![](media/image1.jpeg){width="2.7840277777777778in"
height="0.8270833333333333in"}

Issuance Date: March 15, 2007

Closing Date: April 17, 2007

Closing Time: 2:00 PM EST

Subject: Request for Applications (RFA) Number -- M/OAA/GH-07-315

> Partnership for Health and Development Communication Leader with
> Associate Cooperative Agreement (PHDC)

The United States Agency for International Development (USAID) is
seeking applications for a Leader with Associates Cooperative Agreement
from eligible U.S. for-profit, non-profit, or private voluntary
organization registered with USAID for a program titled, "Partnership
for Health and Development Communication Leader with Associate
Cooperative Agreement." The authority for the RFA is found in the
Foreign Assistance Act of 1961, as amended. USAID strongly encourages
applicants to develop consortiums with other responsible organizations
(U.S. or Non-U.S. Organizations).

**Any questions concerning this RFA must be submitted in writing to
Deanna Radwan, Agreement Specialist, via email at <dradwan@usaid.gov> by
March 29, 2007 at 2:00PM EST.**

With this RFA, USAID's objective is to ensure that **Effectiveness and
sustainability of communication programs** are **improved.** USAID seeks
assistance in development communication for programs in health,
environment, economic growth and poverty alleviation, democracy and
governance, social transition, and education. Specifically, USAID is
seeking assistance to:

-   Implement and apply best practices to evidence-based scaled-up
    health and development communication programs.

-   Transfer health and development communication skills and knowledge
    to developing country institutions.

-   Integrate health and development communication within the wider
    public health and development agendas.

-   Generate and share knowledge about effective social and behavior
    change communication programming.

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

Subject to the availability of funds, USAID seeks to competitively award
the Partnership for Health and Development Communication (PHDC) Leader
with Associates (LWA) Cooperative Agreement. USAID reserves the right to
fund any or none of the applications submitted.

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

> 1\. Section A Cooperative Agreement Application Format;
>
> 2\. Section B Selection Criteria;
>
> 3\. Section C Program Description;
>
> 4\. Section D Certifications, Assurances, and Other Statements of
> Applicant;
>
> 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\".

If you decide to submit an application, it must be received by the
closing date and time indicated at the top of this cover letter at the
place designated in the Technical Application Format for receipt of
applications. Applications and modifications thereof shall be submitted
in envelopes with the name and address of the applicant and RFA #:
M/OAA/GH-07-315

Applicants are requested to submit both technical and cost portions of
their applications in separate volumes. Award will be made to that
responsible applicant(s) whose application(s) offers the greatest value.

Issuance of this RFA does not constitute an award commitment on the part
of the Government, nor does it commit the Government to pay for costs
incurred in the preparation and submission of an application. In
addition, final award of any resultant application(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; if
circumstances prevent award of a cooperative agreement, all preparation
and submission costs are at the applicant\'s expense.

The preferred method of distribution of USAID procurement information is
via internet at [www.grants.gov](http://www.grants.gov/). This RFA and
any future amendments can be downloaded from
[http://www.grants.gov](http://www.grants.gov/). Click on "Search for
Grant Opportunity," then click on \"Browse by Agency\" and choose U.S.
Agency for International Development, then click on the Opportunity
titled, "Partnership for Health and Development Communication Leader
with Associate...." If you have difficulty registering or accessing the
RFA, please contact the Grants.gov Helpdesk at 1-800-518-4726 or via
e-mail at <support@grants.gov> for technical assistance. Receipt of this
RFA through grants.gov must be confirmed by written notification to the
contact person noted below. It is the responsibility of the recipient of
the grant 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.

In the event of an 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.

Sincerely,

Eduardo Elia

Agreement Officer

M/OAA/GH/POP

TABLE OF CONTENTS Page

SECTION A -- APPLICATION FORMAT 5

1\. Preparation Guideline 5

2\. Technical Application Format 6

3\. The Outline for the Technical Application 7

4\. Cost Application Format 14

SECTION B - SELECTION CRITERIA [22](#CL_URFASEBHD_PH000001)

SECTION C - PROGRAM DESCRIPTION 26

SECTION D

> PART I - CERTIFICATIONS AND ASSURANCES 44

# Standard Form 424: [[http://www.whitehouse.gov/omb/grants/sf424.pdf]{.underline}](http://www.whitehouse.gov/omb/grants/sf424.pdf), 

> Standard Form 424A:
> **<http://www.whitehouse.gov/omb/grants/sf424a.pdf>**
>
> Standard Form 424B:
> **<http://www.whitehouse.gov/omb/grants/sf424b.pdf>**

SECTION E - ANNEXES 45

# 1. Mandatory Standard Provisions for U.S. Nongovernmental Recipients: <http://www.usaid.gov/policy/ads/300/303mab.pdf> 

# 

2\. Affirmation of Certifications:

# <http://www.usaid.gov/policy/ads/300/303mad.pdf> 

3\. Assessment of Capacity Building Programs of the Health Communication
Partnership: Summary of Recommendations

# 

# SECTION A - APPLICATION FORMAT

## 1. PREPARATION GUIDELINES

All applications received by the deadline will be reviewed for
responsiveness to the specifications outlined in these guidelines and
the application format. Section B, page 22 addresses the technical
selection criteria and evaluation procedures for the applications.
Applications which are submitted late or are incomplete shall not be
considered in the review process. \"Late applications will not be
considered for award\" or \"Late applications will be considered for
award if the Agreement Officer determines it is in the Government\'s
interest.\"

Applications shall be submitted in two separate parts: (a) technical and
(b) cost or business application. Technical portions of applications
must be submitted in an original and 4 copies and cost portions of
applications in an original and 2 copies. All copies of the Technical
and Cost/Business Applications must be separately placed in sealed
envelopes clearly marked on the outside with the following words \"RFA
No. M/OAA/GH-07-315

Volume 1 -- Technical Application" or \"RFA No. M/OAA/GH-07-315 Volume
2 - Cost/Business Application\".

In addition to the above mentioned hard copies, the application must
also be submitted electronically via CD-ROM.

The application must be prepared according to the structural format set
forth below. Applications must be submitted no later than the date and
time indicated on the cover page of this RFA, to the location indicated
on page 6 of this RFA.

Technical applications 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. The applications must take into account the technical selection
criteria and evaluation procedures found in Section B.

**[Eligibility Criteria]{.underline}**

To be eligible for the Cooperative Agreement under this RFA, an
organization must:

a\. Be a U.S. for-profit, non-profit or private voluntary organization
registered with USAID.

b\. Have demonstrated capacity in health and development communication
in developing countries described in this RFA.

c\. Agree to work with and hire individuals who have the technical
expertise to improve development goals by strengthening in-country
health and development communication activities.

d\. Have managerial, technical, and institutional capacities to achieve
the results outlined in this RFA.

e\. Have the capacity to collaborate with other organizations/groups in
undertaking BCC programming across multiple areas such as health,
environment, and democracy and governance.

**2. TECHNICAL APPLICATION FORMAT**

To facilitate the competitive review of the applications, USAID will
**[consider only applications conforming to the format prescribed
below.]{.underline}**

Technical Applications are limited to 35 pages; any application OVER 35
PAGES WILL NOT BE EVALUATED. The thirty-five pages consist of applicant
response to the Technical Application Sections I -- VI presented on
pages 7-14 of this RFA. Applications shall be written in English, text
should be left-justified using Word 2003, Times New Roman, 12 point font
on standard 8 1/2\" x 11\" paper (210 mm by 297mm paper), single spaced,
with each page numbered consecutively, and no less than 1" margins on
all sides. Supplementary materials such as full resumes of personnel,
documentation of past institutional work, and relevant letters of
support may be provided in annexes accompanying the technical
application. There is no page limit for the annexes, although brevity is
encouraged. A proposed application outline (technical and financial) is
given on the following pages of this document.

The suggested format for the technical section is:

1.  Cover Page (included in the 35-page limit) -- Proposed Project title
    or "proposed alternative title", RFA Number and name of
    organization(s) submitting application, contact person, telephone
    and fax numbers, and address.

> 2\. Applicants must submit their applications no later than 2:00 PM
> EST on April 17, 2007. Please note that in order for your application
> to be considered the Original package must be received through
> Grants.gov website by the close date and time specified on the cover
> page of this document. NO EXCEPTIONS.

3.  Application Body. This section represents the technical approach to
    the RFA (see Section 3, pages 7-14). Applicants will retain for
    their records one copy of the application and all enclosures that
    accompany their application. The person signing the application must
    initial erasures or other changes. [USAID requests that the writers
    of the application be explicitly presented]{.underline} in each
    sub-section of the application; this must be included in the Annex
    in a detailed annotated Table of Contents.

Applications shall be submitted in two separate parts: (a) technical and
(b) cost or business application. [Hard copies of both the technical and
cost application must be submitted by the close date to the following
address]{.underline}:

The applicants must submit the full application package to the following
address:

(By U.S. Mail): Ms. Deanna Radwan

> Agreement Specialist
>
> U.S. Agency for International Development
>
> Office of Acquisition & Assistance
>
> RRB 7.09-086, M/OAA/GH
>
> 1300 Pennsylvania Avenue, N.W.
>
> Washington, D.C. 20523-7100

(By Courier Service/Hand Delivery)\*: U.S. Agency for International
Development

> 1300 Pennsylvania Avenue, N.W.
>
> Ronald Reagan Building,
>
> 14th Side Entrance (Visitor's Desk)
>
> Washington, D.C. 20523-7100

\* Please come to the 14th Street Entrance - Visitor's Desk. The
applicants are required to call Ms. Deanna Radwan at (202) 712-0715
using the visitor's phone. The security guards will not accept
applications.

Applicants may submit questions in response to this Application in
writing by March 29, 2007 at 2:00 PM EST. Questions must be sent to
Deanna Radwan/Agreement Specialist via e-mail at <dradwan@usaid.gov>.
SUBJECT line must read: Questions for "Partnership for Health and
Development Communication Leader with Associate Cooperative Agreement."

**3.** **THE OUTLINE FOR THE TECHNICAL APPLICATION IS**:

**I. Brief Executive Summary**:

**II. Technical Approach:** T[he program description covers activities
that will be funded under the Leader Award]{.underline}. The technical
application must address the program description and objectives in
Section C of this document.

Technical applications 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. The application must take into account the technical selection
criteria and evaluation procedures found in Section B.

Applicants will describe how they propose to achieve the overall
strategic objective of this agreement: to ensure "**effectiveness and
sustainability of communication programs improved"** by (1) achieving
the four intermediate results (IRs) on pages 8-9, (2) addressing the
challenges on pages 35-38, and (3) addressing the cross-cutting issues
on pages 39-40. Applicants will also describe how they will demonstrate
global leadership to accomplish the overall strategic objective.
Applicants will assume that this is going to be a project heavily funded
by Field Support (FS) and minimally by core funds. Over the life of
PHDC, core funds are likely to be applied most heavily to IR4 while IRs
1-3 are more likely to be supported by the field. During the first year
of the project, core funds could be used across all IRs and are expected
to stimulate mission interest. Key staff may be funded by core funds
during the first months and gradually phase into field support as it
becomes available. It is envisioned that field support will be used to
both integrate communication programming across various sectors and to
coordinate vertical parallel communication programs.

Partnership for Health and Development Communication (PHDC) is a Leader
with Associates (LWA) Cooperative Agreement. The Leader Agreement is for
programming in health. Programming in environment, democracy and
governance and other areas will be undertaken through Associate Awards.
Applicants should assume a three year ceiling for the Leader of about
\$105 million, with a possible two-year extension of \$70 million;
contingent on performance. Annual core funding for the Leader is
estimated at \$4 - \$5 million/year, about \$3 - \$4 million for family
planning and reproductive health and about \$1 million for HIV/AIDS. The
total Leader ceiling is \$175 million.

For Economic Growth, Agriculture and Trade Associate Award, applicants
should assume about \$250,000 core funding per year and a three-year
ceiling of about \$13 million, with a possible two-year extension of
about \$8.5 million.

**The application must address the following:**

**A. Strategic Objective of the Project: Effectiveness and
sustainability of communication programs improved.** Applicants shall
describe:

-   their vision for PHDC and philosophy of health and development
    communication in developing countries

-   the interrelationship of the SO, IRs, Challenges, and Cross-Cutting
    Issues

-   their approach to cross sector BCC programming

**B. Statement of the Expected Results:**

**[Intermediate Result 1]{.underline}: Evidence-based scaled-up health
and development communication programs implemented and best practices
for behavior change applied.**

> Applicants shall describe:

-   principal activities to be implemented

-   barriers that could hinder progress and suggested solutions

-   how the applicant will exploit innovations in information and
    communication technology

-   expected results and indicators at the end of 2.5 years and five
    years

**[Intermediate Result 2]{.underline}: Health and development
communication skills and knowledge transferred to developing country
institutions.**

> Applicants shall describe:

-   principal activities to be implemented and steps to be taken to
    strengthen in-country BCC institutional capacity and leadership

-   barriers that could hinder progress and suggested solutions

-   expected results and indicators at the end of 2.5 years and five
    years

**[Intermediate Result 3]{.underline}: Health and development
communication integrated within the wider public health and development
agendas.**

> Applicants shall describe:

-   principal activities to be implemented

-   barriers that could hinder progress and suggested solutions

-   the processes to be used to engage and coordinate with USAID
    collaborating agencies, host-country programs, and other donors,
    foundations and alliances

-   expected results and indicators at the end of 2.5 years and five
    years

**[Intermediate Result 4]{.underline}: Effective social and behavior
change communication knowledge generated and shared to address emerging
health and development issues**

> Applicants shall describe:

-   principal activities to be implemented

-   barriers that could hinder progress and suggested solutions

-   how the applicant will build from existing knowledge and reflect
    advances in theory and practice

-   how research institutions will be strengthened to undertake and
    publish BCC studies

-   expected results and indicators at the end of 2.5 years and five
    years

**C. Challenges:**

-   **Understanding and harnessing the determinants of human behavior,
    with a particular focus on social norms**

-   **Cultivating the media and substantially reducing cost of media
    time**

-   **Measuring long-term impact of BCC interventions**

> For each challenge, applicants shall describe:

-   principal activities to be implemented to tackle each challenge

-   barriers that could hinder progress and suggested solutions

-   expected results and indicators at the end of 2.5 years and five
    years, and

-   how meeting the challenge will help achieve the goals for FP/RH,
    HIV/AIDS, and the environment as defined in the hierarchy of the
    Foreign Assistance Reform Framework[^1]

**D. Project Monitoring and Evaluation:**

-   **Monitor results**

-   **Report requirements**

> Applicants shall provide an illustrative performance monitoring plan
> for PHDC that includes the indicators that will be used for the
> strategic objective, IRs, and to evaluate the effectiveness of
> core-funded activities. Applicants shall identify the approximate
> dates for data collection, the method, type, and source of information
> to be collected.

**E. Country Scenarios:** Applicants shall respond to each of the
following country scenarios, in no more than 2 pages for each scenario.
For each scenario, please outline the behavior change communication
approach to influence the key behaviors necessary to achieve health and
development goals. The strategy development may include linkages with
policy initiatives, faith-based and other community-based organizations.
The response will include how cost sharing and public-private
partnerships might be engaged to maximize success and effectiveness, as
well as an explanation of the role of core funds. Monitoring and
evaluation will be suggested along with proposed indicators to gauge
success. For each scenario, the budget is \$1 million/year for 3 years,
a total of \$3 million/scenario; of which \$250,000/year is core
funding.

[Scenario 1]{.underline}

Please develop a behavior change intervention to increase the number of
couples practicing healthy timing and spacing of pregnancies in a
country of your choice. The messages should be consistent with the 2006
WHO Policy Brief on Birth Spacing.[^2] The scenario will be evaluated
according to technical feasibility and how well applicant addresses the
four intermediate results, changing social norms, monitoring and
evaluation, and the budget.

[Scenario 2]{.underline}

Please develop a behavior change intervention to increase the use of
modern contraceptive methods in a country of your choice in which modern
contraceptive prevalence is less than 20 percent. The most recent DHS
survey indicates relatively high levels of unmet need throughout most of
the country. For the past several years the Government has been
improving access to family planning services and consistent availability
of contraceptive supplies. Currently the government is working on an
initiative to promote long-term and permanent methods. In spite of
improved access to services and high unmet need, contraceptive use is
not increasing to any appreciable extent. Please describe the way in
which you would assess the situation, the behaviors that need to change,
and the activities you would undertake to increase modern contraceptive
use, especially use of long term and permanent methods.

[Scenario 3]{.underline}

Applicants shall describe the communication approaches and interventions
and audience segmentation they would use to address the following
HIV/AIDS scenario. Please include communication approaches that target
both individual behavior and social norms. The interventions should be
developed for a country in sub-Saharan Africa with a highly generalized
and growing HIV/AIDS epidemic, in which data show high levels of HIV
infection among young women (18-24 years) and men approximately 10 years
older. There is anecdotal evidence that young women are engaged in
cross-generational and informal transactional sexual relationships, with
complex sexual networks involving concurrent partnerships (both
transactional and non-transactional). Evidence further indicates that
young women perceive these relationships as a means of both gender and
economic empowerment. While HIV awareness is high, risk perception
appears to be very low.

**III. Management Approach:** Applicants shall provide an organizational
chart for implementation of PHDC, illustrate how responsibility and
lines of authority will be managed across all partners, and clearly
address how each partner will be utilized. Describe the strengths that
the prime and each of the partners will contribute to PHDC and describe
how PHDC will be managed to take advantage of each partner's strengths
while maximizing the cohesiveness and integration of PHDC activities;
subcontractors should not present a management burden. The management
plan should also explain how PHDC proposes to interact with other
Cooperating Agencies and Missions. New technical partners are strongly
encouraged.

The management plan for PHDC will need to specify the management and
administrative arrangements for overall implementation of the program
including organizational structure, logistical support, personnel
management, procurement arrangements for goods and services, developing
intranet web portal, dissemination of publications, and the lines of
authority between organizations and staff. This will be specified across
all partners including local in-country partners, and between Leader and
Associate Award activities. The applicant shall show how it proposes to
manage a complex set of activities in multiple countries and regions of
the world and how PHDC country programs and partner agencies will
respond to Mission requests.

Applications shall include:

-   the management and administrative arrangements for overall
    implementation of the program including organizational structure,
    procurement arrangements for goods and services, dissemination of
    publications;

-   how finances will be managed; philosophy on financial disbursement
    to in-country partners, the lines of authority between prime and
    partners, where approval power is located for expenditures of
    Mission funds and of core funds;

-   how project will be managed to take advantage of each partner's
    strengths;

-   how applicant will interact with Bureaus, Regional Offices,
    Missions, Cooperating Agencies and in-country partners;

-   how personnel will be managed, outline the philosophy for managing
    personnel of the prime, partners, and in-country personnel; the
    lines of authority between prime, partners and in-country partners;

-   how the project will work with the media, develop media capacities
    on health issues, and fund media time;

-   how applicant will contain costs,

-   plans for rapid start up of the project,

-   plans for rapid response to Associate Awards during the start-up
    phase.

Similarly, applicants shall present realistic strategies or approaches
for knowledge management and for coordinating with non-USAID supported
organizations, with foreign governments, and their development partners.

Minimal core or field support funds will be used to develop a PHDC web
presence or invest in a content management system or search engine
technology. The PHDC web portal will inform users about the project and
serve as a resource portal for PHDC in-country personnel.

**IV. Personnel Qualifications:** PHDC will have expertise in, or access
to, health and development communication specialists in the fields
included in the RFA. Applicants are requested to develop a comprehensive
staffing plan that will enable achievement of PHDC results and
demonstrate an appropriate balance of skills and accountability. The
staffing pattern will reflect the minimum number of highly experienced
technical staff sufficient to manage and implement PHDC activities under
this award. USAID's intent is to have a sufficient but small core staff
available to provide global leadership in the identification and
application of best practices and for planning, implementing and
assessing health and development communication programs initially for
FP/RH, HIV/AIDS, and environment. Applicants will propose the optimal
mix of technical personnel considered necessary for global leadership.
The staffing level and pattern may be modified over time if needed to
provide effective support to field programs as they evolve.

The applicant will identify the three key personnel by name and
position. A total of three (3) key personnel shall be proposed: the
Project Director, Deputy Director, and Research Lead. Each key personnel
position requires USAID approval, as noted in substantial involvement
provisions (p. 20).

[Project Director]{.underline}: The required attributes of the Project
Director are: a senior manager with an advanced degree (M.A., M.S., or
Ph.D.) in the social sciences, preferred author of peer-reviewed journal
articles on health and development communication, with at least 10 years
experience leading, managing and implementing large international or
national development communication projects in developing countries, and
has experience interacting with U.S. Government agencies. This is a
full-time position; in order to ensure adequate managerial oversight of
the project, it will involve traveling overseas only 10-20 percent of
the time.

[Deputy Project Director]{.underline}: The required attributes of the
Deputy Project Director are: an advanced degree (M.A., M.S., or Ph.D.)
in the social sciences, with at least 5 years experience in health and
development communication in developing countries with a minimum of 5
years implementing and managing large international development
projects. This is a full-time position; in order to ensure adequate
managerial oversight of the project, it will involve traveling overseas
only 10-20 percent of the time.

[Research and Evaluation Director]{.underline}: The required attributes
of the Research and Evaluation Director are an advanced degree (M.A.,
M.S. or Ph.D.) in psychology, social psychology, or a related field;
experience in conducting and applying cutting-edge research in health
and development communication in areas such as fertility desires, safe
sexual behavior; reducing unmet need for contraception, and other key
social norms; as well as the capability to design and oversee the
project's on-going evaluations of its innovative behavior change
programming.

It is expected that by the end of the second year of the project, at
least 55% of the PHDC staff will be located in developing countries and
by the end of the third year, 75% of the staff will be located overseas;
and that by years 2 and 3, 70% and 85%, respectively, of the staff will
be local nationals working in their respective countries. By the end of
the third (3^rd^) year, PHDC will make every effort to ensure the
majority of the Chiefs of Party are in-country nationals. It is expected
that field personnel will have decision-making and financial authority
to manage country programs and that the management structure within PHDC
will be flexible and adaptable to Mission requirements. It is also
expected that country staff will be leaders in BCC programming.

The section on personnel capability in the main body of the application
will include brief statements of major duties, experience, academic
background and resumes for each of the three (3) key personnel and other
senior program staff. Resumes for key personnel, other senior program
staff and any long-term professional staff/advisors will be limited to 4
pages in length and should be included in the annexes. The annexes
(which are beyond the 35-page limit) will include letters of intent to
participate for at least two years post award for those not already
employed by the proposing organization and letters of commitment from
proposed key personnel.

Please provide a roster of all senior core staff and at least twenty
non-U.S.-based experts who are likely to assist with program activities
and can address the broad range of BCC programming envisioned in the RFA
on an as-needed basis. Resumes and letters of intent to participate for
at least an initial two-year period will be included in the annexes.

Applicants are invited to propose and justify an alternative staffing
structure, including a different configuration of key staff positions,
if they feel that a different structure is more conducive to achieving
the desired project results.

**V. Organizational Past Performance:** The applicant and subcontractors
shall include a minimum of three (3) past performance examples from the
prime or the consortium with accompanying references that can validate
that the work was accomplished. The examples must be for the past five
(5) years for current public or private sector type awards for efforts
similar to this requirement (i.e. examples must be where the partner
provided a significant contribution to the overall objective). Identify
the program activities as it relates to Section C - Program Description.
The reference information shall include the location, current telephone
number, e-mail addresses, point of contact, award number, dollar value,
and brief description of work performed.

-   Applicant(s) must demonstrate the ability to provide or acquire
    technical accomplishment in development communication for health and
    more specifically in FP/RH and HIV/AIDS; natural resource management
    and biodiversity conservation; and democracy and governance;

-   Applicant(s) must demonstrate ability to form strong partnerships
    with a range of research and advocacy institutions/organizations in
    both the U.S. and host countries;

-   Applicant(s) must demonstrate the degree to which the applicant is
    reported to have been effective, efficient, capable, reasonable and
    cooperative;

-   Applicant(s) must demonstrate whether the applicant conformed to the
    terms and conditions of the contract/agreement/grant application;
    and client satisfaction.

**Applicants shall describe the institutional capability of the proposed
prime and subcontractors** and show that they have the array of skills
needed to effectively address the issues within the scope of PHDC, can
produce results and innovations in health and development communication
in developing countries, and that the prime has the ability to work with
multiple partners and to report results and financial information to
each partner. Applicants shall demonstrate their institutional ability
to plan, implement, and support complex programming and the range of
activities outlined in the RFA.

Organizations lacking relevant past performance history shall be given a
"neutral" past performance rating that neither rewards nor penalizes
those applicants.

**Cost Share:** Applicant will be evaluated on their ability to maximize
cost share. At a minimum the cost share requirement for the Leader Award
is 10%. Applicants shall be evaluated on the effectiveness, cost
efficiency and matching resources that the leader award and its partners
bring to the implementation of the Leader Award.

**[Applications that do not meet at least the minimum cost-share
requirement are not eligible for award consideration.]{.underline}**

**VI. Annexes**: Maps of the Activity Areas and relevant letters of
support (i.e. letter(s) of program support from a local government,
letter(s) from a partnering organization expressing their intention to
engage in a partnership, or a letter from a donor making a funding
commitment, as well as past performance references).

## 4. COST APPLICATION FORMAT

The Cost or Business Application is to be submitted under separate cover
from the technical application. Certain documents are required to be
submitted by an applicant in order for a Grant 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 sections describe the documentation that applicants for
Assistance award must submit to USAID prior to award. While there is no
page limit for this portion, applicants are encouraged to be as concise
as possible, but still provide the necessary detail to address the
following:

A. Applicants must include a detailed five-year budget with accompanying
budget narrative for the **[Leader Award only]{.underline}**, which
provides in detail the total costs for implementation of the program
your organization is proposing. The total estimated amount for this
budget over 5 years is \$175 million. The information from the detailed
budget must then be included on the Standard Form 424 and 424A which can
be downloaded from the following links
[[http://www.whitehouse.gov/omb/grants/sf424.pdf]{.underline}](http://www.whitehouse.gov/omb/grants/sf424.pdf)
(Standard Form 424) and
[[http://www.whitehouse.gov/omb/grants/sf424a.pdf]{.underline}](http://www.whitehouse.gov/omb/grants/sf424a.pdf)
(Standard Form 424A).

\- the breakdown of all costs associated with the program according to
costs of, if applicable, headquarters, regional and/or country offices;
project management and administrative costs will be shared equitably
across all funding sources.

\- the breakdown of all costs according to each partner organization
involved in the program;

\- the costs associated with external, expatriate technical assistance
and those associated with local in-country technical assistance;

\- the breakdown of the financial and in-kind contributions of all
organizations involved in implementing this Cooperative Agreement;

\- potential contributions of non-USAID or private commercial donors to
this Cooperative Agreement;

\- your procurement plan for commodities (note that contraceptives and
other health commodities will not be provided under this Cooperative
Agreement).

B. A current Negotiated Indirect Cost Rate Agreement;

C. Required certifications and representations (See Section D):

D. Cost share has been required to be 10% of the total estimated amount
for the Leader Award. If the applicant proposes a cost share of less
than 10%, it will be deemed as not responsive, and will be removed from
further consideration. Under individual Associate Awards cost-sharing
may be individually negotiated as deemed appropriate by each Mission or
Bureau.

Such funds may be contributed from the recipient; other multilateral,
bilateral, and foundation donors; host governments; and local
organizations, communities and private businesses that contribute
financially and in-kind to implementation of activities at the country
level. For consortium or partner type relationships, the cost share may
be distributed amongst the various partners; but ultimately the
organization that is awarded this LWA is responsible for meeting the 10%
cost share. The cost share whether it be in-kind or dollars must have a
direct impact on this program.

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

1\. 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;

2\. projected budget, cash flow and organizational chart;

3\. a copy of the organization\'s accounting manual.

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

1\. Has adequate financial resources or the ability to obtain such
resources as required during the performance of the award.

2\. Has the ability to comply with the award conditions, taking into
account all existing and currently prospective commitments of the
applicant, nongovernmental and governmental.

3\. Has a satisfactory record of performance. Past relevant
unsatisfactory performance is ordinarily sufficient to justify a finding
of non-responsibility, unless there is clear evidence of subsequent
satisfactory performance.

4\. Has a satisfactory record of integrity and business ethics; and

5\. Is otherwise qualified and eligible to receive a grant under
applicable laws and regulations (e.g., EEO).

G. 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.

In addition to the aforementioned guidelines, the applicant is requested
to take note of the following:

H. Unnecessarily Elaborate Applications - 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 art work, expensive paper and bindings,
and expensive visual and other presentation aids are neither necessary
nor wanted.

I. Acknowledgement of Amendments to the RFA - Applicants shall
acknowledge receipt of any amendment to this RFA by signing and
returning the amendment. The Government must receive the acknowledgement
by the time specified for receipt of applications.

J. Receipt of Applications - Applications must be received at the place
designated and by the date and time specified in the cover letter of
this RFA.

K. Submission of Applications:

1\. Applications and modifications thereof shall be submitted in sealed
envelopes or packages (1) addressed to the office specified in the Cover
Letter of this RFA, and (2) showing the time specified for receipt, the
RFA number, and the name and address of the applicant.

L. Preparation of Applications:

1\. Applicants are expected to review, understand, and comply with all
aspects of this RFA. Failure to do so will be at the applicant\'s risk.

2\. Each applicant shall furnish the information required by this RFA.
The applicant shall 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.

3\. 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:

\(a\) 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, a grant 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 grant. 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 ; and

\(b\) 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.\"

M. Explanation to Prospective Applicants - Any prospective applicant
desiring an explanation or interpretation of this RFA must request it in
writing by March 29, 2007 at 2:00PM EST to allow a reply to reach all
prospective applicants before the submission of their applications. Oral
explanations or instructions given before award of a Grant 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.

N. Cooperative Agreement Award:

1\. The Government may make an award resulting from this RFA to the
responsible applicant(s) whose application(s) conforming to this RFA
offers the greatest value (see also Section II of this RFA). The
Government may (a) reject any or all applications, (b) accept other than
the lowest cost application, (c) accept more than one application (see
Section III, Selection Criteria), (d) accept alternate applications, and
(e) waive informalities and minor irregularities in applications
received.

2\. The Government may make an 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.

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

O. Authority to Obligate the Government - The Grant Officer is the only
individual who may legally commit the Government to the expenditure of
public funds. No costs chargeable to the proposed Grant may be incurred
before receipt of either a fully executed Grant or a specific, written
authorization from the Agreement Officer.

P. The Contractor/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/subawards issued under this
contract/agreement.

Q. Foreign Government Delegations to International Conferences - Funds
in this \[contract, agreement, amendment\] 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
\[http://www.info.usaid.gov/pubs/ads/300/refindx3.htm\] or as approved
by the \[CO/AO/CTO\].

R. LWA Cooperative Agreement: It is USAID's intent to award a three-year
leader with associate (LWA) cooperative agreement for assistance with
development communication activities with a two-year optional extension.
Pursuant to guidance contained herein, the two-year optional extension
may be granted if USAID judges that acceptable progress has been made
towards achieving the specifications of the Program Description. This
Request for Applications (RFA) is issued for a cooperative agreement
covering a specified worldwide activity (Leader Award) as described in
the Program Description, Section C of this RFA under which missions or
other offices are authorized to fund associate assistance activities
under separate non-competitive assistance awards that are subject to the
provisions of the Leader agreement. A Worldwide Activity is an activity
or a series of linked activities identified at the business/development
sector's strategic objective level that is intended to provide results
in multiple regions and countries. An Associate Award is a separate
Assistance Agreement funded by a mission or other office and awarded to
the Leader Recipient to support a distinct local or regional activity
that fits within the scope of the broad worldwide program description in
the Leader Agreement. The Associate award can be a grant or cooperative
agreement notwithstanding the type of assistance instrument issued as
the Leader Agreement.

Each Associate award shall contain a separate activity description that
fits within the broader program requirements, but will otherwise be
considered to be covered by the terms and conditions of the Leader
agreement.

The benefits of this mechanism include: (1) no further competition
required for Missions or other USAID offices awards under the
Leader/Associate cooperative agreement, (2) simplified Missions or other
USAID offices award documents, (3) simplified certification by the
recipient of the Leader award and (4) reporting directly to the Missions
or other USAID Offices on the use of Missions or other USAID Offices
funds.

S. Competition: Once a recipient is selected for the Leader Award
pursuant to this RFA, no further competition or waiver of competition is
required for any Associate cooperative agreements/ grants awarded within
the terms of the LWA. The competition under this RFA covers the initial
Leader award, which will provide leadership for regional and/or
worldwide activities and for subsequent Associate awards providing
support to Missions and other USAID Offices. In this manner, Missions or
other USAID offices may fund specific activities of the Leader recipient
that fit within the RFA/Leader program description through field support
or Associate awards without further competition.

T.1. Issuance of Associate Awards: Prior to issuance of an Associate
agreement, the requesting office or Strategic Objective Team in the
Mission or other USAID Office shall consult with the Cognizant Technical
Officer (CTO) at USAID/WASHINGTON. This will help ensure the technical
leadership role of global program and the appropriate use of the
mechanism. After receiving the CTO's concurrence, the appropriate
Mission or other USAID office personnel shall request the recipient of
the Leader award provide an application (specific Program Description
and budget - SF-424 is not required) to the Mission or other USAID
Office. The application shall be reviewed by the appropriate technical
personnel, and the Agreement Officer shall be responsible for cost
analysis and negotiation of the final agreement.

The Mission or other USAID Office has the discretion to decide whether
or not to award the Associate agreement. When the Mission or other USAID
Office and recipient of the Leader award are in agreement on the program
description, budget and substantial involvement anticipated, the
Agreement Officer for the Mission or other USAID Office may award the
Associate agreement. The Mission or other USAID Office activity manager
is the Cognizant Technical Officer for the Associate agreement.

T.2 Certifications: The required certifications, including validation of
the umbrella organization as a single entity with a single accounting
system, shall be obtained from the applicant prior to award of the
Leader Cooperative Agreement. Prior to award of an Associate
grant/cooperative agreement, the recipient of the Leader must affirm
that certifications remain valid, or provide new certifications. (See
attachment) After the Leader is awarded, a copy of the award will be
sent to all Missions or other USAID Offices along with any necessary
guidance or instructions regarding issuance of Associate awards.

T.3 Grant vs. Cooperative Agreement: Regardless of whether the Leader
instrument is a grant or cooperative agreement, Missions and other USAID
Offices may issue an Associate instrument of either type; i.e., an
Associate cooperative agreement may be issued under a Leader grant and
vice versa.

U. Period of Performance: The Leader award will be issued for a
performance period of three years with a possible two-year extension if
USAID judges that acceptable progress has been made towards achieving
the specifications of the Program Description. Associate awards may be
issued until the Leader award expires and can be for a period of
performance up to 5 years past the expiration date of the Leader award.

V. Estimated Dollar Value: This RFA provides an estimate of the dollar
amount for the Leader of \$175 million over five years. Each Associate
Award has its own ceiling that is not included in the Leader ceiling.
The Associate award shall specify the Total Estimated Award (TEA) amount
for the Cooperative Agreement.

W. Reporting Requirements: Upon approval of the project/activities,
USAID will work with the recipient to finalize performance measures and
the method of program evaluation to effectively measure, monitor, and
assess the project's/activities' impact. The format for reporting
requirements will be established as part of the recipient's
Implementation Plan. In addition, the Leader cooperative agreement shall
require the recipient to provide the CTO in USAID/Washington a
programmatic report semi-annually that summarizes activities undertaken,
lessons learned, progress made/results achieved, trends, challenges,
etc., under both the Leader and Associate agreements.

In the schedule of any Associate award, the Agreement Officer will
include appropriate language requiring the recipient to provide a copy
of all program and financial reports to the technical office that funded
the Associate award. Additionally, the recipient shall be required to
provide a copy of all programmatic reports to the CTO in
USAID/Washington. Please note the reporting described in this section is
in addition to knowledge management activities described in the program
description.

X. Substantial Involvement: The intended purpose of CTO involvement is
to assist the recipient in achieving the supported objectives. The
Agreement Officer has delegated the following approvals to the CTO,
except for changes to the Program Description or the approved budget.

In order to assist the recipient in achieving the objectives of the
Leader Award, the CTO of this agreement will be involved in the
following:

> 1\) Approval of the recipient\'s annual workplans. The annual workplan
> requires CTO approval. Significant changes that impact the timing or
> achievement of objectives identified in the plan will require
> additional approval. Workplans must include a timeline for the planned
> achievement of milestones and outputs, as well as budgets identified
> with particular sub-activities.
>
> 2\) Approval of specified key personnel. The applicant shall propose
> the following three (3) key personnel by name and position: Program
> Director, Deputy Director and Research/Evaluation Lead who are
> considered essential to the successful implementation of the award and
> are approved by the CTO.
>
> 3\) Agency and recipient collaboration or joint participation.
> Specific elements of the Program Description which would benefit from
> USAID technical knowledge for the successful accomplishment of stated
> program objectives may warrant the joint participation of USAID and
> the recipient. Involvement is foreseen in the following areas for this
> LWA:

a.  Concurrence on the selection of sub-award recipients, and/or
    concurrence on the substantive provisions of the sub-awards;

> b\. Collaborative involvement in the selection of priorities and
> workplan development.
>
> c\. Approval of the recipient\'s monitoring and evaluation plans; and
>
> d\. Monitoring to permit specified kinds of direction or redirection
> because of interrelationships between or with other projects. All such
> activities must be included in the program description and negotiated
> in the budget of the award.

Y. Other Items: Other items covered in the schedule will include the
authorized Geographic Code for procurement if it is different from the
Leader award (000 and 935), cost sharing requirements for the Associate
award, and any additional standard provisions, such as Title to and Care
of Property, that apply to the Associate award. The following are the
summaries of the principal codes:

Code 000 - The United States of America, any State(s) of the United
States, the District of Columbia, and areas of U.S. Associated
sovereignty, including commonwealths, territories and possessions.

Code 935 - Any area or country including the cooperating country, but
excluding the foreign policy restricted countries.

**SECTION B - SELECTION CRITERIA**

[]{#CL_URFASEBHD_PH000001 .anchor}

The criteria presented below have been tailored to the requirements of
this particular RFA. Applicants must 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 narrative sections of their
applications in the same order as the selection criteria.

The technical applications will be evaluated in accordance with the
Technical Evaluation Criteria set forth below. Thereafter, the cost
application of all applicants submitting a technically acceptable
application will be evaluated for general reasonableness, allowability,
and allocability. To the extent that they are necessary (if award is not
made based on initial applications), negotiations will then be conducted
with all applicants whose application, after discussion and negotiation,
has a reasonable chance of being selected for award. Awards will be made
to responsible applicants whose applications offer the greatest value,
cost and other factors considered.

The applicant\'s cost share contribution will be reviewed for cost
effectiveness and realism and to verify that the applicants meet the
standards set in 22 CFR 226.23 for U.S. organizations, or the Standard
Provision entitled \"Cost Sharing\" for non-U.S. organizations (See 22
CFR 226.23; and Standard Provisions for Non-U.S. Nongovernmental
Recipients).

**Evaluation Criteria (Total: 110 points)**

**[A. TECHNICAL UNDERSTANDING AND APPROACH]{.underline} Total: 50
points**

**Overall approach 6 points**

The Technical Approach demonstrates overall merit (clarity, analytical
depth, state-of-the-art technical knowledge, and responsiveness) and
feasibility of approach and strategies to achieve the project's
strategic objective and intermediate results; demonstrates a thorough
understanding of the interrelationships of the strategic objective,
intermediate results, challenges, and cross-cutting issues, including
presentation of feasible approaches for cross-sectoral BCC programming.
The approach also presents a clear understanding of the determinants of
human behavior and appropriate strategies to influence human behavior in
the defined areas of USAID interest. Finally, the approach demonstrates
an understanding of how to work with the media (to deliver messages as
well as enable more self-sustainable media coverage of health issues),
and proposes a strategy to measure long-term impact of BCC
interventions.

**Intermediate Result 1 5 points**

The application provides feasible and creative technical activities to
exploit innovations in information and communication technology,
demonstrates an understanding of barriers to scaling-up BCC programming
in developing country contexts, and proposes appropriate and feasible
ways of implementing scaled-up programs. The type and level of proposed
results, indicators and targets for results to be achieved in this IR
are challenging and appropriate.

**Intermediate Result 2 5 points**

The application provides feasible and creative technical activities to
maximize capacity building and the development of host country
institutions and individuals and demonstrates a thorough understanding
of barriers to attaining institutional capacity and presents activities
to overcome these barriers. The type and level of proposed results,
indicators and targets for results to be achieved in this IR are
challenging and appropriate.

**Intermediate Result 3 5 points**

The application provides feasible and creative technical activities to
engage and coordinate with USAID collaborating agencies, host-country
programs, and other donors, foundations and alliances, demonstrates an
understanding of barriers to collaborative efforts in BCC and proposes
appropriate solutions. The type and level of proposed results,
indicators and targets for results to be achieved in this IR are
challenging and appropriate.

**Intermediate Result 4 5 points**

The application provides feasible and creative technical activities to
build from existing knowledge to make important advances in theory and
practice for behavior change communication, demonstrates an
understanding of barriers to BCC, gaps in knowledge and obstacles to
dissemination of best practices; and proposes appropriate ways to
overcome these challenges. It also proposes ways to strengthen research
institutions to undertake and publish BCC studies. The type and level of
proposed results, indicators and targets for results to be achieved in
this IR are challenging and appropriate.

**Challenges 10 points**

The applicant demonstrates an understanding of the challenges to BCC
programming; proposes technically sound and economically feasible BCC
activities to tackle each challenge that are both creative and advance
the practice of BCC programming; and describes barriers that could
hinder progress and suggested solutions. The type and level of proposed
results, indicators, and targets for results to be achieved are
challenging and appropriate.

**Project Monitoring and Evaluation 5 points**

The application provides a complete and feasible illustrative
performance monitoring plan that can be used to monitor project
progress, collect data, and disseminate lessons learned and best
practices. The plan must include activities to monitor compliance with
legislative and policy restrictions on the use of FP/RH and HIV/AIDS
funds. The proposed indicators and targets are ambitious but achievable.

**Country Scenarios 9 points (3 each)**

Each proposed country strategy and underlying rationale is complete and
appropriate, demonstrating a thorough understanding of issues in
development communication, use of evidence-based strategies and lessons
learned from past and current work in developing countries. Each country
strategy discusses some of the principal challenges within which PHDC
will operate and how they will be addressed. Evidence is provided of how
the strategic objective, intermediate results, challenges, monitoring
and evaluation will be addressed as part of a holistic approach, and the
proposed budget is justified.

**[B. STAFFING AND KEY PERSONNEL]{.underline}** **35 points**

> **Key Personnel 20 points**

-   Proposed key personnel have requisite experience and expertise and
    meet or exceed requirements specified in Section A 3 IV, pages
    11-12. They have breadth and depth in technical expertise and
    experience in management, design and implementation of complex
    programs.

-   Individually and collectively, proposed key personnel show evidence
    of strong leadership skills and ability to build collaborative
    relationships.

> (Expertise and attributes will be verified in part on past performance
> and references provided in annexes, and may be verified through
> interviews, at the discretion of the technical review panel.)

**Other Proposed Technical Personnel, key attributes 15 points**

-   The staffing pattern and the number and type of positions proposed
    are responsive to technical requirements and principal challenges,
    with an optimal configuration for efficiency and cost containment.

-   Proposed technical or organization specialists have technical and
    operational experience in the subject areas for which they are
    proposed.

-   The technical areas needed to achieve the main results of this
    activity are covered by proposed technical specialists.

**[C. MANAGEMENT APPROACH]{.underline} 15 points**

**Program and personnel management 10 points**

-   The proposed management and administrative arrangements for
    implementation of the program including organizational structure,
    procurement of goods and services, and dissemination of publications
    are well thought out and appropriate for this project. This includes
    how the project will take advantage of each partner's strengths; the
    lines of authority between prime, partners and in-country partners;
    and how personnel will be managed among the prime, partners, and
    in-country offices. (6 points)

```{=html}
<!-- -->
```
-   Application shows feasible and cost-effective approaches for
    interaction with USAID Bureaus, Regional Offices, Missions,
    Cooperating Agencies and in-country partners. (2 points)

-   Feasible plans for rapid start up of the project. (2 points)

**Financial management 5 points**

The proposed approach for financial management includes: how applicant
will contain costs including media costs; how financial disbursement to
in-country partners will be managed; the lines of authority between
prime and partners; where approval authority is located for expenditures
of Mission funds and of core funds; and how the applicant will assure
timely and accurate financial reporting of multiple funding streams.

**[D. INSTITUTIONAL CAPABILITY/PAST PERFORMANCE]{.underline}** **10
points**

The application demonstrates the institutional capability to plan,
implement, and support complex programming and the range of activities
outlined in the RFA; to produce results and innovations in health and
development communication in developing countries; to work with multiple
partners and to report results and financial information to each
partner, and to Missions and USAID. It shows the capacity of the
proposed prime recipient to manage the proposed institutional
relationships including the ability to identify subcontractors and sub
grantees; to allocate the time each partner will devote to the project;
and to minimize non-productive costs. The application demonstrates the
past performance capability of the prime and any principal partners to
undertake a similar or related project, in both complexity and
diversity, as covered in the RFA. Applicant(s) will be evaluated on past
performance over the past 10 years.

Firms lacking relevant past performance history shall be given a
"neutral" past performance rating that neither rewards nor penalizes
those applicants.

Note: a principal partner is any partner proposed to accomplish at least
15% of the activities of the Leader Award, as determined by budget
share.

> **Summary:**
>
> Technical Understanding and Approach 50 points
>
> Staffing and Key Personnel 35 points
>
> Management Approach 15 points
>
> Institutional Capability/Past Performance 10 points
>
> **TOTAL 110 points**

# SECTION C - PROGRAM DESCRIPTION

**[A. Introduction]{.underline}**

Historically, communication activities have been a key component of many
of USAID's development programs, for example, economic growth,
education, democracy and governance and, especially environment and
health. USAID\'s new health and development communication[^3] project
will consolidate and expand the experience gained from these past
programs and from other donors and international agencies.

**[B. Program Background]{.underline}**

**1. History of USAID support for Development Communication**

[Health]{.underline}: Over the decades, USAID's health and population
sector has invested heavily in development communication, including
interpersonal communication, mass media, and community mobilization. A
large body of experience and technical resources was created and
institutionalized by USAID, its partners, and cooperating agencies. In
the 1980s, the USAID population sector scaled up cutting edge
"contraceptive social marketing" approaches that were successful and
that grew into broader "behavior change communication" health
activities.

The "Population Communication Services" project, implemented globally
from 1982 - 2002, grew into the "Health Communication Partnership" that
functioned as the Office of Population and Reproductive Health's (PRH's)
major center of excellence for development communication in health.
Other large health communication projects based in the Health,
Infectious Disease and Nutrition Office (HIDN) are BASICS I (1993-1999)
and II (1999-2004), The CHANGE Project (1998-2005). Those based in the
Office of HIV/AIDS (OHA) are AIDSCOM (1987-1994), AIDSMARK (1997-2007),
and IMPACT (1997-2007).

[Agriculture]{.underline}: In the 1960s, USAID's agriculture sector
supported extension radio to promote adoption of new agricultural
practices by farmers and funded seminal "diffusion of innovations"
research. In the 1970s, USAID's education sector implemented
groundbreaking R&D activities with educational television, early
communication satellites, and interactive educational radio.

[Democracy and Governance]{.underline}: Since the 1980s, Democracy and
Governance (D&G) media programs have pursued two interlinked
communications strategies: primarily and most broadly (1) development
work to support growth of independent, economically viable, professional
media *as an end* in itself; but often also including (2) campaigns that
develop and use media *as a means* to enable more informed citizen
participation in democracy and governance areas such as -- elections,
human rights, transparency, anti-corruption, civil society advocacy,
women's rights, and reducing domestic violence, among others. The
largest and most sustained independent media development programs by D&G
strive to develop local media capacities to provide self-sustained,
professional coverage and discussion of the broadest range of pertinent
development issues, responding to local audience needs and local
political and economic conditions.

[Environment:]{.underline} During the past 13 years, environment and
natural resources programs greatly expanded the use of modern
communication techniques. Lessons learned emphasize the importance of
integrating proven social science and communications strategies with
participatory planning processes.

**2. Relationship of PHDC to the Foreign Assistance Reform: Investing in
People**[^4]

The recent reforms to U.S. Foreign Assistance have produced a new
framework consisting of five priority objectives: peace and security,
governing justly and democratically, investing in people, economic
growth, and humanitarian assistance. The Reform also has five country
categories: rebuilding countries, developing countries, transforming
countries, sustaining partner countries, restrictive countries, as well
as a global or regional program area. Within each of these categories,
all foreign assistance is organized to achieve the overarching USG
foreign assistance goal: *"To help build and sustain democratic, well
governed states that respond to the needs of their people, reduce
widespread poverty and conduct themselves responsibly in the
international system."*

*Investing in People,* an [Objective]{.underline} of the Foreign
Assistance Reform has as its goal "To help nations achieve sustainable
improvements in the well-being and productivity of their populations
through effective and accountable investments in education, health, and
other social services." The *Investing in People*
[Objective]{.underline} has three [Program Areas,]{.underline} one of
which is Health. It, in turn, has eight [Program Elements]{.underline}:
Family Planning and Reproductive Health, HIV/AIDS, Maternal and Child
Health, Tuberculosis, Malaria, Avian Influenza, Water Supply and
Sanitation, and Other Public Health Threats. *Economic Growth,* another
[Objective]{.underline} of the Foreign Assistance Reform, has as its
goal "To generate rapid, sustained, and broad-based economic growth."
The *Economic Growth* [Objective]{.underline} has eight [Program
Areas,]{.underline} one of which is Environment. It, in turn, has three
[Program Elements]{.underline}: Natural Resources and Biodiversity,
Clean Productive Environment, and Program Support.

The U.S. Government's efforts to harmonize foreign assistance messages
across USG agencies resonates with the area of behavior change
communications -- where a strategic, coordinated, multiple communication
channels approach can have more impact than an individual or fragmented
approach. The science and art of development communication involves the
same knowledge, skills and approaches across content areas as diverse as
health, democracy and governance, agriculture, education, poverty
alleviation, support and treatment of HIV/AIDS. It is envisioned that
BCC programming will be strengthened and better coordinated and
harmonized in countries with an overarching mechanism to address
multiple foreign assistance priority BCC objectives.

The PHDC, as a Bureau for Global Health project, falls under the
objective of *investing in people* in the new framework while
environment falls under the objective of e*conomic growth*. While PHDC
will focus primarily on programming in health and environment, it may
accept funding through Associate Awards from other USAID Bureaus,
Offices, Regional Offices, and Missions to work in other areas.

**[C. Funding]{.underline}**

USAID intends to support a three-year leader with associate (LWA)
cooperative agreement for assistance with development communication
activities. A two-year extension may be granted if there is acceptable
progress towards achieving the specifications of the Program
Description. PHDC is open to other Bureaus even though the largest
source of funds is expected to be the Child Survival and Health funds
and the largest areas of emphasis will be family planning, reproductive
health, and HIV/AIDS. However, both the Leader and any Associate Awards
are authorized to accept funds from Missions, Offices and Bureaus.

In general, PHDC will be country oriented, with most of its funding and
efforts geared to country-specific health and development communication
activities. For purposes of bidding, applicants should assume that 80%
of the budget of the Leader Award will come through field support and
MAARDs; core funds are expected to be used primarily for IR4. Core funds
from the Bureau for Global Health (GH) will support the Bureau's key
functions of global leadership, research and evaluation, and technical
support to the field as they apply to PHDC's mandate. Activities
supporting other development objectives will be supported by
corresponding Bureaus, Offices, or Missions through Associate Awards.

**[D. Objective of the Project]{.underline}**

The purpose of this award is to provide USAID Bureaus for Global Health;
Economic Growth, Agriculture and Trade; and Democracy, Conflict and
Humanitarian Assistance; Missions, and other operating units with a
global mechanism to implement strategic health and development
communication programming. PHDC has a strong mandate to assume
leadership for health and development communication programming.

In a world in which countries are trying to cope with persistent
challenges such as malaria, HIV/AIDS, poor maternal/child health, large
numbers of unwanted pregnancies, environmental degradation, poverty and
poor governance, developing countries need to optimize their use of
development communication resources. Development and social change
programming have the goal of improving the quality of life and
well-being of populations. Many sectors share the same challenge of
engaging communities and individuals in the social transformation
process.

The process of developing a BCC program - planning, implementing and
evaluating - is the same across all program areas. Although the process
is the same, the content varies according to the needs of the country.
In the case of PHDC programming, it is expected that the content will
initially relate to health and environment.

The Strategic Objective (SO) of this RFA is to ensure **"[Effectiveness
and sustainability of communication programs improved.]{.underline}"**
PHDC is expected to make major progress towards achieving this objective
and will develop mechanisms for broad social and behavior change
communication programming. PHDC will weave technical competence,
adequate resources and good program content together into sustainable,
flexible programming in each of the four IRs. In each country, it is
expected that PHDC will work with in-country institutions that are or
could be the [providers]{.underline} of BCC programs as well as
in-country institutions that are or could be the [consumers]{.underline}
of BCC programs, such as Ministries of Health, NGOs, and FBOs among
others. Effective and sustainable communication programming as defined
for this RFA:

1.  Is evidence-based, produces measurable impact on individual and
    collective behaviors, and ultimately improves health and development
    outcomes.

2.  Serves as a strategic coordinator of communication activities within
    and across development sectors.

3.  Builds and strengthens in-country institutional capacity of both the
    public and private sectors to plan, implement, and evaluate
    effective, evidence-based, broad, multi-channel, comprehensive BCC
    programming.

4.  Infuses state-of-the-art (SOTA) communication theories, methods and
    best practices into health and development programming.

5.  Includes all relevant in-country stakeholders in all stages of BCC
    programming.

6.  Advances SOTA health and development communication in the program
    area funded.

7.  Disseminates research findings to CAs, USAID, and to the global
    community of health and development communicators.

**[E. Statement of the Strategic Objective and Intermediate
Results]{.underline}**

All PHDC activities, both core and Mission funded, will support
achieving the Strategic Objective and contribute to accomplishing one or
more of the following four Intermediate Results (IRs):

**Graph 1: Strategic Objective and Expected Results**

It is envisioned that Missions will primarily fund IRs 1, 2 and 3; and
core funds will primarily fund IR4.

**Intermediate Result 1: Evidence-based scaled-up health and development
communication programs implemented and best practices for behavior
change applied.**

For the purpose of this RFA, implementing at scale refers to increasing
the volume of outputs, enlarging the scope of activities to reach more
people, and increasing the intensity of impact in a geographic area
and/or a social group.[^5] In most countries, scale will refer to
nationwide programs or to programs reaching all of the target
populations. This IR represents the main area of implementation of the
communication project. The need for increased scaled-up community and
national-level communication activities will be met with a large program
to implement BCC programming using state-of-the-art communication
practices as well as participatory and community-led programming.
Evidence-based communication strategies will be employed including media
and policy advocacy, social marketing, public relations, negotiation,
mass-media campaigns, interpersonal communication,
entertainment-education, community mobilization, and other participatory
approaches. Effective communication will test and support appropriate
approaches to reach audiences of different age groups, gender, marital
status, education level, refugee status, culture, and the socially
marginalized.

This IR responds to global and field program demands for national and
regional communication strategies, campaigns and programs. To carry out
this mandate more effectively and build capacity in countries, PHDC will
work with a wide range of NGOs, FBOs, CBOs, local and national media,
marketing agencies, and research firms; and, when appropriate, will
assist these agencies to develop the ability to acquire from and meet
reporting requirements of donor agencies. Attention will be given to:

1.  ***The essential role of PHDC to support USAID Missions*** to take
    development communication programs to scale, to assess program costs
    and effectiveness, and to report lessons learned. PHDC is an
    agency-wide mechanism with a focus on promoting health and
    well-being, specifically relating to family planning, reproductive
    health, HIV/AIDS, and environment.

2.  ***Scaling-up BCC programming*** will include developing
    evidence-based communication strategies including but not limited
    to: systems approaches, mass media, social marketing, public
    relations, media advocacy, interpersonal communication,
    entertainment-education, social networking, conflict mitigation and
    resolution, community mobilization and other participatory
    approaches. It is also expected that PHDC will implement scaled-up
    programming to shift traditional definitions of masculinity and
    femininity to achieve more gender equitable norms.

3.  ***Developing with in-country counterparts***, culturally
    appropriate materials that shall be relevant and useful to the end
    users, based on formative research, theories of behavior change, and
    multi-disciplinary approaches, and have undergone in-depth field
    testing and input with the end-user.

The state-of-the-art support provided by PHDC to Missions, and
developing country and regional institutions will:

1.  ***Strengthen impact:*** requiring a thorough understanding of
    populations and the broader social and cultural context of their
    community. Based on the availability of funds, baseline studies will
    be conducted *before* the onset of program activities to ensure
    assessment of impact is due to scaled-up programming.

2.  ***Encourage sustainability:*** viewed from the perspective of
    scaling-up by in-country institutions, sustainability is the
    evolution of an institution to the point where it can effectively
    manage and increase BCC programming, can obtain financing into the
    foreseeable future, has the necessary level of program autonomy from
    external actors, and is providing desired and sustainable services
    to its target beneficiaries.

**Illustrative Expected Results:**

-   Effective, evidence-based programs reach large numbers of people and
    diverse nationwide audiences and operate in larger and more diverse
    (rural, peri-urban, urban) geographic areas.

-   Health and development agencies receive funding and design and
    implement national BCC programs independent of external donors.

**Intermediate Result 2: Health and development communication skills and
knowledge transferred to developing country institutions**[^6]**.**

For the purpose of this RFA, capacity building emphasizes institutional
capacity to plan, implement and evaluate comprehensive health and
development communication programs. For this IR, the PHDC counterpart is
an institution primarily working in health and development
communication; however, opportunities to identify and to strengthen
existing development communication capacity in private sector industries
(energy, infrastructure, etc) should also be considered. Attention will
be given to:

1.  ***Developing Centers of Excellence:*** As the flagship development
    communication mechanism for USAID, it is expected that PHDC will
    implement strategies to effectively improve the quality, decrease
    the cost, and increase availability of BCC programming in developing
    countries. An institutional analysis will be conducted in all
    countries providing substantial Field Support (FS) or an Associate
    Award (AA) to identify existing development communication capacity
    *before* the onset of project activities. Based on this information,
    PHDC will develop a plan with measurable benchmarks and results to
    leverage and strengthen existing BCC institutional capacity, develop
    where possible BCC Centers of Excellence, and will promote and
    facilitate South-to-South technical assistance (TA). In all
    in-country activities implemented for each IR, PHDC will work with
    and through local partners, create opportunities for on-the-job
    training, and strengthen in-country institutions on the theories,
    methods and practices of BCC programming.

2.  ***Deepening focus on creating an enabling environment and
    strengthening institutional capacity:*** Building on successful
    approaches in countries where USAID has strong leverage with the
    government and other agencies, PHDC will develop country-specific
    strategies to engage national and local policy and decision-makers
    to support national capacity for development communication and to
    develop a national BCC policy framework.

3.  ***Routinely building capacity across the four IRs*** in all BCC
    program planning, implementation and evaluation activities
    regardless of the level of effort. The project will not be
    considered successful unless the capacity of health and development
    communication institutions are strengthened and in-country BCC
    programming is sustainable in four countries and more sustainable in
    seven countries. It is expected that the applicant will build the
    capacity of universities and provide technical assistance to
    in-country universities to facilitate the professional development
    of professors and students in development communication who, for
    example, can serve as current and future sources of in-country
    expertise.

By expanding and improving the leadership and managerial skills of key
individuals and institutions in each country, PHDC will improve
effectiveness and sustainability as well as reduce the cost of BCC
programming. Capacity building programming by PHDC must:

-   address the national and local context of BCC expertise,

-   work towards creating an enabling environment for BCC programming,

-   include an exit strategy and leave in-country capacity to implement
    scaled-up effective BCC programs.

**Illustrative Expected Results:**

-   In-country development communication and/or advertising agencies are
    sustainable in four countries and have the ability to function as
    independent institutions that can receive external funding and
    monitor and report on project implementation.

-   In-country development communication and/or advertising agencies are
    more sustainable and have the ability to provide technical
    assistance to other in-country groups such as MOH, FBOs, CBOs, the
    private sector.

-   In-country institutions plan and evaluate BCC interventions on
    emerging health and development issues.

**Intermediate Result 3: Health and development communication integrated
within the wider public health and development agendas.**

There are many public and private agencies working in health and
development program areas such as malaria, population, environment, and
freedom of the press. These agencies implement a variety of
interventions in areas such as policy, community mobilization, research,
education, and communication. PHDC will integrate health and development
communication into the programming of public and private organizations
and will increase the number and types of stakeholders developing
effective health and development communication programs. Attention will
be given to:

1.  ***PHDC serving as a SOTA reference center*** for health and
    development communication for counterpart agencies, both national
    and international, to strengthen the communication component of
    their programming.

2.  ***Supporting and strengthening improved quality and
    sustainability*** of behavior change communication activities of
    cooperating agencies (CAs), ministries, non-governmental
    organizations (NGOs), faith-based organizations (FBOs), and other
    public and private agencies.

3.  ***Broadening the types of public and private organizations***
    developing BCC programming such as organizations concerned with
    gender, youth, infectious disease, environment, and poverty
    alleviation.

4.  ***Increasing the quality and quantity of national resources*** of
    Governments and NGOs for behavior change communication (BCC)
    programming.

**Participating Missions will be encouraged to position PHDC as a
strategic coordinator** of communication programs within and across a
country's development sectors by providing service to and coordinating
with a wide network of implementing partners. It is envisioned that PHDC
will work with these partners to increase their capacity to sustain
communication programs at the end of PHDC. Such an approach will
position development communication as a truly cross-cutting issue and
contribute to the following:

-   Improved coordination with relevant stakeholders

-   Reduced duplication of efforts

-   Increased consistency in messaging or reduced contradictory messages

-   Increased audience retention and response to messages

-   Enhanced impact of development interventions

**Illustrative Expected Results:**

-   Agencies working in health and development have the ability to
    develop or contract for SOTA communication programming.

-   Ministries (such as health, environment, agriculture, education)
    understand the essential elements of effective BCC programming.

-   National policies related to health and development communication
    are formulated, financed and implemented.

-   National, regional or local governments understand the importance of
    and allocate resources for effective BCC programming.

**Intermediate Result 4: Effective social and behavior change
communication knowledge generated and shared to address emerging health
and development issues.**

The focus of PHDC's programming is to provide technical leadership,
strengthen global learning, and establish an innovative knowledge agenda
for health and development communication. BCC programming will be based
on evidence, best practices, and state-of-the-art approaches for health
and development communication. It is recognized that Missions will also
identify concerns and issues that will be included in generating and
sharing BCC knowledge. Attention will be given to:

1.  ***Analysis of the effectiveness of campaign programming*.** PHDC
    will provide evidence of what works in areas such as:

-   **Messages**, including fear-based, dialectical to stimulate
    discussion, or messages designed to stimulate individual behavior
    change such as use of contraceptives, or social change such as
    having smaller families, or to stimulate normative change such as
    cultural beliefs on masculinity that may affect contraceptive use
    and perception of risk of acquiring HIV/AIDS.

-   **Communication channels,** traditionally, multiple channels of
    communication are used to increase the success of a campaign. PHDC
    will provide evidence of the cumulative and individual effects of
    each channel of communication to the overall success of the behavior
    change campaign and will provide guidance on the more influential
    channels of communication that should be used in a resource-scarce
    environment.

-   **Analysis of the process of moving from theory to BCC programming
    in multicultural environments**: Although behavior theories are used
    to develop formative research and assess program impact, there are
    fewer communication-driven theories or models that provide guidance
    for moving to program implementation in a context of diverse
    cultural populations. There is a leap between formative research
    generally based on theory to developing the intervention which must
    be grounded within the socio-cultural setting. PHDC will
    systematically document and evaluate BCC theories, methods and
    practices that address health and social change in multicultural
    settings. This will serve as a basis to develop analytical models
    and perhaps theories to address social change across multiple
    behaviors, cultures and populations. [^7]

2.  ***Understanding ethical concerns*** must be appreciated and
    respected when designing, implementing and evaluating BCC
    programming. Messages that are not grounded in the country's
    socio-cultural context may cause confusion or alarm, could result in
    unintended consequences or simply be ineffective messages and
    programs. Although there are different ways to analyze ethical
    issues, it is particularly important for health and development
    communicators to:

    a.  Avoid harm,

    b.  Respect an individual's autonomy,

    c.  Provide benefits,

    d.  Ensure equal and just treatment.

3.  ***Strengthen the ability of researchers and research institutions
    in developing countries*** to study and publish on the theories,
    methods and practices of health and development communication.

**PHDC is expected to be a leader in dissemination** of BCC knowledge
and lessons learned. The purpose of knowledge management will be to
foster innovation, streamline operations, and reduce costs by
eliminating redundant and unnecessary processes. It is expected that
PHDC will identify promising practices and approaches from BCC programs
and analyze processes used for adapting them and bringing them to scale.
In addition to current health and development concerns, emerging issues
such as bird flu and "payment for environmental services,'[^8] will need
to be addressed by the project. It is expected that PHDC will devote
some core resources to these activities, depending on the participating
Bureau, Office or Mission interest and support for such activities. It
is also expected that PHDC will use existing mechanisms to disseminate
BCC knowledge and lessons learned.

It is expected that PHDC will submit articles to peer reviewed journals
that advance the SOTA in health and development communication across all
areas for which it receives funds. Publishing in peer-reviewed journals
is preferred to in-house publications. It is also expected that all[^9]
qualitative and quantitative information collected by PHDC during the
planning, implementation and evaluation of health and development
programs will be available on a permanent website in the language in
which it was collected. Minimal core or field support funds will be used
to upload this information. PHDC will serve as a repository for
communication materials that will serve the USAID community as well as
other donors and foundations. PHDC will disseminate this material using
web services and other technologies to link up with existing SOTA
content management systems service providers that have developed and
refined this technology.

**Illustrative Expected Results:**

-   New models and measurements of communication methodologies such as,
    but not limited to, community participation, mobilization, and
    empowerment produced through the collaborative efforts of the
    Applicant and in-country partners.

-   In-country communication institutions research and publish in
    peer-reviewed journals on the social determinants of human behavior.

-   SOTA BCC literature published by PHDC and in-country BCC
    institutions in peer-reviewed journals.

**[F. Challenges]{.underline}**

The principal challenges and the operational context within which PHDC
will operate, and the types of concerns Missions are likely to address
through PHDC are described below. This discussion reflects USAID's
current interests in the evolving field of behavior change
communication. Although all the challenges are important, understanding
human behavior is critically important and is the highest priority. It
is expected that these challenges will be addressed across most, if not
all, PHDC activities.

**1. Understanding and Harnessing the Determinants of Human Behavior**

Historically, health and development communication focused on the
individual. However, in the past few years, several high-profile
documents have stressed the importance of, and the need to understand
human behavior, with a particular focus on [shifting social and cultural
influences and norms]{.underline} that are deleterious to health and
development.[^10]

To implement more effective BCC programming, there is a need for a
broader understanding of the impact on human behavior of socio-cultural
environments, processes, and norms; life experiences of individuals,
families, and communities; and individual and collective attitudes,
beliefs and practices. The [system approach]{.underline} is one strategy
that incorporates and analyzes the broader context and environment in
which human behavior is embedded. It is expected that PHDC will both
contribute to and document this increased understanding. More
importantly, it is expected that PHDC will develop communication
interventions to help shift social norms towards ones that increase
positive health outcomes for large groups of people. Specific areas
where understanding of human behavior can be increased and that
knowledge subsequently applied to communication interventions include:

[Gender]{.underline}: Research indicates that men who have more gender
equitable norms are more likely to have positive health and development
outcomes. Studies on the impact of beliefs about masculinity conclude
that boys 15-19 years of age who have traditional attitudes towards
masculinity were more likely to have sexually transmitted diseases and
partners with unintended pregnancies, while other studies of young men
who have more gender equitable norms show they were more likely to use
contraceptives and condoms and less likely to have been physically
violent against a current or most recent partner. In FP/RH, PHDC
programming will support shifts in gender norms to promote small family
size and increase the use of contraceptives. For example, PHDC will
promote gender norms that relate masculinity to small family size;
support women to have more independence to visit health clinics, to make
decisions to select and use contraceptives, space their pregnancies, and
have small families; and support men to adopt gender equitable norms and
to have vasectomies. In HIV/AIDS, PHDC communication activities will
seek to modify gender norms that contribute to the continued spread of
HIV and impede the effective delivery of care and treatment services.
For example, PHDC will work to: change male norms that support the nexus
of cross-generational and transactional sex and multiple concurrent
partners that contribute to high HIV transmission in generalized
epidemics; reduce the likelihood of gender-based violence following
women's disclosure of HIV status to their male partners; increase male
support for and involvement in women's use of services for prevention of
mother-to-child transmission; and promote gender-equitable access to
palliative care and anti-retroviral therapy.

[Family Planning & Reproductive Health]{.underline}: In the FP/RH arena
it will be important to identify and seek to affect social and community
norms and cultural determinants of behaviors that either impede or
promote appropriate action by people to meet their expressed desires for
the number and spacing of their children. GH/PRH is particularly
interested in increasing voluntary use of modern contraception and the
number of couples that practice healthy timing and spacing of births,
reducing contraceptive discontinuation and unmet need, and increasing
family planning use by couples in the two lowest economic quintiles. In
addition, PHDC will be expected to participate in and support the Global
Leadership Priorities of the Office of Population and Reproductive
Health as they apply to PHDC expertise.[^11]

[HIV/AIDS]{.underline}: A key challenge in HIV/AIDS prevention is to
harness a wide range of social capital to achieve a "tipping point" in
community norms that can help facilitate widespread adoption of safer
sexual behaviors, such as later initiation of sex, partner reduction and
consistent condom use. USAID is especially interested in increasing both
individual and community perceptions of the risks associated with
multiple, concurrent partners and cross-generational and informal
transactional sex. PHDC will also be expected to diminish societal
tolerance of forced and coerced sex. A further, cross-cutting priority
will be to address the social stigma and discrimination often associated
with AIDS, for example, through more open societal discourse on HIV.
Reducing stigma can help to increase use of HIV testing, and knowledge
and disclosure of personal sero-status.  Communications activities can
also increase social support for improved health-seeking behaviors, such
as increased uptake of HIV palliative care and ART services, and
increased adherence to treatment and follow-up care.

[Interface between BCC and service delivery initiatives]{.underline}:
USAID supports a wide range of programs to strengthen the performance of
FP/RH and HIV/AIDS health personnel and improve other aspects of the
quality of health care programs. Other donors support these initiatives
as well. The quality of interactions between clients, communities and
health care personnel greatly influences the success of these programs.
From a communication perspective, interpersonal communication (IPC)
between health care personnel and clients is an important source of
accurate information that can influence family and community behaviors.
From a service delivery perspective, clients generally perceive health
care services to be of higher quality if they experience culturally
sensitive and respectful IPC from health care providers. The dynamic
between behavior change communication and health service delivery
includes other important elements beyond IPC. BCC programs can and often
must be involved in other aspects of health service delivery, supporting
initiatives such as sustained community involvement in and oversight of
health services, adaptation of services to better meet the expectations
of clients, and development of feedback mechanisms to strengthen the
relationship between health services, communities and different client
populations. In most countries, PHDC will be expected to work in concert
with one or several service delivery programs, including bilaterals, to
achieve changes in client behavior and use of key services. PHDC will
coordinate with health service delivery programs where this is a concern
of USAID, to help strengthen client-centered approaches, harmonize
messages and generally increase communication between health services
and the communities they serve, and synthesize findings from IPC studies
for service delivery projects. As part of this coordination PHDC may be
required to develop mass media programming to promote the use of health
care services and to model health care provider and client
communication.

**2. Cultivating the Media and Substantially Reducing Cost of Media
Time**

USAID's experience and research shows that both the mass media and the
more participatory communication approaches are necessary for success in
health and development outcomes. A key component of implementing
development communication programs at scale involves consideration of
the media as a partner or interested autonomous observer, rather than
merely a channel, and working with the media as a stakeholder from a
project's inception. Media representatives can be engaged by inclusion
in stakeholders' meetings, convening events around health and
development issues, providing training on covering these issues,
providing access to key individuals and information, and facilitating
regular interaction with other stakeholders.

In most cases, albeit not all cases, the cost of reaching *mass*
populations through properly structured media activities is lower per
capita than is possible using non-media communications options. It is
expected that PHDC will work with the local media to increase and
improve coverage of health and development issues while also
demonstrating to local media that enhanced attention to health-related
issues often represents a sound business development and [economic
sustainability]{.underline} strategy. Private, community, and/or public
service media offering improved health-related coverage can actually
expand ratings by media audience or reader circulations, creating a
sustained revenue incentive to provide more regular, higher quality
health reporting and discussion programs. (State-owned media typically
present a separate set of challenges and programmatic responses.)

In some countries and media markets, the cost of media time is perceived
as high, with the result that some Missions have reduced funds for mass
media programming. An objective for PHDC in these situations may be to
assist Missions to identify lower cost media outreach strategies, or
even to assist in coordination of media sector assistance programs with
other donors, in the creation of new media channels with lower costs,
improved community outreach, superior financial and business viability,
or other desirable communications capacities.

Where possible, PHDC will work together with USAID Mission-supported
independent media development programs to raise the professionalism of
health reporting, management capacities, and/or business development of
media outlets, and accordingly, the ability of these media to enhance
their coverage and increase the quality and quantity of health-related
topics and programming on the media, as well as other communication
objectives. Upon country graduation, no further donor assistance would
be required to provide grants or otherwise finance health-related
communication -- since at least some media would be providing such
coverage on a routine, self-sustained basis. (It is understood that the
very poorest local economies and media markets will remain
under-resourced to reach this scenario in the indefinite future; but
even in these most impoverished situations, graduated progress toward at
least partial cost sharing by the local media partners is possible.)

Making local adjustments for each country and media market, PHDC will
work with media to enhance their coverage of health-related issues,
increase their media audiences and develop the economic
self-sustainability of selected media outlets\-- enabling them to
provide enhanced health-related content to their audiences.

**3. Measuring Long-term Impact of Communication Programs**

Measuring the long term impact of health and development communication
is challenging, but essential to disentangle the relationship between a
series of interdependent choices and the subsequent impact on behaviors.
It permits an understanding of the effect of processes at the individual
level and may, based on the study design, facilitate an analysis of the
relative contributions of particular causal factors to a behavioral
outcome. This is of critical importance for BCC since an analysis of
long term impact would permit an assessment of BCC interventions on
behavior with particular interest in behaviors surrounding family
planning and reproductive health such as birth spacing or use of
contraceptives. In HIV/AIDS, PHDC will support strategic information
activities and build in-country capacity to measure the reach of major
communication campaigns and their contribution to changing social norms
and individual-level behavioral responses. PHDC strategic information
efforts will also help to identify major gaps in both HIV/AIDS and FP/RH
communication programming and to inform future communication
interventions. Measuring long-term impact is complicated, particularly
when programs engage multiple stakeholders and use multiple
communication channels. It is further complicated when programs are
implemented across a timeframe that frequently exceeds funding
commitments of donor agencies; when programs can not include a control
group because the BCC intervention may be nation wide; and when messages
and BCC programming are embedded within a broad agenda promoting social
change. PHDC will be expected to address the challenges of developing
research methods and indicators to measure the (1) long-term impact of
communication programs, (2) unintended consequences of BCC programming,
(3) cumulative effects of BCC program interventions, (4) changes in
social norms, and (5) effectiveness of programs to reach the "hard to
reach" and to convince the "hard to convince".

**[G. Cross Cutting Issues]{.underline}**

The following guiding principles are critical for the project's success.
The project will be evaluated on its ability to routinely incorporate
these principles in its programming.

1.  **Build from existing knowledge and reflect advances in theory and
    practice.** Health and development communication programs
    implemented by PHDC will be based on knowledge accumulated during
    the past fifty years of BCC programming such as: conducting
    formative research, developing theory-driven programming, audience
    segmentation, designing message and information to engage target
    audience, and using sensitive outcome evaluation design.[^12] It is
    expected that PHDC will be innovative and devise new solutions to
    health and development BCC challenges. This could entail expanding
    beyond the Applicant's knowledge base and drawing on the knowledge
    of other initiatives.

PHDC will be expected to find ways to collect, systematize and share
lessons from the field including lessons from Associate Awards (AAs) and
inform global understanding of the theory and practice of behavior
change communication (BCC). The increasing complexity of health and
development communication demands that PHDC be a learning organization
that integrates research and theoretical advances into practice at the
field level and documents the results. The conceptual framework and
learning "functions" are of great importance for both USAID and the
field.

2.  **Exploit innovations in information and communication technology.**
    The PHDC project will be expected to select and use information and
    communication technology that could strengthen BCC strategies. This
    could include identifying companies and/or other development
    projects with which to partner, such as telecommunication or mobile
    telephone companies interested in contributing to development
    efforts.

Today the opportunities for harnessing information and communication
technology in developing countries are wide open. Personal digital
assistants (PDAs) can put complex algorithms for managing health care,
formulas for making agricultural decisions, and access to markets and
pricing into the hands of isolated persons. At a time when the dearth of
skilled human resources is a constraint, technology can help ensure that
people are informed, medications are taken, and behaviors changed. USAID
and its partners have pioneered the use of new media technologies in
health and development communication. Radio, television and new,
rapidly-evolving tools such as Internet, wireless, email, cell phones,
CD-ROMs and PDAs play important roles in increasing reach and reducing
the costs of communication. Video and internet gaming technology is also
increasingly being used to expand the reach of development initiatives
and make them more attractive to youth. Substantial barriers still
prevent major segments of the population from seeking or using new
technologies. In many cases, however, the new media can provide
proactive, individualized, and personalized information to the public,
high-risk persons, patients, policymakers and providers. The Science
Panel on Interactive Communication and Health concluded that few other
health-related interventions have the potential of interactive health
communication to simultaneously improve health outcomes, decrease health
costs, and enhance consumer satisfaction.[^13] Contingent on available
funding, this project could also link up with other projects and use
information and knowledge networks to widen the dissemination of
findings.

**3. Coordinate with USAID collaborating agencies, host-country
programs, and other donors, foundations and alliances.** USAID has
learned that communication works best when it is part of a larger public
health or development initiative.[^14] Communication alone often cannot
improve the health and the standard of living of individuals, families
and communities. Coordination among communication activities, health
services, other development interventions, the media, and policy is key
to successful BCC programming. The applicant must be able to work
collaboratively with other USAID partners, mission bilateral programs,
host-country programs and other donors, foundations and alliances to
develop and implement communication programming that promotes individual
behavior change and helps shift social norms of target populations
including health care personnel; PHDC will document lessons learned and
successes in doing so.

 

PHDC has clear links and complementarities with the following USAID
health projects:

-   **BRIDGE, Health Policy Initiative, and Health Systems 20/20**
    projects strengthen governance, advocacy, policy, and work with the
    media to influence policy and decision makers.

-   **ACQUIRE, ESD, FANTA, INFO, LMS, and QA/WD** strengthen specific
    knowledge and skills such as building interpersonal communication
    skills or changing behaviors of health care personnel.

-   **ACQUIRE, Banking on Health, BASICS III,** **ESD, and PSP One**
    promote healthy behaviors targeting specific audiences such as
    mothers, underserved populations such as PLWHA, specific health
    interventions such as post abortion care, or have a specific
    emphasis such as community mobilization, empowerment or the private
    sector.

In some cases PHDC will need to look beyond the health sector to engage
other development partners in areas such as environment, education, or
democracy and governance in strengthening the performance of health and
development communication programs. Following are some examples of
existing mechanisms:

-   **AMAP, EDU and ORG**, **EQUIP, FIELD, GCP, PLACE, RAISE -- PLUS,
    SEGIR, TRANSLINKS, WATER IQC II, and dot GOV** are a few of the EGAT
    Bureau's projects that promote natural resource management,
    sustainable agriculture, education and workforce development,
    energy, economic growth, poverty alleviation, micro-enterprise
    development, access to clean water, and use of ICTs.

Depending on the Strategic Orientation and Intermediate Results of
Mission programming, it is envisioned that PHDC will develop activities
in many of USAID's program areas and will need to ensure in-country
integration and coordination with appropriate Ministries, NGOs, FBOs,
and across USAID CAs.

**[H. Project Monitoring and Evaluation]{.underline}**

Monitoring results is a key element of USAID programs. USAID seeks data
and information to improve performance and effectiveness as well as to
inform planning and management decisions. Monitoring enables adaptation
to changing conditions and mid-course corrections to activities as
necessary. It provides data to demonstrate program impact. Applicants
will be expected to propose a cost-effective, results-oriented
monitoring system to track progress. This includes identifying
indicators that will be collected and proposed as benchmarks and
milestones and how monitoring will be used for mid-term corrections.

The following areas are illustrative for indicator selection. Applicants
are expected to suggest and show how they will develop and apply
specific indicators as measures of success in areas related to the
Partnership for Health and Development Communication.

a.  Increase in key behaviors among target populations as a result of
    activities carried out under this project.

b.  Increased scale of health and development communication impact in
    host countries, measured in terms of percentage of target
    populations acting upon information.

c.  Increased capacity of host-country institutions to design, implement
    and evaluate health and development communication activities, apply
    behavior change theories across all phases of communication
    planning, and provide technical assistance.

d.  Demonstrated value of synergies in health and development
    communication interventions,

e.  Increased ratio of alternate funding, in relation to USAID funding,
    for health and development communication programs.

f.  Public recognition (for example, peer-reviewed journal articles and
    presentations at professional associations) of increased
    understanding of human behavior and social determinants of disease
    and healthy behaviors.

A key early activity of the recipient will be to reach agreement with
the USAID Global Health Cognizant Technical Officer (GH CTO) and
Management Team on a Performance Monitoring Plan, including indicators
and targets for achieving the project's IRs for 2.5 years and 5 years.
Through the annual work plan and progress reports, the Recipient will
report on indicators and provide information that describes the expected
results on a semi-annual basis.

**[I. Management Review and External Evaluations]{.underline}**

Leader Award and Bureau Associate Award Annual Work Plans will form the
basis for annual joint management reviews by USAID and program staff to
review program directions, achievement of the prior year work plan
objectives, major management and implementation issues, and to make
recommendations for any changes as appropriate. Annually, input will be
solicited from DC and field offices.

USAID will conduct a mid-term assessment or evaluation to review overall
progress, assess the continuing appropriateness of the program design,
and identify any factors impeding effective implementation. USAID will
use the results of this assessment to help determine whether or not to
exercise the option to extend the LWA for two additional years; make
changes if necessary, and to help determine appropriate future
directions.

**[J. Implementation]{.underline}**

Activities implemented under the PHDC LWA in any given country will flow
from the approved USAID country strategy.

**1. Strategies and Workplans**

Implementing organizations under the PHDC LWA will work with Mission and
local counterparts to determine how the LWA can best respond to the
development communication needs identified in the country strategy. The
result will be a LWA-specific country strategic framework that will
guide the activities of the PHDC LWA in each country where assistance is
provided. Mission-funded activities can range from a discrete
intervention in a program implemented by a national organization to a
full-blown BCC program for which PHDC is the lead partner. Associate
Awards maybe issued by the corresponding USAID Missions, Offices,
Regional Offices and Bureaus. PHDC will prepare a response to each
Associate Award that will detail its approach to meeting the Mission's,
Office's, or Bureau's requirements. Annual workplans will be submitted
on a July to June schedule.

In consultation with the Mission, Office, or Bureau, PHDC will identify
the strategic objective and intermediate results that PHDC will try to
achieve. Targets, indicators and data sources must be identified for
each intermediate result. PHDC's strategic objective in each country
must flow logically from the Mission, Office, or Bureau strategic
framework as well as the PHDC strategic framework. PHDC will be expected
to identify the Mission SO or IR to which its assistance will
contribute, and PHDC's results must contribute to the achievement of the
Mission, Office, or Bureau results in the country in question. PHDC will
also identify other Cooperating Agencies (CAs) that are working to
achieve the same SO or IR and with Mission, Office, or Bureau direction
and concurrence, will collaborate with these CAs to achieve their common
objectives and results. The projects mentioned in Section 3, p. 40 are
very likely to be active in some, if not all, of the same countries as
PHDC. PHDC is expected to identify common areas of interest and actively
pursue their collaboration; and also that of the appropriate Ministry
and local NGOs, FBOs, and others.

Based on the country strategy, the LWA will draft annual work plans for
each country in which a substantial amount of work is to be undertaken
(i.e., over \$100,000). The work plan will discuss the specific kinds of
technical assistance that will be provided, the counterparts (public,
private and NGO) that will be involved in these activities, any research
and data analyses that will be needed to support the proposed PHDC
activities, the timeline for such activities, and the expected results.
The work plan will describe how PHDC plans to work with other donors and
other USAID-funded projects that are active in the country as well as
with in-country partners.

**2. Coordination with USAID**

The Leader Award applicant shall keep the GH CTO apprised of the status
of technical services provided by the recipient and shall be prepared to
travel to USAID offices in Washington to review the annual work plan, to
review country strategies and work plans, to review planned core
activities, and to debrief USAID on specific country activities. PHDC
will also anticipate meeting periodically with teams from various
Bureaus.

The GH CTO will assist the LWA by providing liaison with Regional
Bureaus, the other offices in the Global Health Bureau, and USAID
Missions. All aspects of travel and Leader Award implementation,
including any global research must be reviewed and approved in advance
by the GH CTO. In addition, the GH CTO will review and approve specified
key personnel and consultants assigned to each activity.

One month after the award of this solicitation, all key personnel shall
meet with the PHDC USAID Management Team in Washington to review the
Leader work plan for the first three months of the project and to
discuss and come to agreement on the work plan for the remainder of the
first year. This work plan shall be updated at least annually based on
the July to June schedule.

**SECTION D - CERTIFICATION, ASSURANCES, AND**

**OTHER STATEMENTS OF APPLICANT**

# Standard Form 424: [[http://www.whitehouse.gov/omb/grants/sf424.pdf]{.underline}](http://www.whitehouse.gov/omb/grants/sf424.pdf), 

> Standard Form 424A:
> **<http://www.whitehouse.gov/omb/grants/sf424a.pdf>**
>
> Standard Form 424B:
> **<http://www.whitehouse.gov/omb/grants/sf424b.pdf>**

**SECTION E -- ANNEXES**

**Annex 1**

# 

# 

# 

# Mandatory Standard Provisions for U.S. Nongovernmental Recipients: <http://www.usaid.gov/policy/ads/300/303mab.pdf> 

**Annex 2**

Affirmation of Certifications:

# <http://www.usaid.gov/policy/ads/300/303mad.pdf> 

**Annex 3**

**Assessment of Capacity Building Programs of the**

**Health Communication Partnership: Summary of Recommendations**

Leader with Associate (LWA) Cooperative Agreement with the Center for
Communication Programs of The Johns Hopkins University to implement the
Health Communication Partnership (HCP)

Subcontractors are Tulane University, the Academy for Educational
Development, Save the Children, and the International HIV/AIDS Alliance.

**Basic Project Information**

Project Name Health Communication Partnership (HCP), Center for
Communication Programs, the Johns Hopkins University

Agreement Number: GPH-A-00-02-00008-00

Effective dates: 26 July 2002 to 24 July 2007

# 

## Overview of Task

## This report constitutes an external mid-term assessment of capacity building of developing country institutions by the Health Communication Partnership (HCP), commissioned by the Bureau for Global Health, Office of Population and Reproductive Health (GH/PRH), United States Agency for International Development (USAID). 

The purpose of the assessment, conducted over a three month period,
was: 1) to evaluate the scope and depth of HCP's progress towards
achieving USAID's investment to improve capacity for strategic planning,
program design, implementation and monitoring and evaluation of
communication programs; 2) to strengthen capacity building by HCP during
the remaining 1.5 years of the project; 3) to review interest and
commitment of USAID/GH missions for BCC capacity building in local
institutions; and 4) to develop a strategy for incorporating capacity
building into the follow-on procurement for communication for social
change.

Five categories of questions -- relating to project implementation and
technical accomplishments, project outcomes and impact, project
organization and management, project limitations and the follow-on
procurement -- guided the inquiry. The assessment drew on several data
collection methods that included individual and group interviews,
meetings, telephone interviews, field trips, non-structured observation
of project activities, a web-based survey, and extensive review of key
documentation on HCP and on capacity building and international aid
issues.

Three steps were taken to analyze the data. First, based on the review
of background documentation, transcripts of interview notes, and
summaries of country visits, responses were developed to each of the
questions included in the SOW. Emerging issues were then identified to
understand the larger picture of capacity building in the context of
USAID's and HCP's objectives. Finally, findings were reviewed and
adjusted to accommodate additional information and comments provided by
USAID and HCP prior to final submission of the report.

A careful review of the existing context in which capacity building
efforts are anchored and how this context affects efforts of various
organizations and initiatives, including HCP's, was conducted, focusing
on: the changing context in foreign aid; the evolving nature of capacity
building/strengthening; and the evolution of communication for health
and development.

## SUMMARY OF RECOMMENDATIONS

Two sets of recommendations were developed: the first directed at HCP's
capacity strengthening efforts during the remaining 1.5 years of the
project; and the second aimed at USAID headquarters and country missions
for the future procurement.

## [Recommendations related to HCP's Progress towards the Cooperative Agreement:]{.underline}

***Identify and support promising initiatives:*** In the remaining 1.5
years of the project, HCP should identify and support promising
initiatives to build and ensure sustainable institutional capacity. A
good example of such an initiative is the support HCP Uganda is
providing to the Uganda AIDS Commission (UAC) by identifying and
recruiting an expert to help develop a coherent country-level basket
funding mechanism to ensure sustainable multi-donor support for the YEAH
BCC campaign.

***Maximize Southern Partners strategy:*** Bearing in mind what is
realistically achievable, and building on progress registered to date,
HCP should take strategic steps to maximize its Southern Partners
strategy in the remaining period of the project. An important
prerequisite for success in this endeavor is the full engagement of
USAID missions and country partners in the process of defining and
implementing initiatives and activities.

***Strengthen exit strategy:*** In line with the renewed USAID emphasis
on graduation and exit, and to ensure the sustainability of HCP's
achievements in devolving capacity to in-country institutions, HCP
should articulate clear exit strategies in all project countries. While
such strategies exist in some countries and in relation to specific
interventions (such as the Ask Consult initiative in Egypt), they are
lacking in others. Where they exist, such strategies should be deepened
or more clearly spelled out.

***Institutionalize follow-up training:*** In order to deepen the
hands-on targeted training that underpins its CLA approach, and where
possible, HCP should develop follow-up training and supervision
activities to cement existing skills, verify the effectiveness and
impact of interventions developed by organizations that have received
TA, and incubate new ideas. Learning by doing requires follow-up
activities and sustained support over time.

***Arrive at clarity on indicators:*** HCP should take steps to address
differences with USAID/GH/PRH (as documented in the SOW) over agreed
indicators of progress in building capacity under the LWA. Under a
Cooperative Agreement, and from the outset, both sides of the
partnership need to be clear as to what is expected, especially given
that it is not immediately apparent how the two indicators HCP suggested
could operationalize the third indicator, which is broad and clearly
focused on institutional strengthening.

***Further strengthen Monitoring and Evaluation:*** HCP should continue
and accelerate ongoing work to strengthen its impressive monitoring and
evaluation system so to enable a more comprehensive, accurate and rich
account of HCP's capacity strengthening impacts. Although past efforts
are important, refinements should be able to clearly show what has been
achieved under HCP -- as opposed to impacts achieved under previous
awards to JHU-CCP. The reporting should also be able to better assess
the influence of HCP framework on other BCC projects funded by USAID,
and identify tools and models developed by other partners.

**[Recommendations related to the Future Procurement]{.underline}**

***Strengthen institutional capacity:*** Beyond current efforts to build
individual capacity, there should be an increased focus on strengthening
institutional capacity among current partners, and develop and implement
explicit strategies to build capacity across different institutions in
project countries. A good example of institutional capacity development
is found in Nepal with local NGOs.

***Scale up impacts:*** Where its hybrid mass media/community
mobilization approach has had impact (such as at community level in
Egypt), and in consultation with the relevant USAID missions and its
country partners, CAs should develop explicit strategies for scaling up.
This is particularly important in countries where focus is on
hard-to-reach communities.

***Deepen focus on creating an enabling environment:*** Building on
successful approaches in countries where it has strong leverage with the
government and other agencies, CAs should develop clear,
country-specific strategies to help build a requisite enabling
environment for sustainable health communication. Among other things,
such strategies could focus on the promotion of health communication
policies and expanded training efforts that address capacity building
issues, and on the allocation of financial resources for sustained
strategic health communication.

***Regularize capacity assessments:*** To the extent possible, CAs
should identify existing health communication capacity in a given
country in a more systematic manner *before* the onset of project
activities, and include an explicit plan to leverage existing capacity.
This will also help ensure broad-based participation, including existing
local knowledge and expertise, and develop strategies that are
increasingly country driven, two of the principles of effective capacity
building.

***Develop clear USAID/GH-wide definition of capacity building:*** For
the purposes of the follow-on procurement, USAID/GH should articulate a
unified philosophical approach to capacity building that draws on its
long track record of building various types of capacity[^15] and leave
less room for misinterpretation of the scope and extent of the capacity
building objective of the follow-on procurement.

***Tighten up the language in the next procurement:*** At the level of
the Global Award capacity building needs to be more clearly defined and
explicitly codified in the follow-on procurement. Clear and unambiguous
language on what is required in capacity building terms should be
developed and added to the follow-on procurement. Potential CAs should
be required to submit proposals on how they would address the challenges
of institutional capacity, sustainability, and exits strategy, as well
as deepening technical capacity through the development of centers of
excellence to build and sustain long-term health communication capacity
in-country.

***Strengthen dialogue on the Cooperative Agreement:*** An important
insight from this evaluation has been HCP's apparent ambiguity regarding
sub-indicators against which to monitor and evaluate progress in
strengthening capacity in the course of the project. The goal should be
to ensure that clarity is arrived at *before* the contract is awarded
while allowing for continuous engagement and iteration after the award.

***Require country capacity building assessments:*** Any procurement or
award should explicitly require baseline studies to be conducted in each
project country to establish existing health communication capacity
*before* the onset of project activities, and include an explicit plan
to leverage existing capacity. This will help CAs to ensure broad-based
participation and develop country-driven strategies, two of the
principles of effective capacity building.

***Address the diverse reality of capacity building needs by
country/region:*** This approach could help address the existing dilemma
of addressing long-term capacity building versus delivering immediate
results. For instance, countries like Haiti may demand a greater focus
on results with capacity being developed through project activities,
while countries such as Indonesia may benefit from specific activities
aimed at strengthening existing capacity.

***Build in a requirement to develop centers of excellence:***
Partnerships with universities are important, although building such
partnerships does not appear to have been a priority for USAID missions.
There are a number of good models to bring to bear -- among them the
regional BCC network in Africa (AfriCommNet) -- which aims to develop
centers of excellence in three countries that can provide health
communication training for other countries in their respective
sub-regions.

***Strengthen requirements for Southern participation and ownership:***
Prospective CAs should indicate how they would engage missions and local
partners in selection of South-to-South TA and to facilitate missions'
buy-in into South-South partnerships. Future procurements should require
CAs to provide supporting information about how prospective Southern
partners understand the role they will play in the process.

***Strengthen language on and develop more binding indicators:***
Prospective CAs should be required to explain how they will demonstrate
progress in capacity building against agreed indicators, and with
specific reference to the project, as opposed to previous projects and
efforts. Clearly, capacity building is a long-term process. Therefore,
while impact indicators are critical, process indicators might provide
the necessary background for a long-term vision on capacity building.

***Test cross-sectoral approaches**:* Capacity building is horizontal
and cross-cutting but the funding for it is divided into vertical
program areas -- HIV, Maternal Health, Child Survival, Reproductive
Health, Infectious Diseases, New and Emerging Health Priorities, etc.
This makes it difficult, though not impossible, to do cross-cutting
capacity building. USAID should think about common funding for capacity
building from various technical areas.

***Explore ways to balance short with long-term:*** The logic of
achieving short-term results continues to dominate the missions' focus.
However, there is increasing concern about the need to create larger
capacity in countries in the long-run. Embedding capacity building into
project activities continues to be the preference among missions,
although some are willing to consider long-term capacity building
efforts if there is support within USAID for such an approach.

***Institutionalize multi-stakeholder consultations to facilitate an
enabling environment.*** This effort will require work at different
levels that might be addressed in a variety of ways with the
participation of donors, CAs, governments, NGOs, and other key partners.
USAID should conduct regional and /or global consultations to devise
future action and agendas on capacity building.

***Develop innovative approaches to ensure institutional capacity:***
Other partnership modalities should be considered in countries that have
developed substantial capacity. Such approaches could include: a)
increasing support to national organizations that have the technical and
financial capability to implement large-scale projects, particularly in
Asia and Latin America[^16]; b) stimulating partnerships between
national organizations and CAs to provide a greater range of
competitiveness and facilitate both North-South and South-South
collaboration; c) implementing small grant programs to boost the
capacity of civil society organizations[^17]; and d) strengthening the
existing health communication capacity of missions.

***Improve in-country coordination, enhance partnerships:*** USAID
Washington should consider strategic advocacy targeted at other donors
and agencies to facilitate in-country coordination of health
communication activities[^18]^.^ USAID should seek to influence other
donors to adjust priorities and ensure donor coherence in policy and in
project terms at country level.

***Deepen USAID Washington/ missions engagement:*** Proposals should be
developed on how to deepen the engagement between Washington and
missions. Although the LWA emanates from and is developed by USAID
headquarters, missions that buy into the global award prefer to work
autonomously with minimal direction from USAID Washington. There is a
need for more sustained communication between Washington and USAID
country missions to ensure internal USAID coherence on capacity building
and to incorporate mission expectations in future procurements.

***Enhance collaboration with other CAs:*** While collaboration between
HCP and other CAs working in health areas is encouraged by USAID, both
by Washington and by the Missions, ensuring this in practical terms is
not always easy. In Bangladesh, for instance, there have been
difficulties in the implementation of the NGO service delivery project,
which involves BCCP, through HCP, as a supporting partner.

***Build local capacity strengthening:*** While achieving immediate
results should remain a priority, USAID missions should identify and
support in-country institutions with good potential to serve as future
hubs for health communication capacity strengthening in the longer-term.
Missions may want to consider working with HCP in the remaining project
period to develop a strategy aimed at building or strengthening local
centers of excellence.

***Develop new partnership modalities:*** Missions should consider
developing new partnership approaches and bilateral agreements, using
tried and tested procurement instruments, with a view to providing
advanced country institutions with more strategic, demand-driven
technical assistance from U.S.-originating CAs. Partnerships between
national organizations and U.S. CAs will lead to greater competitiveness
and facilitate both North-South and South-South collaboration.

**ACRONYMS**

AA Associate Award

AfriCommNet African Communication Network

BCC Behavior change communication

CAs Cooperating Agencies

CBO Community-based Organization

CTO Cognizant Technical Officer

DCHA Office of Democracy, Conflict and Humanitarian Assistance

D&G Democracy and Governance

FBO Faith-based Organization

EGAT Bureau for Economic Growth, Agriculture and Trade

FS Field Support

GH Bureau for Global Health

GH CTO Global Health Cognizant Technical Officer

HIDN Office of Health, Infectious Disease and Nutrition Office

ICT Information and Communication Technology

IPC Interpersonal communication

IR(s) Intermediate Result(s)

LWA Leader with Associates

MAARD Modified Acquisition and Assistance Request Document

M&E Monitoring and evaluation

NGO Nongovernmental Organization

OHA Office of HIV/AIDS

PDA Personal Digital Assistant

PHDC Partnership for Health and Development Communication

PRH Office of Population and Reproductive Health

RFA Request for Applications

SOTA State-of-the-art

SOW Scope of Work, Statement of Work

TA Technical Assistance

TEC Technical Evaluation Criteria

USAID United States Agency for International Development

USG United States Government

[^1]: <http://www.state.gov/f/releases/factsheets2006/79645.htm>. See
    Program Elements 3.1.1 HIV/AIDS, and 3.1.7 FP/RH, and Program Area
    4.8 Environment.

[^2]: <http://www.who.int/making_pregnancy_safer/publications/birth_spacing/en/index.html>;
    [http://www.who.int/reproductive-health/publications/pbriefbirthspacing.pdf#search=%22policy%20brief%20birth%20spacing%20-%20report%20from%20a%20WHO%20technical%20consultation%202005%22](http://www.who.int/reproductive-health/publications/pbriefbirthspacing.pdf#search=).

[^3]: **Health communication** is the art and technique of informing,
    influencing, and motivating individuals, institutions, and large
    public audiences about important health issues based on sound
    scientific and ethical considerations *\[Emerson-Tufts Program in
    Health Communication\].  ***Development communication** refers to a
    spectrum of communication processes, strategies and issues within
    the field of international development, aimed at improving the
    conditions and quality of life of people struggling with
    underdevelopment and marginalization.

[^4]: Please see Foreign Assistance Framework:
    http://www.state.gov/documents/organization/79748.pdf

[^5]: Jocelyn DeJong (2002). A Question of Scale? The Challenge of
    Expanding the Impact of Non-Governmental Organizations' HIV/AIDS
    Efforts in Developing Countries. Washington, DC; Horizons/Alliance

[^6]: See Annex 3, Assessment of Capacity Building Programs of the
    Health Communication Partnership: Summary of Recommendations

[^7]: Institute of Medicine (2002). Speaking of Health: Assessing Health
    Communication Strategies for Diverse Populations. IOM.

[^8]: Communities receive payments for protecting a forested area or
    water quality

[^9]: Exception is data that could be politically or culturally
    sensitive. Exceptions will be approved by CTO.

[^10]: The recently published *Disease Control Priorities in Developing
    Countries* mentions the need to prioritize human behavior and the
    social determinants of disease for future research and development.
    "The factors that lead people to engage in unhealthy or destructive
    behaviors are more complex than simple individual choices. Many of
    the lessons of social epidemiology -- and the flourishing world of
    advertising -- indicate that most behaviors, including risky or
    unhealthy behaviors, are socially patterned. Science has
    unfortunately not done a good job of learning how to change social
    patterns. For example, merely targeting individuals at high risk for
    HIV/AIDS without changing the social context that might reinforce
    stigmatization is not the best way to prevent disease. Indeed, in
    many developing countries that now provide free counseling, testing,
    and antiretroviral drugs for people with HIV/AIDS, the biggest
    barrier remains the social stigma of being HIV positive. Health
    systems must widen their view beyond individual patients to target
    entire communities and the media to change unhealthy socially
    patterned behavior." (Dean T. Jamison, et al (Eds) (2006). [Disease
    Control Priorities in Developing Countries]{.underline}*.*
    Washington, DC: The World Bank & Oxford University Press.)

[^11]: Current Global Leadership Priorities are Family Planning/HIV/AIDS
    Prevention Integration, Repositioning Family Planning, Contraceptive
    Security, Female Genital Cutting, Gender Issues, Maximizing Access
    and Quality (MAQ), Population-Health-Environment, Postabortion Care,
    Refugee Reproductive Health, and Youth.

[^12]: Seth M. Noar (2006). "A 10-year retrospective of research in
    health mass media campaigns: Where de we go from here?" *Journal of
    Health Communication* 11:21-42

[^13]: Thomas Eng and David Gustafson, Science Panel on Interactive
    Communication and Health. *Wired for Health and Well-Being: the
    Emergence of Interactive Health Communication.* (Washington, DC: US
    Department of Health and Human Services, US Government Printing
    Office, 1999).

[^14]: ^14^ Dina Towbin, "A One-Day Consultation Meeting on
    Communication in the Population, Health and Nutrition Sector for
    USAID Staff and External USAID Partners," report from meeting,
    Washington DC, 14 December 2000.

[^15]: Actors define capacity building in different ways, ranging from
    pre-service training to in-service training, from on-the-job
    training to formal classroom training, from issues-based training to
    capacity building in financial management and reporting.

[^16]: In the case of HCP, the Egyptian government and BCCP might fall
    under this category.

[^17]: This might contribute to scaling-up of capacity across the health
    sector, and to achieving health outcomes. Small grants, on a
    competitive basis, could be allocated to local NGOs, while U.S. CAs
    may provide strategic technical assistance that will ensure both
    delivery of programmatic results and enhancement of institutional
    capacity.

[^18]: In line with recommendations contained in the Paris Declaration
    and the outcomes of the US-Euro donor meeting on communication and
    development, see Ministry of Development/Danish International
    Development Agency (DANIDA). 2001. *Report on the Euro American
    Donor Seminar for Communication and Development.*
    http://www.comminit.com/pdf/danidareport_28022002.pdf