Health Financing Improvement Program | 72066318RFA00001

Opportunity Information: Apply for 72066318RFA00001

The Health Financing Improvement Program is a USAID Ethiopia discretionary funding opportunity designed to strengthen Ethiopia's health and nutrition systems so they can operate with greater self-reliance and deliver better health outcomes over time. The activity sits under USAID Ethiopia's Strategic Results Framework, specifically under Development Objective 4, which focuses on building effective systems that advance health and education outcomes. It also supports Development Objective 2, which emphasizes increasing the resilience of vulnerable populations to major shocks. In practical terms, the program is about improving how Ethiopia pays for, manages, and governs primary health care (PHC) so that services are more reliable, higher quality, and less financially burdensome for households.

The award will be made as a cooperative agreement, meaning USAID expects to be substantially involved in how the activity is implemented, not just funding it at arm's length. The opportunity is run by the Agency for International Development (USAID), Ethiopia mission in Addis Ababa, and is open to a wide range of applicant types (unrestricted eligibility), subject to any additional eligibility notes included in the full announcement. The funding opportunity number is 72066318RFA00001, and it is categorized under the health sector (CFDA 98.001). USAID anticipated making a single award, with an award ceiling of up to $40,000,000. The notice was created on May 21, 2018, with an original closing date of July 20, 2018.

Programmatically, the activity is structured around four major intermediate results that together define the core health financing reforms USAID is aiming to support in Ethiopia. The first intermediate result focuses on increasing domestic resource mobilization to enhance the provision of quality primary health care services. This area is typically concerned with helping a country raise and allocate more of its own funding for health, improving public financing flows, and strengthening the sustainability of PHC by reducing reliance on external assistance. It implies attention to budget planning, revenue generation approaches, and better alignment of domestic funding with priority PHC needs.

The second intermediate result aims to streamline risk-pooling mechanisms so more people can access PHC services while facing fewer financial barriers. Risk pooling usually refers to mechanisms like health insurance or community-based insurance where financial risk is shared across a group rather than falling on an individual at the point of care. By improving these mechanisms, the program seeks to reduce out-of-pocket spending that can keep families from seeking care or push them into financial hardship. The emphasis on "streamlined" suggests the program may address fragmentation, inefficiencies, and coverage limitations that can occur when multiple schemes or administrative processes are not well coordinated.

The third intermediate result centers on improving arrangements for strategic purchasing of health services from both public and private providers. Strategic purchasing generally means shifting from simply funding facilities based on historical budgets to paying for services in ways that encourage quality, efficiency, and accountability. This can involve designing provider payment methods, contracting approaches, performance-linked financing, benefit package decisions, and clearer expectations about what services are purchased, from whom, and under what standards. Including both public and private providers signals an intent to improve how the broader health system is engaged to deliver PHC services, not only government facilities.

The fourth intermediate result targets strengthened governance, management, and evidence generation for health financing reforms and for health facilities. This result highlights the enabling conditions needed for financing reforms to actually work: better leadership and oversight, stronger management systems at different levels, improved transparency and accountability, and better use of data and research to guide decisions. "Evidence generation" points to building the capacity to track results, analyze financing performance, evaluate reforms, and use findings to adjust policies and implementation. It also implies support for facility-level systems so that financing changes translate into better day-to-day operations and service delivery.

Overall, the opportunity is structured as a comprehensive health financing reform support package that links revenue and resource mobilization, financial protection through risk pooling, smarter ways of paying for services, and the governance and data systems needed to make reforms stick. The intended outcome is a more resilient, sustainable primary health care financing system in Ethiopia that improves access and reduces financial barriers while strengthening the institutions that manage and oversee the health sector.

• The Agency for International Development, Ethiopia USAID-Addis Ababa in the health sector is offering a public funding opportunity titled "Health Financing Improvement Program" 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 May 21, 2018.
• Applicants must submit their applications by Jul 20, 2018. (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 $40,000,000.00 in funding.
• The number of recipients for this funding is limited to 1 candidate(s).
• Eligible applicants include: Unrestricted (i.e., open to any type of entity above), subject to any clarification in text field entitled Additional Information on Eligibility.

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