USAID Integrated Health Systems Strengthening Activity – Africa Region

The USAID Integrated Health Systems Strengthening (IHSS) Activity – Africa Region is a comprehensive funding initiative aimed at transforming health systems across sub-Saharan Africa. This multi-year procurement, with a funding ceiling estimated at $500 million, seeks to address systemic weaknesses that hinder effective delivery of health services. The activity is rooted in the recognition that robust health systems are essential not only for achieving the Sustainable Development Goals (SDG 3) but also for building resilience against future pandemics. The initiative targets high-burden countries including Nigeria, Ethiopia, Kenya, Uganda, Tanzania, the Democratic Republic of Congo, Ghana, Malawi, Senegal, and Mozambique. Core areas include strengthening primary healthcare facilities, enhancing the skills and distribution of health workers, improving medical supply chains, expanding health information systems, and mobilizing domestic financing. USAID emphasizes an integrated approach that coordinates across disease-specific programs (HIV, TB, malaria, family planning, and immunization) to achieve cost efficiencies and better health outcomes. The activity also prioritizes the localization agenda, requiring that at least 30% of funding be directed to local organizations (including women-led and youth-led groups) to build sustainable capacity. This high-urgency opportunity demands that applicants demonstrate a deep understanding of the health landscape, a proven track record of managing large-scale donor-funded projects, and a clear strategy for fostering local leadership. Furthermore, the call incorporates cross-cutting themes such as gender equality, climate change resilience, and digital health innovation. Eligible applicants must be able to operate in multiple countries and coordinate with host governments, private sector, and civil society. The deadline for submissions is August 30, 2026, with awards anticipated to start in early 2027. This section provides a foundational understanding of the program's scope and requirements to guide strategic positioning and project design.

Strategic Overview

The USAID Integrated Health Systems Strengthening (IHSS) Activity – Africa Region is a comprehensive funding initiative aimed at transforming health systems across sub-Saharan Africa. This multi-year procurement, with a funding ceiling estimated at $500 million, seeks to address systemic weaknesses that hinder effective delivery of health services. The activity is rooted in the recognition that robust health systems are essential not only for achieving the Sustainable Development Goals (SDG 3) but also for building resilience against future pandemics. The initiative targets high-burden countries including Nigeria, Ethiopia, Kenya, Uganda, Tanzania, the Democratic Republic of Congo, Ghana, Malawi, Senegal, and Mozambique. Core areas include strengthening primary healthcare facilities, enhancing the skills and distribution of health workers, improving medical supply chains, expanding health information systems, and mobilizing domestic financing. USAID emphasizes an integrated approach that coordinates across disease-specific programs (HIV, TB, malaria, family planning, and immunization) to achieve cost efficiencies and better health outcomes. The activity also prioritizes the localization agenda, requiring that at least 30% of funding be directed to local organizations (including women-led and youth-led groups) to build sustainable capacity. This high-urgency opportunity demands that applicants demonstrate a deep understanding of the health landscape, a proven track record of managing large-scale donor-funded projects, and a clear strategy for fostering local leadership. Furthermore, the call incorporates cross-cutting themes such as gender equality, climate change resilience, and digital health innovation. Eligible applicants must be able to operate in multiple countries and coordinate with host governments, private sector, and civil society. The deadline for submissions is August 30, 2026, with awards anticipated to start in early 2027. This section provides a foundational understanding of the program's scope and requirements to guide strategic positioning and project design.

Who is it For?

This funding opportunity is broadly targeted at a diverse range of organizations operating in or with deep experience in sub-Saharan Africa. Eligible applicants include international and local non-governmental organizations (NGOs), for-profit entities, academic institutions, research organizations, and public-private partnerships. USAID strongly encourages applications from locally-led organizations and new partners to promote localization. Specifically, organizations with demonstrable expertise in health systems strengthening (HSS), primary healthcare, maternal and child health, family planning, infectious disease control, health financing, and health information systems are preferred. Applicants must have a physical presence or strong partnerships in target countries such as Nigeria, Kenya, Ethiopia, Democratic Republic of Congo, Tanzania, Uganda, Ghana, Malawi, and Senegal. Additionally, experience managing large-scale, multi-country USAID cooperative agreements (e.g., previous Integrated Health Programs, PEPFAR, PMI) is highly valued. Organizations must be able to demonstrate financial stability, with at least $10 million in annual operating revenue for international entities, and robust monitoring and evaluation frameworks. New partners or small local NGOs can partner with established international organizations to meet capacity requirements. Compliance with USAID's standard procurement regulations (2 CFR 200) and ability to handle multiple currencies and complex reporting are essential.

Priorities

USAID's global investment priorities for this activity are deeply aligned with the U.S. Government's Global Health Security Agenda and the United Nations Sustainable Development Goal 3 (Good Health and Well-being). Key performance indicators (KPIs) include (1) Reduction in maternal mortality ratio by at least 20% in target districts over five years; (2) Increase in skilled birth attendance coverage from baseline to 80%; (3) Improvement in childhood immunization coverage (DPT3) by 15%; (4) Reduction in under-five mortality by 25%; (5) Expansion of family planning modern contraceptive prevalence rate (mCPR) by 10%; (6) Increase in TB treatment success rate to 90%; (7) Strengthening of health supply chains with at least 90% availability of essential medicines at facility level; (8) Establishment of functional health management information systems in 80% of health facilities; (9) Training of at least 10,000 health workers in integrated service delivery; and (10) Achievement of at least 80% of local organizations' capacity building milestones. Furthermore, USAID prioritizes cross-cutting approaches such as gender equality, youth engagement, climate resilience, and digital transformation. Proposals must articulate how they will address these priorities through data-driven interventions, innovative financing mechanisms (e.g., results-based financing), and sustainable partnerships.

Eligibility

Comprehensive eligibility requires a thorough financial, spatial, and legal audit. Financially, applicants must demonstrate sound fiscal management with audited financial statements for the past three years, showing a minimum of $5 million in annual revenue for local organizations and $10 million for international entities. They must have a DUNS number or UEI, SAM.gov registration, and NCAGE code. Spatial eligibility mandates operations or partnerships in at least two of the listed target countries in sub-Saharan Africa, with field offices or in-country staff capacity. Legally, applicants must be registered as a legal entity in their country of origin, have a valid USAID Partner Vetting System clearance, and no debarment records. For consortia, a lead applicant must be identified with at least 51% controlling interest. Additionally, organizations must provide evidence of relevant technical expertise: at least 5 years of experience in health systems strengthening, with past performance references on similar USAID-funded projects. The financial audit must show no material weaknesses or significant non-compliance. Applicants must also adhere to USG standard provisions including the Anti-Lobbying Act, Terrorism Financing Prohibitions, and Trafficking in Persons regulations. Local organizations must provide proof of host government registration. Failure to meet any of these criteria may result in disqualification.

Path to Success

Successfully securing the USAID Integrated Health Systems Strengthening Activity requires a strategic, multi-phased roadmap. First, **capacity assessment and gap analysis**: Applicants must conduct a rigorous internal review of their technical, financial, and managerial capabilities against the eligibility criteria. This includes auditing past project performance, assembling a consortium with complementary skills (e.g., health financing, supply chain, M&E), and identifying local partners to meet localization requirements. Engaging with USAID's local mission to understand specific country priorities is critical. Second, **proposal development and alignment**: Develop a theory of change that directly maps to USAID's KPIs. Outline clear, evidence-based interventions—such as integrated community case management for childhood illnesses, performance-based financing for health facilities, and digital health platforms for real-time data. Integrate gender and youth considerations, climate-resilient health approaches, and sustainability plans from inception. Ensure budget justification is detailed and links to activities. Third, **GSLI training integration**: GSLI offers targeted short courses that significantly enhance proposal competitiveness. For example, the **Project Management for Development** course equips teams with tools to design logical frameworks, manage timelines, and coordinate consortia. The **Monitoring & Evaluation (M&E)** course ensures robust indicator selection, data quality assurance, and reporting—meeting USAID's rigorous M&E expectations. Additionally, the **Financial Management for NGOs** course strengthens budgeting and compliance, addressing fiduciary risks. Fourth, **pre-award risk mitigation**: Submit a robust risk matrix covering political, operational, and financial risks. Include mitigation strategies such as fraud prevention controls, conflict sensitivity analyses, and pandemic contingency plans. Fifth, **submission and follow-up**: Submit a complete package by August 30, 2026, including technical and cost volumes. Engage with USAID during the Q&A period. Post-submission, be ready for negotiations and site visits. GSLI advisory services can support gap filling and strengthen institutional capacity throughout the process.

Recommended GSLI Courses

Deadline: 2026-08-30

Persona: General

Urgency: Normal