The United States Agency for International Development in Bangladesh (USAID/Bangladesh) is seeking applications from qualified US and non-US organizations to implement an activity titled USAID’s Urban Health Activity.

The purpose of the Urban Health Activity is to strengthen urban health systems, with the goal of improving equitable health outcomes among all urbanites. To achieve its goal, the activity will work with municipalities and city corporations and focus investments on establishing and strengthening urban health systems to provide quality, equitable public health (including health services), optimize available resources; and become more resilient.

Objectives

This Activity will focus on the following four objectives:

• Improve the capacity of local health authorities to conduct evidence-based analysis of local health systems and epidemiology for decision-making;
• Institutionalize evidence-based planning;
• Strengthen urban health systems; and
• Strengthen urban health system resilience and responsiveness to shocks and stressors.

Program Description

• This Activity has the potential to influence the future of urban health systems in Bangladesh through a timely and strategic intervention. The Activity will engage, coordinate, collaborate, and consider other stakeholders in the urban health space, including but not limited to the World Bank and Asian Development Bank (ADB); MOHFW, MOLGRD&C, municipalities, and city corporations; urbanites; various actors within the public health system; and private healthcare providers and others within the private sector.
• Within this context, USAID/Bangladesh’s health strategy focuses on strengthening health systems to provide quality, equitable public health and healthcare; optimize resources; and become more resilient. This activity will work with municipalities and city corporations to establish and strengthen urban health systems to provide quality, equitable public health (including health services); to optimize the use of resources; and to become more resilient.

Funding Information

Subject to funding availability and at the discretion of the Agency, USAID intends to provide thirty-five million dollars ($35 million) in total USAID funding over a Five (5) year period.

Results

Objective 1:

• Intermediate Result 1: Local health authorities’ capacity to conduct evidence-based action planning and decision-making improved.
• Objective 1 aims to improve the capacity of local health authorities to conduct high-quality analyses of their local health systems and epidemiological studies to carry out evidence-based planning; prioritize catalytic, cost-effective interventions; and efficiently manage human and financial resources. For this objective, USAID expects the successful applicant to build the capacity of local health authorities to analyze their health systems and conduct epidemiological studies of their catchment areas to identify weaknesses in health systems and public health needs, including equity gaps.

Objective 2:

• Intermediate Result 1: Routine use of financial, health system, and epidemiological data during municipal/city corporation health planning processes increased.
• Intermediate Result 2: Evidence-informed work plans and strategies implemented.
• Intermediate Result 3: Ability to adaptively manage health programs and performance strengthened.
• Objective 2 aims to institutionalize evidence-based planning. This activity will support municipalities and city corporations, and as applicable, health facilities, to develop evidence-based annual plans to strengthen health systems to deliver quality, equitable public health interventions, and to become more resilient.

Objective 3:

• Intermediate Result 1: Urban health systems strengthened.
• Resilient, efficient health systems require six building blocks: strong governance; consistent and adequate financing; reliable information systems; commodities; human resources; and equitable, quality service delivery. Objective 3 will work to comprehensively strengthen urban health system building blocks to ensure that urban health systems provide quality, equitable health services without financial hardship to all urbanites. Progress towards this objective will support the GOB’s efforts to achieve universal health coverage by 2030. USAID expects the successful applicant to provide technical assistance to help city corporations and municipalities implement annual plans from objective 2, thereby addressing the most pressing health systems weaknesses/bottlenecks identified by local health authorities in each geographic area.
• Illustrative interventions for Objective 3 may include but are not limited to:
• Governance: Build ownership and capacity within the public sector to take responsibility for providing quality, equitable healthcare in urban areas. This includes both public sector provision of healthcare, and support for the GOB’s stewardship, regulatory, and enforcement roles over the significant private sector in urban areas.
• Financing: Support local health authorities to efficiently finance urban primary health care (e.g., costing, budget advocacy, technical assistance on budget execution, technical assistance on public financial management, technical assistance on strategic purchasing). Stimulate private sector investment in urban healthcare (e.g., improve access to finance).
• Information: As new health systems are introduced and strengthened in urban areas, ensure the inclusion of data systems to collect and use data from the public and private sectors. Support evidence-based decision making. Interventions in this area should be local/small scale.
• Commodities: As new health systems are introduced and strengthened in urban areas, ensure that commodity logistics and supply chain systems are integrated in order to ensure that public facilities have access to medical equipment and medicines. Support effective regulation and enforcement of drug quality, and rational use of pharmaceuticals within the private sector. This may be achieved through coordination with other USAID implementing partners.
• Human Resources: Support rational workforce planning and management to ensure that facilities are adequately staffed with the right mix of employees and expertise to effectively deliver high-quality, equitable services. Interventions in this area do not include national level TA or advocacy. Interventions should be local-level and specific to a municipality/city corporation/facility.
• Service Delivery: Strengthen systems for public and private delivery of quality, equitable healthcare in urban areas.

Objective 4:

• Intermediate Result 1: Urban health systems capacity to plan and prepare for emergencies and shocks increased.
• Intermediate Result 2: Urban health systems capacity to rapidly respond to, and recover from, emergencies and shocks enhanced.
• Objective 4 aims to strengthen urban health systems’ resilience. Resilient and responsive health systems are adaptable and can effectively prevent/anticipate, prepare for, respond to, and recover from public health emergencies or disasters while maintaining routine health system functions. Intermediate results under this objective will work with local health authorities to strengthen urban health systems’ capacity to plan for, respond to, and recover from shocks and stressors.

Approaches

• The applicant is expected to work with municipalities and city corporations, and health facility managers where applicable, and employ the following implementation approach:
• Analyze health systems and the epidemiology of their catchment areas to identify weaknesses and public health needs. Analysis will include equity analysis. The analysis will be evidence-based and rely on the most robust data available as well as input from a participatory process involving city officials, health managers, facility managers, health facility operations committees, and/or community members. The analysis will build the skills of health managers and city officials in data and health systems analysis.
• Strengthen local health authorities’ capacity to coordinate and manage donor/development partners (donor funding coordination).
• Based on the urban health systems and epidemiological analysis from step 1 and available resources from step 2, engage in a participatory process and provide technical assistance to municipalities, city corporations (and facility managers) to develop evidence-based annual plans to optimize limited human and financial resources; improve delivery of equitable, quality public health interventions, including service delivery; and make health systems more resilient.
• Support municipalities and city corporations to implement their annual plans.

Risk and Assumptions

• Over the course of this Activity’s implementation cycle, the Urban Health activity will consider the following risks and potential disruptions to the activity. This list is not exhaustive.
• Global and local shocks/interruptions and emergencies may occur and disrupt the availability of essential services, including large-scale natural disasters, outbreaks, and pandemics.
• Social and political instability (including work with Mayors, municipal government staff, and work to strengthen cooperation and systems between the national government and local governments) related to the 2024 national elections might affect activity implementation.
• The MOHFW and MOLGRD&C may agree on a resolution to ongoing conflict around urban health, and that resolution requires re-design of the activity mid-course, though this is not expected (NB this would also be an opportunity.)
• This Activity will work under the assumption that the GOB will continue to support efforts toward achieving universal health coverage by 2030.

Beneficiaries

OPHN believes an equitable health system affords individuals a fair opportunity to attain their highest level of health regardless of social or demographic factors, with particular emphasis on underserved, socially excluded, and vulnerable populations. The activity will work with municipalities and city corporations that are responsible for urban healthcare provision and urban public health. The specific municipalities and city corporations will be determined during the co-development phase. The activity will target health systems, users of those health systems, and people living within their catchment areas. Beneficiary population targeting will be informed by evidence from an equity and inclusive development analysis using the most robust epidemiological and health data available. The activity is expected to intentionally work to monitor and close those equity gaps. The beneficiary population may be finalized during the co-development phase with the apparently successful applicant.

Eligibility Criteria

• This funding opportunity is open to all eligible U.S. and non-U.S. nongovernmental organizations (NGOs) entities (other than those from foreign policy restricted countries), including educational organizations and universities, and public international organizations, etc.
• Pursuant to Code of Federal Regulations (CFR) 2 CFR 200.400(g), the non-Federal entity may not earn or keep any profit resulting from Federal financial assistance. While for-profit firms may participate, pursuant to 2 CFR 700.13(A)(1), Prohibition against profit, no funds will be paid as profit to any for-profit entity receiving or administering Federal financial assistance as a recipient or sub-recipient, and as such, for-profit organizations must waive profits and/or fees to be eligible to apply.
• USAID welcomes applications from organizations that have not previously received financial assistance from USAID.
• Individuals are not eligible to apply.

Source: https://www.grants.gov/search-results-detail/350913