USAID Improved Maternal, Newborn, Child Health, Immunization and Nutrition Activity (Mozambique)

Deadline: 29-Sep-23

The United States Agency for International Development (USAID) Mission in Mozambique is seeking concept papers from qualified applicants for the USAID improved maternal, newborn, child health, immunization and nutrition activity.

This Annual Program Statement (APS) publicizes the intention of the United States Government (USG), as represented by the United States Agency for International Development (USAID)/Mozambique, Integrated Health Office (IHO), to fund one or multiple awards to address the overarching APS program purpose.

The purpose of this activity is to accelerate reductions in maternal, newborn, and child mortality and morbidity in high-burden regions of Mozambique by increasing the capacity of host country institutions, including local organizations, to improve access, quality, and sustained use of evidence-based maternal, newborn, and child health (MNCH) services, including routine immunization and nutrition services, as well as, promoting optimal MNCH, child development, and nutrition behaviors and practices.

Goal

• Improve maternal, newborn, and child health, including increased routine immunization and reduced malnutrition to decrease deaths from preventable causes and help women, newborns and children thrive in central and northern Mozambique (Nampula, Zambezia, Niassa and/or Tete – noting that additional/alternative geographies may be explored throughout the life of the Activity).

Priorities

• The U.S. Government’s development approach in Mozambique is focused on improving the quality of life for all Mozambicans, targeting specifically the young and vulnerable. To reach this goal, the USG closely collaborates with the GRM, the private sector, and other donors, leveraging emerging opportunities to achieve inclusive development.

Funding Information

• The financial range for award(s) under this APS will be up to $92,000,000 USD.
• The proposed period of performance for each agreement awarded as a result of each Round(s) under this APS will not exceed five years in duration beginning from the negotiated start date, and subject to availability of funds.

Cross-cutting Programmatic Principles and Approaches

• Gender
  • Promoting gender equality, empowering women, and advancing the status of women and girls is vital to achieving USAID’s development objectives. The Applicants are expected to address gender by ensuring both women and men in all their diversity – including of the LGBTQI+ community and those with disabilities – are reached by health services and that women’s voices and agency is strengthened in MNCHI+N at the country, regional, and global levels.
• Localization
  • A strategic priority for USAID is to promote the sustainability and ownership of development projects on the part of the local government and local organizations at all levels, including engagement and empowerment at the community level to shape and drive development needs and approaches.
• Disabilities
  • With respect to engagement of persons with disabilities, USAID and implementing partners will ensure equitable access to resources and services provided, taking into consideration potential barriers that impact this population that were identified in the Gender and Inclusive Development Assessment. Persons with disabilities are diverse and recommended accommodations will vary to respond to social and physical needs.
• Conflict and Instability
  • While there was a limited incursion into northern Nampula in 2022, over 95% of all security incidents took place in Cabo Delgado and more than 90% took place in the northern districts of the province. Considering the MNCHI+N needs of Nampula as well as the needs of populations in conflict zones and those that are internally displaced is essential to appropriately plan and implement activities.
  • This Activity will consider high impact and adaptable interventions for internally displaced people (regardless of where they reside) and host communities that prevent negative health outcomes and support delivery of essential MNCHI+N services that are responsive to the unique needs of northern Nampula and any other areas with conflict and instability in Mozambique that may emerge over the course of the award. Efforts will be made to understand and overcome access challenges that IDPs may face, and encourage utilization of services for all patients who may benefit, regardless of their origin. Given the predictability of ongoing crises and instability, this Activity should be designed with the ability to respond to crises incorporated into activities and approaches.
• Sustainability
  • This Activity has potential to not only support the GRM to operationalize updated policies and improve MNCHI+N; but also to leave behind an approach as a sustained legacy for the country once this Activity comes to an end. The Applicant must demonstrate a commitment to sustainability, such that the activities are implemented and supported in a feasible, cost-efficient and high-quality manner to allow for the GRM and other local partners to carry on the activities, commit resources and ensure the results will continue beyond the life of the Activity.
• Youth
  • USAID is committed to ensuring the integration of youth considerations into its activities. Youth engagement is a cross-cutting issue identified in the USAID/Mozambique’s CDCS, and is a key target population for USAID programs. According to the latest census, over 65 percent of the Mozambican population is considered youth (under age 25).
  • In order to advance USAID/Mozambique’s programming, adolescents and youth are priority populations to be reached and engaged by the Activity. The Activity should consider adolescent girls and young women as the primary group at-risk of MNCH complications, due to early pregnancy prior to achieving full physical maturity and social norms that limit their access to preventive and obstetric care, and as such, each part of the Activity should factor in their needs and access points to health care.
• Climate Change Integration
  • Climate change is a cross-cutting issue that can have significant impacts on regional, national, and local development efforts in all sectors. In recognition of the Executive Order (EO) 13677, which requires all US agencies to factor climate change into their foreign assistance planning and manage the associated climate risks, the Applicant must identify expected climate change impacts over the life of the Activity and demonstrate how those risks will be reduced in order to ensure sustainability of the activities objectives by completing with the AOR a Climate Risk Management (CRM) plan before implementation of the Activity.
• Environmental Compliance Considerations
  • The Foreign Assistance Act of 1961, as amended, Section 117 requires that the impact of USAID’s activities on the environment be considered, and that USAID include environmental sustainability as a central consideration in designing and carrying out its development programs.
  • The recipient must adhere to the conditions set forth in the Mission Initial Environmental Examination and any other environmental documents developed and approved by USAID prior to the initiation of the Activity. In addition, the contractor/recipient must comply with host country environmental regulations unless otherwise directed in writing by USAID. In case of conflict between host country and USAID regulations, the latter shall govern.
• Host Government, Donor, and other Counterpart Collaboration
  • The implementing partner is expected to develop and maintain strong relationships with the Mozambican Government (specifically the Ministry of Health’s (MISAU) relevant MNCH/Nutrition/Immunization divisions (including provincial and district level such as but not limited to SPS, DPS, and SDSMAS), SETSAN, other donors, and counterparts.
• Transparency and Accountability
  • Fostering transparency and accountability is an important focus for the U.S. Mission in Mozambique. All data (as appropriate) generated from the Activity will be made broadly available to the public, government and civil society stakeholders.
• Innovation
  • USAID/Mozambique is supportive of innovative approaches to accelerate and sustain progress in the MNCHI+N space, both in terms of operationalization of programming (i.e., the “how”) and interventions themselves (i.e. “the what”).
  • To support innovative design, USAID/Mozambique is utilizing a co-creation process in which select Applicants that pass the initial Concept Paper submission phase as well as other stakeholders (namely government entities) will be invited to further expand on proposed ideas and ideate on new concepts (e.g. new approaches to improve quality such as small innovation grants to districts and health facilities) that have the potential to disrupt the status quo, reverse recent declines, and accelerate greater improvements in maternal, neonatal, child health, immunization, and nutrition.

Expected Results

• APS Theory of Change: IF there is increased adoption of healthy behaviors, improved access to health services, improved provision of quality services, and strengthened health systems, leading to improved utilization of health services THEN there will be improved MNCHI+N outcomes in select central and northern Mozambican provinces that will result in reduced mortality and morbidity and a pathway for families to thrive.
  • Intermediate Result (IR) 1: Increased adoption of healthy MNCH, immunization and nutrition behaviors
    • Identifying and addressing underlying factors and barriers to positive health behaviors and encouraging adoption of positive behaviors through proven social and behavior change interventions is key to improving individual and community health.
  • IR 2: Improved access to MNCH, immunization and nutrition services
    • Access to high quality, respectful clinical services and medical interventions are critical to improving MNCHI+N outcomes – whether it is preventive care for pregnant and postpartum women, childbirth care, essential newborn care, routine vaccination, treatment for a sick child, growth monitoring and promotion, or responsive and nurturing care by caregivers and health care workers to support optimized child development.
  • IR 3: Improved provision of quality MNCH, immunization, and nutrition services
    • Access to care is an important dimension of MNCHI+N, but the quality delivery of clinical services is just as critical and requires quality improvement throughout the system. If a patient reaches a facility and is treated inadequately, needed supplies are unavailable or referrals are not made in time, confidence in the health system erodes and preventable morbidities and mortalities can occur.
  • IR 4: Strengthened health systems for quality MNCH, immunization and nutrition
    • Sustainable improvements in MNCHI+N are only built when the health system itself is strengthened and able to function without project level inputs. Improved systems for supply chain management, data collection and management, financial planning and management, strategic planning, and human resources and administrative management are all critical underpinnings to ensure access and delivery of quality health services.

Geographic Focus

• In line with USAID/Mozambique’s geographic focus on central and northern provinces, the proposed geographic areas for this Activity are: coverage of districts in Nampula and Zambezia provinces, plus proposed select coverage of key districts in Niassa and/or Tete provinces (i.e. districts with significant unmet need and opportunity).
• The Activity will focus operations at the provincial, district, and local levels; with some resources reserved for central level support. At the central-level resources should be dedicated for planning, strategy, policy development/updating, coordination and leadership of technical assistance in Maputo. Central level support will allow for some technical assistance at the national policy level which would lead to improved operationalization of policies and therefore nation-wide benefit. The decentralized nature of implementation should be taken into account when planning the staffing pattern and management arrangement.

Eligibility Criteria

• U.S. and non-U.S. public, private, for-profit, and nonprofit organizations, as well as institutions of higher education, public international organizations, and non-governmental organizations, are eligible to submit a concept paper under each Round(s) of the APS. Further, the organization must be a legally recognized, organizational entity under applicable law, legally registered in a country within the geographic code 935, which includes the United States, the recipient country, and developing countries other than advanced developing countries, but excluding any country that is a prohibited source.
• Each recipient must be a responsible entity. The AO may determine a Pre-Award survey is required and if so, would establish a formal survey team to conduct an examination that will determine whether the prospective recipient has the necessary organization, experience, accounting and operational controls, and technical skills – or ability to obtain them – in order to achieve the objectives of the program.
• Local organizations are strongly encouraged to apply, inasmuch as they will support not only the objectives of this APS and the Round(s) they are applying to, but also USAID’s objectives to build the opportunities for and capacities of local organizations that are needed for sustainable development. USAID strongly encourages applications from potential new partners who meet the eligibility requirements and are willing to comply with New Partner Pre-Award Survey (NUPAS) requirements.
• Concept papers from organizations that do not meet the above eligibility criteria will not be reviewed and evaluated. Individual persons are not eligible to apply for any Rounds of this APS.

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