RFA-367-10-000004

RFA Number: RFA-367-10-000004Issuance Date: 12/08/2010Deadline for Questions: 23/08/2010 1600 Hours Nepal Time Closing Date: 27/09/ 2010, 1600 Hours Nepal Time

SUBJECT: Request for Applications (RFA) Number RFA-367-10-000004 – Integrated Nutrition Program (INP)

Dear Prospective Applicant:

The United States Agency for International Development (USAID) is seeking applications (proposals for funding) from U.S. or non-U.S., non-profit or for-profit nongovernmental organizations (NGOs), public international organizations (PIO or IO), and other qualified non-U.S. Government (USG) organizations to implement the Integrated Nutrition Program (INP) program for USAID/Nepal. The authority for this Request for Applications (RFA) is found in the Foreign Assistance Act of 1961, as amended.

USAID plans to award one cooperative agreement with a total estimated amount of approximately $46 million, subject to the availability of funds, but reserves the right to make multiple awards if it deems that preferable. The award is intended to cover a period of five years after award. USAID encourages applications from potential new partners.

The chosen Recipient will be responsible for ensuring achievement of the program objectives. Please refer to the Program Description (RFA Section C) for a complete statement of goals and expected results.

Pursuant to 22 CFR 226.81, it is USAID policy not to award profit under assistance instruments. However, all reasonable, allocable, and allowable expenses, direct and indirect, which are related to the Cooperative Agreement and are in accordance with applicable cost standards (22 CFR 226, OMB Circular A-122 for Non-Profit Organizations, OMB Circular A-21 for Universities and the Federal Acquisition Regulation (FAR) Part 31 regarding for-profit organizations) may be paid under the Award.

For the purposes of this program, this RFA is being issued and consists of this cover letter and the following:

1. Section A - Application Format;2. Section B - Selection Criteria;3. Section C - Program Description;4. Section D - Certifications, Assurances, and Other Statements of Applicant/Grantee;5. Section E – Annexes.

For the purposes of this RFA, the term "Grant" is synonymous with "Cooperative Agreement"; "Grantee" is synonymous with "Recipient"; and "Grant Officer" is synonymous with "Agreement Officer".

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Any questions regarding this RFA must be submitted in writing via e-mail to Pradeep Neupane at pneupane@usaid.gov and Ram Gurung at rgurung@usaid.gov, with a copy to Patrick Wilson at pwilson@usaid.gov, or via fax at (977)-1-4007285. Questions must be submitted no later than 1600 hours Nepal time by 23/08/2010. Applications must be received by the closing date and time indicated at the top of this cover letter at the place designated below for receipt of applications in order to be considered.

The federal grant process is now web-enabled, allowing for applications to be received on-line. Applicants may upload applications to www.grants.gov; however, hard copy submissions are still required by USAID/Nepal. This RFA and any future amendments can be downloaded from http://www.grants.gov. If you have difficulty accessing the RFA, please contact the Grants.gov Helpdesk at 1-800-518-472 or via e-mail at support@grants.gov for technical assistance.

Receipt of this RFA through Grants.gov must be confirmed by electronic or written notification to the Agreement Officer. It is the responsibility of the recipient of the application document to ensure that it has been received from Grants.gov in its entirety and USAID bears no responsibility for data errors resulting from transmission or conversion processes.

An original and five paper copies of the technical applications, and an original and two paper copies of the cost applications, along with a CD-ROM with both applications, with text in WORD and budgets/tables in EXCEL, in envelopes with the name and address of the applicant and RFA number (referenced above) inscribed thereon, shall be sent to the address below:

By Air Courier or Hand Delivery:

USAID/Nepal US EmbassyBrahma Cottage, Maharajgunj Narayan Gopal ChowkP.O. Box No. 295Kathmandu, Nepal Attention: Pradeep Neupane and Ram GurungTelephone No: (977)-1- 4007200 ext. 4241

Applications submitted via fax or email will not be accepted. Applicants should retain a copy of their application and accompanying enclosures for their records.

Please be advised that in the past some firms have experienced delays with international air courier services. Also, if you utilize the services of an independent agent in Nepal to deliver your proposal, please be certain that he/she understands additional time may be needed to allow for security review of any packages and that the closing date and time are firm.

Applications received at the Contracts Office late shall be reviewed and considered for award at the sole discretion of the Agreement Officer, if it is determined that it is in the U.S. Government’s interest. All late applications will be treated equally.

Applicants are requested to submit both technical and cost portions of their applications in separate volumes so that they may be reviewed separately. To be eligible for award, the Applicant must provide all required information in its application, including the requirements found in any attachments to the solicitation in Grants.gov. Award will be made to the responsible Applicant whose application(s) offers the best value to the U.S. Government as determined by the Agreement Officer.

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Issuance of this RFA does not constitute an award commitment on the part of the U.S. Government, nor does it commit the U.S. Government to pay for costs incurred in the preparation and submission of an application. Further, USAID reserves the right to reject any or all applications received. In addition, final award of any resultant grant(s) cannot be made until funds have been fully appropriated, allocated, and committed through internal USAID procedures. While it is anticipated that these procedures will be successfully completed, potential Applicants are hereby notified of these requirements and conditions for award. Applications are submitted at the risk of the Applicant; must circumstances prevent award of a cooperative agreement, all preparation and submission costs are at the Applicant's expense. In the event of any inconsistency between the documents comprising this RFA, it shall be resolved by the following descending order of precedence: (a) Section B - Selection Criteria; (b) Section A - Application Format; (c) Section C - Program Description; (d) This Cover Letter.

Thank you for your interest in USAID’s programs and activities.

Sincerely,

Patrick J. WilsonRegional Agreement OfficerUSAID/Regional Development Mission AsiaBangkok, Thailand

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Table of Contents

SECTION PAGE

A – COOPERATIVE AGREEMENT APPLICATION FORMAT..........................................................6

I. General Application Preparation Guidance.................................................................................6II. Technical Application Guidance.................................................................................................8III. Cost Application Guidance........................................................................................................13

B – EVALUATION CRITERIA...........................................................................................................17

C – PROGRAM DESCRIPTION........................................................................................................20

D – CERTIFICATION, ASSURANCES AND OTHER STATEMENTS OF RECIPIENT...................49

PART I. CERTIFICATION AND ASSURANCES..............................................................................49

1. Assurance of Compliance with Laws and Regulations Governing Non-Discrimination in Federally Assisted Programs................................................................................................492. Certification Regarding Lobbying.............................................................................................503. Certification Regarding Terrorist Financing Implementing Executive Order 13224............514. Key Individual Certification Narcotics Offenses and Drug Trafficking.................................535. Participant Certification Narcotics Offenses and Drug Trafficking ......................................536. Certification of Recipient...........................................................................................................54

PART II. OTHER STATEMENTS OF RECIPIENT............................................................................55

1. Authorized Individuals...............................................................................................................552. Taxpayer Identification Number (TIN).......................................................................................553. Contractor Identification Number - Data Universal Numbering System (DUNS) Number...554. Letter of Credit (LOC) Number..................................................................................................565. Procurement Information...........................................................................................................566. Past Performance References...................................................................................................587. Type of Organization..................................................................................................................588. Estimated Cost of Communications Products........................................................................58

PART III. SURVEY ON ENSURING EQUAL OPPORTUNITY FOR APPLICANTS........................59

PART IV. STANDARD PROVISIONS AND OTHER REQUIREMENTS..........................................61

1. Implementation of Executive Order 13224 on Terrorist Financing........................................612. Revised Regulations Concerning Debarment and Suspension and Drug-Free Workplace Applicable to Assistance...........................................................................................................613. Supporting USAID's Disability Policy in Contracts, Grants, and Cooperative Agreements

634. Revised Standard Provisions for Non-Governmental Organizations....................................635. Marking Under USAID-Funded Assistance Instruments........................................................646. Voluntary Population Planning Activities -- Mandatory Requirements (May 2006).............757. Protection of the Individual as a Research Subject (April 1998) ………………………..........788. Reporting of Foreign Taxes (March 2006) ………………………………………………..............78

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7. OFAC License.............................................................................................................................80

E – ANNEXES ..................................................................................................................................83

Annex 1 - Proposed Geographic Coverage and Districts Annex 2 - USAID’s Foreign Assistance Strategic Framework Annex 3 - Abbreviations

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SECTION A: COOPERATIVE AGREEMENT APPLICATION FORMAT

I. GENERAL APPLICATION PREPARATION GUIDANCE

1. Submittal Guidance

Applicants are expected to review, understand, and comply with all aspects of this Request for Application (RFA). Failure to do so will be at the Applicant’s risk.

All applications received by the deadline will be reviewed for responsiveness to the specifications outlined in these guidelines and the application format.

The application must be prepared according to the structural format set forth below. Applications must be submitted no later than the date and time specified in this solicitation, to the location indicated in the Cover Letter accompanying this RFA. Applications received late shall be reviewed and considered for award at the sole discretion of the Agreement Officer, if it is determined that it is in the U.S. Government’s interest. All late applications will be treated equally.

Applications are to be submitted electronically via e-mail attachments formatted in Microsoft Word and/or Excel (version 2000). Please do not send files in Zip format. In addition to the e-mail submission, Applicants shall submit an original and five paper copies of the technical portion of the application and an original plus two paper copies of the cost/business portion of application to the address specified in the cover letter.

Provide the name, address, telephone and facsimile numbers, and e-mail address of the individual in the Applicant’s organization to be contacted, if necessary, during the evaluation of the application.

The Applicant will sign the application and print or type its name on the Cover Page of the Technical and Cost Applications. Erasures or other changes must be initialed by the person signing the application. Applications signed by an agent shall be accompanied by evidence of that agent's authority, unless that evidence has been previously furnished to the issuing office.

a. Following are the procedures for submission of applications by e-mail:

i. Before sending your documents to USAID as e-mail attachments, convert them into Microsoft Word (for narrative text), Excel (for budgets and other tables), or PDF format (for documents requiring signature).

ii. Once sent, check your own e-mails to confirm that your attachments were indeed sent. If you discover an error in your transmission, re-send the material again and note in the subject line of the email that it is a "corrected" submission. Do not send the same e-mail more than once unless there has been a change, and if so, note that it is a corrected e-mail. Do not wait for USAID to advise you that certain documents intended to be sent were not sent, or that certain documents contained errors in formatting, missing sections, etc. Each Applicant is responsible for its submissions.

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iii. To avoid confusion, duplication, and congestion problems with our e-mail system, only one authorized person from your organization should send in the e-mail submissions.

iv. If you send your application by multiple e-mails, indicate in the subject line of the email whether the e-mail relates to the technical or cost proposal, and the desired sequence of multiple e-mails (if more than one is sent) and sequence of attachments (e.g. Organization X, Cost Proposal, Part 1 of 4, etc.). However, you are requested to consolidate, as much as possible, the various parts of your technical application into one technical application document and the various parts of your cost application into one cost application document.

v. The attachments should be formatted in Microsoft Word and/or Excel (version 2000) or PDF format, with a 2MB limit per e-mail. Applications and modifications thereof shall be submitted with the name and address of the Applicant and the RFA number (referenced above) inscribed thereon, via e-mail, to pneupane@usaid.gov and rgurung@usaid.gov with copy to pwilson@usaid.gov. Applicants must confirm with Mr. Pradeep Neupane and/or Mr. Ram Gurung that their e-mail submissions were successfully received by the required due date.

b. Applicants who include data that they do not want disclosed to the public for any purpose or used by the U.S. Government except for evaluation purposes, must:

i. Mark the title page with the following legend:

"This application includes data that shall not be disclosed outside the U.S. Government and shall not be duplicated, used, or disclosed - in whole or in part - for any purpose other than to evaluate this application. If, however, an Agreement is awarded to this Applicant as a result of - or in connection with - the submission of this data, the U.S. Government shall have the right to duplicate, use, or disclose the data to the extent provided in the resulting Agreement. This restriction does not limit the U.S. Government's right to use information contained in this data if it is obtained from another source without restriction. The data subject to this restriction are contained in sheets (to be filled in by the Applicant).”

ii. Mark each sheet of data it wishes to restrict with the following legend:

"Use or disclosure of data contained on this sheet is subject to the restriction on the title page of this application."

Unnecessarily elaborate brochures or other presentations beyond those sufficient to present a complete and effective application in response to this RFA are not desired and may be construed as an indication of the Applicant's lack of cost consciousness. Elaborate artwork, expensive paper and bindings, and expensive visual and other presentation aids are neither necessary nor wanted.

Applicants shall acknowledge receipt of any amendment to this RFA by signing and returning the amendment. The USAID must receive the acknowledgement by the time specified for receipt of applications. `1

Any prospective Applicant desiring an explanation or interpretation of this RFA must request it in writing by 23/08/2010, 1600 hrs, Nepal time to allow a reply to reach all prospective

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Applicants before the submission of their applications. Oral explanations or instructions given before award of a Cooperative Agreement will not be binding. Any information given to a prospective Applicant concerning this RFA will be furnished promptly to all other prospective Applicants as an amendment of this RFA, if that information is necessary in submitting applications or if the lack of it would be prejudicial to any other prospective Applicants.

The Applicant will submit, as part of its application, a list of all current Grants, Cooperative Agreements, Contracts and Sub-Agreements and those completed within the last three years that are similar in size, scope and complexity to the program stated in this solicitation. The information supplied will also include the name and organization for which the work was performed, current telephone number and e-mail address of the Agreement Officer’s Technical Representative (AOTR) for the organization; the number of each award; and a brief description of the services provided or program performed, including the period of performance. The list must be included as an annex to the technical evaluation and will not count against the page limitation. USAID reserves the right to obtain from any sources relevant information concerning an Applicant’s past performance and may consider such information in its evaluation.

SECTION A. II: TECHNICAL APPLICATION GUIDANCE

1. Formatting

Technical applications must not exceed 40 pages, and must be printed on A4 or standard 8 ½-inch by 11-inch letter size paper. The Executive Summary will not count against the page limitation but it must not exceed 3 pages. Annexes specifically required (e.g., resumes, past performances information, certificates, forms, etc.) will not count against the page limitation. The font size must be at least 11-point type with 1-inch margins. The front and backsides of a single sheet are counted as 2 pages. Pages must be sequentially numbered with the page number on each page. Any pages that exceed the page limitation will not be furnished to the Evaluation Committee.

2. Content

Technical Applications in response to this solicitation must be specific, complete and presented concisely. The applications must demonstrate the Applicant’s capabilities and expertise with respect to achieving the goals of this program. Extensive background discussions of the health service delivery situation in Nepal are unnecessary; the Applicant should focus the content of its Technical Application on its proposed program. The Applicant must take into account the Technical Evaluation Criteria found in Section B, and Technical Applications must be organized according to the criteria.

The technical application must at a minimum include the following:

a. Executive Summary

Brief description of the organization, identifying all participating partners and the role of each.

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Briefly describe the process used to identify those roles/responsibilities and the role each partner had in drafting the response to the RFA.

Brief summary of results to be achieved. Identify the total program cost and the total amount of USAID funding and non-

Federal cost share proposed. Brief summary of Applicant’s experience in initiating and administering activities like

those described in the Program Description.

b. Technical Approach

While the Program Description provided in this solicitation describes USAID’s requirements and provides additional guidelines, each Applicant is encouraged to develop its own description of how the organization(s) expects to effectively bring their disciplines, skills and experience to bear on the proposed program. The Applicant must pay close attention to the illustrative activities and indicators set forth in the Program Description and ensure that the following key elements are also addressed.

i. Introduction - Demonstrate a clear and concise understanding of the nutrition and food security situation in Nepal and how it relates to sanitation/hygiene, maternal, newborn and child health (MNCH) and family planning/reproductive (FP/RH), highlighting key issues and challenges that must be appropriately addressed in order to implement the program as described in Section C – Program Description. The Applicant must address the issue of sustainability related to achieving program objectives.

ii. Implementation Approach – The Applicant must clearly describe their overall implementation approach and how this approach will work with government, NGOs, community-based organizations (CBOs), other USAID partners and other donor activities. The approach must describe how the Applicant will link and collaborate with USAID/Nepal’s Food Security Initiative and its activities. It must also address how the implementation approach will remain flexible to respond to a rapidly changing environment, including any changes that result from a move toward federalism or political instability.

iii. Key Strategies and Interventions – Applicants must clearly describe their key strategies and interventions to address nutrition and related needs in Nepal and how these build on successes of USAID’s health program and relate to the results framework. USAID/Nepal’s selection of districts for intensive focus reflects the needs based on key nutrition indicators including stunting and wasting rating among children, food insecurity, the lack of other USAID/Nepal partners working on similar programs, and potential for health impact. The level of effort in the selected districts must be clearly described and is strong and continuous for five years. In order for an application to be competitive it must describe an integrated and sustainable approach.

Applicants must propose and justify implementation approaches based upon their (and their partners’) comparative advantage technically and the realities of political unrest and instability. Applicants must carefully consider their ability to maintain high coverage levels and high quality program interventions. Partnerships are encouraged especially to work with Nepali NGOs and community-based organizations and, where cost-effective and appropriate, to a limited extent with international NGOs and PVOs. Applicants must describe how these partnerships would promote Nepali ownership of the program, both government and non-government. Applicants also include strategies (either at the

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household or community level) to ensure high levels of nutrition in the event of a crisis/disaster.  A “cookie-cutter” approach (the same interventions usedthe same way in each location) should not be used; rather, USAID expects the applicant to use approaches that are effective based on local conditions/needs.

iv. Capacity Building – The Applicant must describe a concrete plan for building local capacity that demonstrates an understanding of the challenges of coordinating work among partners, addresses the sustainability of critical program areas for nutrition, sanitation/hygiene, MNCH, and FP/RH services as well as building essential management capacity within existing public and private institutional systems.

v. Consistency with Government Policies, Guidelines and Standards – The Applicant must demonstrate and describe approaches/interventions that are consistent with GON policies, guidelines and standards and the Nepal Health Sector Programme II (2010-2015) agenda.

vi. Strategic Information – The Applicant must describe a comprehensive and clear approach to the applied research activities to test new approaches to change nutrition and food as well as hygiene related behavior and practices in Nepal that also fosters local capacity in these technical areas and has potential for scale-up.

vii. Program Monitoring and Evaluation – The Applicant must provide a results-oriented performance monitoring and evaluation plan, including the process to gather, share, analyze and use data. How program data will link to MOHP/DOHS or other existing systems must be clearly described showing complementarities. Applicants may propose additional or alternative indicators to the illustrative indicators to measure program success. Approximately 5% budget must be allocated for the program monitoring and evaluation.

viii. Work Plan - The Applicant must provide an overall work plan outline (5 years) including a statement of program objectives and a time line. A more detailed work plan for start-up (until July 2011) and for the first 12 months (July 2011-July 2012) must be provided. The work plan must demonstrate a clear and effective approach to accomplishing the objectives, expected results, and goals of the program. Please refer to Section C.IV.B for work plan requirements.

c. Technical Capabilities and Management Plan

i. Personnel

Key Personnel - Applicants must propose at least three positions to be considered key personnel positions and subject to USAID approval. Illustrative key personnel for this program could include a Chief of Party (COP), a Deputy Chief of Party (DCOP), Senior Nutrition Specialist, a Financial and Administrative Officer, a Capacity-Building Specialist, etc. Applicants must be cognizant of the staffing evaluation criteria when proposing key personnel and other professional staff positions. Please refer to Section C.IV.E Administrative Requirements, for more details.

Other Professional Staff – Provide personnel qualifications (submit complete/current resumes or CVs) for professional staff that would be utilized on this program if an award is made. Identify those personnel whose participation in

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the program is considered essential. The resumes will not count against the page limit.

The proposed staffing must reflect the maximum proportion of senior Nepali management and technical officers to manage and implement the program, with a proposed plan for transition of at least one expatriate professional to a Nepali professional during the life of the program.

For each proposed staff (key/professional), in addition to their CV/resumes, please provide the following, which will not count against the page limit:

Related Experience - Describe the experience of the proposed staff in developing sustainable host country governments and services, and working with partner organizations (e.g. local NGOs, international NGOs, private sector) in the delivery of quality nutrition and related activities in developing countries.

Demonstrated Capabilities - Provide a clear presentation of the relevant specialized technical and managerial capabilities that the individuals possess. Accomplishments must demonstrate success in delivering technical assistance in developing countries and in conducting activities of the types required under this program.

Experience in Conflict/Post-Conflict Settings – Demonstrate proposed staff’s exposure to/experience in working in countries in conflict/post-conflict and/or with political instability as well as their experience designing and implementing health programs that have assisted in mitigating the drivers of instability.

ii. Management Plan

Under this section the Applicant must describe its proposed Management Plan for accomplishing the objectives, results and goals described in the scope of the program. The Applicant must refer to Section C.IV, Program Management and Organization, for more detail on the specific requirements for this section.

Roles and Responsibilities of consortium partners - If applicable, the roles and responsibilities of consortium partners must be made clear and demonstrate appropriate delegation of authorities without overlap.

Program Management Structure - The Applicant must describe its overall organizational, human resource and financial management structures necessary for accomplishing the objectives and results described in the scope of the program.

Program Organization and Responsibilities - The Applicant must provide a staffing plan and an organizational chart (organogram) that includes all technical and administrative positions to be based in Nepal, in the field, and at "Home Office" of the Recipient and the organizational structure of the Partner Organization(s).

Authority and Accountability - The Applicant must describe lines of responsibility, authority, and communication among headquarters staff,

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Kathmandu-based staff, and the project implementation staff, most of whom will be posted outside Kathmandu.

Program Coordination - The Applicant must describe how coordination with other USAID-funded activities (including the Food Security Initiative) and other stakeholders (e.g., Government of Nepal, international NGOs, NGOs and the private sector) will be accomplished and how this will enhance results. Describe operational arrangements with other Partner Organization(s) and the degree of autonomy to be accorded to each in making technical and programmatic decisions.

Cost Share – The Applicant must describe how it plans to generate and track the cost sharing requirements derived from non-USG sources such as commercial firms, contributions from local development funds at the district level, contributions in-kind from communities and households for specific INP activities and so on. (Please see Section C.IV. F)

Gender and Social Inclusion - USAID supports gender equality and social inclusion of marginalized groups as a core development issue and objective. The Recipient must demonstrate the participation of marginalized groups in its target beneficiaries as well as staffing, partnerships, program planning, implementation, and in program evaluation. (See Section C.IV.A.3 Gender and Social Inclusion, for more detail).

Internship Plan – The applicant must include internship plan for capacity building for marginalized groups, janjatis and dalits.

Mobilization Plan - The Applicant must specify the proposed location of a fully functional central and field offices and a plan that shows when key staff will be mobilized, as well as the start up of a fully functional offices.

d. Institutional Capacity

Capability to support personnel – The Applicant organization must demonstrate the capability to support personnel and field operations.

Rapid start up – The Applicant must demonstrate capability and past performance in starting program activities rapidly and providing timely short-term technical assistance.

e. Past Performance Past performance in Nutrition/Sanitation/Hygiene/MNCH/FP/RH Program

Implementation – The Applicant must demonstrate from previous performance on specific programs (listing program name, contact person’s name and address, date and place of performance) their capability to plan, implement and monitor Nutrition/Sanitation/Hygiene/MNCH/FP/RH programs.

Past performance in collaboration and alliance building – The Applicant must demonstrate previous success in specific programs (listing program name, contact person’s name and address, date and place of performance) in forming alliances with other organizations and working with several government ministries at various levels in the system.

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USAID may contact references and use the past performance data, along with other information to determine the applicant’s responsibility. The Government reserves the right to obtain information for use in the evaluation of past performance from any and all sources inside or outside the Government.

f. Other Pertinent Information

Provide any other information that the Applicant believes will assist in the understanding and evaluation of the Applicant’s Technical Application.

SECTION A. III: COST APPLICATION GUIDANCE

The Applicant must submit the Cost Application in a separate volume. There is no page limit for the Cost Application. It must include required forms, schedules and other information necessary to support and/or explain the proposed costs. The Applicant’s estimating processes must be clearly evident and concise. Financial data and information must be fully supported and organized in a manner that facilitates review.

Certain documents must be submitted by the Applicant in order for the Agreement Officer to make a determination of responsibility. However, it is USAID policy not to burden Applicants with undue reporting requirements if that information is readily available through other sources.

The following describes the documentation that Applicants for assistance awards must submit to USAID prior to award:

1. Budget

The Applicant must propose activities within a total budget of up to $46 million over a five-year period ensuring rapid start-up within one month of award. A budget with an accompanying budget narrative that provides in detail the total costs for implementation of the program the Applicant is proposing. The budget must be submitted using Standard Form 424 and 424A which can be downloaded from USAID web site, http://www.grants.gov/agencies/aapproved_standard_forms.jsp. The following forms must be completed and included in the Cost Application submitted in response to this solicitation:

SF 424 SF 424A, Budget Information - Non-Construction Programs Certification, Assurances, Statements and Other Required Forms (per Section D of

the RFA) Detailed data to support each cost element (object class categories) as shown below Current Negotiated Indirect Cost Rate Agreement (NICRA) or proposal for Indirect

Cost Rate as detailed below (if the applicant organization does not have a NICRA)

a. Personneli. Identify, by title and name, each position to be supported under the proposed

award.

ii. For home office support staff, identify who will be compensated by USAID, the

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percentage of time and briefly specify related duties.

iii. State the amounts of time, such as months and percent of time that will be expended by each position, their base pay rate and total direct compensation under this program, e.g., Position/Person Time XX Rate = $XXXX.

iv. Provide rate verification documentation.

b. Fringe Benefitsi. Indicate the rate(s) used and the base of application for each rate.ii. Provide a copy of any Government approval of your indirect cost rates.

c. Traveli. Identify total international and domestic travel as separate items. ii. Indicate the estimated number of trips, number of travelers, position of travelers,

number of days per trip, point of origin, destination and purpose of travel.iii. For each trip, itemize the estimate of transportation and/or subsistence costs,

including airfare and per diem.

d. Allowances - Identify and itemize for each eligible or policy-covered employee/position.

e. Equipment, Materials and Suppliesi. Itemize the equipment, materials and supplies and briefly justify the need for the

items to be purchased as they apply to the Program Description.ii. Indicate the estimated unit cost and number of units for each item to be

purchased.iii. Provide the basis for the cost estimates, e.g., pro forma invoice, published price

lists, etc.

Note: USAID/Nepal plans to seek waivers from the authorized geographic code of 000 to permit the purchase of motor vehicles with a source and origin outside the U.S. Applicants may plan accordingly when preparing their budgets.

f. Agreement i. For each proposed sub-award provide a Statement of Work (contracts) or

Program Description (grants) and Cost Application.ii. Provide complete details of costs that may be incurred.

g. Other Direct Costsi. Identify other costs and briefly justify the need for each cost item proposed

relative to the Program Description.ii. Indicate the estimated unit cost and number of units for each item proposed.iii. Provide the basis for the cost estimates, e.g., market rate, vendor quotes, pro

forma invoice, etc.

h. Indirect Costsi. State the percentages and amounts used for the calculation of indirect costs.ii. Provide a copy of the Applicant's latest Government-approved Negotiated

Indirect Cost Rate Agreement (NICRA).iii. If indirect costs have not been approved by a Federal agency, state the basis for

the proposed indirect cost rates, if any.

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iv. Applicants who do not currently have a Negotiated Indirect Cost Rate Agreement (NICRA) from their cognizant agency must also submit the following information:

Copies of the Applicant’s financial reports for the previous 3-year period, which have been audited by a certified public accountant or other auditor satisfactory to USAID;

Projected budget, cash flow and organizational chart; and A copy of the organization’s accounting manual.

i. Windows of Opportunity The Applicant shall be prepared to respond to unanticipated opportunities that could directly contribute to the achievement of this project’s objectives. Such opportunities may include unanticipated local awareness-raising activities, emergency response, in collaboration with other USAID district-level development program activities and District Health Office. It may also include study or observation tours, special training, and participation in national or international forums, outside evaluations, or assessments and possible commodity support. USAID suggests $500,000 as an appropriate budget amount for the Applicant to designate for such activities. The Applicant must identify specific costs and describe the types of activities that could be funded under this line item in order for USAID to make a determination of cost reasonableness. Decisions to fund specific activities within the Window of Opportunity category must receive prior approval from the USAID Agreement Officer’s Technical Representative.

j. Non-Federal Contributions The Applicant must provide a breakdown of the financial (cash) and in-kind contributions (services, property, donated supplies and equipment, un-recovered indirect costs, etc.) of all organizations (Prime Applicant, participant #1, participant #2, etc.) that would be involved in implementing this Cooperative Agreement. Non-federal contributions are expected to total at least 10% % of the total program cost.

2. Evidence of Responsibility

Applicants must submit any additional evidence of responsibility deemed necessary for the Agreement Officer to make a determination of responsibility. The information submitted must substantiate that the Applicant:

a. Has adequate financial resources or the ability to obtain subject resources as required during the performance of the award.

b. Has the ability to comply with award conditions, taking into account all existing and currently prospective commitments of the Applicant, non-governmental and governmental.

c. Applicants that have never received a Grant, Cooperative Agreement or Contract from the U.S. Government are required to submit a copy of their accounting manual. If a copy has already been submitted to the U.S. Government, the Applicant must advise which Federal Office has a copy.

3. Authority to Obligate U.S. Government Funds

The Agreement Officer is the only individual who may legally commit the U.S. Government to the expenditure of public funds. No costs chargeable to the proposed Cooperative

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Agreement may be incurred before receipt of either a fully executed Cooperative Agreement or a specific, written authorization from the Agreement Officer.

4. Foreign Government Delegations to International Conferences

Funds in the agreement may not be used to finance the travel, per diem, hotel expenses, meals, conference fees or other conference costs for any member of a foreign government's delegation to an international conference sponsored by a public international organization, except as provided in ADS Mandatory Reference "Guidance on Funding Foreign Government Delegations to International Conferences," which can be found at http://www.info.usaid.gov/pubs/ads/300/refindx3.htm or as approved by the Agreement Officer.

IV. AWARD AND ADMINISTRATION INFORMATION

1. Grant Award

a. The Government anticipates the award of one Cooperative Agreement resulting from this RFA to the responsible Applicant whose application best responds to the terms of this RFA. However, the Government reserves the right to: (a) reject any or all applications, (b) accept other than the lowest cost application, (c) accept alternate applications, (d) waive informalities and minor irregularities in applications received and (e) award more than one Cooperative Agreement.

b. The Government also reserves the right to award on the basis of initial applications received, without discussions. Therefore, each initial application must contain the Applicant’s best terms from a cost and technical standpoint.

c. A written award mailed or otherwise furnished to the successful Applicant within the time for acceptance specified either in the application or in this RFA (whichever is later) shall result in a binding Agreement without further action by either party. Before the application’s specified expiration time, the Government may accept an application, whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award. Negotiations conducted after receipt of an application do not constitute a rejection or counter offer by the Government.

d. Neither financial data submitted with an application nor representations concerning facilities or financing, will form a part of the resulting Cooperative Agreement(s).

2. Unsuccessful Applications

Unsuccessful applications will not be returned to the Applicant.

3. U.S. Executive Orders and Law Regarding Terrorism

The Applicant is reminded that U.S. Executive Orders and U.S. law prohibits transactions with, and the provision of resources and support to, individuals and organizations associated with terrorism. It is the legal responsibility of the Successful Applicant to ensure compliance with these Executive Orders and laws. This provision must be included in all subcontracts/sub-awards issued under this agreement.

4. Award Administration:

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For U.S. organizations, 22 CFR 226, OMB Circulars, and the Standard Provisions for U.S. Nongovernmental Recipients will be applicable. For non-U.S. organizations, the Standard Provisions for Non-U.S., Nongovernmental Recipients will apply. While 22 CFR 226 does not directly apply to non-U.S. applicants, the Agreement Officer will use the standards of 22 CFR 226 in the administration of the award. For Public International Organizations (PIOs), the Standard Provisions for Grants to Public International Organizations, along selected provisions from the Standard Provisions for Non-U.S., Nongovernmental Recipients and other negotiated provisions, will be used.

5. OFAC License

Offerors must be aware that OFAC License No. SDGT-760d, dated 25 February, 2010, was issued by the U.S. Department of Treasury, Office of Foreign Assets Control (OFAC). A copy of the license is attached in page 80 of this RFA and shall be incorporated into the award resulting from this RFA. The Contractor shall comply with all conditions stated in the license, including all certification, reporting and record-keeping requirements. The point of contact for the OFAC license for this RFA is Sheila Roquitte, e-mail: sroquitte@usaid.gov, telephone: 977-1-400-7200 ext. 4674 and Tulsi Acharya e-mail: tacharya@usaid.gov, telephone: 977-1-400-7200 ext. 4224.

[END OF SECTION A]

SECTION B: EVALUATION CRITERIA

The criteria presented below have been tailored to the requirements of this particular RFA. Applicants should note that these criteria serve to: (a) identify the significant matters which Applicants must address in their applications and (b) set the standard against which all applications will be evaluated. To facilitate the review of applications, Applicants must organize the technical proposal of their application in the same order as the Technical Application Content Guidance.

A technical evaluation committee will review the applications based upon the criteria set forth below. Approximate weighted points indicate the relative importance of each technical criterion, of which 100 points are possible and against which technical applications shall be evaluated. Thereafter, the cost application of all applicants submitting a technically acceptable application will be reviewed and costs will be evaluated for general reasonableness, allowability, and allocability. An award or awards will be made to responsible applicant(s) whose applications offer the greatest value, cost and other factors considered.

A. Technical Approach (45 points total)

1. The approach is responsive to the RFA and USG Foreign Assistance Strategic Framework based on a clear understanding of the nutrition and health situation and related challenges in Nepal and the objectives of the program. The proposed technical approach will lead to the achievement of USAID’s expected results, with an overall technical and management assistance structure that optimizes outcomes and sustainability of the program. (Section A.II.2b.i and ii)

2. The approach to achieving the results is clear, including how the proposed partners will build on prior successes of the USAID-supported health program and work with the Government of Nepal (GON), NGOs and other USAID partners, with a particular focus at the community

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level. The approach takes into account the need for flexibility, speed and agility to respond to a rapidly changing environment. (Section A.II.2b.ii)

3. Key strategies and interventions are described to address nutrition and related needs in Nepal and how these build on successes of USAID’s health program and relate to the results framework. The potential for health and nutrition impact based on the level of effort in the districts selected for intensive focus is explained. (Section AII.2b.iii)

4. The approach demonstrates a comprehensive understanding of key issues and challenges that must be addressed to coordinate work among partners and in order to facilitate strengthening the capacity of the GON to provide sustainable basic health and social services. (Section A.II.2b.iv)

5. The proposed strategies and interventions have high potential for cost-effectiveness, sustainability, and capacity-building of Nepali organizations and institutions, and demonstrate knowledge of nutrition, water/sanitation/hygiene, household food production and use, and essential maternal, neonatal, child and family planning/reproductive health services in Nepal, including consistency with GON policies, guidelines and standards. (Section A.II.2b iv and v)

6. The proposed strategy provides a comprehensive and clear program of applied research to test new community-based approaches to achieve significant nutrition outcomes in Nepal that also fosters local capacity in these areas. (Section A.II.2b.vi)

7. The approach illustrates a results-oriented performance monitoring and evaluation plan, including the process to gather, share, analyze and use data, and describes how program data will build on government or other existing systems, including complementarities. (Section A.II.2b.vii)

8. A logical and coherent overall work plan is presented that demonstrates program approaches, objectives, a timeline and expected results. (Section A.II.2b.viii)

B. Technical Capabilities and Management Plan (45 points total)

1. Personnel (25 points)

a. The proposed staff reflect the maximum proportion of senior Nepali management and technical officers to manage and implement this program, and the three proposed key personnel are the most senior and experienced project staff. Expatriate residential staff proposed have experience working in countries in conflict and/or political instability, and possess strengths and skills that cannot be found among available Nepali professionals. The proposed plan to transition at least one of the expatriate positions from an expatriate to a Nepali professional during the life of the program is realistic and clear. (Section A.II.2c.i)

b. The proposed staffing plan provides coverage for the range of nutrition, water/sanitation/hygiene, household food production and use, maternal, neonatal and child health and family planning components as required in the program description. (Section A.II.2c.i)

c. The proposed staff have demonstrated expertise in the relevant technical areas including public health, behavior change communications, capacity building, community mobilization, applied research, capacity development of community entities and local NGOs, strengthening public sector service delivery systems, technical and program innovations, monitoring and evaluation, etc. (Section A.II.2c.i)

d. The proposed staff have demonstrated success in delivering technical assistance, in working in collaboration with host country governments and partner organizations, and demonstrated expertise in managing the administrative and financial aspects of a complex program. (Section A.II.2c.i)

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2. Management Plan (20 points)

a. If applicable, the roles and responsibilities of consortium partners are clear and demonstrate appropriate delegation of authorities without overlap. (Section A.II.2c.ii)

b. Clear organizational, human resource, financial, and information management structures are in place, with clear roles and responsibilities of key staff and consortium partners, including defined lines of authority, communication and accountability between and among partners. The program management structure must show how the management structures are needed for accomplishing the objectives and results described in the scope of the program. (Section A.II.2c.ii)

c. The management plan clearly describes how the program coordination will happen among other USAID-funded activities and other stakeholders including those implementing USAID’s Food Security Initiative. (Section A.II.2c.ii)

d. An explicit overall staffing pattern (organigram) is provided. (Section A.II.2c.ii)e. Gender equity and social inclusion is clearly evident in the plan. (Section A.II.2c.ii)f. A mobilization plan is clearly articulated. (Section A.II.2c.ii)g. A realistic cost-sharing plan is clearly described. (Section A.II.2c.ii)

C. Institutional Capacity (5 points total)

a. The Applicant describes that its headquarters office has a demonstrated capacity to support personnel and field operations with demonstrated capability and past performance in starting program activities rapidly and providing timely short-term technical assistance. (Section A.II.2d)

b. The Applicant describes a rapid start up plan. (Section A.II.2d)

D. Past Performance (5 points total)

a. The Applicant references specific programs (program name, contact person’s name and address, date and place of performance) that describe its past performance on, and demonstrated capability to plan, implement and monitor nutrition, hygiene, household food production and public health programs -- including demonstrated success in working with host country governments and in collaboration and alliance building with other organizations. (Section A.II.2e)

b. The Applicant references specific programs (program name, contact person’s name and address, date and place of performance) that describe its past performance in meeting USAID reporting and accountability requirements. (Section A.II.2e)

E. Cost Evaluation (Section A.III):

Cost has not been assigned a score but will be evaluated for cost reasonableness, allocability, allowability, cost effectiveness and realism, adequacy of budget detail and financial feasibility and cost sharing. While cost may be a determining factor in the final decision of an awardee(s), especially between closely ranked Applicants, the technical merit of applications is substantially more important under this RFA.

Notes on cost sharing:

1. Cost share is defined by USAID as “contributions, both cash and in-kind, which are necessary and reasonable to achieve program objectives and which are verifiable from the Recipient’s records.”  Please take note of the provision on cost sharing in 22 CFR 226.23.

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2. Cost share is required to be at least 10% of the total program cost. USAID policy is that cost sharing is an important element of the USAID-Recipient relationship. USAID requires Applicants to demonstrate their commitment to program success by addressing the issue of cost-sharing.

Applications will be evaluated in accordance with the selection criteria identified above.  USAID reserves the right to determine the resulting level of funding for any awards made under this RFA.

[END OF SECTION B]

SECTION C: PROGRAM DESCRIPTION

I. Introduction

The United States Agency for International Development Mission to Nepal (USAID/Nepal) requests applications for the Nepal Integrated Nutrition Program (INP). Subject to annual availability of funds, USAID intends to award one cooperative agreement for approximately $46 million to be allocated over five years, through January 31, 2016. The program will be results-oriented and integrated with USAID’s development assistance in health and other sectors. USAID reserves the right to fund any or none of the applications submitted. USAID will be substantially involved in the implementation and performance monitoring of this award.

A. Program Context The primary purpose of the INP is to improve the nutritional status of women and children under-two years of age in a manner that supports the Government of Nepal (GON). Nepal is often described as one of the most undernourished countries in the world. The lack of sufficient progress in improving the nutritional status of women and young children is highlighted in the new National Health Sector Programme II (NHSP II) (please see INP reference documents under: http://nepal.usaid.gov/working-with-us/business-opportunities.html), for 2010-2015, and has led the Nepal Ministry of Health and Population (MOHP) to identify nutrition as a high priority area for investment. The MOHP, with support from its External Development Partners (EDPs), including USAID/Nepal, conducted the “Nutrition Assessment and Gap Analysis” (NAGA) (please see INP reference documents under: http://nepal.usaid.gov/working-with-us/business-opportunities.html), completed in November 2009, that provides a clear articulation of the problem and steps needed to improve nutritional status of women and children. Based on recommendations from the NAGA and priorities identified in the NSHP II, the MOHP is also leading the development of a National Nutrition Action Plan that will describe a government-led program in nutrition.

The overall intent of the new INP is to support the MOHP-led effort to combat the serious health and nutrition problems facing the country. The INP contributes directly to specific health and nutrition objectives of the NHSP II as well as addressing NAGA recommendations that include additional challenges related to food availability, access and affordability. This RFA articulates a strategic set of activities that takes advantage of USAID/Nepal’s history of health and nutrition work in Nepal and its unique comparative advantages as a donor and a key partner.

USAID’s Foreign Assistance Strategic Framework (Annex 2) focuses on rebuilding Nepal as it recovers from a decade-long insurgency, and encouraging reform and institutional capacity building with the goal of achieving a peaceful, prosperous and democratic Nepal. Health programs will focus on strengthening GON capacity to invest in its citizens and to provide effective, equitable and

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high quality services. USAID emphasizes women’s participation and social inclusion in all its development programs.

This award will be in-line with and will be closely monitored for adherence to USG policies and regulations concerning the use of Child Survival and Health funds, including those supporting family planning activities. Through this award, USAID/Nepal aims to both sustain and build upon the successes of its health program to-date and realign its support to better contribute to building the capacities of, and rebuilding where necessary, Nepal’s health and other relevant social service institutions. This award will expand the depth, reach and impact of programs aimed at reducing undernutrition among women and children under two years of age but will also include hygiene and environmental sanitation, family planning, maternal, newborn, and child health services all of which will contribute to better health and nutrition.

The INP’s primary program focus will be at the community level although it is also expected to focus on district level capacity development as well as some national level inter-ministerial coordination work. The emphasis will be on strengthening institutional capacity, governance, equitable access and community participation in health and social services. USAID’s partners will mitigate exclusion, a key driver of the conflict, through the involvement of populations that have been marginalized in the past due to poverty, caste and ethnicity resulting in reduced access to and use of services.

In regards to sustainability, USAID has adapted the Sustainability Framework developed for the Child Survival Health Grants Program1 (CSHGP) to the broader health portfolio that might be used to inform other programs in the mission and most importantly, the Ministry of Health and Population (MOHP). Applicants must ensure that they are responsive in regards to this framework and respond to the issues raised by the framework.

B. Mandate for CollaborationThe Integrated Nutrition Program incorporates and responds to the objectives and principles of two new US Government (USG) initiatives that are closely related to work at the Mission level: the Global Health Initiative (GHI) and Feed the Future (FTF) (please see INP reference documents under: http://nepal.usaid.gov/working-with-us/business-opportunities.html), the USG’s Hunger and Food Security Initiative. Improved nutrition is a fundamental component of both GHI and FTF. Demonstrated reductions in undernutrition will be a key measure of success in both initiatives, and multisectoral nutrition programming that maximizes synergies between health and agriculture sectors is vital to achieving these outcomes. The INP will be USAID/Nepal’s leading implementing mechanism for achieving and sustaining improvements in nutrition. This program will be carefully coordinated with USAID/Nepal’s investments in agriculture to ensure a comprehensive approach to food security as outlined by FTF. It will also be fundamentally aligned with GHI objectives and other health investments and will contribute substantially to strengthening the health system and community-level capacity to deliver health interventions.

Proactive and close collaboration will also be expected from the successful Applicant in working with partners implementing USAID’s Nepal Family Health Project II (NFHP II), Child Survival and Health Grants Program Awardees including Helen Keller International (HKI), Care International and Plan International, UNICEF, Ghar Ghar Maa Swasthya (Healthy Homes), the social marketing program implemented by Contraceptive Retail Sales (CRS) and the Nepal Economic, Agriculture and Trade Activity (NEAT) and other relevant USAID projects.

All partners are committed to supporting a flexible, country-led approach that will leverage the work of donors and stakeholders, including the private sector, in the area of nutrition. USAID/Nepal will

1 See http://www.childsurvival.com/documents/CSTS/sustainability.cfm for details.

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look for opportunities to encourage better coordination between the MOHP, Agriculture and other relevant ministries as their work on food security becomes better defined and the linkages clearer. The INP will specifically work to improve the situation for women and children, promote social inclusion of the most vulnerable and build sustainable capacity to address nutrition problems in the future. Innovation, research and strong monitoring and evaluation will be integral to this program to ensure that activities meet the specific needs of women, children and their communities in Nepal. USAID/Nepal is able to move forward with an innovative nutrition program anchored in the MOHP because it is one of the strongest and most capable of the government entities working in nutrition with a long and fairly successful track record of achieving its goals.

II. Background

A. Health Care System and Progress to DateThe government’s vision for the health sector is to improve the health and nutritional status of the Nepali population, especially for the poor and excluded. The MOHP developed the first National Health Sector Program (NHSP I) 2004-2010, which successfully reached or surpassed nearly all of its objectives. On track to meet Millennium Development Goals (MDGs) 4 and 5 related to maternal and child health and nutrition, the MOHP developed the NHSP II (2010-2015) to continue best practices and scale up interventions to improve the health of the Nepali population. However, it is clear that the support of the EDP community will need to continue in order to attain those goals identified in the NHSP II.

The MOHP organizes and budgets for its programs in accordance with the targets and priorities set forth in NHSP II. A Health Sector Wide Assistance Program (SWAp) was first organized in 2004. It involved most health development partners with the aim of harmonizing all input into a MOHP-led program. Currently, the donors providing pooled funding under the SWAp are the World Bank, DFID and AusAID for activities in the NHSP. The non-pooling partners such as USAID/Nepal are also active SWAp participants, and ensure that their programs are in direct support of the NHSP. All partners participate in the MOHP-organized biannual progress reviews as well as meet regularly to ensure coordination.

Data from a number of surveys generally show positive health trends in the country. Maternal, neonatal, infant and child mortality rates are declining. Fertility, while not yet at replacement levels, is also declining. TB case detection and treatment success rates are improving and malaria annual parasite incidence is declining. HIV/AIDS remains a concentrated epidemic with continuing risks associated with a large migrant worker population. However, HIV screening and treatment services are expanding and behavior change communication programs are increasing access to information about prevention.

While many positive achievements are evident from the review of progress during the first NHSP, one of the key challenges identified by both the MOHP and partners was the lack of sufficient progress in addressing the complex problems associated with undernutrition, particularly among pregnant women, infants and young children. The commitment level at the MOHP to address these problems, as well as the enthusiasm among the development partners to support the government in this area, has never been stronger. This commitment is evident in the NHSP II, which highlights specific activities and targets in order to improve the nutritional status of women and children. All parties are committed to do so through a GON-owned and led process with external development partners playing a well coordinated supporting role with a defined niche for each player.

B. Nutrition Situation in Nepal.

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The consequences of undernutrition are the most serious for fetal development and for children under 24 months of age. Nepal is making insufficient progress toward the underweight target of the first MDG of “Eradicating Extreme Poverty and Hunger”. As shown in Figure 12.3 from the 2006 Nepal DHS, the prevalence of stunting has declined between the 2001 and 2006 NDHS surveys, although it is still very high at 49%. Wasting has actually seen a small increase during this period; an alarming result of more immediate dietary deficits and/or serious health complications. Underweight showed a slight improvement. The MDG 1 for reducing hunger will not be achieved without dramatic improvements in the overall health and growth of young children.

Chronic energy deficiency and anemia in mothers is a substantial problem with 24.4% of women of reproductive age with a Body Mass Index (BMI) of less than 18.5 kg/m2 and a third of Nepalese women anemic2. Anemia can lead to increased risk of maternal mortality due to postpartum hemorrhage and low-birth weight (LBW) infants. The prevalence of LBW is also high, although accurate, population-based data are not available. Between 14 to 34% of newborns are estimated to be less than two kilograms at birth. One hospital-based study of 3,500 mother-infant pairs from four major hospitals in various regions showed that 27% were LBW and of those, 70% were small-for-date indicating intrauterine growth retardation.3

Nevertheless, Nepal has made significant progress on the nutrition interventions as described in the 2008 Lancet Nutrition Series on Maternal and Child Undernutrition. This is particularly the case for vitamin A supplementation, which is among the evidence-based interventions listed in the Lancet. In fact, Nepal won international acclaim for scaling up of vitamin A programs. In 2006, the vitamin A coverage rate for children 6 to 59 months of age was 87.5% nationally. This has likely had a large effect on decreasing under-five mortality rates. Iron folate supplementation for pregnant women is increasing; rates of anemia have decreased by 44% since 1998. Fortification programs (salt iodization and iron fortification of wheat flour) are largely on track to expand over the next few years. The more difficult challenge now is decreasing the levels of undernutrition, which are driven by cultural and social factors that determine food related practices, as well as food scarcity in some regions.

III. Program Objectives and Expected Results

A. Geographic and Program Coverage

The target the regions and districts for INP were chosen based on the following major criteria: 1) highest levels of undernutrition; 2) no or limited presence of comprehensive nutrition programs and 3) potential for collaboration with other complementary programs. Based on this analysis, 25 districts in the most remote and disadvantaged regions of the country have been identified in the Central and Western Mountains, Western Hills, Western Terai, Far Western Mountains, and Hills. (See Annex 1 for a list of the Regions and Districts.) The graph below provides an overall snapshot of the nutrition challenges in each of the regions. Some of the most severe wasting and underweight problems are found in the Central Terai (a food secure region) and in the Western

2 Nepal Demographic and Health Survey, (DHS) 20063 Nutrition Assessment and Gap Analysis (NAGA), Nov 2009

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Mountains (a food insecure region). The Central Terai region is well covered by the NFHP II and therefore the INP will not work in those districts. The fact that many regions in the Terai have such severe problems with under-nutrition indicates the importance of families understanding the need for access to diverse and nutritious foods and the proper utilization of foods. The graph also illustrates that regions with lower levels of poverty do not necessarily fare any better. In the 25 districts targeted, INP will be expected to work district-wide, i.e., in every VDC in the district, to maximize the coverage and numbers of households reached by program interventions. Regional poverty and child nutrition indicators

In the districts selected for this program, the most important and direct target groups will be pregnant and lactating women and their children under two years of age. The Lancet Nutrition Series established a solid base of evidence on the importance of aiming prevention of undernutrition on the ‘development window of opportunity’, between conception and two years of age, when children are growing most rapidly, are most vulnerable to growth faltering and are most responsive to nutrition interventions. This time period is also critical for long-term improvements in education and productivity: studies demonstrate that investing in improving nutrition during this short timeframe in early life will result in greater educational attainment and reduced poverty decades later.

The INP will attempt to reach and include the poorest and most excluded groups based on ethnicity and caste as well as the broader groups of families in those communities. In Nepal, changing food and health related behaviors must also include other family members in order to succeed and endure. Fathers, mothers and mothers-in-law, local leaders, community groups, youth organizations, local NGOs and other will all be involved in BCC programs that seek to change societal norms about feeding practices, household and community hygiene, social exclusion, utilization of health services, timing and spacing of pregnancies and so on.

In food insecure areas, families and communities will be targeted for household food production and related nutrition education activities. This will include families with insufficient access to food due to

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lack of land or the resources to buy what they need. In areas where the WFP is providing food for work or other food distribution activities, the program will work to supplement those activities with the nutrition and hygiene-related behavior change communication programs as well as household food production as appropriate to ensure that families receive the kind of support they need to improve nutritional status of women and children.

B. Strategic Objective and Intermediate Results

B.1. INP Strategic Objective

The INP directly supports the achievement of the USAID/Nepal Country Assistance Strategy Goal “Health and Well-being of Nepalis Improved and Sustained.” The Strategic Objective (SO) of the INP is to improve the nutritional status of women and children under-two years of age. While the INP will contribute most directly to improving nutritional status, it will also contribute to other program areas such as preventing infectious disease among infants and young children as well as improving the spacing of pregnancies. Presented below are the key results USAID/Nepal expects to achieve through implementation of this program.

B.2. Outcomes and Indicators

Key overall results from this program include a reduction in the percentage of children under two years of age who are classified as undernourished according to three anthropometric indices shown below, disaggregated by demographic/background characteristics including gender, caste/ethnicity and socio-economic status. In addition, the percentage of children with anemia and the percentage of low birth weight babies will be reduced.

For women, the key results are the percentage of women with low body-mass index and the percentage with anemia will be reduced. These results must be monitored and the indicators included in the Performance Monitoring Plan (PMP) of the INP. The planned 2011 Nepal Demographic and Health Survey will produce reliable baseline data for purpose.

C. Intermediate Results and Outputs

Four Intermediate Results (IRs) will contribute directly to achieving the SO. They are: IR 1: Household health and nutrition behaviors are improvedIR 2: Women and children increase their use of quality health and nutrition servicesIR 3: Women and their families increase their consumption of diverse and nutritious foodsIR 4: Coordination on nutrition between government and other actors is strengthened

The successful Applicant will demonstrate flexibility and an ability to respond to immediate needs, taking advantage of windows of opportunity in an uncertain and unstable government, donor and

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Strategic Objective: Improve nutritional status of women and children

Indicators for Children Indicators for Women*

Height-for age Percentage of women whose body-mass index (BMI) is less than 18.5

Weight for age

Weight for height Percentage of women age 15-49 classified as having anemia

% of children classified as having anemia% of low birth weight babies (NHSP indicator)

*Among women with births in the last three years

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security situation, including a readiness to address increased difficulties in carrying out field work which may require new approaches.

The following sections provide more information about the background and aim of activities for each IR, as well as illustrative activities and indicators. The illustrative activities are presented as a guide to the types of interventions envisioned but applicants are encouraged to expand on and add to them in ways that will help achieve the specific outputs listed.

C. 1. IR 1: Household health and nutrition behaviors are improved (40% of program effort)

Background

In Nepal, health and nutrition behaviors remain a key obstacle to improved health and nutrition of women and children. Poor Infant and Young Child Feeding (IYCF) practices are a particularly serious obstacle to improved nutrition. Poor hygiene and sanitation, and recurrent infections such as diarrhea in young children can further exacerbate the inadequate feeding practices by reducing absorption of nutrients. Given the rich diversity of culture, geography, ethnicity and beliefs in Nepal, programs that attempt to change nutrition related practices must begin by understanding both the negative and positive behaviors in a particular location as well as the community level barriers to optimal nutrition behaviors.

A key to improving the practices and behaviors that will have a positive impact on nutritional status is providing effective interpersonal communication (IPC) and counseling to mothers and other decision makers at the household level. Anecdotal evidence suggests that many mothers, and even health workers, are not aware children may be undernourished because ‘thin’ children are the norm in Nepal. Nutrition messages conveyed at the household level can be reinforced through mass media to help change societal norms, as can non-traditional communication techniques such as street theater and other community events. Multiple channels must be used to ensure behavior change occurs and is sustained over time. An important element to an evidenced-based BCC strategy is to measure whether the interventions are having an impact, not only on knowledge but also on practices.

Approach

Two principal approaches will be employed to achieve better household health and nutrition behaviors: (1) households adopting Essential Nutrition Actions and (2) households adopting Essential Hygiene Actions. They are described briefly below. Applicants should propose ways of working with existing community structures, health personnel and programs as well as involving community leaders, decision makers and groups such as youth who may not have traditionally been tapped to influence health related behaviors and practices.

Output 1.1: Households adopt Essential Nutrition Actions (ENA) including IYCF All of the activities under this component work with the existing health programs but also expand the opportunities to involve other community level structures. INP will conduct operations research and then strengthen training and practice accordingly. The nutrition messages and approaches will then be used to modify the current outreach and activities of health workers and community health volunteers. Female community health volunteers (FCHVs) deliver a wide variety of messages in each interaction with households depending on the need. The INP will use a community-based approach to identifying the most effective ways to increase the frequency of contact between community health workers and women and their families. This must go beyond relying only on

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FCHVs and broaden the base of BCC opportunities. The Essential Nutrition Actions (ENA), an internationally accepted set of tools for improving maternal and child nutrition, will be the basis for counseling, community mobilization, and mass media messages and are shown in the box. Initial formative research will be a prerequisite to determining how best to transmit these messages depending on the given area and population.

Evidence globally indicates that there is a statistically significant risk associated with not breastfeeding for all causes of mortality and incidence of diarrhea among infants 6 to 23 months. In

Nepal, while the majority of women breastfeed their children (median duration of about 30 months), exclusive breastfeeding rates have decreased from 68.3% in 2001 to 53% in 2006, which increases the risk of potentially fatal childhood illnesses with the early introduction of other liquids and foods.Complementary feeding practices are also crucial to the first 24 months of a child’s life. According to the 2006 DHS, only 57% of households fed their children in accordance with appropriate infant and young child feeding (IYCF)

practices. Poor breastfeeding and complementary feeding place children at higher risk of morbidity and mortality.

International evidence also suggests that adequate birth spacing is a strong determinant of both mortality and nutritional status among infants and children. There is a clear pattern of increasing chronic and general undernutrition as the birth interval is shorter.4 Birth intervals in Nepal are significantly shorter among teenaged mothers, 34.7% of whom also have unmet needs for spacing methods.

The 2006 NDHS shows a high rate of tobacco use among women of reproductive age (22%), with the highest rates in the Central Mountains, and Mid- and Far-Western Hills. Smoking during pregnancy contributing to the rate of LBW is of concern, as well as its contribution to the ill health and chronic disease in mothers.

Using a community based model, the INP will work closely with the MOHP and other implementing partners to strengthen the ENA components of the following MOHP -endorsed programs such as Community Based Newborn Care Package (CB-NCP), CB-IMCI and Family Planning/ Reproductive Health (FP/RH) as well as other programs underway in various locations. The MOHP is currently engaged in building a complex array of community-based maternal, neonatal and child health (MNCH) programs, most of which have nutrition-related components. Because some are being piloted and others have already been expanded nationally, the approach is somewhat fragmented at this time. None are likely to achieve substantial outcomes in nutrition if not enhanced or modified. At some point, all of these initiatives must come together into a more unified community-

4 S.O. Rutstein, ORC Macro, International Journal of Gynecology and Obstetrics (2005) 89, S7-S24.

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Essential Nutrition Actions in Nepal1. Promotion of optimal breastfeeding during the first six months2. Promotion of optimal complementary feeding starting at 6 months with

continued breastfeeding up to 2 years and beyond3. Promotion of optimal nutrition care of sick and severely malnourished

children, and targeting moderately undernourished children for prevention education

4. Prevention of vitamin A deficiency for women and children5. Promotion of adequate intake of iron and folic acid, and prevention and

control of anemia for women and children 6. Adequate intake of iodine by all members of the household 7. Optimal nutrition for women (especially during pregnancy and lactation

period)

Based on the context of Nepal, two additional actions

8. Promotion of child spacing and family planning for optimal health 9. Dangers of smoking for health of mother and baby

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based approach that addresses the health and nutrition needs from pregnancy through early childhood. The INP will work on strengthening these programs in targeted districts.

Illustrative activities Formative research, focus groups, KAP studies on local practices, beliefs, family decision

making processes related to ENA, for developing BCC strategies. Develop, pilot and expand innovative district-wide approaches to strengthen interpersonal

communication (IPC) and counseling skills among FCHVs using existing job aides from CB-IMCI, CB-NCP and FP training materials and developing new material as needed.

Introduce non-traditional BCC (street theater, puppet shows, etc.) to change societal norms on births spacing, smoking, IYCF.

Develop new approaches by involving youth, farmer, cooperatives, forestry groups to expand opportunities for community action.

Develop and test new models for improved opportunities and frequency of IPC and counseling and referral of pregnant women

Illustrative Indicators Number of children under five years of age who received Vitamin A from USG-supported

program. (mandatory indicator) Percentage of newborns who started breastfeeding within one hour of birth. Percentage of infants under age six months who are exclusively breastfed, by month. Percentage of infants 6 through 9 months of age who receive breast milk and a solid/semi-solid

food (based on 24-hour recall). Percentage of youngest children aged 6-23 months living with mother who were fed according to

three IYCF practices based on breastfeeding status, number of food groups and number of times they are fed during day/night.

Percentage of children age 6-59 months who received vitamin A supplements in the six months preceding the survey.

Percentage of pregnant women who take iron folate for specific number of days (NHSP indicator: by caste and wealth quintile).

Percent distribution of households with salt tested for iodine content, by level of iodine in salt (ppm).

Percentage of women who smoke cigarettes or tobacco and percent distribution of cigarette smokers by number of cigarettes smoked in preceding 24 hours, by maternity status.

Output 1.2: Households adopt Essential Hygiene Actions (EHA)

Nearly 12% of children in Nepal were found to suffer from diarrhea and almost 5% from Acute Respiratory Infections (ARI) during a two-week period prior to the survey visit of the last DHS. Hand washing with soap alone has been estimated to contribute to cutting deaths from diarrhea by half and ARIs by one quarter. A study in the southern part of the country showed a 60% reduced risk of neonatal mortality for mothers who washed their hands with soap and water before handling their child. The nutritional impact of diarrhea and ARIs is well established as it leads to decreased absorption of nutrients, and acute and frequent episodes can increase the risk of acute malnutrition and mortality. Research in the Terai region of Nepal showed that the prevalence of diarrhea has a significant association with underweight status (weight for age) among children under-3 years of age. Futhermore, an issue particular to Nepal is menstrual hygiene among girls and women who are often secluded to “menstrual huts” and suffer significant physical and social consequences (e.g., school absenteeism for adolescent girls) related to unsafe hygienic practices and cultural taboos. Childhood illnesses, especially for children under two years old, can further inhibit optimal growth that can affect the rest of their lives. Repeated bouts of infection such as diarrhea and acute

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respiratory infections can reduce a child’s ability to absorb nutrients and interferes with their ability to eat. Poor hygiene, sanitation and lack of access to clean water make preventing illness among children difficult. Improvements, particularly those related to personal hygiene, are essential elements of reducing undernutrition.

In order to improve overall hygiene practices, the INP will develop effective communication strategies focusing on the globally accepted critical Essential Hygiene Actions (EHAs) shown in the box. Where appropriate, safe menstrual hygiene will be included in the EHA package based on

need. Essential Hygiene Actions will be strongly connected to all BCC activities including those for nutrition. However, EHA programs will also work with additional community groups such as Water Users Groups, Irrigation Groups, Youth Groups, etc. to determine feasible local solutions to sanitation and water storage.

Illustrative activities

The same kind of research described for ENA activities under Output 1.1. With district level GON ministry staff and VDC members, develop plans including hygiene activities for district and VDC development plans designating who will be responsible. Use existing curricula to train community leaders and health staff on EHA and how to include

messages in counseling package (similar to ENA counseling). Develop mass media campaign on EHA to be disseminated via national or local radio. Work with VDC and water users groups to identify potential small-scale projects (linked to

Outcome 3.3) for small grants program for water improvement systems. Work with partner organizations and local community groups to identify local solutions to improve

sanitation (pit latrines, etc.) and water purification methods. Establish agreement with private sector groups to identify collaborative activities. Organize hand-washing days at local schools and facilities along with hygiene education

messages.

Illustrative indicators Percentage of households using an improved source of drinking water (disaggregated by gender

and caste/ethnicity). Percentage of households with hand-washing materials in dwelling/yard/plot. Percentage of mothers who dispose of their youngest child’s fecal matter safely. Percentage of caretakers who wash hands before preparing food. Percentage of households with improved toilet facility.

C. 2. IR 2. Women and children increase their use of quality nutrition and health services (30% of program effort)

Background

In addition to supporting the services delivered by community-level volunteers, facility-based health workers in Nepal provide a range of preventive and curative services, both at health facilities as well as through outreach clinics. A number of these services are critical in both preventing and treating under-nutrition for both women and children. The INP will work to strengthen nutrition education and

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Essential Hygiene Actions in Nepal1. Treatment and safe storage of drinking water2. Handwashing with soap or ash at critical times (i.e., after defecation

or handling children’s feces, before preparing food, before feeding children, before eating)

3. Safe disposal of feces 4. Proper storage and handling of food to prevent contamination 5. Community construction and use of affordable latrines

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integrate IYCF and ENA into all facility-based services. The program also will strengthen the capacity of facility-based staff to implement facility-based services and support community-based services. The implementing partner(s) will be expected to create strong links between facility-based and community-based activities in order to expand opportunities for the health system to contact and engage community members, and for community members to access health services, especially women and their families. This will include developing strategies aimed at social inclusion to ensure that services do benefit lower castes, all ethnic groups and the poorest members of the communities. The approaches supported by the program that will contribute to this outcome are described below.

Approaches

Five approaches will be employed for women and children to increase their use of quality nutrition and health services: (1) pregnant and lactating women and their families have improved access to high-quality facility-based services during the antenatal period and first year post-delivery, (2) facility based IMCI activities, including supervision of CB-IMCI, are improved, (3) facility based Growth Monitoring and Promotion (GMP) services comply with national/global standards including support for shifting GMP work to the community level, (4) services for the treatment of Severe Acute Malnutrition (SAM) adhere to national/global protocols, and (5) facility-based and outreach family planning services provide effective counseling on Healthy Timing and Spacing of Pregnancy (HTSP) as important for good health and nutrition. Each of these is described below. Applicants must propose ways to improve services within VDC and District health facilities but also help the staff in those facilities to better support the health activities at the community level. Applicants should think creatively about how to strengthen the functioning of VDC and district level health services in an environment where staff incentives for improved performance are far from optimum.

Output 2.1: Pregnant and lactating women and their infants have improved access to high-quality facility-based services (including micronutrient supplementation) during the antenatal period and first year post-delivery

The aim of activities under this Output is to improve both the access to and quality of antenatal (ANC) and post delivery services by improving the effectiveness of counseling provided by facility staff, increasing the coverage of interventions that are found to be effective, and testing those interventions that have yet to be implemented. ANC and post-delivery services are key entry points for providing nutritional supplements to pregnant and postpartum women and their children as well as health education to women and their families regarding issues that affect their nutritional status. Within the context of the interventions recommended by the Lancet series, some are currently implemented at scale in Nepal (albeit performed to varying degree of quality and coverage), some are currently being tested, and some are not currently being implemented.Counseling is the basis of several interventions in Nepal that need to be strengthened. Counseling of women during pregnancy and post-delivery periods in Nepal is primarily carried out by staff in community health facilities and FCHVs. FCHVs deliver counseling of variable quality while the quality of counseling delivered by facility-based health cadres is generally poor. While the antenatal period has structured contacts between pregnant women and health workers, there are fewer opportunities built into the system for women to contact health workers and receive information and services during the first year following delivery. Most of the contact opportunities center around child immunizations and micronutrient supplementation and are not used effectively for counseling on other topics that affect nutrition such as breastfeeding and the introduction of complementary foods. INP will work on expanding both the opportunities for counseling in the post delivery period and the quality and effectiveness of the communication, and will measure the behavioral change that does occur.

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Illustrative Activities Training and on-site supervision of facility- and community-level health cadres to improve quality

of pre and post-delivery services including counseling. Develop and test a variety of approaches to improve IYCF through ANC and post-delivery

services. Develop and test approaches above and beyond micronutrient supplementation to improve

maternal nutrition through ANC and post-delivery. Support district-level pilot interventions to test mechanisms to provide calcium supplementation

to pregnant women Support the effort to scale up the neonatal Vitamin A supplementation activity based on results

from ongoing district-level pilot

Illustrative Indicators Number of people trained in maternal/newborn health through USG supported programs

(disaggregated by gender and caste/ethnicity) (mandatory indicator) Number of people trained in child health and nutrition (disaggregated by gender and

caste/ethnicity) (mandatory indicator) Percentage of children and women suffering from anemia in USG supported districts (mandatory

indicator) Percentage of USG-assisted service delivery points experiencing stock-outs of specific tracer

drugs (ORS, Vitamin A, Cotrim P, Iron) (mandatory indicator) Percentage of pregnant women who take calcium supplement for specific number of days Percentage of neonates who receive vitamin A supplement.

Output 2.2: Facility Based IMCI activities, including supervision of CB-IMCI, are improvedThe CB-IMCI program in Nepal includes both facility- and community-based components and is in the final stages of being scaled up. Facility-based IMCI has been introduced in all 75 districts while community-based IMCI will be expanded to all 75 districts by July 2010. The IMCI program is thus about to transition from a scale-up phase to a maintenance phase. The quality of CB-IMCI services delivered, and other aspects of the field level implementation of the program, need to be assessed and steps agreed upon by the MOHP and its EDP partners to strengthen it. Weaknesses of the CB-IMCI program in Nepal include i) supervision and monitoring, ii) intermittent problems with supplies of equipment, job aids, drugs and commodities and iii) little attention given to nutrition education. It takes approximately fifteen minutes to assess a child using CB-IMCI protocols—a long time for a busy health worker faced with a line of waiting patients. Partly because of this reason, the quality of IMCI counseling at health facilities is low. Experience in Nepal has shown that health counseling is often more effective if there is a “hook” (e.g., a tangible item or test result that a client receives during the encounter) and that nutrition-related counseling often does not have an effective hook associated with it.

Illustrative Activities Review existing CB-IMCI program and develop strategies to strengthen nutrition component. Work with VHWs, MCHWs and other facility-based personnel to strengthen their ability to

provide supportive supervision to FCHVs in the conduct of CB-IMCI activities. Explore the innovative use of VDC or DPHO funds to develop incentives for higher-quality supervision.

Support training and supervision activities for CB-IMCI in program districts in coordination with NFHP-II and in line with national protocols.

In coordination with CRS, support national scale-up of zinc treatment for diarrhea including assessment of coverage and compliance.

Develop protocols to guide health workers to conduct an individual assessment of each child for nutritional status and needs for key nutrition-related interventions such as deworming, Vitamin A and zinc supplementation, etc.

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Conduct research and develop programming to strengthen coverage and quality of the diarrheal disease management component of CB-IMCI.

Illustrative Indicators Number of private providers trained in CB-IMCI (disaggregated by gender and caste/ethnicity). Percentage of health workers who accurately diagnose presence/absence of severe and

moderate malnutrition. Percentage of children under age 5 who comply with zinc treatment for diarrhea. Percentage of diarrhea cases among under-5 children treated with zinc and ORS (NHSP

indicator)

Output 2.3: Facility based Growth Monitoring and Promotion (GMP) Services comply with national/global standards (including support for shifting GMP work to community level in accordance with MOHP plans)The Lancet Series states that growth monitoring without accompanying nutrition education is not an effective means of reducing child undernutrition. In Nepal, a UNICEF-led program, Decentralized Assistance to Children and Women (DACAW), is using growth monitoring as an entry point for additional behavior change and nutrition education activities, and showing preliminary positive results. Results in other countries have shown improvements in nutritional status of children if growth monitoring activities are accompanied with nutrition education and counseling.Currently, the MOHP is supporting primarily facility-based growth monitoring with some outreach clinic (ORC) sessions that are held to reach areas that are located far from health facilities. Underweight (weight for age) is the only current anthropometric measurement taken during these sessions and counseling remains a challenge during these visits according to discussions with the Child Health Division of the MOHP.

The INP will support the NHSP II intent to have growth monitoring conducted at community level by FCHVs, rather than at facility level. The program will need to ensure that growth monitoring is accompanied by quality growth promotion services which includes quality counseling (facility and community-led), community participation in planning and implementation and intense follow up and monitoring at the community level. Based on discussions with the MOHP, the following activities will be critical to ensure a high quality growth monitoring and promotion program.

Illustrative Activities Involving district staff, identify plan for community based roll-out of GMP services including key

actors at facility and community level. Train community based workers on GMP actions (community based screening via MUAC,

counseling techniques, follow-up and referral, etc.) and record keeping Support health facility staff and supervisors to conduct regular meetings with volunteers to

discuss results, share lessons, provide additional information and identify any urgent needs at the community level.

Provide basic supplies (i.e. scales, MUAC, height boards, registers, growth charts, etc.) where necessary. This should be organized in conjunction with CMAM activities

Identify connections to other services (immunizations, vitamin A, etc) and how these fit in to BCC activities.

Conduct operational research to assess effectiveness of this activity

Illustrative Indicators Number of providers trained in GMP (disaggregated by gender and caste/ethnicity). Number of community-level meetings held to discuss results of GMP. Percentage of FCHVs actively providing GMP services in districts where GMP is emphasized.

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Percentage of children under age five receiving GMP services in districts where GMP is emphasized.

Output 2.4: Services for the treatment of Severe Acute Malnutrition (SAM) adhere to national/global protocol (with possible CMAM activities in areas with high SAM prevalence) Acute undernutrition (wasting) remains a serious problem in Nepal where over 13% of all children under five fit this category, exceeding the WHO threshold for a nutrition emergency. While most of the activities in the INP are focused on prevention of undernutrition, unfortunately there will continue to be those children who have severe acute malnutrition (SAM) that need immediate intervention. Furthermore, some of these children will have infections such as pneumonia or diarrhea that threaten their lives and must be referred to a heath facility for timely treatment as well as nutrition rehabilitation. The challenge in Nepal is to find these children, provide for community-based management of malnutrition (CMAM) where appropriate and improve the system for timely referral and treatment for those who need medical management. The referral facilities need to have the ability to rehabilitate the children as well as support the mother on feeding her child so that the child does not relapse.

CMAM has also been pilot-tested in three districts with the support of UNICEF and preliminary results are positive. In areas where SAM rates are above 10%, CMAM should be considered and should be set up in close collaboration with the MOHP and UNICEF to utilize lessons learned and assess available capacity, supplies and community based support for the program in any new areas to be targeted. CMAM is an approach that still provides inpatient care for any SAM cases with complications and allows for community-based management with SAM and moderate acute malnutrition

The INP will assess the lessons learned from the NRCs and CMAM work to date, and work with the MOHP to help institutionalize NRCs at appropriate facilities within INP districts as appropriate. The work will focus on finding sustainable ways of identifying, managing and treating children with acute severe malnutrition, gradually phasing out the need for emergency imported food and focusing instead on providing locally prepared RUTF.

Illustrative Activities Assess lessons to date in implementing NRCs and CMAM to guide INP’s approach to this issue Develop training programs for District and facility-based health staff concerning treatment of

SAM (and potentially on CMAM in designated districts) Provision of basic supplies (scales, height boards, MUAC tapes, Growth Charts and Cards) and

training (detection and treatment of SAM) to take accurate anthropometric measurements and record according to WHO 2006 International Growth Standards

Establish collaboration with UNICEF and/or other organizations, including the private sector, for provision or development of therapeutic foods.

Train community-based staff and volunteers on CMAM and screening through MUAC and referral and follow up for identified cases of SAM.

Conduct operations research to determine most effective screening methods at both facility and community levels to detect wasting and for integration of IYCF messages into rehabilitation services.

Support organization of district level (and potentially National) level workshops to develop national CMAM protocol and link all NRC activities into national system.

llustrative Indicators Number of providers trained in management of SAM/CMAM (disaggregated by gender and

caste/ethnicity). Number of children receiving services through Nutrition Rehabilitation Centers. Percentage of children entering treatment for SAM who adhere to treatment protocol.

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Percentage of children entering SAM treatment who have successful outcome. Percentage of children in community with SAM who receive treatment (disaggregated by gender

and caste/ethnicity).

Output 2.5: Facility-based and outreach family planning services provide effective counseling on healthy timing and spacing of pregnancy (HTSP) as important for good health and nutrition Research has linked adequate birth spacing with improved nutritional status of young children. Integrated nutrition programming should provide support as necessary to FP programming with the objective of ensuring that families have access to FP services and that birth spacing messages are conveyed effectively.

FP efforts in Nepal have been highly successful over the past three decades but increases in the contraceptive prevalence rate (CPR) have reached a plateau in recent years. Formal, structured contacts between post-delivery mothers and health workers are limited and narrowly defined (e.g., FP counseling is generally not provided during EPI clinics), restricting the opportunities to effectively counsel mothers regarding FP precisely when those messages are most relevant. FP is increasingly seen by the public health community in Nepal as a way to improve overall maternal and child survival and health and not just as a way to control population. INP will work with NFHP II to develop and pilot-test HTSP programming in order reenergize FP efforts in Nepal. Under HTSP, FCHVs will be trained to tailor the FP messages to the client. Applicants should also include information on how they will monitor USG FP policy compliance as well as the Tiahrt amendment, including budgeting for training staff on Tiahrt related issues.

Illustrative Activities Strengthen quality of training of facility-based and community health workers on birth spacing

and its potential impact on maternal nutrition and low birth weight. Partner with MoHP and NFHP II to support taking pilot work on HTSP to scale. Develop and pilot new, innovative approaches to promote improved maternal and child nutrition

and FP birth-spacing messages through facility-based and outreach services. Strengthen supervisory support provided by facility-based health workers to community-based

cadres related to FP and nutrition. Incorporate messages targeting health workers and clients that link nutrition and birth spacing

into existing BCC materials and mass media communications. Support strengthening the quality of counseling interactions on nutrition and FP delivered

through outreach clinics.

Illustrative Indicators Number of people trained in FP/RH with USG funds (disaggregated by gender and

caste/ethnicity). (mandatory indicator) Percentage of women of reproductive age with knowledge of relationship between birth spacing

and children’s nutritional status. Median duration of the birth interval for non-first births in INP focus districts (disaggregated by

gender and caste/ethnicity). Percentage of EPI outreach clinics that offer FP services in focus districts.

C. 3. IR 3. Women and their families increase their consumption of diverse and nutritious foods (25% of program effort)

Background

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Diet diversity is a major indicator associated with nutrition. This IR will focus on household production and knowledge on diet diversity and available nutritious foods as well as community- based initiatives that will all contribute to improved consumption. In order for consumption patterns to improve, it is essential that all activities be directly linked to BCC activities at both the community and facility levels to provide a comprehensive set of actions aimed at improved nutrition. All activities will also have to be coordinated with both the Ministry of Health and Agriculture in the target communities.

In areas of Nepal where food insecurity remains a challenge, it is critical to provide households and communities with the basic resources and knowledge to improve their availability and access to nutritious and diverse foods. In some areas where production is sufficient, food behaviors and practices remain the major barriers; however, in other communities, the sheer absence of diverse foods poses a threat to the nutritional status of women and children. The choice in types of foods produced will have a particular impact on consumption patterns and its subsequent impact on the nutritional status of women and children. For example, increased production in staple crops will help to fill energy needs, but additional fruits, vegetables, and animal sources products are also necessary to fill micronutrient gaps. This will be carried out in close collaboration with USAID/ Nepal’s FTF Initiative.

Approach

Three approaches will be employed to ensure that women and their families increase their consumption of diverse and nutritious foods. They are: (1) mother and children have access to locally produced nutrient-dense and fortified foods, (2) households have increased knowledge of nutrition of locally available foods, and (3) communities increase resiliency to potential nutrition shocks through community-based initiatives. Applicants must specify the kinds of workers and organizations they propose to involve in the activities under this IR including existing community-based associations and other groups as well as local government workers with responsibilities for food production issues. Practical ways to target the poorest and often the most socially excluded households must be discussed. Each of these is described briefly below.

Output 3.1: Mothers and children have access to locally produced nutrient-dense and fortified foods (including animal source protein)

Limited research is available on the impact of food production programs on nutritional status, but existing sources do show that food production alone without strong nutrition education and BCC activities, will have limited impact. Therefore, integration with IRs 1 and 2 will be critical to the impact of this program. Household food production systems have had some success in both Nepal and neighboring countries.

Food production also allows households to potentially sell surplus products that can be translated into income to be used to purchase additional foods and products to fill dietary needs. Fortified foods can also contribute to reducing micronutrient deficiencies and will be considered in this activity. Because fortified foods are not available throughout the country, this project will work primarily with small-scale farmers to assess potential fortification programs. The World Bank in collaboration with the Micronutrient Initiative, for example, has supported the introduction of small-scale fortification in some areas that could potentially contribute to a reduction in micronutrient deficiencies.

Particular efforts will be made to focus on women as various studies show that more expenditure on children occurs when women are in control of household income. Therefore, INP will require

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evidence-based and innovative approaches to increase women’s control of assets to improve consumption patterns.

Illustrative Activities Assessment of nutritious foods for a given area based on altitude, climate, acceptability, and

land availability. Identify potential community based gardening approaches in consultation with community

groups. Explore existing models for household food production. Training for Ag extension agents and

other community leaders may include FCHVs, small farmer group leaders, mothers’ group leaders, youth group leaders, etc.

Train community members on community based food production techniques including women and men on innovative techniques targeting landless households.

Support small livestock and animal husbandry to improve access to animal foods (i.e. meat, eggs, milk).

Organize sessions with community leaders to identify potential land that can be used for community-based activities

Support to access small-scale fortification products and mills through existing programs. Support or referral to activities to increase income at local level to improve access to diverse and

nutritious foods.

Illustrative Indicators Household food insecurity access scale (disaggregated by gender and caste/ethnicity) Household dietary diversity score (disaggregated by caste/ethnicity) Women’s dietary diversity score (disaggregated by gender and caste/ethnicity) Percentage of children aged 6-24 months who consumed vitamin A / iron-rich / animal-source

foods during previous 24 hour period (disaggregated by gender and caste/ethnicity). Number of outlets providing socially marketed MNCH products in rural outlets (mandatory

indicator)

Output 3.2: Households have increased knowledge of nutrition of locally available foods (seasonal and acceptable)In addition to the production of nutritious and diverse foods, women and families need information on available foods and improved food preparation techniques as well as feeding practices to improve nutritional status (please see INP reference documents under: http://nepal.usaid.gov/working-with-us/business-opportunities.html). The following set of illustrative activities is aimed primarily at women’s knowledge and will incorporate groups and community activities.

Illustrative Activities Conduct qualitative research with women and their households that helps to identify which foods

will be available at various times throughout the year. Sessions with women, led by FCHV or other community leaders, on the use of aids such as food

calendars and how to plan for feeding children depending on their age and time of the year. Training of community groups on the production of improved stoves made of local materials that

reduce the amount of wood/charcoal needed to cook foods. Organize cooking demonstrations which use locally available foods and targets specific age

groups. Develop simple recipe booklets that include locally available foods by season and area that meet

nutrition needs. Organize regular community meetings with groups and local leaders to discuss lessons learned,

share experiences and answer any questions.

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Illustrative Indicator Percentage of women of reproductive age with adequate knowledge of nutrition of locally

available foods (disaggregated by gender and caste/ethnicity).

Output 3.3: Communities increase resiliency to potential nutrition shocks through community-based initiatives Nepal often witnesses natural disasters including floods and droughts that impact food availability. In late 2009, landslides caused by torrential monsoon rains affecting 15 districts and displaced over 4,000 families. Communities that have experience with these shocks will best understand the consequences of these crises and are best placed to initiate activities that can mitigate the effects on the community long before the crisis happen. Aside from major disasters, many communities go through more predictable periods of drought and other conditions of food shortages. In addition to the community-based activities focused on production and consumption, a small-scale grants program may allow communities to propose and implement community-developed ideas related to nutrition security. Nepali NGOs will be encouraged to solicit ideas for mitigating nutrition crises from the communities themselves, and to develop proposals for assisting communities to operationalize these ideas. The grants will fund activities such as food preservation and storage ideas, community food and nutrition planning activities related to natural disasters, and other activities of that kind. It is not intended to fund construction or infrastructure projects. Applicants are encouraged to propose criteria for selecting proposals and a small grants management system to ensure accountability, equity and results.

Illustrative Activities Organize NGO- community meetings to understand the types of shocks that may be experienced

in target areas and produce documentation for a given area. Develop guidelines for a small grants program (no more than $5,000 USD per project) and

award a selected number of grants for NGOs to work with community organizations and associations.

Provide orientation and training as needed to all grantees on the requirements (programmatic and financial). Provide continual technical assistance to all programs and document any innovative models that produce positive results.

Organize additional community meetings that include all household members to discuss the program, its impact on the community and any additional ideas to improve the program

Illustrative Indicator Number of communities in INP focus districts that develop resiliency plans

C. 4. IR 4: Coordination on nutrition between government and other actors is strengthened (5% of program effort)

BackgroundReducing undernutrition requires strengthened relationships across a number of GON ministries including Health, Agriculture, Local Development, Planning and Physical Works and Education as well as the private sector. At the national level, the National Planning Commission (NPC) is a logical entity to help bring various ministries together for discussing nutrition issues and sharing information. At the District level, the District Development Committees can help encourage a more collaborative work planning process that will focus attention and resources on nutrition challenges. The aim of this component of the INP is to work with the appropriate government entities to help bridge working relationships and mechanisms that help address the coordination challenges identified in the NAGA.

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ApproachTwo approaches will be employed to encourage coordination on nutrition between government and other actors: (1) a national mechanism in place that allows for regular coordination and information sharing among government and other entities with responsibilities for achieving MDG 1 and (2) regional and district mechanisms in place to improve collaborative action on nutrition among government entities, civil society partners and the private sector. Applicants should propose practical ways of encouraging government ministries that have little experience with inter-ministerial collaboration to work together. Each of these is described below.

Output 4.1: A national mechanism in place that allows for regular coordination and information sharing among government and other entities with responsibilities for achieving MDG 1 and reducing the level of undernutrition in NepalAs articulated in the NAGA, strengthening systems and capacities to address the nutrition challenges is important. Many of the activities described under IRs 1, 2 and 3 emphasize building increased capacity to plan, implement and monitor nutrition and other health programs, especially at the district, VDC, facility and community levels. However, there are also some important actions at the national level, particularly those related to forging closer links among the activities of various government ministries as well as non-governmental entities and the private sector (please see organizations/interventions under INP reference documents under: http://nepal.usaid.gov/working-with-us/business-opportunities.html). The USAID/Nepal Food Security Initiative and the INP will work closely with the nutrition secretariats in Agriculture and Health to encourage collaborativ planning and sharing of information. USAID/Nepal also has strong working relationships with private sector entities that can play a key role in achieving nutrition objectives.

Illustrative Activities Support follow-up of Nutrition Action Plan and NAGA recommendations, and a reactivation of the

National Nutrition Coordinating Committee. Facilitate regular meetings with donors and government actors, and be an interface between

nutrition and food security actors to ensure improved coordination among the different line ministries

With the government and EDPs, lead the effort to evaluate and establish a strong evidence-base for the new nutrition and food security initiatives piloted in Nepal. Help to identify who is working where and on what type of interventions.

Organize meetings with government officials and other actors to share lessons learned and initiate joint programs (i.e. pilot programs, research, evaluations, etc.)

Support exchange visits/trainings to facilitate improved coordination of nutrition activities.

Illustrative Indicators Number of USG-assisted organizations and/or service delivery systems strengthened that serve

vulnerable population (mandatory indicator) Existence of document describing mechanism that allows for regular coordination and

information sharing among government and other entities Number of meetings taking place where written minutes are taken and approved by attendees

Output 4.2: A regional and district mechanism in place to improve collaborative action on nutrition and hygiene among government entities, civil society partners and the private sector

Given the range of government agencies functioning at the regional and district level, and the importance of strengthening and sustaining management capacity for nutrition and related programs, the INP will build capacity at those levels. Because the roles and responsibilities may

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change once the new Constitution establishes how the ‘federal’ state will be organized below the national level, the INP will remain flexible about which agencies and types of staff should be involved.

Illustrative Activities Support the development and implementation of district nutrition/hygiene plans involving

appropriate staff from Health, Agriculture, Local Development, and local or international NGOs and civil society organizations.

Provide technical assistance and support for monitoring and assessment progress toward achieving the objectives of those plans.

Support exchange visits between districts to share experiences, lessons learned, etc. Organize planning meetings in collaboration with government and non-government actors on

regular basis (quarterly, bi annually, annually).

Illustrative Indicators Number of USG-assisted organizations and/or service delivery systems strengthened that serve

vulnerable population (mandatory indicator) Existence of document describing mechanism that allows for regular coordination and

information sharing among government and other entities Number of meetings taking place where written minutes are taken and approved by attendees

D. Integration of our IRs – program components

The four components of the program, essentially the four IRs, can be simplified as follows: IR 1 focuses on household and community level behavior change to improve nutrition and

related health programs, IR 2 is aimed at strengthening the health system’s ability to support improved health and

nutrition at the community level, IR 3 works to ensure that locally produced foods are not only produced at the household

level, but also are consumed in ways that enhance the nutritional status of women and children,

IR 4 works at the national, regional and district levels to bring together various ministries, NGO partners and civil society organizations for better coordination and concerted action on nutrition programs.

Most of the effort of the program is at the community level, working with existing volunteers, associations, groups of community members and local leaders. This is especially true of the first three components. At the village level, these activities must be planned with communities and organized in a fully integrated way, building on any successful initiatives already in place and with any other implementing partners on the ground. Implementing organizations must be cognizant of FCHVs’ already heavy set of responsibilities and seek to also involve other community members and leaders to support the activities. Not every activity is suitable for every location; much will depend on the programs already underway and the particular circumstances in each location. Most importantly, there must be a concerted effort to reach and include those members of communities that are traditionally excluded (the poorest, the lower castes, ethnic groups, and others) who are stigmatized. Program staff working at the community level will gather information to help determine whether the people most at risk are included and specifically targeted for special attention in every component of the program.

IV. Program Management and Organization

A. Implementation Approach

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Government of Nepal Counterpart

1. USAID/Nepal and the Recipient will work with the MOHP as the primary counterpart for this project, with participation of the Ministry of Finance and other ministries, as relevant. Potential secondary partners are the Social Welfare Council, the Ministry of Physical Planning, Ministry of Agriculture and Cooperative and Works and the Ministry of Local Development, as relevant. It is expected that the Grantee will coordinate with government and other stakeholders to complement and inform national planning for the INP. The Recipient’s operational framework must include development of a system for collaboration with district and local authorities, including but not limited to the Child Health Division. The Recipient must work in coordination and share information with the District Health Office, District and Village Development Committees and other relevant local authorities.

The Recipient must conduct baseline contextual assessments and consult with local GON representatives, donors and other implementing bodies to ensure that there is no duplication of effort under this project. Throughout implementation of this project, USAID/Nepal and the Recipient will consult regularly with multilateral, bilateral and national development partners operating in the geographic target areas to ensure that project interventions are complementary rather than duplicative of other efforts.

2. Capacity Building: The primary focus of the capacity building effort must be at the district, VDC and community levels. It should involve appropriate government staff and institutions as well as non-governmental entities such as local NGOs, civil society institutions and the private sector. The capacity building approach must also foster local level ownership and be carefully integrated with existing activities supported by the GON or other donor activities within the same program areas. Planning and budgeting must take GON/pooled health sector funding into consideration to allow for USAID resources to be used for priority activities where no alternative mechanism exists. The Applicant’s proposed activities must also be grounded in a capacity building/sustainability plan.

Implementation approaches must be appropriate to the scale and context of activities. In particular within national program areas, support to individual districts is expected to vary based on actual needs, local capacity and existence of support from other projects

INP must be flexible and the successful Applicant will be able to adjust interventions when evidence suggests that a particular approach is less effective than anticipated. The need for change may come from an unstable security situation, from opportunities to work in collaboration with new projects or from changes in government capacity over time. External mid-program and end-of-program evaluations will be scheduled, but the implementing partners are expected to self-assess their own performance on a quarterly basis through a process that Applicants must describe in their proposal. This process need not be formal, but can be a simple examination of which interventions are indeed increasing/maintaining quality program coverage. These assessments and the more formal evaluations are only valuable if they serve as living tools and lessons learned are then incorporated into on-going programming.

3. Rapid Start Up: USAID expects that the successful Applicant establish operations rapidly and efficiently. In particular the following activities will require rapid start-up:

As a health SWAp partner, USAID/Nepal will work with the MOHP and EDP partners to reflect the work of its programs, including the INP work plans, every year to ensure optimal coordination and transparency. Discussions for national work plan support for 2011/2012 will need to start very early in the project (planning starts in January).

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Much of work in specific regions and districts will depend on formative research and other tools for learning about nutrition and hygiene related behaviors and practices as well as the issues and challenges facing each of the communities where INP will work. The successful Applicant will need to describe efficient ways of using implementation partners to rapidly accomplish this kind of preparatory work, as well as collecting the baseline data needed to be able to measure program effectiveness and impact.

Attempts must be made to work with local partners that have proven know-how and experience to manage effective programs in each location. Moreover, where appropriate, the recipient should use existing national, regional, and global best practices, protocols and tools to avoid a long start up period.

The following factors should assist successful Applicants in planning for a rapid start up:

Applicants must have letters of commitment from the key staff, including their length of commitment through at least one year of program implementation. To the extent possible, Applicants must have determined the optimal mix of people for the project implementation team, in terms of knowledge, skills, and personal chemistry.

Applicants must have letters of commitment from key implementing agencies. Exclusivity contracts are discouraged so as not to limit the pool of capable partner organizations available to implement this program. Unless the same implementing agencies also submit proposed work plans and budgets in the application, additional approval will be required as sub-agreements are developed after award.

Early and intensive meetings between the successful Applicant and the USAID

Agreement Officer Technical Representative (AOTR) and technical team will be critical to establishing a clear understanding of the expectations.

Applicants must clearly describe the achievable and substantive activities that can be accomplished within the first 90 days with measurable milestones in a timeline.

4. Gender and Social Inclusion: Both USAID/Nepal and the MOHP support gender equality and social inclusion of marginalized groups as a core development issue and objective. Overall, research demonstrates that there are widespread gaps among various social and ethnic groups in access to and control of resources, economic opportunities, power and political voice. The gender and social inequalities of under-represented groups impose costs on the health and wellbeing of men, women and children by directly influencing health outcomes in terms of the supply of and demand for services, service utilization, and desirable health practices. The successful Applicant will involve the participation of marginalized groups in its staffing, partnerships, program planning and implementation, as well as in program evaluation. The PMP Plan must show how data will be collected to monitor how programs are reaching and benefiting the groups that have traditionally been excluded from the benefits of such development activities.

USAID/Nepal supports gender equity and social inclusion of marginalized groups as a core development issue and objective. Overall, research demonstrates that there are widespread gaps in access to and control of resources, economic opportunities, power and political voice, between the elite or mainstream and marginalized groups. The inequalities experienced by marginalized groups impose costs on the health and well-being of men, women and children by directly influencing health outcomes in terms of the supply of and demand for services, service utilization,

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and desirable health practices. The Recipient must appropriately involve the participation of marginalized groups in its staffing, partnerships, program planning and implementation, as well as in program evaluation. USAID’s Disability Policy policy paper can be found at the following website: http://pdf.dec.org/pdf_docs/PDABQ631.pdf

5. Public-Private Partnerships: USAID/Nepal will be looking for innovative PPP ideas from Applicants to describe the approach that the INP will take when working with the private sector. Some of the potential areas for involving the private sector may include zinc treatment for diarrhea, water purification products, locally-produced RUTFs and commercial partnerships for conducting BCC activities. Given the state of the Nepali economy and the current environment of corporate social responsibility in Nepal, the private sector may not donate significant resources or to work in areas where companies cannot realize profits. The INP will need to seek niches where project objectives coincide with strategic interests of the private sector..

6. Sustainability Strategy: USAID/Nepal’s Sustainability Framework is based on practical experience in Nepal that indicates health outcomes are more likely to be sustained when there is improvement in the capacity and viability of key components such as health workers, clients and community, and local organizations that support them. An enabling supportive environment is an essential underpinning. The INP is organized to address the key components of program sustainability and to measure progress. Achievement of outcomes will not be assumed but rather carefully measured by the program to ensure the cost effectiveness of investments. In the Nepal context, experience has shown that developing a strong evidence-base for new approaches is the key to nation-wide expansion and institutionalization. The successful Applicant will need to demonstrate how it work on the key elements of the Sustainability Framework of community capacity development, quality health service provision and viability and organizational capacity to help achieve sustainable health and nutrition outcomes.

B. Work Plan Requirements

Applicants must propose an overall work plan outline for the entire project period, with more detail in the first year work plan including rapid start up. There must be an overview of proposed activities and a timeline, showing how the project will accomplish its objectives, expected results and goals.

Within 30 days after the award, the successful Applicant must submit for approval and detailed work plan and budget for the first part of the year (March to July 2011) describing specific work to be accomplished during this preparatory and program launching period. The first one-year work plan (July 2011- July 2012) must also be submitted within 60 days after the award clearly showing the targets to be met and activities to be undertaken.

Applicants should note that results reporting for the INP will be in line with the GON fiscal year and annual performance reporting schedule, mid-July to mid-July of each year. All USAID health programs report on results according to this schedule allowing consolidated and synchronous reporting to USAID/Washington. This also allows for reporting results with data that is collected as part of the GON’s annual work cycle.

USAID will provide final approval of work plans and budgets as defined in the substantial involvement clause of the cooperative agreement. The successful Applicant will coordinate with USAID to develop, produce and subsequently submit to USAID for approval on an annual basis a detailed work plan for the coming year in conjunction with the annual planning process with the GON. The planning process begins in January of each year.

C. Monitoring and Evaluation

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Illustrative and required indicators relevant to the INP are provided in this document. During the first thirty days after the award is made, the successful Applicant will work closely with USAID to refine indicators, performance targets for each indicator based on the most recent results, and finalize a project monitoring and evaluation plan that monitors progress towards achieving program objectives and results according to USAID guidelines. USAID and the successful Applicant will conduct six-monthly performance reviews with the GON to monitor the progress of work and the achievement of results based on the targets specified in the M&E plan.

The INP, through collaborative efforts and appropriate partnerships, must achieve impact in the 25 districts targeted by the program. The 2011 DHS will provide some of the baseline data for the program but it should be supplemented by specific data collection efforts in the project sites that will allow for more frequent assessments of progress. Applicants must propose a monitoring plan to measure the outcome and impact of the program. The plan must also describe collaboration with the GON’s information systems (e.g. HMIS/LMIS) so as to work within the government framework wherever possible. This is a results-oriented Cooperative Agreement sensitive to conflict and instability. Success will be measured not only through improved coverage and quality of health services and impact on health status but also through activities that improve GON legitimacy and effectiveness, such as the dependability of the health services. The successful Applicant will also be responsible for data collection and analysis required by USAID for performance reporting. The required indicators for that purpose have been notes in Section III.

The successful Applicant will be responsible for sharing information in a timely manner with USAID, donor partners, and GON entities. Information sharing will create opportunities to discuss progress, identify constraints and find solutions with all stakeholders.

It is critical that the successful Applicant continually monitor and report to USAID on a regular basis the impact on the program of civil and political unrest and instability. Applicants must describe in detail how they propose to do this.

D. Reporting Requirements (Technical and Financial)

The successful Applicant must submit a technical report annually by October 30 for the previous 12-month period (including indicator results according to the GON fiscal year), and by April 30 of each year for the previous 6-month period, October to March. The format for the technical report will be jointly determined by USAID and the successful Applicant, but must include at a minimum results reporting for indicators agreed upon in the M & E plan according to the GON fiscal year schedule with proposed targets for the next three years. The report must discuss progress against the implementation plan, results achieved, constraints affecting implementation and proposed solutions. The report must also address whether and how constraints reported in previous reports have been addressed and resolved, and must also include discussion of activities and events planned for the upcoming quarter. A section on the impact of the political unrest and conflict and consequent challenges and how they were or will be addressed must also be included. A section on the program’s monitoring and compliance with U.S. Government population policies is also required.

Within 45 days of the end of each quarter, the successful Applicant must submit a quarterly financial report to USAID. The financial report must include form SF-425as well as accruals, expenditure and pipeline information for all line items approved in the final budget.

E. Administrative Requirements

Staffing:

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A majority of the Nepali program staff must be located in proposed regional or district offices to provide direct technical support and supervision. The successful Applicant will show how they are planning to hire such program staff resident in those regions and provide sufficient mentoring and oversight to ensure that they are successful. Applicants are also asked to demonstrate evidence of gender and social inclusion in their staffing plan and hiring policies. Applicants are asked to provide the following:

A complete staffing plan including support staff, with underlying rationale, including an organizational chart demonstrating lines of authority and staff responsibility accompanied by position descriptions for each technical and management position proposed. Expatriate resident and non-resident technical assistance must be included, but with a plan in place to “work themselves out of a job”. A realistic phase-out plan for at least one of the expatriate resident staff if two are proposed should be included. The plan must identify or describe the recruitment of a senior Nepali professional who will be mentored and in whom capacity will be built to replace the expatriate resident staff.

A matrix of all personnel and relevant skills they bring to the performance of this program.

Resumes and letters of commitment from key personnel in an annex. Letters of commitment must include commitment from each key staff to complete at least one year of program implementation.

The type of technical and general skills required within the mix of staff must include the following:

Demonstrated expertise in relevant public health technical areas (community nutrition, FP/RH, IMCI, micronutrient supplementation and fortification, maternal and newborn health, household gardening, small livestock and community food production), and medical management of severe acute malnutrition.

Demonstrated expertise in applied research, monitoring and evaluation of nutrition and FP/MCH-related interventions including formative research on the behavioral aspects of feeding, hygiene, environmental sanitation and health seeking behaviors.

Demonstrated expertise in cross-cutting program areas of training, communications and behavior change, leadership and management.

Knowledge of issues influencing community participation and community based interventions. Knowledge of Nepalese district and local level issues influencing management and delivery of

GON health services. Fluency in Nepali and English as required for specific positions. Experience in quality improvement as it applies to a multi-dimensional program. Expertise in scaling up large programs in complex environments. Ability to manage changes in programs to accommodate a changing environment in a conflict

and civil unrest situation. Ability to work constructively and effectively with a wide range of partners with varying interests

and priorities in the fields of nutrition, health agriculture, education and so on.

Other staffing considerations should include:

Short-term expatriate and local consultants –Applicants must propose sufficient short-term expatriate and Nepali expertise as required to implement this program effectively.

Local staff –Applicants must propose sufficient local, professional staff based in field locations outside of Kathmandu in order to implement this program effectively.

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2. Management of Partnerships and Subagreements: Applicants must endeavor to create partnerships among public and private sectors, with an emphasis on local organizations to implement this program effectively. They must describe how they will establish relationships (sub-agreement, MOU, etc.) with a variety of partners (e.g., GON, NGOs, CBOs, PVOs, other private organizations, networks, associations, etc.). The ultimate aim of partnerships is to make optimal use of each organization’s expertise and appropriate role in carrying out program tasks and to build local capacity in management. To this end, Applicants must propose a capacity building and sustainability plan that addresses management and technical challenges. In the plan, Applicants must also outline transition plans for turning over management responsibility to the extent possible to the GON within the context of a decentralizing government system. The INP also calls for the Recipient and its partners to manage a small grants program under IR 3.3. The application must contain some information on how this program will be administered.

Applicant must include a list of contracts, grants and cooperative agreements that Applicants have managed involving similar and related programs over the past five years with USAID and with other organizations.

F. Planned Budget

USAID expects Applicants to propose activities over a five-year period, ensuring rapid start-up no later than March 1, 2011 with a strong, continuous level of effort without gaps through January 31, 2016. The total planned budget for the INP is approximately $46 million, divided approximately among the following Intermediate Results.

In terms of implementation emphasis, the budget must reflect the following anticipated approximate level of effort by Intermediate Results with activities focusing on field implementation:

IR 1: 40% of the total level of effortIR 2: 30% of the total level of effortIR 3: 25% of the total level of effortIR 4: 5% of the total level of effort

Applicants are required to display their budgets in a manner that will allow USAID to easily determine the proportion of the program activity and staffing budgets that will be spent at the district and community levels and how much at the national level. Because the majority of the INP interventions are focused on work at the community and local levels, the budgets will need to reflect this intent

The Cooperative Agreement budget will be complemented in the national program work plans with approximately $2,500,000 of separate USAID funds that will be channeled directly through the GON’s “Redbook.” The Applicants are also required to show a cost-share of at least 10% of total program support over a five year period derived from non-USG sources such as PPPs, contributions from local development funds at the district level, contributions in kind from communities and households for specific INP activities and so on.

G. USAID/Nepal ManagementUSAID/Nepal will be substantially involved during performance of the Cooperative Agreement as set forth below:

a. Approval of annual work plans, including the activities of each partner organization. b. Approval of key personnel to include a maximum of three senior managers

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c. Approval of the recipient's monitoring and evaluation plans to include measureable benchmarks toward attainment of organizational and financial viability and sustainability.

d. Concurrence on the substantive provisions of the sub-awards, including approval of work conducted by a Third Party under the agreement.

H. Environmental Assessment 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 programs. An IEE has been submitted following the guidance in 22 CFR 216 and ADS Parts 201.5.10g and 204, which, in part, require that the potential environmental impacts of USAID-financed activities are identified prior to a final decision to proceed and that appropriate environmental safeguards are adopted for all activities. It is anticipated that the technical assistance activities of INP will be determined to have an environmental threshold decision of “categorical exclusion.” The improved ANC/PNC services including tetanus toxoid injection, from IR 1 will require that health service providers must properly handle and dispose of the syringes for administering injections and the medical waste which they will generate.  The household water, sanitation and hygiene activities from IR 2 will require proper safe disposal of human waste, environmental sanitation and safe water practices.  

No funds will be obligated for this award prior to an approved Regulation 216 environmental documentation, which will be provided to the Recipient by the AOTR, as well as any subsequent updates.

The Recipient must comply with USAID Regulation 22 CFR 216, Agency Environmental Procedures, which is available at

http://www.usaid.gov/our_work/environment/compliance/reg216.pdf

and must follow the recommended mitigation measures as outlined in WHO Guidelines for Handling and Disposal of Medical Waste, as found at this web site:http://www.who.int/topics/medical_waste/en/.

The Recipient must also comply with the guidance provided at Environmental Guidelines for Small-Scale Activities in Africa, 2nd edition at:

http://www.encapafrica.org/egssaa.htm

and IFC Environmental, Health and Safety Guidelines at:

http://www.ifc.org/ifcext/sustainability.nsf/Content/EnvironmentalGuidelines.

Recipients will be directed to the Environmental Guidelines for Small-Scale Activities in Africa at http://encapafrica.org/egssaa.htm and the Environmental, Health and Safety Guidelines at http://www.ifc.orgn/ifcext/sustainability.nsf/content/EHSGuidelines for guidance on the water and sanitation activities.

Proper infection control measures are required for collection, elimination or disposal, reduction, or recycling of sharp objects and medical and device waste through separation into designated containers, and final safe disposal through low-impact incinerators, burial or other method as relevant to the item and location. The Recipient will be required to review and obtain approval from the AOTR for each type of safe medical and solid waste disposal method and to show how they will

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monitor compliance. In addition, the Recipient must comply with host country environmental regulations unless otherwise directed in writing by USAID.

The Recipient shall include required environmental compliance and reporting language into each sub-implementation instrument, and ensure that appropriate resources (budget), staff, equipment, and reporting procedures are dedicated to this portion of the project. The Recipient will ensure that sub-implementing partners have sufficient capacity to complete the environmental screening process and to implement mitigation and monitoring measures.

As part of its initial Work Plan, and all Annual Work Plans thereafter, the Recipient, in collaboration with the USAID AOTR, shall review all ongoing and planned activities under this agreement, to determine whether they are within the scope of the approved Regulation 216 environmental documentation. Any ongoing activities found to be outside of the approved Regulation 216 environmental documentation shall be halted until an amendment to the documentation is submitted and written approval is received from USAID. If the Recipient plans any new activities outside the scope of the approved Regulation 216 environmental documentation, it shall prepare an amendment to the documentation for USAID review and approval. The Recipient shall prepare a project mitigation and monitoring plan describing how they and sub-contractor/grantees will implement all IEE conditions and monitor their implementation and effectiveness.

I. Special Considerations

a. Reduction Of Agreement Period The term of the agreement is five years. This agreement is a sub-obligation under USAID’s Assistance Agreement with the Government of Nepal for Fiscal Years 2011 - 2016. In the event of reduction to the end date of this Assistance Agreement, then the Recipient agrees that the term of this agreement may be reduced to a new expiration date that shall be set at the unilateral discretion of the Agreement Officer and the parties agree that the agreement shall expire on that new date.

b. Local Taxes Under the bilateral agreement between USAID/Nepal and the Government of Nepal (GON) development assistance programmatic funds are exempt from taxes to the GON.  As such USAID does not finance any identifiable host country taxes.  The Recipient is responsible for asserting and obtaining the necessary tax exemptions and reimbursements.  Upon request USAID/Nepal will provide available documentation to support allowable exemption from incurrence of host country taxes on project-related activities.

c. Outreach The Recipient must participate proactively in outreach activities to promote the objectives of this Agreement and to identify USAID as the funding source in accordance with the branding and marking requirements outlined in the Recipient’s approved Branding Strategy. The Recipient shall also capture information on the qualitative progress of this program through success stories, case studies, press releases, etc., as part of its overall reporting requirements to USAID.

d. Branding Strategy and Marking PlanApplicants must state only their general approach to branding and marking, the regulations, guidance, and graphics for which are available at http://www.usaid.gov/branding/. See A.II.2.b.ii, above and also D. Part IV.5, below, for the full text of the Branding and Marking provisions under Assistance Instruments.

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The Apparently Successful Applicant selected for award will be required to provide a “Branding Strategy” and a “Marking Plan” for review and inclusion in the final award by the Agreement officer. A Branding Strategy is required to describe how the program, project, or activity is named and positioned, how it is promoted and communicated to beneficiaries and host country citizens, and how USAID will be identified and acknowledged as the donor. The Marking Plan details the public communications, commodities, and program materials and other items that will visibly bear the USAID Identity.

e. Exchange Visitors and Training i. Definition: An eligible host-country resident or national sponsored by USAID for

a learning activity conducted within the U.S., a third country, or in-country for the purpose of furthering USAID development objectives. A learning activity takes place in a setting in which an individual (the participant) interacts with a knowledgeable professional predominantly for the purpose of acquiring knowledge, skills, or information for the professional or technical enhancement of the individual. Learning activities may be formally structured, such as an academic program or a technical course, or they may be more informal, such as an observational study tour.

ii. Application of ADS Chapter 252 and ADS Chapter 253: The Recipient will conform to USAID Automated Directives System (ADS) Chapter 252 – Visa Compliance for Exchange Visitors, ADS Chapter 253 – Training for Development, and USAID/Nepal-specific requirements for processing of J-1 Exchange Visitors. The Recipient will enter applicable information into USAID’s web-based training information system, TraiNet, for any exchange visitors, participant training, third-country training, or in-country training funded through this award. Information on ADS 252 and 253 requirements is available in http://www.usaid.gov/policy/ads/.

J. LogisticsUSAID policy concerning the provision of logistic support under a grant is that the grantee’s employees shall maintain private status and may not rely on local U.S. Government offices or facilities except for:a. Travel arrangements – Recipients and their employees may utilize the services of

the USAID travel contractor for travel arrangements.b. AMA commissary and recreational facilities – In accordance with AMA policies and

procedures.c. Pouch – Recipients and their employees are authorized by the Department of State

to use the diplomatic pouch to transmit up to two pounds per shipment of correspondence and documents needed in the administration of foreign assistance programs. U.S. citizen grantees may receive enveloped personal mail of up to one pound per shipment; merchandise, parcels, magazines and newspapers are not considered to be “personal mail”.

K. Information SystemsUSAID requires that Recipients review their data collection system and data standards with the Agreement Officer’s Technical Representative (AOTR) and the Geographic Information Systems Officer, if applicable, and set up a system for regular sharing of data with USAID.

L. Flexibility in Implementation

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The political, economic, and law and order situation in Nepal is in flux and the Recipient must be prepared for flexibility based on changing circumstances.  If there are changes in the situational law and order or political will, the grantee may need to shift the location of project activities.  The Recipient must discuss any such situation and recommendations with the AOTR and must obtain Agreement Officer concurrence of any changes that fall within the scope of the agreement prior to the implementation of changes to the program. Changes in program location within Nepal will be considered within the scope of the agreement.   

M. Anti Corruption USAID/Nepal is committed to anti-corruption efforts. If, during implementation of projects, one or more of the intended beneficiaries (community, subcontractor/grantee, local government official or other) significantly impedes progress or completion of a project (e.g., through bribe demand or threats to the safety of staff), the Recipient must inform USAID/Nepal. The Recipient and USAID/Nepal will consult on the appropriate course of action, which may include halting the project until the issue is resolved. USAID reserves its rights to exercise any and all other remedies under this agreement.

[END OF SECTION C]

SECTION D: CERTIFICATIONS, ASSURANCES, AND OTHER STATEMENTS OF RECIPIENT (May 2006)

Note: [1] When these Certifications, Assurances, and Other Statements of Recipient are used for cooperative agreements, the term “Grant” means “Cooperative Agreement”. [2] The Recipient must obtain from each identified sub-grantee and (sub) contractor, and submit with its application/proposal, the Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion – Lower Tier Transactions. The Recipient should reproduce additional copies as necessary.

PART I - CERTIFICATIONS AND ASSURANCES 1. ASSURANCE OF COMPLIANCE WITH LAWS AND REGULATIONS GOVERNING NON-DISCRIMINATION IN FEDERALLY ASSISTED PROGRAMS (a) The Recipient hereby assures that no person in the United States shall, on the bases set forth below, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under, any program or activity receiving financial assistance from USAID, and that with respect to the grant for which application is being made, it will comply with the requirements of:

(1) Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352, 42 U.S.C. 2000-d), which prohibits discrimination on the basis of race, color or national origin, in programs and activities receiving Federal financial assistance; (2) Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), which prohibits discrimination on the basis of handicap in programs and activities receiving Federal financial assistance;

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(3) The Age Discrimination Act of 1975, as amended (Pub. L. 95-478), which prohibits discrimination based on age in the delivery of services and benefits supported with Federal funds; (4) Title IX of the Education Amendments of 1972 (20 U.S.C. 1681, et seq.), which prohibits discrimination on the basis of sex in education programs and activities receiving Federal financial assistance (whether or not the programs or activities are offered or sponsored by an educational institution); and (5) USAID regulations implementing the above nondiscrimination laws, set forth in Chapter II of Title 22 of the Code of Federal Regulations.

(b) If the Recipient is an institution of higher education, the Assurances given herein extend to admission practices and to all other practices relating to the treatment of students or clients of the institution, or relating to the opportunity to participate in the provision of services or other benefits to such individuals, and shall be applicable to the entire institution unless the Recipient establishes to the satisfaction of the USAID Administrator that the institution's practices in designated parts or programs of the institution will in no way affect its practices in the program of the institution for which financial assistance is sought, or the beneficiaries of, or participants in, such programs. (c) This assurance is given in consideration of and for the purpose of obtaining any and all Federal grants, loans, contracts, property, discounts, or other Federal financial assistance extended after the date hereof to the Recipient by the Agency, including installment payments after such date on account of applications for Federal financial assistance which was approved before such date. The Recipient recognizes and agrees that such Federal financial assistance will be extended in reliance on the representations and agreements made in this Assurance, and that the United States shall have the right to seek judicial enforcement of this Assurance. This Assurance is binding on the Recipient, its successors, transferees, and assignees, and the person or persons whose signatures appear below are authorized to sign this Assurance on behalf of the Recipient.

2. CERTIFICATION REGARDING LOBBYING The undersigned certifies, to the best of his or her knowledge and belief, that: (a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan, or cooperative agreement. (b) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. (c) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under

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grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, United States Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Statement for Loan Guarantees and Loan Insurance The undersigned states, to the best of his or her knowledge and belief, that: If any funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this commitment providing for the United States to insure or guarantee a loan, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. Submission of this statement is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required statement shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

3. CERTIFICATION REGARDING TERRORIST FINANCING IMPLEMENTING E.O. 13224

By signing and submitting this application, the prospective Recipient provides the certification set out below:

1. The Recipient, to the best of its current knowledge, did not provide, within the previous ten years, and will take all reasonable steps to ensure that it does not and will not knowingly provide, material support or resources to any individual or entity that commits, attempts to commit, advocates, facilitates, or participates in terrorist acts, or has committed, attempted to commit, facilitated, or participated in terrorist acts, as that term is defined in paragraph 3.

2. The following steps may enable the Recipient to comply with its obligations under paragraph 1:

a. Before providing any material support or resources to an individual or entity, the Recipient will verify that the individual or entity does not (i) appear on the master list of Specially Designated Nationals and Blocked Persons, which list is maintained by the U.S. Treasury's Office of Foreign Assets Control (OFAC) and is available online at OFAC's website : http://www.treas.gov/offices/eotffc/ofac/sdn/t11sdn.pdf, or (ii) is not included in any supplementary information concerning prohibited individuals or entities that may be provided by USAID to the Recipient.

b. Before providing any material support or resources to an individual or entity, the Recipient also will verify that the individual or entity has not been designated by the United Nations Security (UNSC) sanctions committee established under UNSC Resolution 1267 (1999) (the "1267 Committee") [individuals and entities linked to the Taliban, Usama bin Laden, or the Al Qaida Organization]. To determine whether there has been a published designation of an individual or entity by the 1267 Committee, the Recipient must refer to the consolidated list available online at the Committee's website: http://www.un.org/Docs/sc/committees/1267/1267ListEng.htm

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c. Before providing any material support or resources to an individual or entity, the Recipient will consider all information about that individual or entity of which it is aware and all public information that is reasonably available to it or of which it should be aware.

d. The Recipient also will implement reasonable monitoring and oversight procedures to safeguard against assistance being diverted to support terrorist activity.

3. For purposes of this Certification-

a. "Material support and resources" means currency or monetary instruments or financial securities, financial services, lodging, training, expert advice or assistance, safehouses, false documentation or identification, communications equipment, facilities, weapons, lethal substances, explosives, personnel, transportation, and other physical assets, except medicine or religious materials."

b. "Terrorist act" means-

(i) an act prohibited pursuant to one of the 12 United Nations Conventions and Protocols related to terrorism (see UN terrorism conventions Internet site: http://untreaty.un.org/English/Terrorism.asp); or

(ii) an act of premeditated, politically motivated violence perpetrated against noncombatant targets by subnational groups or clandestine agents; or

(iii) any other act intended to cause death or serious bodily injury to a civilian, or to any other person not taking an active part in hostilities in a situation of armed conflict, when the purpose of such act, by its nature or context, is to intimidate a population, or to compel a government or an international organization to do or to abstain from doing any act.

c. "Entity" means a partnership, association, corporation, or other organization, group or subgroup.

d. References in this Certification to the provision of material support and resources shall not be deemed to include the furnishing of USAID funds or USAID-financed commodities to the ultimate beneficiaries of USAID assistance, such as Recipients of food, medical care, micro-enterprise loans, shelter, etc., unless the Recipient has reason to believe that one or more of these beneficiaries commits, attempts to commit, advocates, facilitates, or participates in terrorist acts, or has committed, attempted to commit, facilitated or participated in terrorist acts.

e. The Recipient's obligations under paragraph 1 are not applicable to the procurement of goods and/or services by the Recipient that are acquired in the ordinary course of business through contract or purchase, e.g., utilities, rents, office supplies, gasoline, etc., unless the Recipient has reason to believe that a vendor or supplier of such goods and services commits, attempts to commit, advocates, facilitates, or participates in terrorist acts, or has committed, attempted to commit, facilitated or participated in terrorist acts.

This Certification is an express term and condition of any agreement issued as a result of this application, and any violation of it shall be grounds for unilateral termination of the agreement by USAID prior to the end of its term.

4. KEY INDIVIDUAL CERTIFICATION NARCOTICS OFFENSES AND DRUG TRAFFICKING

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I hereby certify that within the last ten years: 1. I have not been convicted of a violation of, or a conspiracy to violate, any law or regulation of the United States or any other country concerning narcotic or psychotropic drugs or other controlled substances. 2. I am not and have not been an illicit trafficker in any such drug or controlled substance. 3. I am not and have not been a knowing assistor, abettor, conspirator, or colluder with others in the illicit trafficking in any such drug or substance. NOTICE: 1. You are required to sign this Certification under the provisions of 22 CFR Part 140, Prohibition on Assistance to Drug Traffickers. These regulations were issued by the Department of State and require that certain key individuals of organizations must sign this Certification. 2. If you make a false Certification you are subject to U.S. criminal prosecution under 18 U.S.C. 1001.

5. PARTICIPANT CERTIFICATION NARCOTICS OFFENSES AND DRUG TRAFFICKING

1. I hereby certify that within the last ten years:

a. I have not been convicted of a violation of, or a conspiracy to violate, any law or regulation of the United States or any other country concerning narcotic or psychotropic drugs or other controlled substances. b. I am not and have not been an illicit trafficker in any such drug or controlled substance. c. I am not or have not been a knowing assistor, abettor, conspirator, or colluder with others in the illicit trafficking in any such drug or substance.

2. I understand that USAID may terminate my training if it is determined that I engaged in the above conduct during the last ten years or during my USAID training.

NOTICE: If you make a false Certification you are subject to U.S. criminal prosecution under 18 U.S.C. 1001.

6. CERTIFICATION OF RECIPIENT

By signing below the Recipient provides certifications and assurance for (1) the Assurance of Compliance with Laws and Regulations Governing Non-Discrimination in Federally Assisted Programs, (2) the Certification Regarding Lobbying, (3) the Certification Regarding Terrorist Financing Implementing Executive Order 13224, (4) the Key Individual Certification Narcotics Offenses and Drug Trafficking and (5) the Participant Certification Narcotics Offenses and Drug Trafficking, above.

RFA No.:___________________________________________

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Application No.:_____________________________________

Date of Application:__________________________________

Name of Recipient:___________________________________

Typed Name and Title:________________________________

Signature:__________________________________________

Date:______________________________________________

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PART II - OTHER STATEMENTS OF RECIPIENT 1. AUTHORIZED INDIVIDUALS The Recipient represents that the following persons are authorized to negotiate on its behalf with the Government and to bind the Recipient in connection with this application or grant: Name Title Telephone No. Facsimile No. ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________

2. TAXPAYER IDENTIFICATION NUMBER (TIN) If the Recipient is a U.S. organization, or a foreign organization which has income effectively connected with the conduct of activities in the U.S. or has an office or a place of business or a fiscal paying agent in the U.S., please indicate the Recipient's TIN: TIN: ________________________________

3. CONTRACTOR IDENTIFICATION NUMBER - DATA UNIVERSAL NUMBERING SYSTEM (DUNS) NUMBER (a) In the space provided at the end of this provision, the Recipient must supply the Data Universal Numbering System (DUNS) number applicable to that name and address. Recipients must take care to report the number that identifies the Recipient's name and address exactly as stated in the proposal. (b) The DUNS is a 9-digit number assigned by Dun and Bradstreet Information Services. If the Recipient does not have a DUNS number, the Recipient should call Dun and Bradstreet directly at 1-800-333-0505. A DUNS number will be provided immediately by telephone at no charge to the Recipient. The Recipient must be prepared to provide the following information: (1) Recipient's name. (2) Recipient's address. (3) Recipient's telephone number. (4) Line of business. (5) Chief executive officer/key manager. (6) Date the organization was started. (7) Number of people employed by the Recipient. (8) Company affiliation. (c) Recipients located outside the United States may obtain the location and phone number of the local Dun and Bradstreet Information Services office from the Internet Home Page at http://www.dbisna.com/dbis/customer/custlist.htm. If an offeror is unable to locate a local service center, it may send an e-mail to Dun and Bradstreet at globalinfo@dbisma.com.

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The DUNS system is distinct from the Federal Taxpayer Identification Number (TIN) system. DUNS: ________________________________________

4. LETTER OF CREDIT (LOC) NUMBER If the Recipient has an existing Letter of Credit (LOC) with USAID, please indicate the LOC number: LOC: _________________________________________

5. PROCUREMENT INFORMATION (a) Applicability. This applies to the procurement of goods and services planned by the Recipient (i.e., contracts, purchase orders, etc.) from a supplier of goods or services for the direct use or benefit of the Recipient in conducting the program supported by the grant, and not to assistance provided by the Recipient (i.e., a subgrant or subagreement) to a subgrantee or subrecipient in support of the subgrantee's or subrecipient's program. Provision by the Recipient of the requested information does not, in and of itself, constitute USAID approval. (b) Amount of Procurement. Please indicate the total estimated dollar amount of goods and services which the Recipient plans to purchase under the grant: $__________________________ (c) Nonexpendable Property. If the Recipient plans to purchase nonexpendable equipment which would require the approval of the Agreement Officer, please indicate below (using a continuation page, as necessary) the types, quantities of each, and estimated unit costs. Nonexpendable equipment for which the Agreement Officer's approval to purchase is required is any article of nonexpendable tangible personal property charged directly to the grant, having a useful life of more than one year and an acquisition cost of $5,000 or more per unit. TYPE/DESCRIPTIONQUANTITYESTIMATED UNIT COST

(d) Source, Origin, and Componentry of Goods. If the Recipient plans to purchase any goods/commodities which are not of U.S. source and/or U.S. origin, please indicate below (using a continuation page, as necessary) the types and quantities of each, estimated unit costs of each, and probable source and/or origin. "Source" means the country from which a commodity is shipped to the cooperating country or the cooperating country itself if the commodity is located therein at the time of purchase. However, where a commodity is shipped from a free port or bonded warehouse in the form in which received therein, "source" means the country from which the commodity was shipped to the free port or bonded warehouse. Any commodity whose source is a non-Free World country is ineligible for USAID financing. The "origin" of a commodity is the country or area in which a commodity is mined, grown, or produced. A commodity is produced when, through manufacturing, processing, or substantial and major assembling of components, a commercially recognized new commodity results, which is substantially different in basic characteristics or in purpose or utility from its components. Merely packaging various items together for a particular procurement or relabeling items does not constitute production of a commodity. Any commodity

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whose origin is a non-Free World country is ineligible for USAID financing. "Components" are the goods which go directly into the production of a produced commodity. Any component from a non-Free World country makes the commodity ineligible for USAID financing. TYPE/DESCRIPTIONQUANTITYESTIMATED GOODSPROBABLE GOODSPROBABLE (Generic)ESTIMATED UNIT COSTGOODS COMPONENTSPROBABLE SOURCEGOODS COMPONENTSPROBABLE ORIGIN

(e) Restricted Goods. If the Recipient plans to purchase any restricted goods, please indicate below (using a continuation page, as necessary) the types and quantities of each, estimated unit costs of each, intended use, and probable source and/or origin. Restricted goods are Agricultural Commodities, Motor Vehicles, Pharmaceuticals, Pesticides, Rubber Compounding Chemicals and Plasticizers, Used Equipment, U.S. Government-Owned Excess Property, and Fertilizer. TYPE/DESCRIPTIONQUANTITYESTIMATED UNIT COSTPROBABLE SOURCEPROBABLE ORIGININTENDED USE

(f) Supplier Nationality. If the Recipient plans to purchase any goods or services from suppliers of goods and services whose nationality is not in the U.S., please indicate below (using a continuation page, as necessary) the types and quantities of each good or service, estimated costs of each, probable nationality of each non-U.S. supplier of each good or service, and the rationale for purchasing from a non-U.S. supplier. Any supplier whose nationality is a non-Free World country is ineligible for USAID financing. TYPE/DESCRIPTIONQUANTITYESTIMATED UNIT COSTPROBABLE SUPPLIERPROBABLE NATIONALITYRATIONALE FOR NON-U.S.

(g) Proposed Disposition. If the Recipient plans to purchase any nonexpendable equipment with a unit acquisition cost of $5,000 or more, please indicate below (using a continuation page, as necessary) the proposed disposition of each such item. Generally, the Recipient may either retain the property for other uses and make compensation to USAID (computed by applying the percentage of federal participation in the cost of the original program to the current fair market value of the property), or sell the property and reimburse USAID an amount computed by applying to the sales proceeds the percentage of federal participation in the cost of the original program (except that the Recipient may deduct from the federal share $500 or 10% of the proceeds, whichever is greater, for selling and handling expenses), or donate the property to a host country institution, or otherwise dispose of the property as instructed by USAID.

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TYPE/DESCRIPTIONQUANTITYESTIMATED UNIT COSTPROPOSED DISPOSITION

6. PAST PERFORMANCE REFERENCES On a continuation page, please provide a list of the ten most current U.S. Government and/or privately-funded contracts, grants, cooperative agreements, etc., and the name, address, and telephone number of the Contract/Agreement Officer or other contact person.

7. TYPE OF ORGANIZATION The Recipient, by checking the applicable box, represents that - (a) If the Recipient is a U.S. entity, it operates as [ ] a corporation incorporated under the laws of the State of, [ ] an individual, [ ] a partnership, [ ] a nongovernmental nonprofit organization, [ ] a state or loc al governmental organization, [ ] a private college or university, [ ] a public college or university, [ ] an international organization, or [ ] a joint venture; or (b) If the Recipient is a non-U.S. entity, it operates as [ ] a corporation organized under the laws of _____________________________ (country), [ ] an individual, [ ] a partnership, [ ] a nongovernmental nonprofit organization, [ ] a nongovernmental educational institution, [ ] a governmental organization, [ ] an international organization, or [ ] a joint venture.

8. ESTIMATED COSTS OF COMMUNICATIONS PRODUCTS The following are the estimate(s) of the cost of each separate communications product (i.e., any printed material [other than non-color photocopy material], photographic services, or video production services) which is anticipated under the grant. Each estimate must include all the costs associated with preparation and execution of the product. Use a continuation page as necessary.

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59

PART III -Survey on Ensuring Equal Opportunity for ApplicantsOMB No. 1890-0014 Exp. 1/31/2006

Purpose: The Federal government is committed to ensuring that all qualified applicants, small or large, non-religious or faith-based, have an equal opportunity to compete for Federal funding. In order for us to better understand the population of applicantsfor Federal funds, we are asking nonprofit private organizations (not including private universities) to fill out this survey.

Upon receipt, the survey will be separated from the application. Information on the survey will not be considered in anyway in making funding decisions and will not be included in the Federal grants database. While your help in this data collectionprocess is greatly appreciated, completion of this survey is voluntary.

Instructions for Submitting the Survey: If you are applying using a hard copy application, please place the completed survey inan envelope labeled "Applicant Survey." Seal the envelope and include it along with your application package. If you are applyingelectronically, please submit this survey along with your application.

Applicant's (Organization) Name: _______________________________________________________________________

Applicant's DUNS Number: ____________________________________________________________________________

Grant Name: _______________________________________________________________CFDA Number: ____________

1. Does the applicant have 501(c)(3) status?

2. How many full-time equivalent employees doesthe applicant have? (Check only one box).

3. What is the size of the applicant's annual budget?(Check only one box.)

4. Is the applicant a faith-based/religiousorganization?

5. Is the applicant a non-religious community basedorganization?

6. Is the applicant an intermediary that will managethe grant on behalf of other organizations?

7. Has the applicant ever received a governmentgrant or contract (Federal, State, or local)?

8. Is the applicant a local affiliate of a nationalorganization?

Yes

3 or Fewer

4-5

6-12

Less than $150,000

$150,000 - $299,999

$300,000 - $499,999

$500,000 - $999,999

$1,000,000 - $4,999,999

$5,000,000 or more

No

15-50

51-100

over 100

Yes

Yes

Yes

Yes

Yes

No

No

No

No

No

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Survey Instructions on Ensuring Equal Opportunity for Applicants

Provide the applicant's (organization)name and DUNS number and thegrant name and CFDA number.

1. 501(c)(3) status is a legal designationprovided on application to the InternalRevenue Service by eligibleorganizations. Some grant programsmay require nonprofit applicants to have501(c)(3) status. Other grant programs donot.

2. For example, two part-time employeeswho each work half-time equal one full-time equivalent employee. If theapplicant is a local affiliate of a nationalorganization, the responses to surveyquestions 2 and 3 should reflect the staffand budget size of the local affiliate.

3. Annual budget means the amount ofmoney our organization spends each year on all of its activities.

4. Self-identify.

5. An organization is considered acommunity-based organization if itsheadquarters/service location shares the same zip code as the clients you serve.

6. An "intermediary" is an organization thatenables a group of small organizations toreceive and manage government funds by administering the grant on theirbehalf.

7. Self-explanatory.

8. Self-explanatory.

Paperwork Burden Statement

According to the Paperwork Reduction Act of1995, no persons are required to respond to acollection of information unless suchcollection displays a valid OMB controlnumber. The valid OMB control number forthis information collection is 1890-0014. Thetime required to complete this information collection is estimated to average five (5)minutes per response, including the time toreview instructions, search existing data resources, gather the data needed, andcomplete and review the informationcollection. If you have any commentsconcerning the accuracy of the timeestimate(s) or suggestions for improvingthis form, please write to:U.S. Departmentof Education, Washington, D.C. 20202-4651.

If you have comments or concernsregarding the status of your individualsubmission of this form, write directly to:Joyce I. Mays, Application Control Center,U.S. Department of Education, 7th and DStreets, SW, ROB-3, Room 3671,Washington, D.C. 20202-4725.

OMB No. 1890-0014 Exp. 1/31/2006

RFA-367-10-000004

PART IV – STANDARD PROVISIONS AND OTHER REQUIREMENTS

1. IMPLEMENTATION OF EXECUTIVE ORDER 13224 ON TERRORIST FINANCING

The Recipient is reminded that U.S. Executive Orders and U.S. law prohibits transactions with, and the provision of resources and support to, individuals and organizations associated with terrorism. It is the legal responsibility of the contractor/Recipient to ensure compliance with these Executive Orders and laws. This provision must be included in all subcontracts/sub-awards issued under this contract/agreement.

2. REVISED REGULATIONS CONCERNING DEBARMENT AND SUSPENSION AND DRUG-FREE WORKPLACE APPLICABLE TO ASSISTANCE

A. DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS (JANUARY 2004)

(1) The Recipient agrees to notify the Agreement Officer immediately upon learning that it or any of its principals:

(a) Are presently excluded or disqualified from covered transactions by any Federal department or agency;

(b) Have been convicted within the preceding three-years period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, receiving stolen property, making false claims, or obstruction of justice; commission of any other offense indicating a lack of business integrity or business honesty that seriously and directly affects your present responsibility;

(c) Are presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1)(b); and

(d) Have had one or more public transactions (Federal, State, or local) terminated for cause or default within the preceding three years.

(2) The Recipient agrees that, unless authorized by the Agreement Officer, it will not knowingly enter into any subagreements or contracts under this grant with a person or entity that is included on the Excluded Parties List System (http://epls.arnet.gov). The Recipient further agrees to include the following provision in any subagreements or contracts entered into under this award:

B. DEBARMENT, SUSPENSION, INELIGIBILITY, AND VOLUNTARY EXCLUSION (DECEMBER 2003)

The Recipient/contractor certifies that neither it nor its principals is presently excluded or disqualified from participation in this transaction by any Federal department or agency.

(1) The policies and procedures applicable to debarment, suspension, and ineligibility under USAID-financed transactions are set forth in 22 CFR Part 208.

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C. DRUG-FREE WORKPLACE (JANUARY 2004)

(1) The Recipient agrees that it will publish a drug-free workplace statement and provide a copy to each employee who will be engaged in the performance of any Federal award. The statement must:

(a) Tell the employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in its workplace;

(b) Specify the actions the Recipient will take against employees for violating that prohibition; and

(c) Let each employee know that, as a condition of employment under any award, he or she

(1) Must abide by the terms of the statement, and

(2) Must notify you in writing if he or she is convicted for a violation of a criminal drug statute occurring in the workplace, and must do so no more than five calendar days after the conviction.

(3) The Recipient agrees that it will establish an ongoing drug-free awareness program to inform employees about

(a) The dangers of drug abuse in the workplace;

(b) Your policy of maintaining a drug-free workplace;

(c) Any available drug counseling, rehabilitation and employee assistance programs; and

(d) The penalties that you may impose upon them for drug abuse violations occurring in the workplace.

(4) Without the Agreement Officer’s expressed written approval, the policy statement and program must be in place as soon as possible, no later than the 30 days after the effective date of this award, or the completion date of this award, whichever occurs first.

(5) The Recipient agrees to immediately notify the Agreement Officer if an employee is convicted of a drug violation in the workplace. The notification must be in writing, identify the employee’s position title, the number of each award on which the employee worked. The notification must be sent to the Agreement Officer within ten calendar days after the Recipient learns of the conviction.

(6) Within 30 calendar days of learning about an employee’s conviction, the Recipient must either

(a) Take appropriate personnel action against the employee, up to and including termination, consistent with the requirements of the Rehabilitation Act of 1973 (29 USC 794), as amended, or

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(b) Require the employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for these purposes by a Federal, State or local health, law enforcement, or other appropriate agency.

(7) The policies and procedures applicable to violations of these requirements are set forth in 22 CFR Part 210.

3. SUPPORTING USAID’S DISABILITY POLICY IN CONTRACTS, GRANTS AND COOPERATIVE AGREEMENTS USAID DISABILITY POLICY - ASSISTANCE (DECEMBER 2004):

(a) The objectives of the USAID Disability Policy are (1) to enhance the attainment of United States foreign assistance program goals by promoting the participation and equalization of opportunities of individuals with disabilities in USAID policy, country and sector strategies, activity designs and implementation; (2) to increase awareness of issues of people with disabilities both within USAID programs and in host countries; (3) to engage other U.S. government agencies, host country counterparts, governments, implementing organizations and other donors in fostering a climate of nondiscrimination against people with disabilities; and (4) to support international advocacy for people with disabilities. The full text of the policy paper can be found at the following website: http://pdf.dec.org/pdf_docs/PDABQ631.pdf.

(b) USAID therefore requires that the Recipient not discriminate against people with disabilities in the implementation of USAID funded programs and that it make every effort to comply with the objectives of the USAID Disability Policy in performing the program under this grant or cooperative agreement. To that end and to the extent it can accomplish this goal within the scope of the program objectives, the Recipient should demonstrate a comprehensive and consistent approach for including men, women and children with disabilities.

4. REVISED STANDARD PROVISIONS FOR NON-GOVERNMENTAL ORGANIZATIONS

APPLICABILITY OF 22 CFR PART 226 (MAY 2005)

(a) All provisions of 22 CFR 226 and all Standard Provisions attached to this agreement are applicable to the Recipient and to sub-recipients which meet the definition of “Recipient” in Part 226, unless a section specifically excludes a sub-recipient from coverage. The Recipient shall assure that sub-recipients have copies of all the attached standard provisions.

(b) For any sub-awards made with Non-U.S. sub-recipients, the Recipient shall include the applicable “Standard Provisions for Non-U.S. Non-Governmental Grantees.” Recipients are required to ensure compliance with sub-recipient monitoring procedures in accordance with OMB Circular A-133.

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5. MARKING UNDER USAID-FUNDED ASSISTANCE INSTRUMENTS:

I. BRANDING STRATEGY - ASSISTANCE (December 2005)

(a) Definitions

Branding Strategy means a strategy that is submitted at the specific request of a USAID Agreement Officer by an Apparently Successful Applicant after evaluation of an application for USAID funding, describing how the program, project, or activity is named and positioned, and how it is promoted and communicated to beneficiaries and host country citizens. It identifies all donors and explains how they will be acknowledged.

Apparently Successful Applicant(s) means the applicant(s) for USAID funding recommended for an award after evaluation, but who has not yet been awarded a grant, cooperative agreement or other assistance award by the Agreement Officer. The Agreement Officer will request that the Apparently Successful Applicants submit a Branding Strategy and Marking Plan. Apparently Successful Applicant status confers no right and constitutes no USAID commitment to an award.

USAID Identity (Identity) means the official marking for the Agency, comprised of the USAID logo and new brandmark, which clearly communicates that our assistance is from the American people. The USAID Identity is available on the USAID website and is provided without royalty, license, or other fee to recipients of USAID-funded grants or cooperative agreements or other assistance awards or sub-awards.

(b) Submission

The Apparently Successful Applicant, upon request of the Agreement Officer, will submit and negotiate a Branding Strategy. The Branding Strategy will be included in and made a part of the resulting grant or cooperative agreement. The Branding Strategy will be negotiated within the time that the Agreement Officer specifies. Failure to submit and negotiate a Branding Strategy will make the applicant ineligible for award of a grant or cooperative agreement. The Apparently Successful Applicant must include all estimated costs associated with branding and marking USAID programs, such as plaques, stickers, banners, press events and materials, and the like.

(c) Submission Requirements

At a minimum, the Apparently Successful Applicant’s Branding Strategy will address the following:

(1) Positioning

What is the intended name of this program, project, or activity?

Guidelines: USAID prefers to have the USAID Identity included as part of the program or project name, such as a "title sponsor," if possible and appropriate. It is acceptable to "co-brand" the title with USAID’s and the Apparently Successful Applicant’s identities. For example: "The USAID and [Apparently Successful Applicant] Health Center."

If it would be inappropriate or is not possible to "brand" the project this way, such as when rehabilitating a structure that already exists or if there are multiple donors, please explain and indicate how you intend to showcase USAID's involvement in publicizing the program or project. For example: School #123, rehabilitated by USAID and [Apparently Successful Applicant]/ [other donors]. Note: the Agency prefers "made possible by (or with) the generous support of the

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American People" next to the USAID Identity in acknowledging our contribution, instead of the phrase "funded by." USAID prefers local language translations.

Will a program logo be developed and used consistently to identify this program? If yes, please attach a copy of the proposed program logo.

Note: USAID prefers to fund projects that do NOT have a separate logo or identity that competes with the USAID Identity.

(2) Program Communications and Publicity

Who are the primary and secondary audiences for this project or program?

Guidelines: Please include direct beneficiaries and any special target segments or influencers. For Example: Primary audience: schoolgirls age 8-12, Secondary audience: teachers and parents–specifically mothers.What communications or program materials will be used to explain or market the program to beneficiaries?

Guidelines: These include training materials, posters, pamphlets, Public Service Announcements, billboards, websites, and so forth.

What is the main program message(s)?

Guidelines: For example: "Be tested for HIV-AIDS" or "Have your child inoculated." Please indicate if you also plan to incorporate USAID’s primary message – this aid is "from the American people" – into the narrative of program materials. This is optional; however, marking with the USAID Identity is required.

Will the recipient announce and promote publicly this program or project to host country citizens? If yes, what press and promotional activities are planned?

Guidelines: These may include media releases, press conferences, public events, and so forth.Note: incorporating the message, “USAID from the American People”, and the USAID Identity is required.

Please provide any additional ideas about how to increase awareness that the American people support this project or program.

Guidelines: One of our goals is to ensure that both beneficiaries and host-country citizens know that the aid the Agency is providing is "from the American people." Please provide any initial ideas on how to further this goal.

(3) Acknowledgements

Will there be any direct involvement from a host-country government ministry? If yes, please indicate which one or ones. Will the recipient acknowledge the ministry as an additional co-sponsor?Note: it is perfectly acceptable and often encouraged for USAID to "co-brand" programs with government ministries.Please indicate if there are any other groups whose logo or identity the recipient will use on program materials and related communications.

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Guidelines: Please indicate if they are also a donor or why they will be visibly acknowledged, and if they will receive the same prominence as USAID.

(d) Award Criteria. The Agreement Officer will review the Branding Strategy for adequacy, ensuring that it contains the required information on naming and positioning the USAID-funded program, project, or activity, and promoting and communicating it to cooperating country beneficiaries and citizens. The Agreement Officer also will evaluate this information to ensure that it is consistent with the stated objectives of the award; with the Apparently Successful Applicant’s cost data submissions; with the Apparently Successful Applicant’s project, activity, or program performance plan; and with the regulatory requirements set out in 22 CFR 226.91. The Agreement Officer may obtain advice and from technical experts while performing the evaluation.

II. MARKING PLAN – ASSISTANCE (December 2005)

(a) Definitions

Marking Plan means a plan that the Apparently Successful Applicant submits at the specific request of a USAID Agreement Officer after evaluation of an application for USAID funding, detailing the public communications, commodities, and program materials and other items that will visibly bear the USAID Identity. Recipients may request approval of Presumptive Exceptions to marking requirements in the Marking Plan.

Apparently Successful Applicant(s) means the applicant(s) for USAID funding recommended for an award after evaluation, but who has not yet been awarded a grant, cooperative agreement or other assistance award by the Agreement Officer. The Agreement Officer will request that Apparently Successful Applicants submit a Branding Strategy and Marking Plan. Apparently Successful Applicant status confers no right and constitutes no USAID commitment to an award, which the Agreement Officer must still obligate.

USAID Identity (Identity) means the official marking for the Agency, comprised of the USAID logo and new brandmark, which clearly communicates that our assistance is from the American people. The USAID Identity is available on the USAID website and USAID provides it without royalty, license, or other fee to recipients of USAID funded grants, cooperative agreements, or other assistance awards or subawards.

Presumptive Exception exempts the applicant from the general marking requirements for a particular USAID-funded public communication, commodity, program material or other deliverable, or a category of USAID-funded public communications, commodities, program materials or other deliverables that would otherwise be required to visibly bear the USAID Identity. The Presumptive Exceptions are: Presumptive Exception (i). USAID marking requirements may not apply if they would compromise the intrinsic independence or neutrality of a program or materials where independence or neutrality is an inherent aspect of the program and materials, such as election monitoring or ballots, and voter information literature; political party support or public policy advocacy or reform; independent media, such as television and radio broadcasts, newspaper articles and editorials; and public service announcements or public opinion polls and surveys (22 C.F.R. 226.91(h)(1)).

Presumptive Exception (ii). USAID marking requirements may not apply if they would diminish the credibility of audits, reports, analyses, studies, or policy recommendations whose data or findings must be seen as independent (22 C.F.R. 226.91(h)(2)).

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Presumptive Exception (iii). USAID marking requirements may not apply if they would undercut host-country government “ownership” of constitutions, laws, regulations, policies, studies, assessments, reports, publications, surveys or audits, public service announcements, or other communications better positioned as “by” or “from” a cooperating country ministry or government official (22 C.F.R. 226.91(h)(3)).

Presumptive Exception (iv). USAID marking requirements may not apply if they would impair the functionality of an item, such as sterilized equipment or spare parts (22 C.F.R. 226.91(h) (4)).

Presumptive Exception (v). USAID marking requirements may not apply if they would incur substantial costs or be impractical, such as items too small or otherwise unsuited for individual marking, such as food in bulk (22 C.F.R. 226.91(h)(5)).

Presumptive Exception (vi). USAID marking requirements may not apply if they would local cultural or social norms, or be considered inappropriate on such items as condoms, toilets, bed pans, or similar commodities (22 C.F.R. 226.91(h)(6)).

Presumptive Exception (vii). USAID marking requirements may not apply if they would conflict with international law (22 C.F.R. 226.91(h)(7)).

(b) Submission. The Apparently Successful Applicant, upon the request of the Agreement Officer, will submit and negotiate a Marking Plan that addresses the details of the public communications, commodities, program materials that will visibly bear the USAID Identity. The marking plan will be customized for the particular program, project, or activity under the resultant grant or cooperative agreement. The plan will be included in and made a part of the resulting grant or cooperative agreement. USAID and the Apparently Successful Applicant will negotiate the Marking Plan within the time specified by the Agreement Officer. Failure to submit and negotiate a Marking Plan will make the applicant ineligible for award of a grant or cooperative agreement. The applicant must include an estimate of all costs associated with branding and marking USAID programs, such as plaques, labels, banners, press events, promotional materials, and so forth in the budget portion of its application. These costs are subject to revision and negotiation with the Agreement Officer upon submission of the Marking Plan and will be incorporated into the Total Estimated Amount of the grant, cooperative agreement or other assistance instrument.

(c) Submission Requirements.

The Marking Plan will include the following:

(1) A description of the public communications, commodities, and program materials that the recipient will be produced as a part of the grant or cooperative agreement and which will visibly bear the USAID Identity. These include:

(i) program, project, or activity sites funded by USAID, including visible infrastructure projects or other programs, projects, or activities that are physical in nature;

(ii) technical assistance, studies, reports, papers, publications, audio-visual productions, public service announcements, Web sites/Internet activities and other promotional, informational, media, or communications products funded by USAID;

(iii) events financed by USAID, such as training courses, conferences, seminars, exhibitions, fairs, workshops, press conferences, and other public activities; and (iv) all commodities financed by USAID, including commodities or equipment provided under humanitarian

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assistance or disaster relief programs, and all other equipment, supplies and other materials funded by USAID, and their export packaging.

(2) A table specifying:

(i) the program deliverables that the recipient will mark with the USAID Identity,

(ii) the type of marking and what materials the applicant will be used to mark the program deliverables with the USAID Identity, and

(iii) when in the performance period the applicant will mark the program deliverables, and where the applicant will place the marking.

(3) A table specifying:

(i) what program deliverables will not be marked with the USAID Identity, and (ii) the rationale for not marking these program deliverables.

(d) Presumptive Exceptions.

(1) The Apparently Successful Applicant may request a Presumptive Exception as part of the overall Marking Plan submission. To request a Presumptive Exception, the Apparently Successful Applicant must identify which Presumptive Exception applies, and state why, in light of the Apparently Successful Applicant’s technical proposal and in the context of the program description or program statement in the USAID Request For Application or Annual Program Statement, marking requirements should not be required.

(2) Specific guidelines for addressing each Presumptive Exception are:

(i) For Presumptive Exception (i), identify the USAID Strategic Objective, Interim Result, or program goal furthered by an appearance of neutrality, or state why the program, project, activity, commodity, or communication is ‘intrinsically neutral.’ Identify, by category or deliverable item, examples of program materials funded under the award for which you are seeking exception 1.

(ii) For Presumptive Exception (ii), state what data, studies, or other deliverables will be produced under the USAID funded award, and explain why the data, studies, or deliverables must be seen as credible.

(iii) For Presumptive Exception (iii), identify the item or media product produced under the USAID funded award, and explain why each item or product, or category of item and product, is better positioned as an item or product produced by the cooperating country government.

(iv) For Presumptive Exception (iv), identify the item or commodity to be marked, or categories of items or commodities, and explain how marking would impair the item’s or commodity’s functionality.

(v) For Presumptive Exception (v), explain why marking would not be cost-beneficial or practical.

(vi) For Presumptive Exception (vi), identify the relevant cultural or social norm, and explain why marking would violate that norm or otherwise be inappropriate.

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(vii) For Presumptive Exception (vii), identify the applicable international law violated by marking.

(3) The Agreement Officer will review the request for adequacy and reasonableness.

In consultation with the Agreement Officer’s Technical Representative Technical Officer and other agency personnel as necessary, the Agreement Officer will approve or disapprove the requested Presumptive Exception. Approved exceptions will be made part of the approved Marking Plan, and will apply for the term of the award, unless provided otherwise.

(e) Award Criteria: The Agreement Officer will review the Marking Plan for adequacy and reasonableness, ensuring that it contains sufficient detail and information concerning public communications, commodities, and program materials that will visibly bear the USAID Identity. The Agreement Officer will evaluate the plan to ensure that it is consistent with the stated objectives of the award; with the applicant’s cost data submissions; with the applicant’s actual project, activity, or program performance plan; and with the regulatory requirements of 22 C.F.R.226.91. The Agreement Officer will approve or disapprove any requested Presumptive Exceptions (see paragraph (d)) on the basis of adequacy and reasonableness. The Agreement Officer may obtain advice and recommendations from technical experts while performing the evaluation.

III. MARKING UNDER USAID-FUNDED ASSISTANCE INSTRUMENTS (December 2005)

(a) Definitions

Commodities mean any material, article, supply, goods or equipment, excluding recipient offices, vehicles, and non-deliverable items for recipient’s internal use, in administration of the USAID funded grant, cooperative agreement, or other agreement or sub-agreement.

Principal Officer means the most senior officer in a USAID Operating Unit in the field, e.g., USAID Mission Director or USAID Representative. For global programs managed from Washington but executed across many countries, such as disaster relief and assistance to internally displaced persons, humanitarian emergencies or immediate post conflict and political crisis response, the Cognizant Principal Officer may be an Office Director, for example, the Directors of USAID/W/Office of Foreign Disaster Assistance and Office of Transition Initiatives. For non-presence countries, the Cognizant Principal Officer is the Senior USAID officer in a regional USAID Operating Unit responsible for the non-presence country, or in the absence of such a responsible operating unit, the Principal U.S Diplomatic Officer in the non-presence country exercising delegated authority from USAID.

Programs mean an organized set of activities and allocation of resources directed toward a common purpose, objective, or goal undertaken or proposed by an organization to carry out the responsibilities assigned to it.

Projects include all the marginal costs of inputs (including the proposed investment) technically required to produce a discrete marketable output or a desired result (for example, services from a fully functional water/sewage treatment facility).

Public communications are documents and messages intended for distribution to audiences external to the recipient’s organization. They include, but are not limited to, correspondence, publications, studies, reports, audio visual productions, and other informational products; applications, forms, press and promotional materials used in connection with USAID funded

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programs, projects or activities, including signage and plaques; Web sites/Internet activities; and events such as training courses, conferences, seminars, press conferences and so forth.

Sub-recipient means any person or government (including cooperating country government) department, agency, establishment, or for profit or nonprofit organization that receives a USAID sub-award, as defined in 22 C.F.R. 226.2.

Technical Assistance means the provision of funds, goods, services, or other foreign assistance, such as loan guarantees or food for work, to developing countries and other USAID recipients, and through such recipients to sub-recipients, in direct support of a development objective – as opposed to the internal management of the foreign assistance program.

USAID Identity (Identity) means the official marking for the United States Agency for International Development (USAID), comprised of the USAID logo or seal and new brandmark, with the tagline that clearly communicates that our assistance is “from the American people.” The USAID Identity is available on the USAID website at www.usaid.gov/branding and USAID provides it without royalty, license, or other fee to recipients of USAID-funded grants, or cooperative agreements, or other assistance awards.

(b) Marking of Program Deliverables

(1) All recipients must mark appropriately all overseas programs, projects, activities, public communications, and commodities partially or fully funded by a USAID grant or cooperative agreement or other assistance award or sub-award with the USAID Identity, of a size and prominence equivalent to or greater than the recipient’s, other donor’s, or any other third party’s identity or logo.

(2) The Recipient will mark all program, project, or activity sites funded by USAID, including visible infrastructure projects (for example, roads, bridges, buildings) or other programs, projects, or activities that are physical in nature (for example, agriculture, forestry, water management) with the USAID Identity. The Recipient should erect temporary signs or plaques early in the construction or implementation phase. When construction or implementation is complete, the Recipient must install a permanent, durable sign, plaque or other marking. (3) The Recipient will mark technical assistance, studies, reports, papers, publications, audio-visual productions, public service announcements, Web sites/Internet activities and other promotional, informational, media, or communications products funded by USAID with the USAID Identity.

(4) The Recipient will appropriately mark events financed by USAID, such as training courses, conferences, seminars, exhibitions, fairs, workshops, press conferences and other public activities, with the USAID Identity. Unless directly prohibited and as appropriate to the surroundings, recipients should display additional materials, such as signs and banners, with the USAID Identity. In circumstances in which the USAID Identity cannot be displayed visually, the recipient is encouraged otherwise to acknowledge USAID and the American people’s support.

(5) The Recipient will mark all commodities financed by USAID, including commodities or equipment provided under humanitarian assistance or disaster relief programs, and all other equipment, supplies, and other materials funded by USAID, and their export packaging with the USAID Identity.

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(6) The Agreement Officer may require the USAID Identity to be larger and more prominent if it is the majority donor, or to require that a cooperating country government’s identity be larger and more prominent if circumstances warrant, and as appropriate depending on the audience, program goals, and materials produced.

(7) The Agreement Officer may require marking with the USAID Identity in the event that the recipient does not choose to mark with its own identity or logo.

(8) The Agreement Officer may require a pre-production review of USAID-funded public communications and program materials for compliance with the approved Marking Plan.

(9) Sub-recipients. To ensure that the marking requirements “flow down'' to sub-recipients of sub-awards, recipients of USAID funded grants and cooperative agreements or other assistance awards will include the USAID-approved marking provision in any USAID funded sub-award, as follows: “As a condition of receipt of this sub-award, marking with the USAID Identity of a size and prominence equivalent to or greater than the recipient’s, sub-recipient’s, other donor’s or third party’s is required. In the event the recipient chooses not to require marking with its own identity or logo by the sub-recipient, USAID may, at its discretion, require marking by the sub-recipient with the USAID Identity.”

(10) Any ‘public communications’, as defined in 22 C.F.R. 226.2, funded by USAID, in which the content has not been approved by USAID, must contain the following disclaimer: “This study/report/audio/visual/other information/media product (specify) is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of [insert recipient name] and do not necessarily reflect the views of USAID or the United States Government.”

(11) The recipient will provide the Agreement Officer’s Technical Representative Technical Officer (AOTR) or other USAID personnel designated in the grant or cooperative agreement with two copies of all program and communications materials produced under the award. In addition, the recipient will submit one electronic or one hard copy of all final documents to USAID’s Development Experience Clearinghouse.

(c) Implementation of marking requirements.

(1) When the grant or cooperative agreement contains an approved Marking Plan, the recipient will implement the requirements of this provision following the approved Marking Plan.

(2) When the grant or cooperative agreement does not contain an approved Marking Plan, the recipient will propose and submit a plan for implementing the requirements of this provision within 60 days after the effective date of this provision. The plan will include:

(i) A description of the program deliverables specified in paragraph (b) of this provision that the recipient will produce as a part of the grant or cooperative agreement and which will visibly bear the USAID Identity.

(ii) the type of marking and what materials the applicant uses to mark the program deliverables with the USAID Identity,

(iii) when in the performance period the applicant will mark the program deliverables, and where the applicant will place the marking,

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(3) The recipient may request program deliverables not be marked with the USAID Identity by identifying the program deliverables and providing a rationale for not marking these program deliverables. Program deliverables may be exempted from USAID marking requirements when:

(i) USAID marking requirements would compromise the intrinsic independence or neutrality of a program or materials where independence or neutrality is an inherent aspect of the program and materials;

(ii) USAID marking requirements would diminish the credibility of audits, reports, analyses, studies, or policy recommendations whose data or findings must be seen as independent;

(iii) USAID marking requirements would undercut host-country government “ownership” of constitutions, laws, regulations, policies, studies, assessments, reports, publications, surveys or audits, public service announcements, or other communications better positioned as “by” or “from” a cooperating country ministry or government official;

(iv) USAID marking requirements would impair the functionality of an item;

(v) USAID marking requirements would incur substantial costs or be impractical;

(vi) USAID marking requirements would offend local cultural or social norms, or be considered inappropriate;

(vii) USAID marking requirements would conflict with international law.

(4) The proposed plan for implementing the requirements of this provision, including any proposed exemptions, will be negotiated within the time specified by the Agreement Officer after receipt of the proposed plan. Failure to negotiate an approved plan with the time specified by the Agreement Officer may be considered as noncompliance with the requirements is provision.

(d) Waivers.

(1) The recipient may request a waiver of the Marking Plan or of the marking requirements of this provision, in whole or in part, for each program, project, activity, public communication or commodity, or, in exceptional circumstances, for a region or country, when USAID required marking would pose compelling political, safety, or security concerns, or when marking would have an adverse impact in the cooperating country. The recipient will submit the request through the Cognizant Technical Officer. The Principal Officer is responsible for approvals or disapprovals of waiver requests.

(2) The request will describe the compelling political, safety, security concerns, or adverse impact that require a waiver, detail the circumstances and rationale for the waiver, detail the specific requirements to be waived, the specific portion of the Marking Plan to be waived, or specific marking to be waived, and include a description of how program materials will be marked (if at all) if the USAID Identity is removed. The request should also provide a rationale for any use of recipient’s own identity/logo or that of a third party on materials that will be subject to the waiver.

(3) Approved waivers are not limited in duration but are subject to Principal Officer review at any time, due to changed circumstances.

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(4) Approved waivers “flow down” to recipients of sub-awards unless specified otherwise. The waiver may also include the removal of USAID markings already affixed, if circumstances warrant.

(5) Determinations regarding waiver requests are subject to appeal to the Principal Officer’s Cognizant Assistant Administrator. The recipient may appeal by submitting a written request to reconsider the Principal Officer’s waiver determination to the Cognizant Assistant Administrator.

(e) Non-retroactivity.

The requirements of this provision do apply to any materials, events, or commodities produced prior to January 2, 2006. The requirements of this provision do not apply to program, project, or activity sites funded by USAID, including visible infrastructure projects (For example, roads, bridges, buildings) or other programs, projects, or activities that are physical in nature (for example, agriculture, forestry, water management) where the construction and implementation of these are complete prior to January 2, 2006 and the period of the grant does not extend past January 2, 2006.

(f) Implementation of marking requirements.

(1) When the grant or cooperative agreement contains an approved Marking Plan, the Recipient will implement the requirements of this provision following the approved Marking Plan.

(2) When the grant or cooperative agreement does not contain an approved Marking Plan, the Recipient will propose and submit a plan for implementing the requirements of this provision within 30 days after the effective date of this provision. The plan will include:

(i) A description of the program deliverables specified in paragraph (b) of this provision that the Recipient will produce as a part of the grant or cooperative agreement and which will visibly bear the USAID Identity.

(ii) the type of marking and what materials the applicant uses to mark the program deliverables with the USAID Identity,

(iii) when in the performance period the applicant will mark the program deliverables, and where the applicant will place the marking,

(3) The Recipient may request program deliverables not be marked with the USAID Identity by identifying the program deliverables and providing a rationale for not marking these program deliverables. Program deliverables may be exempted from USAID marking requirements when:

(i) USAID marking requirements would compromise the intrinsic independence or neutrality of a program or materials where independence or neutrality is an inherent aspect of the program and materials;

(ii) USAID marking requirements would diminish the credibility of audits, reports, analyses, studies, or policy recommendations whose data or findings must be seen as independent;

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(iii) USAID marking requirements would undercut host-country government “ownership” of constitutions, laws, regulations, policies, studies, assessments, reports, publications, surveys or audits, public service announcements, or other communications better positioned as “by” or “from” a cooperating country ministry or government official;

(iv) USAID marking requirements would impair the functionality of an item;

(v) USAID marking requirements would incur substantial costs or be impractical;

(vi) USAID marking requirements would offend local cultural or social norms, or be considered inappropriate;

(vii) USAID marking requirements would conflict with international law.

(4) The proposed plan for implementing the requirements of this provision, including any proposed exemptions, will be negotiated within the time specified by the Agreement Officer after receipt of the proposed plan. Failure to negotiate an approved plan with the time specified by the Agreement Officer may be considered as noncompliance with the requirements is provision.

(g) Waivers.

(1) The Recipient may request a waiver of the Marking Plan or of the marking requirements of this provision, in whole or in part, for each program, project, activity, public communication or commodity, or, in exceptional circumstances, for a region or country, when USAID required marking would pose compelling political, safety, or security concerns, or when marking would have an adverse impact in the cooperating country.

The Recipient will submit the request through the Cognizant Technical Officer. The Principal Officer is responsible for approvals or disapprovals of waiver requests.

(2) The request will describe the compelling political, safety, security concerns, or adverse impact that require a waiver, detail the circumstances and rationale for the waiver, detail the specific requirements to be waived, the specific portion of the Marking Plan to be waived, or specific marking to be waived, and include a description of how program materials will be marked (if at all) if the USAID Identity is removed. The request should also provide a rationale for any use of Recipient’s own identity/logo or that of a third party on materials that will be subject to the waiver.

(3) Approved waivers are not limited in duration but are subject to Principal Officer review at any time, due to changed circumstances.

(4) Approved waivers “flow down” to Recipients of subawards unless specified otherwise. The waiver may also include the removal of USAID markings already affixed, if circumstances warrant.

(5) Determinations regarding waiver requests are subject to appeal to the Principal Officer’s cognizant Assistant Administrator. The Recipient may appeal by submitting a written request to reconsider the Principal Officer’s waiver determination to the cognizant Assistant Administrator.

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(h) Non-retroactivity

The requirements of this provision do not apply to any materials, events, or commodities produced prior to January 2, 2006. The requirements of this provision do not apply to program, project, or activity sites funded by USAID, including visible infrastructure projects (for example, roads, bridges, buildings) or other programs, projects, or activities that are physical in nature (for example, agriculture, forestry, water management) where the construction and implementation of these are complete prior to January 2, 2006 and the period of the grant does not extend past January 2, 2006.

6. VOLUNTARY POPULATION PLANNING ACTIVITIES – MANDATORY REQUIREMENTS (MAY 2006)

Requirements for Voluntary Sterilization Programs

None of the funds made available under this award shall be used to pay for the performance of involuntary sterilization as a method of family planning or to coerce or provide any financial incentive to any individual to practice sterilization.

Prohibition on Abortion-Related Activities

(1) No funds made available under this award will be used to finance, support, or be attributed to the following activities: (i) procurement or distribution of equipment intended to be used for the purpose of inducing abortions as a method of family planning; (ii) special fees or incentives to any person to coerce or motivate them to have abortions; (iii) payments to persons to perform abortions or to solicit persons to undergo abortions; (iv) information, education, training, or communication programs that seek to promote abortion as a method of family planning; and (v) lobbying for or against abortion. The term “motivate”, as it relates to family planning assistance, shall not be construed to prohibit the provision, consistent with local law, of information or counseling about all pregnancy options.

(2) No funds made available under this award will be used to pay for any biomedical research which relates, in whole or in part, to methods of, or the performance of, abortions or involuntary sterilizations as a means of family planning. Epidemiologic or descriptive research to assess the incidence, extent or consequences of abortions is not precluded.

VOLUNTARY POPULATION PLANNING ACTIVITIES – SUPPLEMENTAL REQUIREMENTS (JANUARY 2009)

a. Voluntary Participation and Family Planning Methods:

(1) The recipient agrees to take any steps necessary to ensure that funds made available under this award will not be used to coerce any individual to practice methods of family planning inconsistent with such individual's moral, philosophical, or religious beliefs. Further, the recipient agrees to conduct its activities in a manner which safeguards the rights, health and welfare of all individuals who take part in the program.

(2) Activities which provide family planning services or information to individuals, financed in whole or in part under this agreement, shall provide a broad range of family planning methods and services available in the country in which the activity is conducted or shall provide information to such individuals regarding where such methods and services may be obtained.

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b. Requirements for Voluntary Family Planning Projects

(1) A Family planning project must comply with the requirements of this paragraph.

(2) A project is a discrete activity through which a governmental or nongovernmental organization or public international organization provides family planning services to people and for which funds obligated under this award, or goods or services financed with such funds, are provided under this award, except funds solely for the participation of personnel in short-term, widely attended training conferences or programs.

(3) Service providers and referral agents in the project shall not implement or be subject to quotas or other numerical targets of total number of births, number of family planning acceptors, or acceptors of a particular method of family planning. Quantitative estimates or indicators of the number of births, acceptors, and acceptors of a particular method that are used for the purpose of budgeting, planning, or reporting with respect to the project are not quotas or targets under this paragraph, unless service providers or referral agents in the project are required to achieve the estimates or indicators.

(4) The project shall not include the payment of incentives, bribes, gratuities or financial rewards to (i) any individual in exchange for becoming a family planning acceptor or (ii) any personnel performing functions under the project for achieving a numerical quota or target of total number of births, number of family planning acceptors, or acceptors of a particular method of contraception. This restriction applies to salaries or payments paid or made to personnel performing functions under the project if the amount of the salary or payment increases or decreases based on a predetermined number of births, number of family planning acceptors, or number of acceptors of a particular method of contraception that the personnel affect or achieve.

(5) No person shall be denied any right or benefit, including the right of access to participate in any program of general welfare or health care, based on the person’s decision not to accept family planning services offered by the project.

(6) The project shall provide family planning acceptors comprehensible information about the health benefits and risks of the method chosen, including those conditions that might render the use of the method inadvisable and those adverse side effects known to be consequent to the use of the method. This requirement may be satisfied by providing information in accordance with the medical practices and standards and health conditions in the country where the project is conducted through counseling, brochures, posters, or package inserts.

(7) The project shall ensure that experimental contraceptive drugs and devices and medical procedures are provided only in the context of a scientific study in which participants are advised of potential risks and benefits.

(8) With respect to projects for which USAID provides, or finances the contribution of, contraceptive commodities or technical services and for which there is no subaward or contract under this award, the organization implementing a project for which such assistance is provided shall agree that the project will comply with the requirements of this paragraph while using such commodities or receiving such services.

(9) i) The recipient shall notify USAID when it learns about an alleged violation in a project of the requirements of subparagraphs (3), (4), (5) or (7) of this paragraph;

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ii) The recipient shall investigate and take appropriate corrective action, if necessary, when it learns about an alleged violation in a project of subparagraph (6) of this paragraph and shall notify USAID about violations in a project affecting a number of people over a period of time that indicate there is a systemic problem in the project.

iii) The recipient shall provide USAID such additional information about violations as USAID may request.

c. Additional Requirements for Voluntary Sterilization Programs

(1) None of the funds made available under this award shall be used to pay for the performance of involuntary sterilization as a method of family planning or to coerce or provide any financial incentive to any individual to practice sterilization.

(2) The recipient shall ensure that any surgical sterilization procedures supported in whole or in part by funds from this award are performed only after the individual has voluntarily appeared at the treatment facility and has given informed consent to the sterilization procedure. Informed consent means the voluntary, knowing assent from the individual after being advised of the surgical procedures to be followed, the attendant discomforts and risks, the benefits to be expected, the availability of alternative methods of family planning, the purpose of the operation and its irreversibility, and the option to withdraw consent anytime prior to the operation. An individual's consent is considered voluntary if it is based upon the exercise of free choice and is not obtained by any special inducement or any element of force, fraud, deceit, duress, or other forms of coercion or misrepresentation.

(3) Further, the recipient shall document the patient's informed consent by (i) a written consent document in a language the patient understands and speaks, which explains the basic elements of informed consent, as set out above, and which is signed by the individual and by the attending physician or by the authorized assistant of the attending physician; or (ii) when a patient is unable to read adequately a written certification by the attending physician or by the authorized assistant of the attending physician that the basic elements of informed consent above were orally presented to the patient, and that the patient thereafter consented to the performance of the operation. The receipt of this oral explanation shall be acknowledged by the patient's mark on the certification and by the signature or mark of a witness who shall speak the same language as the patient.

(4) The recipient must retain copies of informed consent forms and certification documents for each voluntary sterilization for a period of three years after performance of the sterilization procedure.

d. Prohibition on Abortion-Related Activities:

(1) No funds made available under this award will be used to finance, support, or be attributed to the following activities: (i) procurement or distribution of equipment intended to be used for the purpose of inducing abortions as a method of family planning; (ii) special fees or incentives to any person to coerce or motivate them to have abortions; (iii) payments to persons to perform abortions or to solicit persons to undergo abortions; (iv) information, education, training, or communication programs that seek to promote abortion as a method of family planning; and (v) lobbying for or against abortion. The term “motivate”, as it relates to family planning assistance, shall not be construed to prohibit the provision, consistent with local law, of information or counseling about all pregnancy options.

(2) No funds made available under this award will be used to pay for any biomedical research which relates, in whole or in part, to methods of, or the performance of, abortions or involuntary

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sterilizations as a means of family planning. Epidemiologic or descriptive research to assess the incidence, extent or consequences of abortions is not precluded.

e. The recipient shall insert this provision in all subsequent subagreements and contracts involving family planning or population activities that will be supported in whole or in part from funds under this award. The term subagreement means subgrants and subcooperative agreements.

7. PROTECTION OF THE INDIVIDUAL AS A RESEARCH SUBJECT (April 1998)

a. Safeguarding the rights and welfare of human subjects involved in research supported by USAID is the responsibility of the organization to which support is awarded. USAID has adopted theCommon Federal Policy for the Protection of Human Subjects, Part 225 of Title 22 of the Code of Federal Regulations (the "Policy"). Additional interpretation, procedures, and implementation guidance of the Policy are found in USAID General Notice entitled "Procedures for the Protection of Human Subjects in Research Supported by USAID," issued April 19, 1995, as from time to time amended. USAID's Cognizant Human Subjects Officer (CHSO) in USAID/W has oversight, guidance, and interpretation responsibility for the Policy.

b. Recipient organizations must comply with USAID policy when humans are the subject of research, as defined in 22 CFR 225.102(d), funded by the grant and recipients must provide "assurance", as required by 22 CFR 225.103, that they follow and abide by the procedures in the Policy. See also Section 5 of the April 19, 1995, USAID General Notice which sets forth activities towhich the Policy is applicable. The existence of a bona fide, applicable assurance approved by the Department of Health and Human Services (HHS) such as the "multiple project assurance" (MPA)will satisfy this requirement. Alternatively, organizations can provide an acceptable writtenassurance to USAID as described in 22 CFR 225.103. Such assurances must be determined by theCHSO to be acceptable prior to any applicable research being initiated or conducted under theaward. In some limited instances outside the U.S., alternative systems for the protection of human subjects may be used provided they are deemed "at least equivalent" to those outlined in Part 225 (See 22 CFR 225.101[h]). Criteria and procedures for making this determination are described in the General Notice cited in the preceding paragraph.

c. Since the welfare of the research subject is a matter of concern to USAID as well as to the organization, USAID staff consultants and advisory groups may independently review and inspect research and research processes and procedures involving human subjects, and based on such findings, the CHSO may prohibit research which presents unacceptable hazards or otherwise fails to comply with USAID procedures. Informed consent documents must include the stipulation that the subject's records may be subject to such review.

8. REPORTING OF FOREIGN TAXES (March 2006)

a. The recipient must annually submit a report by April 16 of the next year.

b. Contents of Report. The report must contain: (i) Contractor/recipient name. (ii) Contact name with phone, fax and email. (iii) Agreement number(s). (iv) Amount of foreign taxes assessed by a foreign government [each foreign government must be listed separately] on commodity purchase transactions valued at $500 or more financed with U.S. foreign assistance funds under this agreement during the prior U.S. fiscal year. (v) Only foreign taxes assessed by the foreign government in the country receiving U.S. assistance is to be reported. Foreign taxes by a third party foreign government are not to be reported. For

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example, if an assistance program for Lesotho involves the purchase of commodities in South Africa using foreign assistance funds, any taxes imposed by South Africa would not be reported in the report for Lesotho (or South Africa). (vi) Any reimbursements received by the Recipient during the period in (iv) regardless of when the foreign tax was assessed and any reimbursements on the taxes reported in (iv) received through March 31. (vii) Report is required even if the recipient did not pay any taxes during the report period. (viii) Cumulative reports may be provided if the recipient is implementing more than one program in a foreign country.

c. Definitions. For purposes of this clause: (i) “Agreement” includes USAID direct and country contracts, grants, cooperative agreements and interagency agreements. (ii) “Commodity” means any material, article, supply, goods, or equipment. (iii) “Foreign government” includes any foreign governmental entity. (iv) “Foreign taxes” means value-added taxes and custom duties assessed by a foreign government on a commodity. It does not include foreign sales taxes.

d. Where. Submit the reports to: [insert address and point of contact at the Embassy Mission orFM/CMP as appropriate. see b. below] [optional with a copy to ]

e. Subagreements. The recipient must include this reporting requirement in all applicablesubcontracts, subgrants and other subagreements. f. For further information see http://www.state.gov/m/rm/c10443.htm.

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OFAC LICENSE 6.

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7.

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[END OF SECTION D]

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SECTION E: ANNEXES

Annex 1Proposed of Geographic Coverage and Districts

(Total 25 Districts)

Eastern Region (3)1. Taplejung2. Sankhuwasava3. Solukhumbu

Central Region (3)4. Dolakha5. Sindhupalchok6. Rasuwa

Western Region (12)7. Rupandehi8. Gorkha9. Lamjung10. Syangja11. Palpa12. Parbat13. Myagdi14. Baglung15. Gulmi16. Arghakhanchi17. Mustang 18. Manag

Mid-western Region (2)19. Bardiya20. Banke

Far-western Region (5)21. Darchula22. Baitadi23. Doti24. Kanchanpur25. Kailali

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Annex 2 - USAID’s Foreign Assistance Strategic Framework

Annex 3 - ABBREVIATIONS

AAPD Acquisition and Assistance Policy DirectivesADD Activity Design DocumentADT Activity Design TeamAOTR Agreement Officer’s Technical Representative ANC Antenatal CareAO Assistance ObjectiveARI Acute Respiratory InfectionASHA Advancing Surveillance, Policies, Prevention, Treatment, Care and Support to Fight

HIV/AIDSAusAID Australian Agency for International DevelopmentBPP Birth Preparedness PackageBCC Behavior Change CommunicationBMI Body Mass IndexCA Cooperative AgreementCAS Country Assistance StrategyCBO Community-based Organization

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CB-IMCI Community-Based Integrated Management of Childhood IllnessCB-NCP Community-Based Newborn Care PackageCFJ Child Fund JapanCHD Child Health DivisionCMAM Community Management of Acute MalnutritionCRS Contraceptive Retail Sales CompanyDACAW Decentralized Assistance to Children and WomenDFID Department for International DevelopmentDHS Demographic and Health SurveyDOHS Department of Health ServicesDHO District Health OfficeDPHO District Public Health OfficerEDP External Development PartnerEH Environmental HealthENA Essential Nutrition ActionsEHA Essential Hygiene ActionsFAO Food and Agriculture OrganizationFCHV Female Community Health VolunteerFHD Family Health DivisionFHI Family Health InternationalFP Family PlanningFSN Foreign Service NationalFTF Feed the FutureGESI Gender Equality and Social InclusionGDP Gross Domestic ProductGHI Global Health InitiativeGMP Growth Monitoring and PromotionGON Government of NepalGTZ German Agency for Technical CooperationHFP Health and Family PlanningHKI Helen Keller InternationalHMIS Health Management Information SystemHTSP Health Timing and Spacing of PregnancyIEE Initial Environmental ExaminationIL Implementation LetterINGO International Non-governmental OrganizationINP Integrated Nutrition ProgramIPC Interpersonal CommunicationIR Intermediate ResultIYCF Infant and Young Child FeedingKAP Knowledge, Attitudes, and PracticesLBW Low Birth WeightLOC Letter of CreditMCH Maternal and Child HealthMCHW Maternal and Child Health WorkerMDG Millennium Development GoalsMNCH Maternal, Neonatal and Child HealthMOF Ministry of FinanceMOHP Ministry of Health and PopulationMOLD Ministry of Local DevelopmentMOU Memorandum of UnderstandingMWCSW Ministry of Women Children and Social Welfare

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MUAC Mid-Upper Arm CircumferenceNAGA Nutrition Assessment and Gap AnalysisNCR Nutrition Rehabilitation CenterNFHP II National Family Health Project IINGO Non-government OrganizationNICRA Negotiated Individual Cost Rate AgreementNHSP-IP Nepal Health Sector Program – Implementation PlanN-MARC Nepal Social Marketing and Franchising Project: AIDS, Reproductive Health, and

Child SurvivalNNAP National Nutrition Action PlanNPC National Planning CommissionNPCS Nutrition Promotion and Consultancy ServiceNYOF Nepalese Youth Opportunity FoundationOFAC Office of Foreign Assets ControlOMB Office of Management and BudgetORC Outreach clinicsORS Oral Rehydration SaltsPMP Performance Monitoring PlanPNC Postnatal CarePPP Public Private PartnershipRFA Request for ApplicationsTIN Taxpayer Identification NumberQA Quality AssuranceRH Reproductive HealthRUTF Ready-to-Use Therapeutic FoodSAM Severe Acute MalnutritionSO Strategic ObjectiveSWAp Sector Wide ApproachTB TuberculosisUMN United Mission for NepalUNICEF United Nations Children’s FundUSAID United States Agency for International DevelopmentUSG United States GovernmentVDC Village Development CommitteesVHW Village Health WorkerWB World BankWFP World Food ProgramWHO World Health Organization

[END OF SECTION E]

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