USAID RESPONSE 72068724RFA00007 MIAHY Amendment #1 signed.pdf

USAID RESPONSE 72068724RFA00007 MIAHY Amendment #1 Page 1 of 19

Amendment No: 01 Amendment Issuance Date : November 20, 2024 Issuance Date : October 7, 2024 Closing Date for Questions : October 26, 2024 Closing Date/Time for Application : November 27, 2024 at 23:59 GMT+3 Subject : Amendment#1 to NOFO 72068724RFA00007 Program Title : USAID Access Miahy

Federal Assistance Listing Number : 98.001

Agreement Officer signature :

Questions and Answers

1. Can USAID please clarify if the Past Performance Information template in Annex 5 should be included as part of the “Organizational capacity and history of experience” or as an annex to the technical application?

1.1. Annex 5: Past Performance Template should be included as an attachment with your application. Section V.(e) “Organizational capacity and history of experience”, has its own instructions regarding content requirements.

2. Can USAID kindly clarify how they would like applicants to refer to the results within objectives (1.1, 1.2, 1.3, etc.)? For instance, shall they be referred to as sub-objectives, intermediate results, or something else?

2.1. As mentioned in the logic model, there are three “Objectives “, 1.1, 1.2… and then “sub-objectives”

3. Can USAID please clarify the objectives and intermediate results/sub-objectives within the Logic Model on NOFO page 10 as they do not all align with the language used on pages 14-17? Specifically, the following:

3.1. There is an intermediate result 1.5 on page 14 that does not appear in the Logic Model. Is intermediate result 1.5 envisioned as part of the Logic Model?

3.1.1. 1.5 “Improved service delivery by focusing on provider behavior change to improve quality & experience of care” is part of quality improvement but dedicated for health providers, it is then part of the sub-objective 1.4.

3.2. Objective 2 language within the Logic Model states, “Subnational leadership, governance, and accountability are strengthened to ensure long term sustainability of PHC services” however the Objective 2 language on page 14 states, “Improved governance and accountability at all levels of the health system for PHC.” Can USAID please clarify which language to use?

https://www.grants.gov/search-results-detail/356643

USAID RESPONSE 72068724RFA00007 MIAHY Amendment #1 Page 2 of 19

3.2.1. This Objective is related to the “leadership governance and accountability strengthening” (objective 3). Please consider the language in the logical model: “Subnational leadership, governance, and accountability are strengthened to ensure long term sustainability of PHC services”

3.3. Objective 3 language within the Logic Model states, “The Malagasy people sustainably adopt healthy behaviors, social norms and use available health services; however, the Objective 3 language on page 16 states, “The Malagasy people sustainably practice health behaviors, supportive social norms, and utilize available health services.” Additionally, the language for intermediate results

3.1 and 3.2 in the Logic Model is different from what is stated on page 17. Can USAID please clarify which language to use?

3.3.1. Please use the language in the logical model: “The Malagasy people sustainably adopt healthy behaviors, social norms and use available health services”

4. Page 10 of the NOFO presents “Institutionalize continuous quality improvement at community, facility and district levels” as cross-cutting across all objectives, however its inclusion under the Objective 3 narrative on page 17 as 3.3 suggests that it is cross-cutting only across Objective 3. Can USAID kindly confirm that “Institutionalize continuous quality improvement at community, facility and district levels” is not specific to Objective 3 but could be considered as its own objective (Objective 4) that crosscuts the other three objectives?

4.1. As it is specified in page 17 and illustrated in the logical model, we confirm that “ Institutionalize continuous quality improvement at community, facility and district levels.” Is a crosscutting component for all the three objectives.

5. On NOFO page 19, there is a word missing from the following sentence: "While the primary role of the activity will be to reinforce performance of the public health system, concrete and practical approaches to engagement and partnership/collaboration with the private sector for sustainable behavior change interventions and solutions to reach remote populations to achieve the expected results and outcomes as described in the section A.4.” Can USAID kindly clarify the sentence?

5.1. The primary role of the activity will be to reinforce the performance of the public health system. However, concrete and practical approaches to engaging and collaborating with the private sector are essential. These approaches will support sustainable behavior change interventions and help deliver solutions to remote populations, ensuring the expected results and outcomes described in Section A.4 are achieved.

6. On page 21, the NOFO states that “The recipient must conduct a detailed and comprehensive gender analysis to inform the strategy.” However, Annex 4 of the NOFO

USAID RESPONSE 72068724RFA00007 MIAHY Amendment #1 Page 3 of 19 states that “Applicants should use this [attached] gender analysis tool for reference to inform the technical design.” The attachment includes a gender analysis completed by the HPN office. Can USAID kindly confirm that the gender analysis provided as an annex to the NOFO is the intended “detailed and comprehensive gender analysis” that should be used to inform the technical strategy?

6.1. No, NOFO Annex 4 is not the intended “detailed and comprehensive gender analysis”. “the recipient must conduct a detailed and comprehensive gender analysis…” using NOFO Annex 4 attachment as a tool.

7. On page 26, the NOFO states that "The staffing structure of key and non-key personnel should include expertise in finance/business development, governance, logistic, supply chain, behavior change, localization, Monitoring, Learning and Digital Health.” Is there a logistics and supply chain role envisioned for Access Miahy?

7.1. Logistics and supply chain activities will not be the principal focus for Access Miahy. Applicants should justify any proposed staffing plan.

8. Regarding the UEI requirements on NOFO page 35, would USAID like applicants to include a valid UEI for all proposed sub-recipients on the Cover Page of both the Technical and Cost Applications?

8.1. UEI is required for all subrecipients. Obtaining a UEI and registering in SAM are separate actions, both completed in SAM.gov. It is possible for an entity to obtain a UEI without completing full SAM registration; SAM.gov only requires basic information to conduct the entity validation process that results in a UEI. Full registration in SAM.gov is required for prime. Full SAM registration is not required for subrecipients.

9. Can USAID please provide a full, defined list of the indicators listed on NOFO pages 23 and 24? If an indicator category is referenced, can USAID provide the specific outcome indicators within that category which should be utilized?

9.1. Please refer to Attachment 1 of this document.

10. On page 13, USAID refers to mobile clinics. Can USAID kindly confirm if Access Miahy is expected to fund mobile clinics?

10.1. We confirm that Access Miahy is expected to fund mobile clinics as part of “outreach “ activities

11. On page 11, the NOFO states that “the recipient shall strengthen health sector staff performance through the expansion of current quality assurance mechanisms (AQS) with particular attention to high impact MNCH, malaria, HIV, family planning and nutrition interventions at the CSB and community levels to address the leading causes of maternal, neonatal, and child morbidity and mortality.” And on page 13 “Access Miahy

USAID RESPONSE 72068724RFA00007 MIAHY Amendment #1 Page 4 of 19 will train the CHVs on the Integrated Community Case Management (iCCM) module on HIV screening and referral to increase community awareness and improve the reach of HIV assessments and referrals to facility services.” There is an HIV indicator included in the proposed indicator list (HIV testing including # positives identified). However, on page 12, the NOFO states “should Madagascar receive future HIV funding, Access Miahy may also integrate some HIV services including testing during antenatal care (ANC).” Can USAID clarify whether HIV services should be a part of proposed Access Miahy activities or if applicants should only demonstrate readiness to implement HIV services in the case that HIV funding is received?

11.1. As outlined in Sub-objective 1.1, the mission currently does not have HIV funding.

However, applicants are encouraged to propose an HIV-related technical approach based on the elements detailed in this NOFO, but no costs for these activities should be included in the budget. HIV-related activities are subject to a future award modification when HIV funds become available.

12. USAID references both “CHV” and “CHW” throughout the NOFO. Can USAID kindly confirm which term the applicant should use in their proposal?

12.1. Applicants should use “CHW” to refer to Community Health Workers in all documents.

13. Will USAID release the SBC assessment of the ACCESS project in Madagascar?

13.1. This document will not be available during the application submission period for this NOFO.

14. On Page 18, USAID mentions “the existing curriculum for healthcare providers and community health workers on CQI principles, data collection, analysis, and QI tools”, can USAID please clarify and share the specific curriculum that is being referred to?

14.1. These tools are “national documents” available at the MoH/Departments (DSSB:

Basic Health Care Directorate Direction des Soins de Sante de Base..) and can be consulted at the Ministry Of Public Health.

15. Does the “National Quality Improvement (QI) Framework document” that USAID mentions on NOFO page 6 refer to the Politique Nationale pour la Qualité des Soins et de Services de Santé (2024-2034)?

15.1. We confirm that the referenced document is the “Politique Nationale pour la Qualité des Soins et de Services de Santé (2024-2034)”

16. On Page 32, Section VI states “The business (cost) application must illustrate the entire period of performance, using the budget format shown in the SF-424A.” However, section VI.(b) SF 424 Forms(s), does not list the SF 424A form as a requirement. Please

USAID RESPONSE 72068724RFA00007 MIAHY Amendment #1 Page 5 of 19 confirm that SF424A BUDGET INFORMATION - Non-Construction Programs is not required.

16.1. SF-424A is required as part of the SF-424 series.

17. On Page 32, USAID requires the Assurances for Non-Construction programs (SF 424B) to be submitted as part of the cost application in both sections (b) SF 424 Form(s) and (c) Required Certifications and Assurances. Please confirm SF424B needs only to be submitted once with the forms in section (b).

17.1. The SF-424B form is a required component of the SF-424 series and needs to be submitted only once.

18. On page 33, USAID states, “The apparently successful applicant(s) will be required to provide a copy of the applicant’s policy manuals for personnel, procurement, and travel to support USAID’s determination that the proposed costs are fair and reasonable.”

However, the requirements for the Personnel and Travel sections of the budget narrative state, “Applicants must provide their established written policies on personnel compensation” and “When appropriate please provide supporting documentation as an attachment, such as company travel policy.” Please confirm that Personnel and Travel policies should not be submitted with the business (cost) application.

18.1. Do not submit any policy manuals. These will be required for apparently successful applicant(s).

19. Can USAID kindly clarify if the reference on NOFO page 31 to “resource partners” as part of the requirements for the Organizational capacity and history of experience section should instead refer to “consortium partners”?

19.1. Yes, ‘resource partners’ refer to “consortium partners” and “subrecipients”.

20. On the cover page of the NOFO, USAID indicates that they intend to make "ONE OR MORE award(s) to the applicant (s) who best meet the objectives of the funding opportunity". Can USAID please provide details on how and when this decision will be made? Under what circumstances will the award be split and how many awards are anticipated? Should applicants prepare an application for one award at this time for submission?

20.1. The decision on the number of awards will be made by the Agreement Officer and will depend on several factors, including the review committee’s memorandum and USAID priorities.

20.2. Applicants are requested to prepare and submit an application for a single award at this time.

USAID RESPONSE 72068724RFA00007 MIAHY Amendment #1 Page 6 of 19

21. Currently on grants.gov there are two opportunities entitled USAID Access Miahy. One has the opportunity number 7206872RFA00007, the other has the opportunity number 7206872RFA00008. Can USAID please confirm which opportunity number should be used on the application?

21.1. The opportunity has been uploaded twice, resulting in two separate numbers.

Please note that the correct opportunity number is 7206872RFA00007, and both versions contain the same content.

22. The context section of the NOFO highlights supply chain challenges. With the release of a separate NOFO in July devoted to supply chain management, can USAID please clarify how these two activities will collaborate at regional, district, and facility levels?

22.1. Mahenika and Miahy are two complementary activities designed to support the Malagasy health system. Applicants are encouraged to propose the most effective approach for coordinating supply chain efforts between the two Activities.

23. The information in the results framework table for sub-Objective 1.1 does not match the sub-Objectives text verbatim. In the table on page 10, 1.1 reads: "Improved performance among CSB staff and community health volunteers to deliver quality care at first point of contact with the health system". In the text on page 11, 1.1 reads:

"Improved performance among health care providers to deliver quality care at first point of contact with the health system". Can USAID clarify which version of sub-objective 1.1 should be used?

23.1. Please use the language in the logical model: "Improved performance among CSB staff and community health volunteers to deliver quality care at first point of contact with the health system"

24. The information in the results framework table on page 10 is missing sub-Objective 1.5:

Improved service delivery by focusing on provider behavior change to improve quality & experience of care; which is described on page 14. Can USAID confirm that sub-objective

1.5 should be part of the Results Framework?

24.1. 1.5 “Improved service delivery by focusing on provider behavior change to improve quality & experience of care” is part of quality improvement but dedicated for health providers. Then , YES ,1.5 is part of the sub-objective 1.4 ( not figuring in the logical model)

25. The information in the results framework table for Objective 2 does not match the sub- Objectives text verbatim. In the table on page 10, it reads: "Objective 2: Subnational leadership, governance, and accountability are strengthened to ensure long term sustainability of PHC services". In the text on page 14, it reads: "Objective 2 - Improved governance and accountability at all levels of the health system for PHC". Can USAID clarify which version of Objective 2 should be used?

USAID RESPONSE 72068724RFA00007 MIAHY Amendment #1 Page 7 of 19

25.1. Please use the language in the logical model: Objective 2 “Subnational leadership, governance, and accountability are strengthened to ensure long term sustainability of PHC services”

26. The information in the results framework table for sub-Objective 3.1 does not match the sub-Objectives text verbatim. In the table on page 10, 3.1 reads: "3.1 Communities and institutions promote and support healthy behaviors". In the text on page 17, 3.1 reads:

"3.1 Improved behavior change activities that promote optimal health practices among beneficiaries". Can USAID clarify which version of sub-objective 3.1 should be used?

26.1. Please use the logical model language: Sub-Objective 3.1. “Communities and institutions promote and support healthy behaviors”

27. The information in the results framework table for sub-Objective 3.2 does not match the sub-Objectives text verbatim. In the table on page 10, 3.2 reads: "3.2 Barriers to healthy and health seeking behaviors for the poor and underserved are reduced". In the text on page 17, 3.2 reads: "3.2 Improved social and gender norms that support healthy practices." Can USAID clarify which version of sub-objective 3.2 should be used?

27.1. Please use logical model language: sub-objective 3.2 ”Barriers to healthy and health seeking behaviors for the poor and underserved are reduced”

28. On page 11, USAID mentions the inclusion of “donation CSB funds”. Can USAID please provide a definition for this term?

28.1. Please refer to the link below : https://www.dgbf.mg/wp-content/uploads/2021/04/MANUEL-DOTATION-CSB-CU-CR1-VF.pdf

29. On page 12, USAID describes recent data regarding very high numbers of new HIV diagnoses among young pregnant women in some regions. Can USAID please clarify whether HIV funding will be part of this award from inception or whether it is anticipated once the award is underway?

29.1. As outlined in Sub-objective 1.1, the mission currently does not have HIV funding.

However, applicants are encouraged to propose an HIV-related technical approach based on the elements detailed in the NOFO, but no costs for these activities should be included in the budget. HIV-related activities are subject to a future award modification when HIV funds become available.

30. On page 13, USAID mentions the training of CHVs on the iCCM module. Can USAID please specify whether this training on HIV screening and referrals should occur even if there is not specific HIV fundings included as part of the activity?

30.1. As outlined in Sub-objective 1.1, the mission currently does not have HIV funding.

However, applicants are encouraged to propose an HIV-related technical approach based on the elements detailed in the NOFO, but no costs for these https://www.dgbf.mg/wp-content/uploads/2021/04/MANUEL-DOTATION-CSB-CU-CR1-VF.pdf https://www.dgbf.mg/wp-content/uploads/2021/04/MANUEL-DOTATION-CSB-CU-CR1-VF.pdf

USAID RESPONSE 72068724RFA00007 MIAHY Amendment #1 Page 8 of 19 activities should be included in the budget. HIV-related activities are subject to a future award modification when HIV funds become available.

31. To foster building on USAID ACCESS program experience and lessons, can USAID please make the last approved annual report from the USAID ACCESS program available to applicants?

31.1. The last ACCESS annual report is not yet available. The ACCESS Mid-term evaluation report is available in this link : chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.data4impactproject.

org/wp-content/uploads/2023/01/ACCESS-Midterm-Evaluation-Report- Madagascar_TR-22-493-D4I_508c.pdf

32. Can USAID please clarify what it means by the following statement found on page 13 under sub-objective 1.3; “This may include understanding barriers providing material support in the form of phones and airtime to expand CommCare in areas where it has not already been established as well as training relevant CHWs in its use for clinical decision making”?

32.1. This sentence highlights the challenges associated with rolling out “Commcare,” particularly ensuring the availability and appropriate use of resources such as phones and airtime. It also requests applicants to demonstrate their ability to overcome these barriers.

33. Can USAID clarify the expected division of responsibilities between the Access Miahy activity and the anticipated Arakisa activity, particularly as it relates to design and roll out of systems for data use?

33.1. Access Miahy will focus at “District , facility and community levels”, as specified in the objective ( Section A2.2 of the NOFO)

34. The NOFO is clear that this activity will work in 9 regions in Madagascar: Atsimo Andrefana, Menabe, Melaky, Boeny, Sofia, Diana, Sava, Atsinanana, and Analanjirofo.

The map on page 19 indicates the Atsimo Atsinanana region will conduct malaria only activities. Can USAID clarify if applicants should include the Atsimo Atsinanana region and the respective malaria activities for that region in the illustrative Year One workplan and in the budget? Will there be additional funds made available if Atsimo Atsinanana is added?

34.1. Yes, we confirm that Atsimo Atsinanana has been ADDED to the list of regions.

Applicants should include malaria activities for this region in the illustrative Year One work plan and budget.

34.2. Yes, funds for malaria activities in the Atsimo Atsinanana region are included in the Total Estimated Amount (TEA) of $90 million. Applicants are expected to

USAID RESPONSE 72068724RFA00007 MIAHY Amendment #1 Page 9 of 19 incorporate malaria activities for this region into the illustrative Year One work plan and budget.

35. On page 23, USAID provided a list of required foreign standard indicators. Can USAID provide applicants with the name and definition of each of the following 8 indicators?

HL 6-5, HL 6-8, HL 6-10, HL 7-3, HL 7-4, HL 7-5, HL 7-6, HL 8-8.

35.1. Please see Attachment 1.

36. Can USAID please clarify if the applicant should budget for third party midline or endline evaluations (p25)?

36.1. The applicant should budget for these series of evaluations (Baseline, Midline and endline)

37. Can USAID clarify the difference between (e) Organizational capacity and history of experience (p31) in the Technical Application, and h) History of Performance (p 36) in the Business (Cost) Application?

Do either of these count toward the 10 points allocated to the history of performance on page 43?

37.1. No, Section V.(e) “Organizational capacity and history of experience”, Section VI.(h) and Section VI.(h), "History of Performance", and Annex 5: Past Performance Template have their own detailed instructions regarding content requirements. All of these count toward the 10 points..

38. On page 31, USAID indicates that the brief history of the organization attachment should be no more than 2 pages. Can USAID clarify if the page limit applies for each partner individually (2 pages per partner) or for all partners, including the applicant, implementing partners and resource partners (2 pages total)?

38.1. Both implementing partners and resource partners history of the organizations count toward a maximum of 2 pages.

39. There are two History of Performance requirements found in the NOFO. One appears on page 36 under Business (Cost) Application requirements, and the other “History of Performance” mention appears in Section E Application Review Information, described on page 43 and Annex 5. Can USAID explain the difference between these two requirements?

39.1. No, Section V.(e) “Organizational capacity and history of experience”, Section VI.(h) and Section VI.(h), "History of Performance", and Annex 5: Past Performance Template have their own detailed instructions regarding content requirements.

USAID RESPONSE 72068724RFA00007 MIAHY Amendment #1 Page 10 of 19

40. Can USAID please clarify which "History of Performance" requirement receives the 10 points allocated to it on page 43?

40.1. The evaluation of Section V.(e) Organizational capacity and history of experience, Section VI.(h), "History of Performance”, and Annex 5: Past Performance Template " will count 10 points.

41. The requirement to submit "Annex 5" is not included in the NOFO section III General Content and Form of Application, which starts on page 29, or in the subsequent application sections. Can USAID clarify if Annex 5 is required for submission by the applicant? If so, should it be included in the Technical Application, Attachments, or the Cost Application?

41.1. Annex 5: Past Performance Template should be included as an attachment with your application. Please note that Section V.(e) “Organizational capacity and history of experience”, Section VI.(h) and Section VI.(h), "History of Performance," have their own detailed instructions regarding content requirements.

42. Can USAID please indicate how many past projects should be included in Annex 5 (p 54), and whether this information is required for the Prime applicant only or for Prime and sub partners as well.

42.1. As many relevant projects in the past 3 years.

43. On page 42, the criteria A.I.B states: "The extent to which the overall five-year implementation-plan and the detailed first year implementation plan demonstrate how the performance objectives/outputs will be achieved and validates the technical approach." In the Technical Application Format guidance on page 31, the detailed first year implementation plan is required as Attachment 1. We do not see any specific section in the Technical Application Format guidance on pages 30-32 that mentions the overall five-year implementation-plan. Can USAID inform applicants where they should include the five-year plan in the proposal? Can USAID also specify what level of detail is required for this plan?

43.1. Please refer to Attachment 3 of this document. The NOFO Annex 1: Budget Template is a required document. Amendment N01 includes Attachment 3, which contains the same Budget Template as the NOFO Annex 1 but includes additional sheets for work plans templates in subsequent years that applicants should use.

44. On page 47, USAID states: "The recipient shall integrate a completed EMMP in the initial work plan…." Can USAID confirm that the EMMP is completed post-award, and therefore is not required for submission with the illustrative first - year project workplan submitted with the proposal?

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44.1. The EMMP is only required with the first-year workplan post-award, then each year with subsequent annual workplans.

45. On page 48, USAID states: "The recipient shall integrate a completed CRMP in the initial work plan...." Can USAID confirm that the CRMP is completed post-award, and therefore is not required for submission with the illustrative first - year project workplan submitted with the proposal?

45.1. USAID confirms that the CRMP is not required for the application submission.

46. The link to the climate risk analysis on page 23 (A.8 Climate Risk Management) is not accessible. Can USAID please provide a copy of the climate risk analysis or a working link to the document?

46.1. Please see below the related links:

- IEE HPN Portfolio 2022-2027

- ADS Reference 201mal

- Climate Risk Screening and Management Tools

- Climate Risk Management for USAID Projects and Activities: A Mandatory Reference for ADS Chapter 201

47. Can USAID kindly clarify if the Executive Summary is included in the 30-page limit for the technical application?

47.1. Executive Summary is included in the 30-page limit.

48. On page 31, in both (e) and (f), USAID refers to “resource partners”. Could USAID clarify if resource partners would include sub-recipients?

48.1. Yes, it includes sub-recipients.

49. Under Technical Application, (f) Attachments, i. “A brief statement of the history of the organization (both implementing and resource partner)....” Can USAID please clarify if only the prime or if the prime and all partners in the team/consortium should be included within the 2-page limit?

49.1. All these should be included in the 2 page limit.

50. Past Performance Information (Annex 5-page 54):

50.1. Can USAID clarify where it intends the applicant to present the Past Performance Information within the application, as the merit review criteria under Section IV History of Performance (page 43 of the NOFO) would seem to suggest that the PPIs should be under section (e) Organizational capacity and history of experience?

https://drive.google.com/file/d/12aE3J7BqeCrhCBziqO48ftI7o4ZwqWec/view?usp=sharing https://www.usaid.gov/about-us/agency-policy/series-200/references-chapter/201mal https://www.climatelinks.org/resources/climate-risk-screening-and-management-tools https://www.climatelinks.org/resources/climate-risk-management-usaid-projects-and-activities-mandatory-reference-ads-chapter-201 https://www.climatelinks.org/resources/climate-risk-management-usaid-projects-and-activities-mandatory-reference-ads-chapter-201

USAID RESPONSE 72068724RFA00007 MIAHY Amendment #1 Page 12 of 19

50.2. No, Section V.(e) “Organizational capacity and history of experience”, Section VI.(h) and Section VI.(h), "History of Performance", and Annex 5: Past Performance Template have their own detailed instructions regarding content requirements. They all count toward the 10 points.

50.3. Can USAID clarify the number of past performance information tables that it would like the applicant to present?

50.4. As many tables as the number of experiences within the past 3 years.

50.5. Can USAID clarify if the applicant should provide past performance information for the prime recipient only, or also for its sub-recipient partners?

50.6. This includes both prime and sub-recipient experiences.

51. Under Objective 3, there are two conflicting lists of sub-objectives. On page 10, under the Results Framework, two sub-objectives are listed: (3.1) Communities and institutions promote and support healthy behaviors and (3.2) Barriers to healthy and health seeking behaviors for the poor and underserved are reduced, with Institutional continuous quality improvement at community, facility and district levels under all three Objectives. However, under the Objective 3 description starting on page 16, there are three sub-objectives: (3.1) Improved behavior change activities that promote optimal health practices among beneficiaries; (3.2) Improved social and gender norms that support healthy practices; and (3.3) Crosscutting component - Institutionalize continuous quality improvement at community, facility and district levels. Could USAID please confirm which set of sub-objectives is correct?

51.1. Please use the formulation in the Logical model:

51.2. (3.1) Communities and institutions promote and support healthy behaviors and (3.2) Barriers to healthy and health seeking behaviors for the poor and underserved are reduced, with Institutional continuous quality improvement at community, facility and district levels under all three Objectives….

52. In the Technical Evaluation criteria on page 42, the NOFO states “b. The extent to which the overall five-year implementation-plan, and the detailed first year implementation plan...” whereas under the Technical Application requirements, on page 32, Annex iv. is described as “a notional first-year implementation work plan”. Can USAID please clarify if the activities described in the overall technical application are sufficient to describe the five-year implementation plan? If USAID expects a separate five-year implementation plan, can that be included as an additional attachment?

52.1. Please use Attachment 3 for the first-year and subsequent years work plan.

USAID RESPONSE 72068724RFA00007 MIAHY Amendment #1 Page 13 of 19

53. Would USAID share the estimated funding allocations across FP/RH, MNCH, immunization, malaria, nutrition, WASH, and any other expected funding streams to guide planning?

53.1. Currently, we do not have detailed information on the level of funds allocated per program element for this activity. .

54. For the submission, is there an upper limit of size of email file attachments that USAID will accept?

54.1. The maximum attachment total size is 25MB per email.

55. Could USAID provide the Local Compensation Plan (FSN scale) to better assist in reviewing and evaluating sub-recipient proposed salaries?

55.1. Please refer to Attachment 2 of this document.

56. Could USAID please confirm that if an applicant and/or a proposed sub-recipient has per diem rates that fall under the provided ceilings in Annex 7, then the applicant and/or proposed subrecipient should budget their internal lower rates?

56.1. No, Annex 7 is a document jointly agreed upon by donors and the Government of Madagascar to standardize costs related to in-country per diem, lodging, and transportation payments for Government of Madagascar officials, civil society organizations, private sector staff, and stipends for community health volunteers.

This document serves as the guiding framework for all USAID funded activities.

57. On page 33 of the NOFO it is stated that in both the summary budget and detailed budget for the prime applicant and any potential sub-recipients a breakdown is required for program costs, both federal and non-federal. Per 2 CFR 200.306(b)(6), would USAID be amenable to applicants proposing their cost-share as an annual lump sum amount inclusive of all sources (prime recipient and all sub-recipients), accompanied by a detailed cost share plan included in the prime recipient’s budget narrative?

57.1. Yes, applicants may propose their cost-share as an annual lump sum amount inclusive of all sources (prime recipient and all sub-recipients), accompanied by a detailed cost share plan included in the prime recipient’s budget narrative.

End of Questions and Answers

USAID RESPONSE 72068724RFA00007 MIAHY Amendment #1 Page 14 of 19

Attachment 1: LIST OF ILLUSTRATIVE INDICATORS

Indicator Number

Indicator Title

HL.5 Financial risk protection - Percentage of people enrolled in USAID-assisted financial protection schemes in area(s) receiving USAID assistance

HL.6-1 Estimated potential beneficiary population for maternal, newborn and child survival program: number of live births.

HL.6.2-1 Number of women giving birth who received uterotonic in the third stage of labor (OR immediately after birth) through USG-supported programs

HL.6.2-2 Number of women giving birth in a health facility receiving USG support

HL.6.3-1 Number of newborns not breathing at birth who were resuscitated in USG-supported programs

HL.6.3-63 Number of newborns who received postnatal care within two days of childbirth in USG-supported programs.

HL.6.4-62 Number of children who received their first dose of measles-containing vaccine (MCV1) by 12 months of age in USG-assisted programs

HL.6.6-1 Number of cases of child diarrhea treated in USG-assisted programs

HL.6.6-64 Number of cases of childhood pneumonia treated in USG-assisted programs

HL.7.1-1 Couple Years of Protection in USG supported programs

HL.7.1-2 Percent of USG-assisted service delivery sites providing family planning counseling and/or services

HL.7.1-3 Average stockout rate of contraceptives at service delivery points by family planning method

HL.7.2-1 Percent of audience who recall hearing or seeing a specific USG-supported Family Planning/Reproductive Health (FP/RH) message

HL.7.2-2 Number of USG-assisted community health workers (CHWs) providing Family Planning (FP) information, referrals, and/or services during the year

HL.7.2-3 Number of individuals in the target population exposed to USG funded Family Planning (FP) messages through/on radio, television, electronic platforms, USAID RESPONSE 72068724RFA00007 MIAHY Amendment #1 Page 15 of 19 community group dialogue, interpersonal communication or in print (by channel/# of channels)

HL.8.1-1 Number of people gaining access to basic drinking water services as a result of USG assistance

HL.8.1-2 Number of people gaining access to safely managed drinking water services as a result of USG assistance

HL.8.1-3 Number of people receiving improved service quality from an existing basic or safely managed drinking water service as a result of USG assistance

HL.8.1-4 Number of health facilities and schools gaining access to basic drinking water services as a result of USG assistance

HL.8.2-1 Number of communities verified as open defecation free (ODF) as a result of USG assistance

HL.8.2-2 Number of people gaining access to a basic sanitation service as a result of USG assistance

HL.8.2-3 Number of people gaining access to safely managed sanitation services as a result of USG assistance

HL.8.2-5 Percent of households with soap and water at a handwashing station on premises

HL.8.2-7 Number of people receiving improved sanitation service quality from an existing "limited" or "basic" service as a result of USG assistance

HL.8.2-8 Number of health facilities and schools gaining access to basic sanitation and hygiene services as a result of USG assistance

HL.8.3-3 Number of water and sanitation sector institutions strengthened to manage water resources or improve water supply and sanitation services as a result of USG assistance.

HL.8.4-1 Value of new funding mobilized to the water and sanitation sectors as a result of USG assistance

HL.8.5-1 Number of people benefiting from the adoption and implementation of measures to improve water resources management as a result of USG assistance

HL.8.5-2 Number of people benefiting from the implementation of measures to improve water resources management as a result of USG assistance

HL.9-1 Number of children under five (0-59 months) reached with nutrition-specific interventions through USG-supported nutrition activities

HL.9-2 Number of children under two (0-23 months) reached with community-level nutrition interventions through USG-supported programs

USAID RESPONSE 72068724RFA00007 MIAHY Amendment #1 Page 16 of 19

HL.9-3 Number of pregnant women reached with nutrition-specific interventions through USG-supported programs

HL.9-4 Number of individuals receiving nutrition-related professional training through USG-supported programs

HL.9-5 A national multi-sectoral nutrition plan or policy is in place that includes responding to emergency nutrition needs (Yes=1, No=0)

GNDR-2 Percentage of female participants in USG-assisted programs designed to increase access to productive economic resources (assets, credit, income or employment)

GNDR-6 Number of people reached by a USG funded intervention providing GBV services (e.g., health, legal, psycho-social counseling, shelters, hotlines, other)

GNDR-8 Number of persons trained with USG assistance to advance outcomes consistent with gender equality or female empowerment through their roles in public or private sector institutions or organizations

GNDR-13 Number of people trained in gender-based violence (GBV) prevention, response, or risk mitigation with USG support

YOUTH-1 Number of youths trained in soft skills/life skills through USG assisted programs

YOUTH-7 Number of children (0-19 years) and youth (10-29) reached with USG assistance

PSE-1 Number of USG engagements jointly undertaken with private sector enterprises to support U.S. foreign assistance objectives

PSE-2 Number of private sector enterprises that engaged with the USG to support U.S.

Foreign Assistance objectives

PSE-3 Number of private sector enterprises with improved participation in the local economy as a result of USG assistance

HIV Number of Individuals tested for HIV with disaggregation (male, female, age)

HIV Number of individuals testing HIV Positive with disaggregation (male, female, age)

HIV Number of HIV exposed infant testing at <2 months, by 12 months

USAID RESPONSE 72068724RFA00007 MIAHY Amendment #1 Page 17 of 19

Attachment 2: SALARY SCALE 2024 (Effective 7 avril 2024)

IN LINE WITH LOCAL COMPENSATION PLAN OF USAID/MADAGASCAR

SALAIRE DE BASE ANNUEL – ANNUAL BASE SALARY

POSITION CATEGORIZATION IN ACCORDANCE WITH MALAGASY

LABOR CODE

USG LCP Equivalence

Catégorie Professionnelle

Professional category

QUALIFICATION PROFESSIONNELLE

PROFESSIONAL QUALIFICATION

MINIMUM

MAXIMUM

Employés exécutant des travaux qui n'exigent qu'une initiation de courte durée ou une formation professionnelle simple.

Employees executing work that only needs short introduction course or basic training.

6,887,775 MGA 17,780,372 MGA

Employés ayant des connaissances personnelles et une expérience du métier qui ne peuvent être acquises que par un apprentissage ou une pratique suffisante, mais dont les fonctions ne comportent pas de responsabilités particulières.

Employees with specific knowledge and experience in the work gained through adequate learning and practice, but whose job does not involve specific responsibilities.

13,223,250

MGA

38,721,590 MGA

Employés qualifiés ayant une formation professionnelle approfondie et qui pour l'exécution des travaux qui leur sont confiés, sont appelés à prendre des initiatives ou supportent des responsabilités particulières.

Cadres débutants titulaires d'un diplôme d'études supérieures ou exerçant des fonctions exigeant des connaissances équivalentes.

Qualified employees with extensive training, and who take specific initiatives or responsibilities in the accomplishment of their duties. Entry level for senior employees, holding university degree or responsibilities requiring knowledge and skills at similar level.

29,663,773

61,416,531 MGA

Cadres administratifs techniques ou commerciaux et assimilés.

Les travailleurs de cette catégorie peuvent notamment être placés sous les ordres d'un chef de service ou de l'employeur mais doivent soit avoir des fonctions entraînant le commandement sur tout ou partie du personnel, soit diriger ou coordonner les travaux d'ouvriers, employés, techniciens, agents de maîtrise ou collaborateurs de toute nature.

Les travailleurs qui, remplissant les conditions prévues ci-dessus, 51,017,659

97,713,287 MGA

USAID RESPONSE 72068724RFA00007 MIAHY Amendment #1 Page 18 of 19 occupent les emplois d'adjoints au directeur, sous-directeurs, fondés de pouvoirs, chef d'agence régionale, représentants de commerce.

Administrative, Technical or Commercial Executives or equivalent. Workers in this group may work under a section officer or the employer, but should supervise whole or part of the staff, oversee and coordinate other workers, employees, technicians, supervisors, or employees of any kind.

Workers that meet the above conditions hold positions of deputy managers, assistant managers, authorized representatives, regional branch manager, sales representatives.

Cadres et assimilés occupant des fonctions hiérarchiquement supérieures à celles rangées dans les positions types précédentes comportant commandement sur un ou plusieurs cadres ayant eux mêmes pour leur autorité des collaborateurs, et dont la situation exige une valeur élevée ou justifiée par la nécessité de la coordination de plusieurs services dans une entreprise ou un établissement important.

Executives or equivalent that hold senior positions involving supervision of one or more executives, the latter having employees working under them, and whose position requires elevated value that is warranted by the need to coordinate several sections in an important business.

76,995,055

MGA

127,041,831

Hors Catégorie (HC)

Non-categorized

Rémunération à définir dans chaque cas particulier, compte tenu des diplômes d’études supérieures ou techniques, des références, de l’expérience acquise dans la branche d’activité considérée.

Compensation to be determined on case-by-case basis depending on higher /technical education degrees, credentials, experience gained in the considered business sector.

84,693,374

MGA

139,744,071

MGA

Annual Bonus : 10% of annual base salary for all categories

Miscellaneous allowances : 1,100,000 MGA /year for all categories

Transportation allowances :

Cat. % of base salary

1-2 10%

3-4 10-15%

5 25-30%

HC 30%

USAID RESPONSE 72068724RFA00007 MIAHY Amendment #1 Page 19 of 19

Attachment 3. Budget template with work plans (See attached)

(End of Amendment 01 of 72068724RFA00007)