Empowered Communities for Better Health (ECBH) and Health System Strengthening (HSS) | RFI 663 20 000003

Opportunity Information: Apply for RFI 663 20 000003

USAID/Ethiopia issued this notice as a Request for Information (RFI) tied to the early design of two major health investments in Ethiopia: Empowered Communities for Better Health (ECBH) and Health System Strengthening (HSS). The RFI (Reference Number RFI-663-20-000003) was released on February 14, 2020, with responses due by March 13, 2020 at 1600 Addis Ababa time. The key point is that this is not a solicitation for funding yet. It is not a Request for Proposals (RFP) or a Notice of Funding Opportunity (NOFO), and it does not commit the U.S. Government to issue one later. USAID is using the RFI to gather market feedback and technical input to improve project design. Organizations that respond do so at their own cost, should not submit proprietary information, and should not expect any competitive advantage in a future procurement simply because they responded to the RFI. USAID also states it may use submitted feedback without restriction, and it is not required to acknowledge receipt or provide responses to questions.

The overall opportunity is framed around two complementary projects that are meant to work together, with each relying on the other to achieve results. The funding figures presented are very large, signaling the scale USAID was considering at the design stage. ECBH is estimated at $450 million, while HSS is estimated at $310 million over five years, for a combined estimate of roughly $760 million (also reflected as the award ceiling in the source data). The funding instrument type listed is a cooperative agreement, the activity category is health, the CFDA number is 98.001, and eligibility is described as unrestricted, with both non-profit and for-profit organizations encouraged to provide input.

The ECBH project is the community-facing piece. Its purpose is to empower communities to take ownership and action over health and nutrition, while also creating a reinforcing cycle where health services become more accountable and responsive to community needs. USAID positions ECBH as aiming at big population-level outcomes: reduced maternal and child deaths and a lower burden of infectious disease. The project design emphasizes that healthier outcomes are expected to come not only from service availability, but from stronger community knowledge, skills, confidence, and decision-making power related to health and nutrition. ECBH is described as building on a decade of prior work by USAID, the Government of Ethiopia, and partners, especially in behavior change, social and community mobilization, community health governance and accountability, and capacity building of local groups so they can act as advocates, stewards, and watchdogs for the health system.

USAID breaks ECBH into two interdependent sub-purposes. First, it aims to increase sustained adoption and practice of key health and nutrition behaviors, meaning the project is not just focused on awareness campaigns but on long-term behavior maintenance at the household and community level. Second, it aims to increase accountability and responsiveness to community health needs by key parts of the public health system, specifically Primary Health Care Units (PHCUs) as well as woreda (district) and regional health offices. This signals an intent to strengthen the feedback loop between communities and government health structures, reducing barriers that prevent communities from defining quality, demanding it, and receiving it. Operationally, ECBH is described as engaging all levels (national, regional, zonal, woreda, and community), but with the main emphasis on woreda and community levels where most Ethiopians actually access care. It is led by USAID/Ethiopia's Health Office in collaboration with the Economic Growth and Transformation Office, particularly for nutrition, and is intended to contribute to Ethiopia's Health Sector Transformation Plan (HSTP) II and broader self-reliance goals (J2SR).

The HSS project is the system-facing piece focused on how the health sector functions and performs. Its purpose statement is explicitly performance-oriented: improved Ethiopian health system performance for responsive, efficient, equitable, and quality services. Like ECBH, it is framed as the product of extensive consultations and assessments and as building on the last decade of joint investments in health and nutrition. HSS is organized around three interdependent sub-purposes: increasing health system responsiveness, improving quality of essential services, and reducing health inequities. In practical terms, that combination points toward strengthening governance and management, improving service delivery standards and consistency, and ensuring underserved populations benefit more fairly from the system. The project is described as engaging primarily at federal, regional, and woreda government levels and aligning with HSTP II objectives. It also anticipates coordinated partnership with the Government of Ethiopia, other donors, the private sector, and NGOs.

A notable design feature is the mutual dependency described between the two projects. ECBH is said to depend on the efforts of the new HSS project to achieve results, and HSS is also said to depend on implementing partners under ECBH to achieve its results. In other words, USAID is signaling a two-sided strategy: communities are expected to generate demand, accountability, and behavior change, while the health system is expected to respond with better performance, higher quality services, and more equitable outcomes. The intended result is a reinforcing cycle where community voice and system capacity improve together, increasing trust, transparency, and ultimately health outcomes.

For submission, USAID requested emailed comments to caddis@usaid.gov with a copy to yabraham@usaid.gov by the stated deadline. Respondents were instructed to label the email subject line with the RFI reference and the relevant project title(s). USAID also pointed potential applicants to beta.SAM.gov and grants.gov to monitor for any future official solicitations, emphasizing that this RFI itself is only part of planning and does not guarantee a funding competition will follow.

• The Ethiopia USAID-Addis Ababa in the health sector is offering a public funding opportunity titled "Empowered Communities for Better Health (ECBH) and Health System Strengthening (HSS)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 98.001.
• This funding opportunity was created on 2020-02-14.
• Applicants must submit their applications by 2020-03-13. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Each selected applicant is eligible to receive up to $760,000,000.00 in funding.
• Eligible applicants include: Unrestricted.

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