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The American International Health Alliance (AIHA) Announces a Request for Proposals for a Partnership to increase South Africa’s human and organizational capacity in the delivery of HIV care and treatment services

(for this announcement in PDF format, click here)

Date Issued: June 7, 2007
Closing Date and Time: August 17, 2007 5:00 PM (EST)

The deadline for submitting Proposals is Friday, August 17, 2007 5:00 PM (EST).

AIHA is pleased to announce a request for proposals in support of establishing a new partnership between the Centre for Health Systems Research and Development (CHSR&D) of the University of the Free State in South Africa and a US-based University with expertise in TB and TB/HIV integration research and practice. AIHA is currently requesting proposals from qualified U.S. universities to strengthen South Africa’s human and institutional capacity to use the HIV and TB data to inform policy and clinical intervention development as well as future research areas on TB and TB/HIV integration. Interested universities should be willing to devote in-kind resources, mainly in the form of human resources committed on a volunteer basis, for an approximately one-year partnership in South Africa with the possibility, subject to funding, of an additional two- to three-year extension period.

I. Background

A. AIHA

The mission of the American International Health Alliance is to advance global health through volunteer-driven partnerships that mobilize communities to better address healthcare priorities while improving productivity and quality of care. Operating under a series of cooperative agreements, grants, and contracts with HRSA, USAID and other donors, AIHA establishes and manages partnerships between healthcare institutions in the United States and their counterparts overseas. AIHA also sponsors a number of supportive and collaborative activities, including inter-partnership conferences and workshops and an online clearinghouse of healthcare information.

AIHA, through a Cooperative Agreement with the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services, has established an “HIV/AIDS Twinning Center” (www.twinningagainstaids.org) to support partnership and volunteer activities as part of the implementation of the President’s Emergency Plan for AIDS Relief (PEPFAR). Through twinning partnerships, volunteers, and supportive assistance programs, the Twinning Center will contribute significantly to building key human and organizational capacity by: (a) directly training and mentoring care givers, (b) strengthening educational institutions and developing models of care for improved organization and delivery of services for rapid scale-up of interventions to help meet the goals of the President’s Emergency Plan to prevent seven million new infections, treat two million HIV-infected people, and care for 10 million HIV-infected individuals and AIDS orphans.

Under the current solicitation, AIHA will award one partnership. Funds for the grant awarded through this request for proposals are provided by HRSA and CDC-South Africa to AIHA through a Cooperative Agreement.

B. Partnership Methodology

Unlike traditional consultancy approaches, the AIHA partnerships are peer-based technical assistance programs, with an emphasis on professional exchanges, voluntary contributions, and leveraging resources. AIHA endeavors to create and facilitate sustainable partnerships based on commitment from the partners at the institutional level. In addition to the partners themselves, AIHA also plays an active role as a “partner,” providing key support services as well as facilitating partnership work plan development, performance monitoring, and evaluation. AIHA enables partners to maximize human and material resources by identifying and securing additional voluntary services from AIHA’s own strategic partners and providing a framework for collaboration within a larger international and policy context.

II. Partnership Strategy and Description

A. Goal and Objectives

The partnership will contribute to PEPFAR objectives and be integrated into the South African and US government activities in South Africa. The following objectives have been preliminarily identified for this partnership and are illustrative of possible focus areas. More targeted and measurable objectives and indicators will be developed jointly by the partners, with CDC-South African input, during the initial months of the partnership, consistent with AIHA’s partnership methodology which emphasizes a highly participatory approach to work plan development:

Objective #1: To strengthen the research and data management capacity of the CHSR&D staff to develop, manage, analyze (using correct statistical methods and software e.g. SPSS and STATA and Epi-Info) and report on epidemiologically sound TB/HIV integration research studies.

Objective #2: To develop skills and supporting mechanisms and materials essential to effectively translate research into policy and clinical practice.

Objective #3: To strengthen the capacity of CHSR&D staff to develop a multi-faceted intervention with M&E system for TB-HIV intervention based on the research findings to increase uptake of HIV counseling and testing among TB patients in the Free State.

Objective #4: To strengthen the capacity of the CHSR&D staff at the University of Free State to integrate and apply the knowledge, skills and lessons learnt through training and mentoring students and provincial staff to ensure sustainability.

B. Partnership Site

The Centre for Health Systems Research & Development (CHSR&D) was established at the University of the Free State (UFS) in 1993. The objectives of the CHSR&D include the following:

• To meet the need for social scientific research and development work skills in the field of health and health care
• To generate and disseminate research findings and information regarding health and health care
• To assist in the development and restructuring of health systems with a view to enhancing equity, equality, effectiveness and efficiency
• To empower staff, clients and target beneficiary groups through their active involvement in research and development activities
• To provide training and expand expertise in health systems research and development work

The CHSR&D perceives its role primarily as acting upon the prevailing policy, information and development needs in the health system of the Free State and South Africa. The focus areas and activities of the CHSR&D comprise of seven main programs, namely:

• HIV/AIDS/STIs, sexuality and reproductive health
• Tuberculosis (TB) control
• Health information systems, health surveys and environmental profiling
• Health systems research development
• District health system development
• Health policy, legislation and human rights
• Health management development

C. Collaboration and Coordination

AIHA seeks to ensure its partnerships and programs maximize effective use of resources and avoid duplication of efforts. Therefore, AIHA and its partners work to identify and develop collaboration between related programs in a country. Such collaboration and coordination also facilitate the sustainability of partnership accomplishments. The partnership work plan, developed in consultation with stakeholders, will pay special attention to the role and contribution of other US government partners as well as other foreign-sourced development activities, such as activities supported by the Global Fund for AIDS, TB, and Malaria. In turn, the partnership’s outputs and outcomes will be shared with the US government country team and other in-country partners.

D. Monitoring and Evaluation

Partners are expected to participate actively in program performance monitoring and evaluation (M&E) efforts, including the development of measurable partnership objectives and output/outcome indicators, collecting data, designing surveys or other assessment tools, and reporting to AIHA. Partnership M&E activities will be responsive to PEPFAR indicator targets and consistent with AIHA’s overall program M&E strategy (AIHA will provide the necessary orientation and training to partners). M&E activities will serve to: provide timely feedback about program performance and partnership progress and accomplishments (including PEPFAR indicators); ensure optimum use of available resources and improve programmatic decision-making; and strengthen the capacity of the South African university to conduct monitoring and evaluation. AIHA will coordinate closely with the South African government and CDC-South Africa on performance monitoring activities to serve stakeholders’ reporting and management needs.

As part of its monitoring activities, AIHA requires all partners to submit quarterly performance reports and progress against PEPFAR indicators within fifteen days of the end of each quarter. These reports are used to prepare AIHA’s quarterly reports to CDC-South Africa and are critical to monitoring partnership progress. The reports include information on progress towards achieving PEPFAR targets and objectives, status of activities and outputs, and a discussion of any obstacles or constraints affecting the project during the reporting period along with plans to address these.

Finally, partners will participate in a final program review and assessment towards the end of the funding period. Conducted jointly with local partners, this review will examine results accomplished during the life of the project, lessons learned, and future needs. The report will be submitted by AIHA to CDC-South Africa within 90 days after the end of the contract.

E. Program Funding

The amount of funds to be awarded to this partnership is expected to total approximately $150,000 for the initial 12-month-period. Award of a partnership will be made once the AIHA selection process is complete and concurrence from CDC-South Africa is obtained. Funds are generally disbursed in incremental amounts based on program progress and adherence to reporting requirements. The award can be renewed annually.

The award to the lead partner institution is typically used to fund partnership program and exchange travel-related expenses (including economy class airfare, visas, immunizations, lodging, meals and incidentals per diem, local transportation, and excess baggage fees), limited partner-initiated purchases of equipment and supplies (requires separate prior approval), translations, materials development and other training-related expenses – all of which must correspond with the approved work plan. In addition, AIHA allows for minimal partnership administration and coordination costs. As this award is funded by CDC-South Africa, AIHA utilizes the US government Federal Travel Regulations (FTR) as the basis for determining the reasonableness of proposed costs. The FTR regulation international per diem and lodging rate ceilings may be found at: http://www.state.gov/m/a/als/prdm/.

Award recipients are required to forego indirect/overhead charges, but minimal direct administrative costs related to coordinating the partnership are allowable. Awards should not be used to cover the salaries of personnel participating in partnership exchanges. Exceptions to these fundamental principles will be made only in cases where severe hardship is justified, documented and approved in writing by the TC Project Director.

III. Terms of Solicitation

A. Eligibility Criteria

AIHA is seeking applications from a U.S. academic institution or association that are committed to the goals of this program. Eligible applicants include education institutions and affiliated centers, and professional associations. Applicants should have established expertise in organizational strengthening and development, particularly in TB and TB/HIV integration research and practice. While profit-making entities are eligible to receive funding under this solicitation, AIHA will not pay any profit or fee under the sub-grant.

B. Requirements and Expectations of the Lead Partner

AIHA is seeking applications from a U.S. or non-US university that has the capacity to meet the goals and objectives of the partnership program as set forth in section II. Applications are encouraged from universities that have not traditionally been involved in international development and technical assistance programs.

The following are key requirements and expectations of partners under the program:

• Applicants are required to demonstrate their willingness to undertake the commitments of a partner required under the AIHA partnership model, including in-kind contributions, travel to South Africa, hosting South African partners, reporting on partnership activities and outcomes, and attending partnership orientations, workshops, and conferences. The lead partner institution is expected to contribute the human resource component of their activities and forego customary institutional indirect charges.
• Applicants must agree to adhere to AIHA's objective-setting and results-oriented approach, including AIHA’s quarterly programmatic and monthly financial reporting, accountability procedures and requirements, and participate in program monitoring and evaluations to assess partnership progress and achievements.
• Applicants must be willing to share information openly and participate fully in AIHA's efforts to exchange information with other partnerships through the AIHA Web site and through dissemination conferences and seminars.
• Applicants must be willing to brief and debrief with CDC-South Africa, South African Ministry of Health, and others as needed.
• The successful applicant will be required to participate in a series of post-award preparatory activities. (See Section V.C. below).
• The lead partner is required to designate a Partnership Coordinator whose role is to oversee the programmatic and administrative activities in support of the partnership and to serve as the point person in relations with AIHA. Partnership Coordinators are typically existing employees of the U.S. partner institution and serve in the position on a voluntary basis. Partnership Coordinator role and responsibilities will include:
  • overseeing and guiding development of partnership work plans
  • identifying and recruiting volunteers to participate in the partnership
  • coordinating partnership exchanges, trainings and other activities
  • monitoring progress of the partnership against stated objectives and tracking appropriate PEPFAR indicators
  • submitting progress reports and other required paperwork to AIHA
  • managing partnership budgets
• The lead partner institution is required to commit their organization to the principles of voluntarism that serve as the cornerstone of the twinning center program and AHIA’s partnership methodology. These principles stipulate that:
  • Professional participants from partnering institutions are expected to provide their time on volunteer (in-kind) basis;
  • Organizations participating as Twinning Partners are expected to forego indirect rate charges such as overheads and G&A.¹

¹Twinning Organizations may charge a minimal amount in direct administrative charges to the subgrant to include the labor costs associated with a program coordinator.

C. Required Start-up Activities

The successful applicant must be prepared to participate in a rapid start-up of activities once notification of award is made by AIHA. The initial expected activities, funded under this award, are as follows:

• Partner orientation: Key lead partners, including the partnership coordinator and financial administrator of the partnership will be expected to participate in an orientation meeting with AIHA at a location to be determined (DC or university). The orientation will include an introduction to AIHA and its partnership model; roles, responsibilities and expectations of lead partners; best practices and lessons learned from successful AIHA partnerships; administrative and financial polices/procedures; and monitoring and evaluation. The orientation session will be scheduled to take place within four weeks of the announcement of the award.
• First partnership visit: A delegation of lead partners is expected to visit the South African partner to meet with in-country partners and CDC-South Africa, to complete a site assessment, and to initiate partnership work plan discussions. AIHA will facilitate the development of a draft partnership work plan. This first exchange is expected to occur within eight weeks of the award announcement.
• Submission of partnership work plan: Partners must submit a jointly developed draft work plan (template and guidelines will be provided) to AIHA within one month of the initial exchange visit. The work plan will include partnership objectives, expected outcomes, and outcome indicators for the entire period of the partnership, as well as a detailed implementation plan (with activities and outputs) for the first program year.

D. Role of AIHA

• Throughout the duration of the partnership, AIHA staff in Washington, DC and South Africa will provide overall program management under the auspices of a Country Director (CD)/South Africa, with support from a Program Associate (PA)/Washington DC.
• The CD will be the local presence of AIHA in coordination and consultation meetings with all in-country stakeholders, particularly the Ministry of Health and CDC-South Africa, as well as other donors and implementing partners. The CD will also provide support to lead partners during their exchanges to South Africa.
• AIHA will coordinate with other relevant government entities, representatives of academic institutions, leading practitioners from different disciplines, and other key stakeholders in the project.
• AIHA will provide support and guidance to partners for work plan development, ensure effective work plan implementation, facilitate administrative functions, provide active support in problem solving, and identify and maximize collaboration with other AIHA partnerships and programs worldwide.
• AIHA may participate in planned site visits and will accompany partners during the first partnership exchanges.
• AIHA makes available centralized travel services, should the partners choose to use these services. During the start-up phase, prior to finalization of a sub-grant agreement, AIHA can make all necessary travel arrangements (for the orientation and initial exchanges described above). After that time, the partners may opt to make their own air travel arrangements funded under the partnership sub-grants.
• AIHA and its auditors will assess the lead partner organization’s financial management practices, based on a Risk Assessment Form to be completed by the lead partner. This risk assessment will determine the organization’s risk level from 1-4 so that appropriate monitoring and audit procedures can be applied. Depending upon the organization’s overall rank, AIHA will recommend specific steps to adequately monitor the partner and determine appropriate audit requirements.
• AIHA will approve a preliminary budget at the time of award of the partnership grant and approve subsequent annual budgets based on approved partnership work plans. Subsequent changes to the budget must be agreed to in writing by AIHA.
• AIHA will review and approve all partnership work plans. Subsequent changes to the work plan must be agreed to in writing by AIHA.

IV. Application Process

A. Proposal format

The following section provides instructions for formatting and organizing the proposal. A clearly written and easy-to-read proposal should be the goal of every applicant since the outcome of the review process depends on the reviewers’ understanding of the information provided. Reviewers will use only the information presented in the application to assess the responsiveness to the review criteria stated below in Section IV B.

Solicitation for interested applicants is through submission of a Proposal. The narrative section of the Proposal must be written in English and not exceed five (5) pages (8 ½ x 11 paper size, easily readable typeface, 11-point font, single-spaced with one-inch margins). The final Proposal must include the following sections:

1. Cover sheet
2. Description of institutional/organizational and personnel capacity
3. Narrative section
4. In-kind contribution/financial
5. Financial Certification Form

Note that the cover page, in-kind contribution/financial section, Financial Certification Form, P.L. 108 Certification, and any other attachments WILL NOT count toward the page limit.

1. Cover Sheet: Indicate title of the Proposal, and contact information (name, title, address, telephone, fax number, and e-mail, plus name and title of primary contact person) of lead institution and all other expected partnership institutions, including specific department/division, as appropriate.

2. Description of Institutional and Personnel Capacity:
Institutional Capacity and Past Performance: Provide a brief description, including legal or registration status, of the institution(s) to be involved in the partnership and their existing relationship with one another. Describe how the strengths of the institution(s) match up with the priority needs of the program and the identified needs for the South African institution. Describe applicant’s previous activities and concrete results that are pertinent to the proposed partnership.

Personnel Capability and Experience: This section should cover both partnership management and technical resource capabilities. Information on key personnel, including for each key person a short description of experience and capacity relevant to the project description, and indication of level of effort each will dedicate to the proposed activities and the roles and responsibilities of each. Clearly identify the proposed Partnership Coordinator and describe his/her program management skills.

3. Narrative section: AIHA does not require a traditional technical proposal since the actual partnership work plan detailing objectives and activities will be developed jointly with the South African partners based on assessed needs and available resources. However, based on information contained in this request for Proposals, the applicant is asked to describe both technical resources available to meet the program goals outlined above; possible approaches to addressing the key program areas; and a proposed timeline for implementing the proposed approach. The applicant should address the following in this section:

1. Proposed approaches to the following components and related institutional experience and capacity (please refer to section II):
• To strengthen the human and organizational capacity of the University of the Free State to develop methodologically sound and epidemiologically focused TB/HIV integration research studies.
• To strengthen the human and organizational capacity of a South African university to determine best practices in TB and TB/HIV integration by converting current research into clinical practice.
2. Illustrative approaches and timeline for meeting programmatic goals related to the above components within the partnership timeframe of 12 months.
3. Approaches to maintaining partnership communications and progress between exchange visits.
4. Approaches to monitoring and evaluation based on the aforementioned components. Relevant PEPFAR indicators for this partnership include:
   • Number of HIV-infected clients attending HIV care/treatment services that are receiving treatment for TB disease
   • Number of individuals trained to provide treatment for TB to HIV-infected individuals (diagnosed or presumed)
   • Number of individuals trained in strategic information (includes M&E, surveillance, and/or HMIS)
5. Sustainability strategy

4. In-kind Contributions/Financial Section: Describe the applicant’s commitment to provide voluntary resources and its plan to generate and leverage in-kind contributions from its community and the private sector. If possible, please indicate the value of in-kind time, goods and services expected to be contributed to the partnership.

Administrative support and coordination costs: Applicants should clearly indicate whether financial support from AIHA will be necessary for administrative support and coordination of partnership activities and estimate the level of funding that will be required.

5. Required Forms and Certifications: All applicants are required to complete and submit with their application, the following forms/certifications:

• Coversheet
• Financial Certification Form (US applicants) or Financial Survey Questionnaire (non-US applicants)
• Letter Certifying Compliance with P.L. 108, “Prostitution and Related Activities”

The forms/certifications are available on the Twinning Center Web site (via links above).

These forms/certifications must be signed by an individual in the organization who is authorized to legally bind the organization. This is generally the Executive Director, Chief Executive Officer, President, Chief Financial Officer or an authorized contracts officer.

6. Solicitation Reference Documents: In order to facilitate understanding of the subgrant requirements, AIHA has posted model subgrant documents on the Twinning Center Web site for review and informational purposes:

• Partnership Quarterly Progress Report Template
• Partnership/Project Workplan Template
• Model Subgrant Provisions for US and non-US Non-Governmental Organizations

B. Proposal Review

Proposals will be reviewed and rated by a review committee composed of AIHA staff and outside experts. Applicants may be asked to answer questions of clarification.

Based on the results of the review process, AIHA will recommend to CDC-South Africa the applicant that best matches the needs of the South African partner, best fulfills the criteria below, and offers the greatest potential for sustaining a partnership beyond the availability of AIHA funding. Notification of the winning proposal is expected to occur by August 31, 2007.

Review Criteria: The following key factors will be considered in selecting the successful applicants:

General [15 Points]

• Clear and strong support of senior leadership and Board(s) of Directors of lead institution and any other institutions involved in the application.
• Clear understanding of and commitment to voluntary nature of partnership program.

Institutional Capability and Past Performance [25 Points]

• Documented ability to strengthen the institutional capacity for provision of HIV care and treatment services.
• Linkages with a broad range of other relevant institutions in applicant’s community, including universities, NGOs, faith-based organizations, etc.
• Evidence of strong project management capability.
• Evidence of strong financial management capability and internal controls.
• Potential for sustainable relationship beyond US government/AIHA funding.

Personnel Capability and Experience [15 Points]

• Range and extent of technical expertise available to contribute to accomplishing program goals.
• Appropriate qualifications and relevant experience of Partnership Coordinator and other key individuals involved in managing the partnership. Adequacy of Partnership Coordinator in technical and managerial skills to provide guidance and oversight to the partnership, including skills in consensus building.

Technical Proposal [30 Points]

• Demonstrated understanding of the partnership methodology, particularly the collaborative and peer-to-peer aspects.
• Adequacy of proposed approaches to program components and related institutional experience and capacity to address these components.
• Sound and realistic approaches and timeline for meeting programmatic goals within the partnership timeframe.
• Clearly articulated approaches to gathering information and conducting assessments related to identified program components.
• Proposed approach to monitoring and evaluation, evidence of experience in measuring program outcomes, and a willingness to participate in AIHA's M&E activities.
• Approaches to maintaining partnership communications and progress between exchange visits.
• Demonstrated willingness to work collaboratively with other related programs and organizations, as well as with South African ministries and other local entities.

In-kind Contributions/Financial [15 Points]

• Significant in-kind contribution of resources, including human resources.
• Clear commitment or plan to generate additional in-kind resources, such as equipment, supplies, housing for visiting South African partners, etc.
• Foregone institutional overhead and other indirect costs.
• Level of funding required for partnership coordination and administrative support.

C. Guidance and Support for Applicants

Applicants may obtain additional information and guidance in the following ways:

AIHA’s Twinning Center Web site at www.twinningagainstaids.org contains information about AIHA, its partnership philosophy, institutional structure, and past experience in facilitating partnerships. In addition, a special section for this Request for Proposals and its supplemental attachments, along with Frequently Asked Questions can be found on the Twinning Center Web site under “Funding Opportunities” and “Solicitation Announcements.”

AIHA will accept questions and provide responses concerning this solicitation via e-mail. Please send questions to CHSRDsolicit@aiha.com or via fax at (202) 789-1277, Attention: South African TB/HIV Partnership-Proposals.

D. Submitting a Proposal

Electronic Submission:
Proposals may be submitted electronically as a Microsoft Word attachment(s) to CHSRDsolicit@aiha.com. We recommend that applicants include a received/read receipt to the email. Proposals also may be submitted by mail service as outlined below.

Hard Copy Submission
Applicants must submit one (1) hard copy of the Proposal. This should be submitted to the address below.

American International Health Alliance
Attn: South African TB/HIV Partnership-Proposal
1250 Eye Street, NW, Suite 350
Washington, DC  20005
Telephone:  (202) 789-1136
Fax:  (202) 789-1277

Applicants should retain for their records one copy of any and all concept papers, attachments, and other submissions to AIHA.

The deadline for submitting proposals is Friday, August 17, 2007 5:00 PM (EST).

X. Disclaimer

Applications are submitted at the risk of the applicant. Issuance of this RFP does not constitute an award commitment on the part of AIHA, nor does it commit AIHA to pay for costs incurred in the preparation and submission of applications. AIHA reserves the right to reject any or all applications received. Award of the grants contemplated by this RFA cannot be made until funds have been appropriated, allocated, and committed to AIHA. Continued funding for all projects throughout their duration will be dependent upon the grantee's performance and availability of funds from HRSA. While AIHA anticipates that these procedures will be successfully completed, potential applicants are hereby notified of these requirements and conditions for the award.