USAID’s Gaza Health Recovery Activity – Palestine

Deadline: 03-Jun-2024

The United States Agency for International Development (USAID) is seeking applications for a Cooperative Agreement from qualified U.S. Non-Profit Organizations (NGOs) and U.S. For Profit Organizations (that forgo profit), to implement a five-year program, entitled the “Gaza Health Recovery Activity.”

Goal 

• The goal of GHRA is to improve health outcomes for Gazans through the restoration of NGO health services across the Gaza Strip. To address the complex health needs of Gazans post-conflict, this activity will not only focus on restoring services at the primary health care level, but also will provide limited support to secondary health care services and facilities as determined by the rapid needs assessment and USAID/WBG priorities and funding availability.

Cross-Cutting Themes

• Inclusive Development
  • Inclusive Development is at the core of effective USAID programming. The Agency is committed to elevating women and local voices, including marginalized communities. GHRA will promote the approaches of inclusive development by ensuring that community leaders and members, including marginalized groups and people with disabilities and special health care needs, inform the activities and approaches used to advance GHRA. An inclusiveness assessment focused on gender, disability, and youth must be conducted by the Recipient and it will be the basis for developing relevant interventions in response to the findings and recommendations.
• Gender
  • The USAID’s 2020 Gender Equality and Female Empowerment Policy requires that women, girls, men, and boys enjoy equal economic, social, cultural, civil, and political rights and are equally empowered to secure better lives for themselves, their families, their communities, and their countries.
  • The Gaza Health Recovery Activity will be required to conduct a detailed gender analysis when it starts implementation as detailed in Annex 1. A gender analysis will be combined with an inclusive development analysis, to ensure an intersectional lens is utilized to better understand an individuals’ experience with gender and other important aspects of identity. The analysis should identify gender issues and determine possible entry-points for the Activity. Focus should be related to the different roles, needs, priorities, and strengths of Palestinian women/girls and men/boys, including for medical staff and patients treated in health facilities as well as the complexity of gender relations in the context of social relations and how this constrains or provides opportunities for addressing gender inequality.
• Youth
  • The Recipient will be required to conduct a youth analysis when it starts implementation as detailed in Annex 1. This analysis will examine barriers and opportunities to increase meaningful youth engagement in GHRA. The Activity will engage youth as viable partners in all activities.
• Disability
  • The Recipient will be required to conduct a disability analysis when it starts implementation as detailed in Annex 1. This analysis will examine barriers and opportunities to increase meaningful engagement for persons with disability (PWDs) in GHRA. The Activity will engage PWDs as viable partners and in all activities and beneficiaries from GHRA’s activities.
• Climate Change
  • USAID expects its activities to positively contribute to the environment. An Initial Environmental Examination (IEE) is to be conducted for the GHRA (a copy of the IEE approval will be shared with the potential recipient during the co-creation phase and will be incorporated in the award). The Recipient should develop an Environmental Monitoring and Mitigation Plan (EMMP) for each intervention. The Recipient should perform climate risk analysis and develop the necessary actions to address those risks. The climate risk analysis should be included in the EMMP reports.
• Localization
  • Localization is at the core of effective USAID programming. The Agency is committed to elevating local voices, including marginalized communities. By 2030, fifty percent of USAID programming will place local communities in the lead to set priorities, co-design projects, drive implementation, or evaluate the impact of programs.

Funding Information

• USAID intends to provide U.S. Dollars $50 million in total USAID funding over a five-year period. Actual funding amounts are subject to availability of funds and internal USAID approvals. USAID reserves the right to fund any or none of the concept papers submitted.
• The anticipated period of performance is five years. The estimated start date will be upon the signature of the award, on or about August 15, 2024.

Results Framework

• The following represents the intermediate results (IRs) for GHRA and some illustrated interventions:
  • IR.1: Improved access for the Gazans to high quality primary and secondary health care services including; 
    • Primary health services, including:
      • Maternal, newborn and child health (MNCH) services
      • Nutrition screening and services, including malnutrition interventions
      • Outpatient care, including chronic and communicable disease services ○ Mental health and psychosocial services, including through referrals
    • Secondary and specialized healthcare services, including:
      • Emergency Obstetric Care (EmOC)
      • Neonatal intensive care
      • Surgical and specialized services for severe injuries
      • Services for people with disabilities (prosthesis, assistive devices)
    • GHRA will be focused on providing technical and operational support to non-governmental primary and secondary health organizations to provide high quality health services across the Gaza Strip. The focus will be on primary health and community level support, but will include limited interventions to support secondary healthcare services identified as critical needs during the assessment phase as needed and approved by the USAID/WBG.
    • As appropriate, sub-grant support will be provided to non-governmental providers to help them transition back to where they were prior to October 7th. Sub-grant support could include:
      • Grants to help local non-governmental health providers restore their capacity to provide quality health, nutrition, psycho-social and mental health, disability accessibility and physical rehabilitation services. The grants will be short-term and focused on helping local organizations restore staffing, ensure quality standards for care and procure needed equipment, devices and pharmaceuticals that will enable them to restart their programming. The sub-grants can be used to provide short term job opportunities for medical and administrative staff, organizational operational support and running costs, special project activities, etc. Sub-grant support should be complemented with technical and/or managerial capacity building measures, if warranted, in order to increase the quality, effectiveness and sustainability of the organizations’ ability to provide long-term critical services.
      • Grants to small community-based organizations that provide health, nutrition, psychosocial and mental health and physical rehabilitation services. Grants can also be provided to community-led organizations and marginalized groups to advance inclusive development in the informal health sector.
    • IR.1.1 Restored institutional and operational capacity of health NGOs in Gaza to provide access to health services for Gazans
      • Illustrative interventions 
        • Conduct rapid needs assessments of health facilities, supply chain and human resources to inform the quick restoration of key health services as outlined in the results section.
        • Develop and implement health services restoration plans for each targeted NGO facility/clinic/hospital and other health service providers.
        • Reestablish medical protocols and administrative systems per national standards, including physical rehabilitation and inclusive of assistive technology.
        • Explore opportunities to utilize tele-health and digital health services/support to enable task shifting and client centered care.
        • Recruit skilled clinicians and health support staff to provide static and mobile/community outreach services and manage clinic operations and logistics.
    • IR.1.1.1 Strengthened supply chain systems to ensure reliable access to essential equipment, commodities, pharmaceuticals and assistive devices for their service delivery sites
      • Illustrative interventions 
        • Development of pharmaceutical management systems and training of relevant staff
        • Development/upgrade of procurement systems
        • Support/provision of medical equipment and spare parts for medical equipment
        • Support/provision of pharmaceutical and medical supplies
        • Provision of center-based disability rehabilitation equipment
    • IR.1.1.2 Sub-grant support to non-governmental healthcare providers 
      • Illustrative interventions 
        • Short term funding for staffing, small scale non-structural renovations or facility/service operations to enable the sub-grantee to restart services
        • Expand/improve services currently provided by the sub grantee
        • Introduce new services that are not available in Gaza, but that are highly needed in the current context (e.g. therapeutic feeding for children suffering from severe acute malnutrition)
        • Improve quality of services through technical assistance from GHRA or contracted organization
    • IR.1.1.3 Human resources trained (technical health and administrative staff) 
      • Illustrative interventions 
        • Train and support health care providers on evidence-based updates to clinical care and application of promising practices for fragile settings
        • Train and support medical teams on emergent health needs
    • IR. 1.1.4 Physical upgrade/rehabilitation to health facilities 
      • Illustrative interventions 
        • Provide limited support for NGO health facility rehabilitation, including efforts to restore access to water, electricity and internet services – award recipients should collaborate with other USAID partners to support these needs
  • IR.2 Increased community utilization and engagement to expand the reach out of targeted health care services to more vulnerable Gazans.
    • Illustrative interventions 
      • Support to community-based rehabilitation organizations and community-based mental and psycho-social support organizations in order to reach a larger number of program participants and communities through their outreach and mobile services
      • Support initiatives/programs that advance cross-cutting inclusive development and community involvement in the planning and implementation of interventions that address health services needs of marginalized and underrepresented groups, including mental health, disability inclusion and rehabilitation services.
      • Revitalize or design approaches for integrating mental health and psycho-social support into primary and secondary health care services, including establishing a clear referral pathway, strengthening mental health community helplines, and supporting mental health needs of healthcare workers and auxiliary health service staff
      • Conduct trauma-informed consultations with the community to better understand needs and priorities
      • Conduct Inclusive Development Analysis or expand a gender and disability assessment/analysis to include an inclusive development lens to better assess contextual factors impacting war-affected children, women, youth and adults, access to services and provide programmatic recommendations.
      • Provide disability rehabilitation services that actively engage and utilize the community’s human and material resources.
      • Train health staff on inclusive practices, such as the social model of disability, gender sensitivity, youth engagement and principles of resilience and inclusive development.
      • Provide psycho-social support and mental health services, including creating and equipping a cadre of mental health providers that can provide community-based interventions.

Eligibility Criteria

• Eligible Applicants under this NOFO are those that are: qualified U.S. organizations, non-profit, or for-profit entities14; who had an active presence (i.e., operations and staff) in Gaza prior to the events of October 7, 2023; and have previously implemented activities and programs in the Health sector in Gaza in the past five years preceding October 7, 2023; and are registered to work in the Palestinian Territories, may apply for funding under this NOFO. See Section C for more information.
• Note that qualified U.S. For-Profit Organizations may apply for funding under this NOFO. Potential for-profit Applicants should note that, pursuant to 22 CFR 226.81, the payment of fee/profit to the prime recipient under grants and cooperative agreements is prohibited. However, if a prime recipient has a subcontract with a for-profit organization for the acquisition of goods or services (i.e., if a buyer-seller relationship is created), fee/profit for the subcontractor may be authorized.

For more information, visit Grants.gov.