Opportunity Information: Apply for 72063624RFA00002
The Strengthening Integrated Health Services Activity (SIHSA) is a USAID-funded health program opportunity intended to support Sierra Leone in improving and sustaining better health outcomes over a five-year period. USAID plans to make one Cooperative Agreement award with a total estimated funding level of up to $45,000,000 (award ceiling $45,000,000). The activity is framed as a systems-oriented effort that goes beyond short-term service delivery by aiming to strengthen the underlying structures and performance of the health system, particularly at community and district levels where day-to-day access and quality are most directly felt.
SIHSA is designed to advance integrated health services with a strong emphasis on populations that typically face higher health risks or barriers to care. Priority groups include children under five, pregnant and postpartum women, and youth, with particular attention to adolescent girls. The activity also places special focus on women and children living in hard-to-reach areas where limited infrastructure, distance, and shortages of health workers often reduce access to essential services. Within these groups, USAID signals explicit attention to people who are especially vulnerable or routinely underserved, including persons with disabilities, gender and sexual minorities (GSM), and ethnic and religious minorities, reflecting an intent to reduce inequities in service access and health outcomes.
From a technical perspective, SIHSA targets improvements in both availability and quality across several key service areas: family planning (FP), reproductive health (RH), maternal, newborn and child health (MNCH), adolescent health, and malaria services. The emphasis on integration suggests that applicants should think in terms of coordinated service packages and referral linkages rather than isolated vertical programs, with the goal of improving continuity of care and ensuring that clients can receive multiple related services efficiently and safely. The opportunity also stresses effectiveness, implying a focus on measurable results, better clinical and community practices, and stronger performance of the health system to deliver consistent outcomes.
A central theme of the opportunity is building a sustainable and resilient health system response. In practical terms, this points toward strengthening the ability of the Sierra Leone health system to maintain essential services over time and to withstand shocks or disruptions, whether from outbreaks, supply constraints, workforce gaps, or other stresses. The description also highlights a desired "paradigm shift" within the health system, suggesting that USAID is looking for approaches that encourage broader reforms and system-wide improvements, not only incremental changes at individual facilities.
Community engagement is another core pillar of SIHSA. USAID indicates that the activity should strengthen communities' active participation and support community-driven solutions, which commonly involves helping communities identify priority health barriers, improve health-seeking behaviors, and collaborate with health providers and local authorities to improve accountability and service responsiveness. This community focus is positioned as a means of improving outcomes and ensuring that changes in service delivery match local realities, especially in remote or marginalized settings.
The opportunity also encourages partnerships that can expand reach and improve performance, specifically pointing to collaboration with local civil society and the private sector. This signals that proposals may be expected to leverage local organizations for community mobilization, service support, advocacy, and feedback mechanisms, and to consider how private providers, pharmacies, or other non-state actors can complement public services where appropriate. Overall, SIHSA is presented as a comprehensive, equity-focused health systems strengthening activity meant to improve integrated primary health care and related services in Sierra Leone, with clear expectations around inclusion, community ownership, and durable improvements at district and community levels.
Key administrative details include the funding opportunity number 72063624RFA00002, the assistance instrument type as a Cooperative Agreement, the activity category as Health, and CFDA number 98.001. Eligibility is listed as unrestricted. The opportunity was created on March 13, 2024, with an original closing date of May 15, 2024, and USAID expects to make one award under this announcement.Apply for 72063624RFA00002
- The Guinea USAID-Conakry in the health sector is offering a public funding opportunity titled "Strengthening Integrated Health Services Activity (SIHSA)" 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 2024-03-13.
- Applicants must submit their applications by 2024-05-15. (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 $45,000,000.00 in funding.
- The number of recipients for this funding is limited to 1 candidate(s).
- Eligible applicants include: Unrestricted.
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Frequently Asked Questions (FAQs): Strengthening Integrated Health Services Activity (SIHSA)
1) What is the Strengthening Integrated Health Services Activity (SIHSA)?
SIHSA is a USAID-funded health program opportunity intended to support Sierra Leone in improving and sustaining better health outcomes over a five-year period. It is framed as a systems-oriented effort designed to strengthen the underlying structures and performance of the health system, particularly at the community and district levels.
2) What is USAID trying to achieve through this opportunity?
The opportunity aims to improve and sustain health outcomes by strengthening the health system beyond short-term service delivery. It emphasizes integrated health services, measurable improvements in availability and quality, stronger community participation, and durable (sustainable and resilient) system performance over time.
3) What is the period of performance?
The activity is intended to operate over a five-year period.
4) How much funding is available?
USAID plans a single Cooperative Agreement award with total estimated funding of up to $45,000,000. The award ceiling is $45,000,000.
5) How many awards does USAID expect to make?
USAID expects to make one award under this announcement.
6) What type of award is this?
The assistance instrument type is a Cooperative Agreement.
7) What is the funding opportunity number?
The funding opportunity number is 72063624RFA00002.
8) What is the activity category and CFDA number?
The activity category is Health, and the CFDA number is 98.001.
9) Who is eligible to apply?
Eligibility is listed as unrestricted.
10) When was the opportunity posted and when did it close?
The opportunity was created on March 13, 2024. The original closing date was May 15, 2024.
11) What geographic focus does SIHSA cover?
SIHSA is intended to support Sierra Leone, with particular emphasis on strengthening the health system at community and district levels.
12) What does “systems-oriented” mean in the context of SIHSA?
In this opportunity, “systems-oriented” refers to approaches that strengthen the structures and performance of the broader health system, rather than focusing only on short-term service delivery. The intent is to improve how the system functions at the levels where people most directly experience access and quality: communities and districts.
13) Which populations are prioritized by SIHSA?
Priority groups include children under five, pregnant and postpartum women, and youth, with particular attention to adolescent girls. The activity also prioritizes women and children living in hard-to-reach areas where access is limited by distance, infrastructure constraints, and health worker shortages.
14) Does SIHSA emphasize inclusion of underserved or vulnerable groups?
Yes. USAID signals explicit attention to people who are especially vulnerable or routinely underserved, including persons with disabilities, gender and sexual minorities (GSM), and ethnic and religious minorities. This reflects an intent to reduce inequities in access and outcomes.
15) What service areas does SIHSA focus on?
SIHSA targets improvements in both availability and quality across multiple areas: family planning (FP), reproductive health (RH), maternal, newborn and child health (MNCH), adolescent health, and malaria services.
16) What does “integrated health services” mean for this activity?
The opportunity’s emphasis on integration suggests a focus on coordinated service packages and referral linkages rather than isolated, vertical programs. The goal is continuity of care and enabling clients to receive multiple related services efficiently and safely.
17) Is the opportunity focused only on service delivery?
No. While the activity is meant to improve availability and quality of services, it is described as going beyond short-term service delivery by strengthening underlying health system structures and performance.
18) What does USAID mean by improving “availability and quality” of services?
Based on the description, the opportunity seeks measurable improvements in whether services can be accessed (availability) and how well they are delivered (quality), across priority service areas, especially at district and community levels.
19) What is meant by “effectiveness” in this opportunity?
The opportunity stresses effectiveness in terms of focusing on measurable results, improving clinical and community practices, and strengthening the health system’s performance so it delivers consistent outcomes.
20) What does it mean that SIHSA aims for a “sustainable and resilient” health system?
It means strengthening the system’s ability to maintain essential services over time and to withstand shocks or disruptions. Examples of disruptions mentioned or implied include outbreaks, supply constraints, workforce gaps, and other stresses.
21) What is the “paradigm shift” USAID mentions?
The term “paradigm shift” indicates that USAID is looking for approaches that encourage broader reforms and system-wide improvements, not only incremental changes limited to individual facilities.
22) How important is community engagement in SIHSA?
Community engagement is described as a core pillar. The activity is expected to strengthen communities’ active participation and support community-driven solutions to improve outcomes and ensure services are responsive to local realities, especially in remote or marginalized settings.
23) What might “community-driven solutions” involve under SIHSA?
The description links community-driven solutions to helping communities identify priority health barriers, improving health-seeking behaviors, and fostering collaboration among communities, health providers, and local authorities to strengthen accountability and responsiveness.
24) Does SIHSA encourage partnerships, and with whom?
Yes. The opportunity encourages partnerships, specifically pointing to collaboration with local civil society and the private sector to expand reach and improve performance.
25) What role might civil society play in SIHSA?
Based on the opportunity description, local civil society may be leveraged for community mobilization, service support, advocacy, and feedback mechanisms.
26) What role might the private sector play in SIHSA?
The opportunity suggests considering how private providers, pharmacies, or other non-state actors can complement public services where appropriate, potentially helping to expand reach and improve performance.
27) At what health system levels is SIHSA most focused?
SIHSA particularly emphasizes the community and district levels, described as where day-to-day access and quality are most directly experienced.
28) What is the equity focus of SIHSA?
SIHSA is described as equity-focused through its prioritization of high-risk groups and explicit attention to underserved populations (including persons with disabilities, GSM, and ethnic and religious minorities), as well as women and children in hard-to-reach areas.
29) Does SIHSA include malaria in its scope?
Yes. Malaria services are explicitly included among the key service areas for which the activity targets improvements in availability and quality.
30) Is adolescent health included, and is there a particular emphasis within youth?
Yes. Adolescent health is included, and within youth, the opportunity highlights particular attention to adolescent girls.
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