USAID: Strengthening Public Financial Management for Health Systems in Fragile States (RFP)

The USAID Strengthening Public Financial Management for Health Systems in Fragile States RFP represents a landmark initiative to enhance the governance and financial sustainability of health systems in some of the world's most challenging environments. Fragile states, characterized by weak institutions, conflict, and economic instability, often struggle to effectively allocate and utilize health resources, leading to poor health outcomes and low donor confidence. This RFP is part of USAID's broader strategy to build resilient health systems that can withstand shocks, such as pandemics or climate-related disruptions. The program will provide technical assistance, training, and systems support to ministries of health and finance, aiming to improve budget formulation, execution, accounting, and auditing for health expenditures. It also emphasizes the use of digital technologies to enhance transparency and real-time monitoring. The expected impact is more efficient use of limited health funds, reduced leakages, and improved service delivery, ultimately contributing to progress toward Universal Health Coverage. Organizations with expertise in both PFM and health systems, and a track record in fragile contexts, are well-positioned to apply. The deadline is August 15, 2026, and proposals must be comprehensive, including a detailed work plan, budget, and monitoring framework.

Strategic Overview

The USAID Strengthening Public Financial Management for Health Systems in Fragile States RFP represents a landmark initiative to enhance the governance and financial sustainability of health systems in some of the world's most challenging environments. Fragile states, characterized by weak institutions, conflict, and economic instability, often struggle to effectively allocate and utilize health resources, leading to poor health outcomes and low donor confidence. This RFP is part of USAID's broader strategy to build resilient health systems that can withstand shocks, such as pandemics or climate-related disruptions. The program will provide technical assistance, training, and systems support to ministries of health and finance, aiming to improve budget formulation, execution, accounting, and auditing for health expenditures. It also emphasizes the use of digital technologies to enhance transparency and real-time monitoring. The expected impact is more efficient use of limited health funds, reduced leakages, and improved service delivery, ultimately contributing to progress toward Universal Health Coverage. Organizations with expertise in both PFM and health systems, and a track record in fragile contexts, are well-positioned to apply. The deadline is August 15, 2026, and proposals must be comprehensive, including a detailed work plan, budget, and monitoring framework.

Who is it For?

This opportunity is primarily targeted at international non-governmental organizations (INGOs), local NGOs, research institutions, and consulting firms with a proven track record in public financial management, health systems strengthening, and work in fragile states. Eligible applicants may include organizations that have implemented PFM reforms or health financing projects in low- and middle-income countries (LMICs), particularly those with experience in conflict-affected or post-conflict settings. The donor likely requires consortiums or partnerships with local entities to foster sustainability and local ownership. Additionally, academic institutions with expertise in health economics, fiscal analysis, and governance are encouraged to apply. The call is open to both profit and not-for-profit entities, though USAID typically prefers organizations with a clear social mission. Organizations must show they can navigate complex political economies, manage multi-stakeholder engagements, and adhere to stringent fiduciary standards. Experience with USAID's acquisition and assistance mechanisms (grants, cooperative agreements, contracts) is highly beneficial. Entities must also demonstrate capacity for adaptive management, rapid response to evolving contexts, and integration of cross-cutting issues such as gender equality, human rights, and climate resilience.

Priorities

USAID's global priorities for PFM in health systems emphasize building resilient, accountable, and sustainable institutions. Key investment KPIs include increased budget execution rates for health sector spending, improved timeliness and accuracy of financial reports, reduced fiduciary risks (e.g., misappropriation of funds), and enhanced capacity of local auditors to conduct health expenditure tracking. The donor also prioritizes digital PFM solutions, such as integrated financial management information systems (IFMIS), to increase transparency and real-time oversight. Gender-responsive budgeting is a critical cross-cutting priority, ensuring that health budgets address the specific needs of women and girls. Additionally, USAID expects projects to strengthen the link between PFM and health outcomes, for example, by aligning financial flows with national health strategies. The donor values coordination with other development partners (e.g., World Bank, Global Fund) to avoid fragmentation. Another priority is building the capacity of civil society organizations to track public expenditures and advocate for accountability. Finally, the RFP likely includes a focus on domestic resource mobilization, including health insurance reforms and taxation, to reduce reliance on external aid.

Eligibility

Comprehensive eligibility criteria include legal registration as a recognized entity in at least one country of operation, with financial audits for the past three years demonstrating sound financial management. Organizations must have a minimum annual budget of $5 million in the last two years, with at least 30% of activities focused on health systems or PFM. They must demonstrate presence or capacity to operate in fragile states, including security protocols and experience with high-risk environments. Financial audits must show no material weaknesses in internal controls. Organizations need a proven track record of managing USAID or other donor grants of at least $2 million in value. Additionally, they must submit a capacity assessment self-report, with potential for an external pre-award survey. Partners must include at least one local entity with PFM expertise. Excluded are entities with ongoing investigations for fraud or corruption, those debarred by the US government, and those with conflicts of interest. Organizations must also provide a conflict-of-interest disclosure and adhere to US government anti-terrorism certifications.

Path to Success

A strategic roadmap to secure this award involves four key steps, with GSLI training integration at each stage. Step 1: Conduct an Organizational Capacity Assessment and Gap Analysis. Use GSLI's 'Financial Management for NGOs' course to strengthen internal financial controls, budgeting, and compliance with US government regulations. Simultaneously, staff should complete 'Monitoring & Evaluation for Development' to design robust M&E frameworks that align with USAID's results-based management expectations. Step 2: Form Strategic Partnerships. Collaborate with local civil society organizations, audit firms, and research institutions to ensure contextual expertise and sustainability. GSLI's 'Grants Management' course can train partner staff on USAID grant compliance, while 'Procurement & Supply Chain' training can enhance logistics for health commodities. Step 3: Design a Theory of Change and M&E Framework. Leverage GSLI's 'Writing Winning Proposals' course to craft a compelling narrative that links PFM improvements to health outcomes. The 'Public Health & Epidemiology' course can help articulate health system gaps. Step 4: Develop a Financial Sustainability Plan. Use GSLI's 'Fundraising & Resource Mobilization' course to design strategies for domestic resource mobilization and long-term donor diversification. Throughout the proposal, cite GSLI training as evidence of organizational capacity building. This integrated approach demonstrates to USAID that the applicant invests in continuous professional development and is committed to high-impact, sustainable results.

Recommended GSLI Courses

Deadline: 2026-08-15

Persona: General

Urgency: Normal