengthen program implementation, effectiveness, sustainability, and continued program improvement after the award ends.

All evaluation reports will be publicly available on PEPFAR resource sites.

Step 1: Review the Opportunity 27

Evaluation and performance measurement plan You must submit an initial draft of your evaluation and performance measurement plan with your application. You must submit a more detailed plan within the first six months of the award. See reporting.

As you develop your evaluation and performance measurement plan, align it with national, PEPFAR, and agency priorities as detailed in the NOFO. If awarded, we will work with you to finalize the plan and ensure it takes into account agreements made during COP/ROP planning.

Include the following elements in your evaluation and performance measurement plan.

Methods Describe how you will:

• Collect the performance measures.

• Respond to the evaluation topics.

• Use evaluation findings for continuous program quality improvement.

• Incorporate evaluation and performance measurement into planning, implementing, and reporting of project activities.

Additionally, explain:

• How findings will contribute to reducing or eliminating health disparities, as relevant.

• How key program partners will participate in the evaluation and performance measurement process.

• How feasible it will be to collect appropriate evaluation and performance data.

• How you will share evaluation findings with communities and populations of interest in a way that meets their needs.

• Other relevant information, such as performance measures you propose.

Evaluation activities You must carry out specific evaluation activities.

At least one evaluation must be carried out for each cooperative agreement during the course of funding. The evaluation can be:

• Process evaluation: Measures how the intervention was delivered, what worked and did not, the differences between the intended population and the population served, and access to the intervention.

Step 1: Review the Opportunity 28

• Outcome evaluation: Determines the effects of the intervention in the focus population, such as change in knowledge, attitudes, behavior, or capacity.

• Economic evaluation: Determines cost, cost drivers, cost effectiveness, efficiency, factors influencing economic behavior and choices, or the economic impact of interventions or activities to justify the investment.

Describe:

• The type of evaluations you will complete (process, outcome, and/or economic).

• Key evaluation questions these evaluations will address.

• Other information, such as measures and data sources.

Data management plan (DMP) For all public health data you plan to collect, a DMP is required. For a definition of “public health data” and other key information, see AR 25: Data Management and Access on our website.

You must submit an initial draft of your DMP with your application. You must submit a more detailed plan within the first six months of the award. See reporting.

Submit your initial DMP with your application and include:

• The data you will collect or generate and their sources.

• Any reasons why you cannot share this data with CDC. These could include legal, regulatory, policy, or technical reasons.

• Who can access the data and how you will protect and secure it.

• Data standards that explain what documentation released data will have.

That documentation should describe collection methods, what the data represent, and data limitations.

• Archival and long-term data preservation plans.

• How you will update the DMP as new information becomes available during the project. You will provide updates to the DMP in annual reports. For more information about CDC’s policy on the DMP, see Data Management and Access Requirement at CDC’s website.

In addition to the other requirements listed, also include:

• Cybersecurity plans.

• How you will protect personally identifiable information (PII) when you collect, store, transfer, and use this data.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 29 https://www.cdc.gov/grants/additional-requirements/ar-25.html https://www.cdc.gov/grants/additional-requirements/ar-25.html https://www.cdc.gov/grants/additional-requirements/ar-25.html https://www.cdc.gov/grants/additional-requirements/ar-25.html

• How you will remove information from the data that could reveal participants’ identities (de-identify the data) in intermediate and final data sets.

CDC and PEPFAR will inform you of data you need to share with us and how and when it should be shared.

Work plan You must provide a work plan for your project. The work plan connects your performance outcomes, strategies and activities, and measures. It provides more detail on how you will measure outcomes and processes. A sample work plan is provided as follows.

You should provide a detailed work plan for the first year and a high-level work plan for later years.

Table: Sample format

Activities you will implement

Progress or process measures

From the data, monitoring, and evaluation section.

Relevant period of performance outcomes

From the logic model.

Responsible position or party

Funding component / completion date

Strategy 1:

1.

2.

3.

Strategy 2:

1.

2.

3.

Paperwork Reduction Act Any activities involving information collection from 10 or more individuals or organizations may require Paperwork Reduction Act (PRA) approval. The PRA requires review and approval of the information collection by the White House Office of Management and Budget. For further information to

Step 1: Review the Opportunity 30 determine if a proposed activity requires PRA approval, contact your project officer. Collections include items like surveys and questionnaires. If you have collections requiring PRA approval, CDC is responsible for working with OMB to gain the approval.

For more information about CDC’s requirements under PRA see CDC Paperwork Reduction Act Compliance.

Funding policies and limitations General policies

• Your budget is arranged in eight categories: salaries and wages, fringe benefits, consultant costs, equipment, supplies, travel, other, and contractual.

• You may use funds only for reasonable program purposes consistent with the award, its terms and conditions, and federal laws and regulations that apply to the award. If you have questions about this determination, ask the grants management officer.

• Generally, you may not use funds to purchase furniture or equipment.

Clearly identify and justify any such proposed spending in the budget.

• All requests for funds contained in the budget should be stated in U.S.

dollars.

• Cost increases due to changes in exchange rates are allowed if enough funding is available. If an increase in the exchange rate would reduce the scope of the project or cause you to need more federal funding, you must get prior approval for exchange rate fluctuations.

• Support beyond the first budget year will depend on:

◦ Appropriation of funds.

◦ Satisfactory progress in meeting your project’s objectives.

◦ A decision that continued funding is in the government’s best interest.

• If we receive more funding for this program, we will consider:

◦ Funding more applicants.

◦ Extending the period of performance.

◦ Awarding supplemental funding.

See also program-specific limitations.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 31 https://www.cdc.gov/scientific-integrity/php/public-information-collection/?CDC_AAref_Val=https://www.cdc.gov/os/integrity/reducepublicburden/index.htm https://www.cdc.gov/scientific-integrity/php/public-information-collection/?CDC_AAref_Val=https://www.cdc.gov/os/integrity/reducepublicburden/index.htm https://www.law.cornell.edu/definitions/index.php?width=840&height=800&iframe=true&def_id=13f24ea1f961f5f0d14b87ec1b39b25f&term_occur=999&term_src=Title:45:Chapter:A:Subchapter:A:Part:75:Subpart:E:Subjgrp:39:75.440

Unallowable costs You may not use funds for:

• Research.

• Clinical care, except as allowed by law.

• Pre-award costs, unless we give you prior written approval.

• Other than for normal and recognized executive-legislative relationships:

◦ Publicity or propaganda purposes, including preparing, distributing, or using any material designed to support or defeat the enactment of legislation before any legislative body.

◦ The salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative action, or executive order proposed or pending before any legislative body.

◦ See Anti-Lobbying Restrictions for CDC Recipients.

• Needle exchange programs.

For guidance on some types of costs that we restrict or do not allow, see 45 CFR part 75, General Provisions for Selected Items of Cost.

Indirect costs Indirect costs have a common or joint purpose across more than one project and cannot be easily separated by project. Learn more at CDC Budget Preparation Guidelines.

To charge indirect costs you can select one of two methods:

Method 1 — Approved rate. You currently have an indirect cost rate approved by your cognizant federal agency.

Provide a summary of the rate. Enclose a copy of the current approved rate agreement in your attachments.

Method 2 — De minimis rate. Per 2 CFR 200.414(f), if you have never received a negotiated indirect cost rate, you may elect to charge a de minimis rate. If you choose this method, costs included in the indirect cost pool must not be charged as direct costs.

This rate is 15% of modified total direct costs (MTDC). See 2 CFR 200.1 for the definition of MTDC. You can use this rate indefinitely.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 32 http://www.cdc.gov/grants/documents/Anti-Lobbying_Restrictions_for_CDC_Grantees_July_2012.pdf https://www.ecfr.gov/current/title-45/part-75/subject-group-ECFR5d90ba314caea08 https://www.cdc.gov/grants/documents/budget-preparation-guidance.pdf https://www.cdc.gov/grants/documents/budget-preparation-guidance.pdf https://www.ecfr.gov/current/title-2/section-200.414 https://www.ecfr.gov/current/title-2/part-200#p-200.1(Modified%20Total%20Direct%20Cost%20(MTDC))

Foreign organizations and foreign public entities Indirect costs on awards to foreign organizations and foreign public entities performed fully outside of the U.S.