[Federal Register Volume 72, Number 158 (Thursday, August 16, 2007)]
[Notices]
[Pages 46063-46073]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-16096]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES


Announcement of Availability of Funds for a Cooperative Agreement 
To Provide Baccalaureate Nursing Education Supportive of Maternal-Child 
Nursing at Kabul Medical University (KMU) and Support for the 
Development of a Nursing Board for Registration and Licensure at the 
Ministry of Public Health

AGENCY: Department of Health and Human Services, Office of the 
Secretary, Office of Global Health Affairs.

ACTION: Notice.

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SUMMARY: The primary goal of this project is to assist Afghanistan in 
the development and strengthening of maternal and child health clinics/
hospital systems by creating a solid, university-based, culturally-
appropriate professional nursing educational program and building upon 
previous educational and training efforts. Funding is made available 
for the development of a basic baccalaureate program at Kabul Medical 
University and a registered nurse completion program at the Institute 
of Health Sciences (IHS) in Kabul, Afghanistan. The focus of both 
programs must be toward an emphasis on clinical training, to include 
the demonstration of direct patient care alongside Afghan health-care 
nurse providers.
    Announcement Type: Single Eligibility--FY 2007 Initial 
Announcement.
    GSA Catalog of Federal Domestic Assistance: 93.017.

DATES: Application Availability: August 16, 2007. Optional Letter of 
Intent must be received by 5 p.m. ET August 23, 2007. Applications must 
be received by 5 p.m. ET August 31, 2007. Award date: September 15, 
2007.

SUPPLEMENTARY INFORMATION: The Office of Global Health Affairs (OGHA) 
within the Department of Health and Human Services (HHS) announces that 
up to $625,000 in fiscal year (FY) 2007 funds is available for one 
cooperative agreement to the Aga Khan Foundation (AKF), to provide 
support for the development of a basic baccalaureate program at Kabul 
Medical University and a registered nurse completion program at the 
Institute of Health Sciences (IHS) in Kabul, Afghanistan to include the 
implementation of curriculum reform in support of evidence-based 
theoretical and clinical nursing knowledge and practice in community 
based maternal-child health at Kabul Medical University, the 
strengthening of the nursing program at IHS and the development of a 
systematic program for faculty development and the development of a 
Board of Nursing for licensure and certification at the Ministry of 
Public Health (MoPH) of Afghanistan.\1\ An emphasis will focus on 
clinical training, which will include the demonstration of direct 
patient care alongside Afghan health-care nurse providers. All care 
will also reflect an interdisciplinary approach with full participation 
of the medical and allied health team in the delivery of care. Nurses 
can be the front-line provider of care and first point of contact in 
many clinic settings, especially for women and children.
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    \1\ The Baccalaureate Nursing Education and Nursing Registration 
and Licensure described in this document are not intended to be 
equal with U.S. or other Western standards for such training.
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    The primary goal of this project is to assist Afghanistan in the 
development and strengthening of maternal and child health clinics/
hospital systems by creating a solid, university-based, culturally-
appropriate professional nursing educational program and building upon 
previous educational and training efforts at the IHS by enhancing its 
three-year program for basic nursing. The program will be approved 
initially for a program period of one year in the amount of $625,000 
available (including indirect costs), with continuing awards 
contemplated for year two and year three. Funding for the cooperative 
agreement in subsequent years is contingent upon the availability of 
funds and the satisfactory performance of the recipient.

I. Funding Opportunity Description

    Authority: FY 2006 Labor/HHS/Education appropriations act, Pub. 
L. 109-149. 119 Stat. 2833, 2856 (Dec. 30, 2005), continued by 
sections 101(a)(5) and 104 of Division B of the FY 2007 Continuing 
Resolution, Pub. L. 110-5 (Feb. 15, 2007).

Purpose of the Agreement

    HHS, in partnership with other relevant U.S. Government Departments 
and agencies, anticipates involvement in the development, 
administration and oversight of this program to improve

[[Page 46064]]

professional nursing education and training at Kabul Medical University 
and the IHS in Kabul, Afghanistan. The program will be for a program 
period of one year. Approximately a total of $625,000 will be available 
for the one-year program period.
    The primary goal of this project is assist Afghanistan in the 
development of maternal and child health clinics/hospital systems. One 
way is by creating a solid, university-based, culturally-appropriate 
professional nursing educational program and building upon previous 
educational and training efforts at the IHS by enhancing its three-year 
program for basic nursing.
    A secondary goal is to support basic curriculum revision within the 
present nursing program in community-based maternal and child health 
related course work. The award recipient will also conduct a 
comprehensive evaluation of conditions and elements necessary for the 
eventual implementation of a culturally-appropriate licensing and 
certification program.\2\ The funding will provide essential material 
resources within budgetary limitations for educational materials and 
for grant activities related to faculty leadership development.
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    \2\ The Baccalaureate Nursing Education and Nursing Registration 
and Licensure described in this document are not intended to be 
equal with U.S. or other Western standards for such training.
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    Afghanistan has been at war with foreign forces and neighboring 
countries for over a quarter of a century and sectional violence has 
been rampant among ethnic groups. Over 5 million people including 
300,000 children have died. Another 4.2 million Afghans have fled to 
Pakistan and Iran after the Soviet invasion in 1979 and repatriation 
continues to date. Afghanistan is a nation, which today even though 
nominally at peace, remains politically unstable with a resurgence of 
the Taliban movement primarily in the east and south. The past and 
present political situation impacts immensely on the physical security 
and health and psychological well-being of the Afghanistan people.
    Afghanistan is among the countries with the poorest human 
development indicators. It has the second highest maternal death rate 
in the world and the highest infant and child mortality in Asia. Save 
the Children and others report that the greatest health risk to Afghan 
women is pregnancy. According to the United Nations Children's Fund 
(UNICEF) less than 15 percent of the births are attended by medically 
trained personnel and only 90 percent are assisted by a traditional 
midwife. For every 100,000 live births, about 1,400 women die each 
year. When mothers die in childbirth, their infants are from three to 
ten times more likely to die before their second birthday due to 
preventable illnesses and poor immunization standards and practices. 
This unnecessary mortality can be partially attributed to the lack of 
safe drinking water where outside the cities only about 30 percent of 
the households have access to safe water. Drought and crop failure has 
diminished the supplies of grains and fresh produce contributing to 
significant malnutrition (54 percent) and vitamin deficiencies. The 
harsh winters and seasonal flooding also take its toll on the health of 
the population. Nearly 40 percent of the children less than three years 
of age are underweight and more than half of the children in this age 
group are stunted. Afghan men have an average life expectancy of 45 
years of age and the average life expectancy for women is 47 years of 
age, though the Maternal Mortality Rate (MMR) is higher in rural and 
remote areas. Addressing poverty, lack of income and limited access to 
health-care have been recognized as priorities by the Afghanistan 
government and the international donor community.
    Afghanistan's resources for education and access to schools have 
always been limited. During the Taliban era, many teachers left the 
country and those that remained received little or no continuing 
education. The Taliban neglected or destroyed school buildings. Women 
and girls were denied access to education during the Taliban era and 
even today, older girls are prohibited from sharing classroom education 
with boys. As a result, literacy rates vary significantly between men 
and women. Nearly half of the Afghan men are illiterate and women in 
Afghanistan have the lowest literacy rate in the world (between 9 
percent and 15 percent). The World Bank reports (January 2006) that 
despite the success of back to school campaigns, half of the school age 
children are not educated. The United States Agency for International 
Development (USAID) reports that there are 5 million students in school 
and that only 34 percent of those are girls. Although this is higher 
than at any time in the history of Afghanistan, women and girls lag far 
behind men and boys in education and the gap is not narrowing.
    The Afghanistan Ministry of Public Health (MoPH) has been 
reconstituted and has stated that their mission is ``to provide health-
care to all Afghans especially to women and children and to under-
served areas of the country by working effectively with communities and 
MoPH partners.'' The primary priorities of the MoPH are as follows:
     Reduce maternal and neonatal mortality;
     Reduce child mortality;
     Reduce communicable disease;
     Reduce malnutrition;
     Improve health system; and,
     Improve mental health.
    The World Health Organization (WHO) Assignment Report (16-23 May 
2002) summarized the constraints facing the Afghan Health Sector, which 
will be reexamined in light of their status today. These constraints 
are as follows:
     Lack of accurate information regarding the number and 
nature of the work of the health-care workforce especially nurses, 
midwives and allied health workers: As of 2006, this remains a problem. 
It is estimated that there are between 3,000 to 4,000 doctors in 
Afghanistan with a doctor to nurse-midwife ratio of 1:1. It has also 
been estimated that there are 11,000 medical students in 8 medical 
schools and 2,200 to 2,500 students in intermediate schools for nursing 
and midwifery. With the financial assistance of USAID and the Aga Khan 
Development Network (AKDN), 228 female graduates from more than 20 
provinces completed the two-year competency-based program in April 
2005. As of June 2006, 805 new midwives have received training from one 
of two programs with approximately 70 percent completing the shorter 
community midwifery program. This represented a 65 percent increase 
from the 467 trained midwives in Afghanistan after the fall of the 
Taliban in 2001. By the end of 2006, 830 new midwives were expected to 
be trained. USAID has also provided training to 6,036 Community Health 
Workers of whom over half are women. USAID also reports that 227 women 
graduated from literacy programs that prepare them to enter the health-
care professions.
    Nursing as a profession, without the major emphasis on midwifery, 
historically has been a male-dominated profession in Afghanistan. It is 
estimated that there are 3,800 nurses of whom 900 are female graduates 
from a three-year diploma program likely practicing midwifery rather 
than basic nursing. Because of the high mortality associated with 
childbirth, all initial efforts focused on providing support to 
decrease this health disparity. Numerous studies state that the country 
will eventually need 8,000 to 10,000 midwives to strengthen the overall 
quality of health-care. In the past, less attention has been directed 
toward the needs and utilization of basic or specialized nursing 
professions or the

[[Page 46065]]

development of a formal degree program in nursing. Most current efforts 
are being directed toward providing in-service or continuing education 
in a hospital-based curative oriented model.
    Though most health planners would suggest that mortality associated 
with childbirth is a significant problem, it could also be argued that 
a comprehensive approach to health would be better served by devoting 
significant resources to the creation of a cadre of professional 
nurses. This nursing cadre would provide a wide repertoire of 
preventative as well as curative services in a wide variety of settings 
to patients of all ages and all genders. In 2002, recognizing the 
significant need for females to be prepared for a modern model of 
nursing practice, the Government of Afghanistan invited Aga Khan 
University of Nursing (AKU-SON), in collaboration with WHO, to support 
the development of Afghanistan's human resources in the health sector, 
especially midwifery, nursing and allied health within the Afghan 
Institute of Health Sciences (IHS).
    The quantity of students graduating from the Aga Khan IHS nursing 
diploma program in Kabul are not as great as those graduating from the 
midwifery program. In 2006, of the eighty-six students graduating from 
the newly designed three-year diploma program, only 19 were female. 
Presently, there are 90 students in the second year and 70 in the first 
year. Across all years, the gender distribution has been 
disproportionately male and efforts to recruit females have become a 
priority, as it remains a major issue. Cognizant of the gender 
disparity, the MoPH declared that the class of 2007 will have a gender 
distribution of 80 percent female and 20 percent male on the condition 
that males serve in the rural areas.
     Lack of clarity/ role definition of different health 
practitioner categories:
    This lack of specific role definition is particularly evident in 
the approach to the recent development of the nurse midwives for 
Afghanistan. Understandably, the curriculum and practice design focused 
on the need to deal with life threatening complications such as 
hemorrhage, which were occurring frequently in the rural areas and 
among unassisted births. In 2005, it was estimated that over 92 percent 
of births in Afghanistan were unassisted. Thus, two tracts of 
practitioners were trained or retrained if they had graduated from any 
of the variable length programs created after the national revolution 
in 1978. The difference in expectations for practice is generally 
determined by need or in this case, by the lack of health-care in rural 
areas rather than by performance-based criteria. Similarly, with basic 
nursing, the curative services adopted from the Soviet Union were 
traditionally practiced within the confines of a health-care 
institution and did not extended into practice in the ambulatory unit 
or community. Historically, all health-care was supposed to take place 
within the walls of a hospital.
     Workforce imbalance and misdistribution: As stated 
previously, the ratio of nurses to physicians, ratio of midwives to 
nurses and the predominance of males in the health profession, remains 
problematic. This problem is particularly salient given the highly 
conservative culture of Afghanistan. This year however, Afghanistan has 
made progress, as both the medical and nursing diploma program will 
admit 80 percent female and 20 percent male students to the new class. 
Both programs will also limit their enrollment substantially. The 
question of misdistribution in the field remains problematic. The IHS 
will admit males to the nursing program on the condition that they 
return to the rural provinces to practice. As Benjamin Loevinsohn, a 
World Bank health specialist states, Health workers in Afghanistan are 
afflicted by the ``3 wrongs'': Wrong gender, wrong skills, and wrong 
location.''
     Absence of national standards of curriculum development 
for all health professionals: Progress on this endeavor has been made 
in both basic nursing and midwifery. However, lack of exposure to the 
newest clinical knowledge and skills among the present health faculty 
makes the task very difficult. The lack of accepted academic 
preparation is a major obstacle. Presently, within the university 
community of scholars, only three percent of the 711 higher education 
teachers with a master's degree (39 percent) are female. Of the 132 
faculty members with a Doctorate degree, none are female and of the 998 
professors with a baccalaureate degree, only nine percent are female.
     Multiple categories and varying lengths of training 
programs within nursing, midwifery and allied health: The length of the 
midwifery training programs has been standardized by the MoPH. The 
nursing diploma program of AKU-SON also has a standardized length. 
Discussion of the length and content of the baccalaureate program 
remains to be determined, although the newly established Kabul 
University program will follow a four-year model. The allied health 
programs follow a three-year technical school pattern.
     Proliferation of disease specific vertical training 
programs: Vertical training programs remain prevalent and are most 
widely seen in educational programs that resemble didactic continuing 
education programs, as these programs are promoted most often by the 
latest infusion of donor dollars.
     Lack of professional regulation of practice: Little 
progress has been made in the area of accreditation, licensure/
registration and certification. Nursing and midwifery have recognized 
this need and established it as a high priority. A positive development 
has been the formation of a professional midwife organization, which is 
in the process of qualifying for membership in the International 
Confederation of Midwives. The MoPH recognized the importance of 
nursing by establishing a Directorate of Nursing in 2006. However, 
program funds are scarce or non-existent and the designation of 
responsibility for monitoring nursing and allied health has yet to be 
determined. It is therefore evident that the present Director and staff 
require assistance to accomplish this objective.
     Isolation and lack of coordination among professional 
health education schools: Unlike most programs in Afghanistan, basic 
nursing and midwifery programs supported by AKU-SON and USAID/JHPIEGO, 
an affiliate of John Hopkins University, are based on standardized 
competency-based curriculums, supervised routinely and coordinated 
centrally. The allied health programs outside of Kabul have closed due 
to a lack of resources, faulty physical facilities and equipment. 
Requests for donor support in this area have not materialized to date.
     Limited clinical experience/deficiencies in clinical 
training in hospital and community settings: There has been marked 
improvement in identifying and obtaining access to appropriate clinical 
experiences particularly as it relates to maternity services, which 
have been the recipient of the majority of the donor funding. 
Similarly, in those community health clinics and provincial health 
district hospitals supported by the World Bank, European Community and 
USAID, deficiencies in clinical training have begun to disappear. At 
the tertiary care level, children's clinical services supported by 
bilateral partners have been rehabilitated to the extent that they have 
become excellent sites for clinical training. Premier hospitals 
supported by a heavy reliance of expatriate leadership and management 
have also provided opportunities beyond the provision of

[[Page 46066]]

basic care. Deficits in the fields of psychiatry and mental health as 
well as other areas of specialized and highly technical practice such 
as oncology and laboratory-intensive domains however continue to exist.
     Lack of coordination among educational institutions, 
services and policy-makers in preparing health professional cadres: Key 
individuals responsible for the education and practice of key 
professional groups have indicated a willingness to cooperate at the 
central level. Current bilateral funding tends to support midwifery 
development and with only a small percentage of donor dollars dedicated 
to medicine, even less was allocated to allied health. USAID has 
recognized that literacy at all levels is essential for development in 
the social sector. However, coordination between the Ministry of 
Education (MOE) and the MoPH still needs strengthening. The vital role 
of primary and secondary education in the development of professional 
education could also be significantly strengthened. Professional 
education demands critical thinking skills and an inquisitive mind for 
exploration of new information in the arts and sciences that are 
essential to the development of a humanistic role for the health 
practitioner.
     Lack of exposure to regional and international trends in 
health-care: The travel portfolio in the International Relations 
Department attests to the multiple trips abroad by key health 
professionals. Documentation to evidence the application of newly 
acquired information and skills and its subsequent affect on the 
quality of health-care delivery however does not exist. The Director of 
Information and Education did state that a system to track and monitor 
foreign travel is being implemented which will require that all trips 
abroad must be approved by the Ministry of Foreign Affairs (MOFA) with 
those of Director and above, approved by the President of Afghanistan.
    The recipient of this cooperative agreement will support the 
development of a basic baccalaureate and a registered nurse completion 
program through the implementation of curriculum reform in support of 
evidence-based theoretical and clinical nursing knowledge and practice 
in community-based maternal-child health at Kabul Medical University 
and the strengthening of the nursing program at the Institute of Health 
Sciences (IHS). The recipient of this agreement will also develop a 
systematic program for faculty development and establish a Board of 
Nursing for licensure and certification at the MoPH in Kabul, 
Afghanistan while building the Afghan capacity to assume these 
functions in the future.
    It is anticipated that multiple sources of significant revenue, in 
addition to this cooperative agreement, will be available for 
leveraging in accomplishment of the objectives. These sources include 
current MoPH and MOHE operating expenses, supplies, and staff for IHS 
and Kabul Medical University and international donor contributions or 
in-kind donations to support educational reform and growth.
    The recipient will develop and upon award, implement a formal, 
mutually agreed-upon one-year work plan. The work plan must contain all 
elements listed below including timelines for completion and designated 
responsible agents. Measurable goals, objectives, and outcomes are 
expected to be integrated into the work plan as follows:
     Provide a mission statement, including the projected scope 
of service;
     Develop an annual operational and personnel budget, 
including a plan to identify, optimize, consolidate and effectively 
utilize all available funding sources for Kabul Medical University 
(KMU) and IHS;
     Document and assess the current nursing training 
curriculum, identifying areas of need and devising sustainable 
solutions for curriculum reform;
     Assess the clinical training heads of faculty and students 
to establish and sustain quality training and education;
     Develop and implement a plan for the revision of the 
nursing curriculum to include a focus on evidence-based theoretical and 
clinical nursing knowledge and practice in maternal-child community 
health for the basic nursing and registered nurse completion program;
     Prepare new course syllabi and corresponding teaching/
learning resource packets based on the revised curriculum;
     Create a plan to establish the linkage between the IHS 
curriculum and the basic baccalaureate program to demonstrate the 
articulation between both;
     Establish a system of credit by examination for presently 
active registered nurses so they may matriculate in the baccalaureate 
nursing program;
     Develop a system for nurse-midwives to receive credit for 
clinical practice and admission into the basic and subsequent 
Baccalaureate program;
     Create a model for the development of clinical educators 
and the recruitment of health-care workers from the community to 
function as adjunct clinical faculty;
     Develop and establish a system for faculty and student 
recruitment and community outreach;
     Create a plan for the development of a Management 
Information System (MIS) for documentation of all training and 
developmental efforts and achievements;
     Create a model for faculty training which may consist of 
planned exercises, mentoring by international experts and facilitation 
by peer networking. All efforts must compliment MoPH efforts and 
reflect IHS and Kabul Medical School education/training standards;
     Develop a quality assurance and quality improvement 
assessment, monitoring and evaluation system for faculty, students and 
programs;
     Establish a mechanism for national dialogue in 
collaboration with non-governmental organizations (NGOs) providing 
nursing training and continuing education and other partners in 
relation to health planning and policy development within the MoPH, 
MOHE, Ministry of Women's Affairs and others; and;
     Create a plan to support the MoPH Directorate of Nursing 
in the development of its capacity as a regulatory and authoritative 
body for nursing in Afghanistan.
    The award recipient will be responsible for preparing any sub-
recipient request for application (RFA), conducting the RFA 
announcement and competition process, awarding the grant(s) and 
monitoring the grant(s) performance.
    Finally, the award recipient will monitor and report progress 
quarterly and annually and conduct a comprehensive evaluation of all 
required elements and conditions, including outcome measures for 
effectiveness and efficiency.

II. Award Information

    The administrative and funding instrument for this program will be 
the cooperative agreement, in which HHS will have substantial 
scientific and/or programmatic involvement during the performance of 
the project. Under the cooperative agreement, HHS/OGHA will support 
and/or stimulate award recipient activities by working with them in a 
non-directive partnership role. HHS staff will be substantially 
involved in the program activities, above and beyond routine 
monitoring. Through this cooperative agreement, HHS will collaborate in 
an advisory capacity with the award recipient, especially during the 
development and implementation of a mutually agreed-upon work plan. HHS 
will actively

[[Page 46067]]

participate in periodic reviews and in a final evaluation of the 
program.
    HHS/OGHA provides policy and staffing support to the Secretary and 
other HHS leaders in the area of global health, and provides policy 
advice, leadership and coordination of international health matters 
across HHS, including leadership on major crosscutting global health 
initiatives and the Department's relationships with multilateral 
organizations.
    Approximately up to $625,000 (including indirect costs) is 
available under the Department of Health and Human Services Revised 
Continuing Appropriations Resolution, 2007, Division B, section 101(6), 
Public Law 109-289 (2007) to support this agreement.
    The anticipated start date is September 15, 2007. There will only 
be one, single award made from this announcement. The project period 
for this agreement is for one year with an individual budget period of 
12-months for a total of $625,000. Continuation of this project and the 
level of funding are subject to satisfactory performance, availability 
of funds, and program priorities.
    The award recipient must comply with all HHS management 
requirements for meeting progress against milestones and for financial 
reporting for this cooperative agreement. (Please see HHS Activities 
and Program Evaluation Sections below.)
    HHS/OGHA activities for this program are as follows: In a 
cooperative agreement, HHS staff is substantially involved in the 
program activities, above and beyond routine grant-monitoring. HHS 
Activities for this program are as follows:
     Organize an orientation meeting with the grantee to brief 
it on applicable U.S. Government and HHS expectations, regulations and 
key management requirements, as well as report formats and contents.
     Review and approve the process used by the grantee to 
select key personnel and/or post-award subcontractors and/or 
subgrantees to be involved in the activities performed under this 
agreement.
     Review and approve the grantee's annual work plan and 
detailed budget.
     Review and approve the grantee's monitoring and evaluation 
plan.
     Meet on a monthly basis with the grantee to assess monthly 
expenditures in relation to approved work plan and modify plans, as 
necessary.
     Meet on a quarterly basis with the grantee to assess 
quarterly technical and financial progress reports and modify plans as 
necessary.
     Meet on an annual basis with the grantee to review annual 
progress report for each U.S. Government Fiscal Year, and to review 
annual work plans and budgets for subsequent year.
     Provide technical assistance, as mutually agreed upon, and 
revise annually during validation of the first and subsequent annual 
work plans.
     Provide in-country administrative support to help grantee 
meet U.S. Government financial and reporting requirements approved by 
the Office of Management and Budget (OMB) under 0920-0428 (Public 
Health Service Form 5161).
     Collaborate with the awardee on designing and implementing 
the activities listed above, including, but not limited to the 
provision of technical assistance to develop program activities, data 
management and analysis, quality assurance, the presentation and 
possibly publication of program results and findings, and the 
management and tracking of finances.
     Provide consultation and scientific and technical 
assistance based on appropriate, HHS/CDC documents to promote the use 
of best practices known at the time.
     Assist the recipient in developing and implementing 
quality-assurance criteria and procedures.
     Facilitate in-country planning and review meetings for 
technical assistance activities.
     Assure experienced HHS or other subject-matter experts 
from other relevant U.S. Government Departments and agencies will 
participate in the planning, development, implementation and evaluation 
of all phases of this project.
     Assist in establishing and maintaining U. S. Government, 
Afghan MoPH and NGOs contracts and agreements to carry out the program.

Program Evaluation Criteria

    The applicant must have a comprehensive evaluation plan consistent 
with the scope, stated goals and objectives and funding level of the 
project. The evaluation plan should include both a process evaluation 
to track the implementation of the project activities and outcome 
evaluation criteria.
    In addition to conducting internal evaluations, the successful 
applicant must be prepared to participate in external evaluations 
supported by the Afghan MoPH and HHS.
    In addition to routine communications with the Afghan MoPH and HHS 
within 30 days following the end of each quarter, the grantee will 
submit a written quarterly performance and financial status report of 
no more than ten pages in length to the Ministry and HHS. At a minimum, 
quarterly performance reports will include the following:
     A concise summary of the most significant achievements and 
problems encountered during the reporting period, e.g., a comparison of 
work progress with objectives established for the quarter against the 
award recipient's implementation schedule. Where the awardee does not 
meet objectives, the report must include a statement of cause and a 
summary of corrective actions.
     Specific action(s) HHS and/or the Afghan MoPH needs to 
undertake to alleviate obstacles to progress.
     Other pertinent information that will permit overview and 
evaluation of project operations.
    Within 90 days following the end of each project period, the 
awardee must submit a final report that contains all required 
information and data to MoPH and HHS. At minimum, the report will 
contain the following:
     A summary of the major activities supported under the 
cooperative agreement and the major accomplishments that resulted from 
activities to improve performance.
     An analysis of the project, based on the challenges 
described in the ``Background'' Section of the RFA performed prior to 
or during the project period, including a description of the specific 
objectives stated in the grant application and the accomplishments and 
failures that resulted from activities during the grant agreement 
period. The awardee should place emphasis on indicators and measures of 
operational efficiency and effectiveness.

III. Eligibility Information

1. Eligible Applicants

    This is a single source, cooperative agreement with the Aga Khan 
Foundation (AKF), a non-denominational, international health, education 
and development agency operating in Afghanistan under the aegis of the 
Aga Khan Development Network (AKDN). The goal of the AKF's health 
program is to achieve sustainable improvements in health status among 
vulnerable groups, especially the geographically remote, women of 
childbearing age and children under five.
    The U.S. Government remains committed to supporting efforts to 
improve the health status of women and children, while assisting in the 
further development of Afghanistan's overall health-care 
infrastructure. This proposal builds upon the extensive network of

[[Page 46068]]

the AKDN and leverages the established relationships between the AKDN 
and the Government of Afghanistan.
    At the invitation of the Afghan government, the Aga Khan University 
School of Nursing (AKU-SON), a component of the Aga Khan Health 
Services (AKHS) has been assisting in strengthening and implementing 
programs at the Afghan Institute of Health Sciences (IHS) since 2002. 
In collaboration with the Ministry of Health, Government of 
Afghanistan, WHO and Aga Kahn University (AKU), AKU-SON aims to support 
the development of Afghanistan's human resources in the health sector, 
especially nurses, midwives and health personnel through technical 
assistance and capacity building. These efforts have included providing 
nurse-based services and enhancing the existing skills of nurses 
through in-service training.
    In 2003, AKHS undertook the task of enhancing the operations of IHS 
for the purpose of creating a centre of excellence that meets 
Afghanistan's needs for nursing, midwifery and allied health personnel 
training. AKU-SON's capacity building measures at IHS, Kabul, are 
geared towards learning methodology, knowledge upgrading and clinical 
skills training for both faculty and students. The training programs of 
AKU-SON enable nursing and midwifery students to hone clinical skills 
prior to interventions on patients by working on models in a renovated 
learning lab. In the area of technical assistance, the School has 
played an important role in revising the nursing and midwifery 
curricula and translating reference material into the local Dari 
language. The revised curriculum, since established as the national 
curricula in Afghanistan, has been introduced in regional Institutes in 
Herat, Jalalabad, Mazar-e-Sharif and Kunduz in 2005. Under the revised 
curriculum, nurses are trained to work alongside medical teams in 
clinics, hospitals and outreach centers providing direct care as well 
as sharing their skills and training with others.
    The AKHS consists of a Medical College and a School of Nursing. 
Both components work in an interactive partnership with the Aga Khan 
University Hospital, which serves as the principal clinical and 
teaching facility. Components of the nursing and midwifery programs are 
also taught by AKU in Kabul and Karachi.
    The curriculum at Kabul Medical University is also based upon the 
AKU-SON curriculum being implemented at the health institutes. In 2006, 
the Afghan MoPH granted AKU-SON permission to share all teaching 
materials. The AKU-SON curriculum consists of an eight semester, four-
year program, which will provide graduates with education in subjects 
appropriate to the university level. The course catalog describes this 
curriculum as an education, which enables graduates to be competent 
practitioners of nursing, prepared to teach nursing, seek further 
qualification, and actively collaborate to improve the health of 
individuals, families, communities and the nation.
    In 2007, AKU-SON is due to renew a five-year plan to strengthen 
nursing, midwifery and allied health education in Afghanistan. Since 
2002, AKU-SON has been providing study tours to AKU and other colleges 
and universities to expose faculty to modern educational methods and 
systems. Every year since 2002, AKU-SON has also sponsored two faculty 
members for a Bachelor of Science in Nursing (BScN) and Master of 
Science in Nursing (MScN) degree at AKU in Pakistan. This education 
faculty has returned to Afghanistan and forms a small cadre of 
individuals qualified to lead Afghanistan nursing into the 21st 
Century.
    The development of a baccalaureate degree in nursing in Afghanistan 
has always been a goal of AKU-SON. With funding from this cooperative 
agreement, AKF will be able to improve the government system of 
professional education for nurses in Afghanistan. This effort will work 
toward ensuring a cadre of nursing professionals who can provide the 
full range of quality prenatal, intrapartum and newborn care in all 
components of the Afghan health-care, including the community. HHS, 
through this cooperative agreement, will support the development of a 
multidisciplinary approach to health-care and will augment the funding 
and services AKDN and AKF are providing to foster the development of 
professional nursing. AKU-SON's reputation as a leader and as an 
advocate for the advancement of women in the health professions, 
especially nursing, is well established in the Central Asian region. 
AKDN and its many operating agencies, have demonstrated their 
commitment to Afghanistan in many spheres but have been relatively 
alone amongst donors in the support of the modernization of the health 
professions.

2. Cost Sharing or Matching

    Although cost sharing, matching funds, and cost participation are 
not a requirement of this agreement, if the applicant receives funding 
from other sources to underwrite the same or similar activities, or 
anticipate receiving such funding in the next 12 months, they must 
detail how the disparate streams of financing complement each other.

3. Other--(If Applicable)

    N/A

IV. Application and Submission Information

1. Address To Request Application Kit

    Application kits may be obtained by accessing Grants.gov at http://www.grants.gov or the eGrants system at http://GrantSolution.gov. To 
obtain a hard copy of the application kit, contact OPHS Office of 
Grants Management. Applications must be prepared using Form OPHS-1, 
which can be obtained at the Web sites noted above.

2. Content and Form of Application Submission

Application Materials
    A separate budget page is required for each budget year. The 
applicant must submit with their proposals a line-item budget (SF 424A) 
with coinciding justification to support each of the budget years. 
These forms will represent the full project period of Federal 
assistance requested. HHS/OGHA will reject proposals submitted without 
a budget and justification for each budget year requested in the 
application.
    The applicant must include in their application a Project Abstract, 
submitted on 3.5-inch floppy disk. The abstract must be typed, single-
spaced, and not exceed two (2) pages. Reviewers and staff will refer 
frequently to the information contained in the abstract, and therefore 
it should contain substantive information about the proposed projects 
in summary form. A list of suggested keywords and a format sheet for 
your use in preparing the abstract will accompany the application 
packet.
    The applicant must include a Project Narrative in their grant 
applications. Format requirements are the same as for the ``Project 
Abstract'' Section; margins should be one-inch at the top and one-inch 
at the bottom and both sides; and typeset must be no smaller than 12 
cpi and unreduced. The applicant should type biographical sketches 
either on the appropriate form or on plain paper and they should not 
exceed two pages; list only publications directly relevant to this 
project.
Application Format Requirements
    If an applicant is applying on paper, the entire application may 
not exceed 80 pages in length, including the abstract, project and 
budget narratives, face page, attachments, any appendices

[[Page 46069]]

and letters of commitment and support. The applicant must number pages 
consecutively.
    HHS/OGHA will deem non-compliant applications submitted 
electronically that exceed 80 pages when printed and will return them 
to the applicant without further consideration.
a. Number of Copies
    If submitting in hard-copy, please submit one original and two 
unbound copies of the application. Please do not bind or staple the 
application. The application must be single sided.
b. Font
    Please use an easily readable serif typeface, such as Times Roman, 
Courier, or CG Times. The applicant must submit the text and table 
portions of the application in not less than 12-point and 1.0 line 
spacing. HHS/OGHA will deem applications that do not adhere to the 12-
point font requirement non-compliant.
c. Paper Size and Margins
    For scanning purposes, please submit the application on 8\1/
2\ x 11 white paper. Margins must be at least one 
inch at the top, bottom, left and right of the paper. Please left-align 
text.
d. Numbering
    Please number the pages of the application sequentially from page 
one (face page) to the end of the application, including charts, 
figures, tables, and appendices.
e. Names
    Please include the name of the applicant on each page.
f. Section Headings
    Please put all section headings flush left in bold type.
Application Format
    An application for funding must consist of the following documents 
in the following order:
i. Application Face Page
    HHS/PHS Application Form OPHS-1, provided with the application 
package. Prepare this page according to instructions provided in the 
form itself.
DUNS Number
    All applicant organizations must have a Data Universal Numbering 
System (DUNS) number to apply for a grant from the Federal Government. 
The DUNS number is a unique, nine-character identification number 
provided by the commercial company Dun and Bradstreet. There is no 
charge to obtain a DUNS number. Information about obtaining a DUNS 
number is available at the following Internet address: https://www.dnb.com/product/eupdate/requestOptions.html or by calling 1-866-
705-5711. Please include the DUNS number next to the Office of 
Management and Budget (OMB) Approval Number on the application face 
page. HHS/OGHA will not review applications that do not have a DUNS 
number.
    Additionally, the applicant organization must register with the 
Federal Government's Central Contractor Registry (CCR) to do electronic 
business with the Federal Government. Information about registering 
with the CCR is available at the following Internet address: http://www.hrsa.gov/grants/ccr.htm.
    Finally, the applicant that applies electronically through 
Grants.gov must register with the Credential Provider for Grants.gov. 
Information about this requirement is available at the following 
Internet address: http://www.grants.gov/CredentialProvider.
    An applicant that is applying electronically through the HHS/OPHS 
GrantSolutions System must register with the provider. Information 
about this requirement is available at the following Internet address: 
https://www.grantsolutions.gov/gs/login.do.
ii. Table of Contents
    Provide a Table of Contents for the remainder of the application 
(including appendices), with page numbers.
iii. Application Checklist
    Application Form HHS/OPHS-1, provided with the application package.
iv. Budget
    Application Form HHS/OPHS-1, provided with the application package.
v. Budget Justification
    The applicant must enter the amount of financial support (direct 
and indirect costs) they are requesting from the Federal granting 
agency for the first year on the Face Sheet of Application Form HHS/PHS 
5161-1, Line 15a. The application should include funds for electronic-
mail capability, unless access to the Internet is already available. 
The amount of financial support (direct and indirect costs) entered on 
the SF 424 is the amount an applicant is requesting from the Federal 
granting agency for the project year.
    Personnel Costs: The applicant should explain their personnel costs 
by listing each staff member supported from Federal funds, name (if 
possible), position title, percent full-time equivalency, annual 
salary, and the exact amount requested.
    Fringe Benefits: The applicant must list the components that 
comprise the fringe benefit rate, for example, health insurance, taxes, 
unemployment insurance, life insurance, retirement plan, tuition 
reimbursement. The fringe benefits should be directly proportional to 
that portion of personnel costs allocated for the project.
    Travel: The applicant must list travel costs according to local and 
long distance travel. For local travel the applicant should outline the 
mileage rate, number of miles, reason for the travel and the staff 
member/consumers who will be completing the travel.
    Equipment: The applicant must list equipment costs, and provide 
justification for the need of the equipment to carry out the program's 
goals. The applicant must provide an extensive justification and a 
detailed status of current equipment when they request funds for the 
purchase of computers and furniture items.
    Supplies: The applicant must list the items the project will use. 
In this category, separate office supplies from medical and educational 
purchases. ``Office supplies'' could include paper, pencils, and the 
like; ``medical supplies'' are syringes, blood tubes, plastic gloves, 
etc., and ``educational supplies'' can be pamphlets and educational 
videotapes. The applicant must list these categories separately.
    Subcontracts: To the extent possible, the applicant should 
standardize all subcontract budgets and justifications, and should 
present contract budgets by using the same object-class categories 
contained in the Standard Form 424A. The applicant must provide a clear 
explanation as to the purpose of each contract, how the organization 
estimated the costs, and the specific contract deliverables.
    Other: The applicant must put all costs that do not fit into any 
other category into this category, and provide and explanation of each 
cost in this category.
vi. Staffing Plan and Personnel Requirements
    The applicant must present a staffing plan, and provide a 
justification for the plan that includes education and experience 
qualifications and the rationale for the amount of time requested for 
each staff position. The applicant must include in Appendix B position 
descriptions that include the roles, responsibilities, and 
qualifications of proposed project staff. The applicant must include in 
Appendix C copies of biographical sketches for any key

[[Page 46070]]

employed personnel assigned to work on the proposed project.
vii. Project Abstract
    The applicant must provide a summary of the application. Because 
HHS/OHGA often distributes the abstract to provide information to the 
American public and the U.S. Congress, the applicant should prepare 
this so it is clear, accurate, concise, and without reference to other 
parts of the application. It must include a brief description of the 
proposed grant project, including the needs addressed, the proposed 
work, and the population group(s) served.
    The applicant must place the following at the top of the abstract:
     Project Title;
     Applicant Name;
     Address;
     Contact Phone Numbers (Voice, Fax);
     E-Mail Address; and
     Web Site Address, if applicable.
    The project abstract must be single-spaced and limited to two pages 
in length.
viii. Program Narrative
    This section provides a comprehensive framework and description of 
all aspects of the proposed program. It should be succinct, self-
explanatory and well-organized so reviewers can understand the proposed 
project.
    The applicant should use the following section headers for the 
Narrative:
     Introduction
    This section should briefly describe the purpose of the proposed 
project.
     Work Plan
    The applicant should describe the activities or steps to achieve 
each of the activities proposed in the methodology section and use a 
time line that includes each activity and identifies responsible staff.
     Resolution of Challenges
    The applicant should discuss likely challenges designing and 
implementing the activities described in the Work Plan, and approaches 
to resolve such challenges.
     Evaluation and Technical Support Capacity
    The applicant should describe their current, relevant experience, 
skills, and knowledge, including individuals on staff, materials 
published, and previous work of a similar nature.
     Organizational Information
    The applicant should provide information on their current mission 
and structure, scope of current activities, and an organizational 
chart, and describe how these all contribute to the ability of the 
organization to conduct the program requirements and meet program 
expectations.
ix. Appendices
    The applicant must provide the following items to complete the 
content of their applications. Please note these are supplementary in 
nature, and are not a continuation of the project narrative. The 
applicant should label each appendix.
Appendix A: Tables, Charts, etc.
    To give further details about the proposal.
Appendix B: Job Descriptions for Key Personnel
    The applicant should keep each to one page in length as much as 
possible. Item 6 in the ``Program Narrative'' section of the HHS/PHS 
5161-1 Form provides some guidance on items to include in a job 
description.
Appendix C: Biographical Sketches of Key Personnel
    The applicant should include biographical sketches for persons who 
are occupying the key positions described in Appendix B, not to exceed 
two pages in length. In the event an applicant includes a biographical 
sketch for an identified individual not yet hired, it must include a 
letter of commitment from that person with the biographical sketch.
Appendix D: Letters of Agreement and/or Description(s) of Proposed/
Existing Contracts (project specific)
    The applicant must provide any documents that describe working 
relationships between the applicant agency and other agencies and 
programs cited in the proposal. Documents that confirm actual or 
pending contractual agreements should clearly describe the roles of the 
subcontractors and any deliverable. Letters of Agreement must be dated.
Appendix E: Organizational Chart for the Project
    The applicant must provide a one-page figure that depicts the 
organizational structure of the project, including subcontractors and 
other significant collaborators.
Appendix F: Other Relevant Documents
    Include here any other documents relevant to the application, 
including letters of support. Letters of support must be dated.

3. Submission Dates and Times

    To be considered for review, applications must be received by the 
Office of Public Health and Science, Office of Grants Management, by 5 
p.m. Eastern Time on August 31, 2007. Applications will be considered 
as meeting the deadline if they are received on or before the deadline 
date. The application due date requirement in this announcement 
supersedes the instructions in the OPHS-1 form.
Application Submission
    The Office of Public Health and Science (OPHS) provides multiple 
mechanisms for submission of applications, as described in the 
following sections. Applicants will receive notification via mail from 
the OPHS Office of Grants Management confirming the receipt of 
applications submitted using any of these mechanisms. Applications 
submitted to the OPHS Office of Grants Management after the deadlines 
described below will not be accepted for review. Applications which do 
not conform to the requirements of the grant announcement will not be 
accepted for review and will be returned to the applicant.
    While applications are accepted in hard copy, the use of the 
electronic application submission capabilities provided is encouraged. 
Applications may only be submitted electronically via the electronic 
submission mechanisms specified below. Any applications submitted via 
any other means of electronic communication, including facsimile or 
electronic mail, will not be accepted for review.
    Electronic grant application submissions must be submitted no later 
than 5 p.m. Eastern Time 90 days prior to your current budget period 
end date (refer to your most recent Notice of Grant Award box 
7 for this information). All required hardcopy original 
signatures and mail-in items must be received by the OPHS Office of 
Grants Management no later than 5 p.m. Eastern Time on the next 
business day after the deadline date for your non-competing 
application.
    Applications will not be considered valid until all electronic 
application components, hardcopy original signatures, and mail-in items 
are received by the OPHS Office of Grants Management according to the 
deadlines specified above. Application submissions that do not adhere 
to the due date requirements will be considered late and will be deemed 
ineligible.
    Applicants are encouraged to initiate electronic applications early 
in the

[[Page 46071]]

application development process, and to submit early on the due date or 
before. This will aid in addressing any problems with submissions prior 
to the application deadline.
Electronic Submissions
    The electronic grants management system, GrantSolutions.gov, 
provides for applications to be submitted electronically. When 
submitting applications via the GrantSolutions system, applicants are 
required to submit a hard copy of the application face page (Standard 
Form 424) with the original signature of an individual authorized to 
act for the applicant agency and assume the obligations imposed by the 
terms and conditions of the grant award. If required, applicants will 
also need to submit a hard copy of the Standard Form LLL and/or certain 
Program related forms (e.g., Program Certifications) with the original 
signature of an individual authorized to act for the applicant agency. 
When submitting the required forms, do not send the entire application. 
Complete hard copy applications submitted after the electronic 
submission will not be considered for review.
    Electronic applications submitted via the GrantSolutions system 
must contain all completed online forms required by the application 
kit, the Program Narrative, Budget Narrative and any appendices or 
exhibits. The applicant may identify specific mail-in items to be sent 
to the Office of Grants Management separate from the electronic 
submission; however these mail-in items must be entered on the 
GrantSolutions Application Checklist at the time of electronic 
submission, and must be received by the due date requirements specified 
above. Mail-In items may only include publications, resumes, or 
organizational documentation. When submitting the required forms, do 
not send the entire application. Complete hard copy applications 
submitted after the electronic submission will not be considered for 
review.
    Upon completion of a successful electronic application submission, 
the GrantSolutions system will provide the applicant with a 
confirmation page indicating the date and time (Eastern Time) of the 
electronic application submission. This confirmation page will also 
provide a listing of all items that constitute the final application 
submission including all electronic application components, required 
hardcopy original signatures, and mail-in items, as well as the mailing 
address of the OPHS Office of Grants Management where all required hard 
copy materials must be submitted.
    As items are received by the OPHS Office of Grants Management, the 
electronic application status will be updated to reflect the receipt of 
mail-in items. It is recommended that the applicant monitor the status 
of their application in the GrantSolutions system to ensure that all 
signatures and mail-in items are received.
Mailed or Hand-Delivered Hard Copy Applications
    Applicants who submit applications in hard copy (via mail or hand-
delivered) are required to submit an original and two copies of the 
application. The original application must be signed by an individual 
authorized to act for the applicant agency or organization and to 
assume for the organization the obligations imposed by the terms and 
conditions of the grant award.
    Mailed or hand-delivered applications will be considered as meeting 
the deadline if they are received by the OPHS Office of Grant 
Management on or before 5 p.m. Eastern Time 90 days prior to your 
current budget period end date (refer to your most recent Notice of 
Grant Award box 7 for this information). The application 
deadline date requirement specified in this announcement supersedes the 
instructions in the OPHS-1. Applications that do not meet the deadline 
will be returned to the applicant unread.

4. Intergovernmental Review

    This program is not subject to the review requirements of Executive 
Order 12372, Intergovernmental Review of Federal Programs.

5. Funding Restrictions

    Allowability, allocability, reasonableness, and necessity of direct 
costs the applicant may charge appear in the following documents: OMB-
21 (Institutes of Higher Education); OMB Circular A-122 (Nonprofit 
Organizations) and 45 CFR Part 74, Appendix E (Hospitals). Copies of 
these circulars are available on the Internet at the following Internet 
address: http://www.whitehouse.gov/omb. No pre-award costs are allowed.

6. Other Submission Requirements

    N/A.

V. Application Review Information

1. Criteria

    OGHA will be screen the application for completeness and for 
responsiveness to the program guidance. Applicant should pay strict 
attention addressing these criteria, as they are the basis upon which 
the application will be judged. If the application is judged to be non-
responsive or incomplete, it will be returned to the applicant without 
review.
    If the application is complete and responsive to the guidance, it 
will be evaluated for scientific and technical merit by an appropriate 
peer review group specifically convened for this solicitation and in 
accordance with HHS policies and procedures. As part of the initial 
merit review, all applications will receive a written critique. The 
application will be discussed fully by the ad hoc peer review group and 
assigned a priority score for funding. The application will be assessed 
according the following criteria:
    (1) Technical Approach (40 points):
     The applicant's presentation of a sound and practical 
technical approach for executing the requirements with adequate 
explanation, substantiation and justification for methods for handling 
the projected needs of the partner institution.
     The successful applicant must demonstrate a clear 
understanding of the scope and objectives of the cooperative agreement, 
recognition of potential difficulties that may arise in performing the 
work required, presentation of adequate solutions, and understanding of 
the close coordination necessary between the OGHA/HHS, Afghanistan 
Ministry of Public Health, U.S. Agency for International Development, 
and other organizations, such as the World Health Organization and 
United Nations Children's Fund.
     Applicant must submit a strategic plan that outlines the 
schedule of activities and expected products of the Group's work with 
benchmarks at months six, 12. The strategic plan should specifically 
address the expected progress of the Quality of Care program.
    (2) Experience and Capabilities of the Organization (30 Points):
     The applicant should submit documented relevant experience 
of the organization in managing projects of similar complexity and 
scope of the activities.
     Clarity and appropriateness of lines of communication and 
authority for coordination and management of the project. Adequacy and 
feasibility of plans to ensure successful coordination among multiple-
partner collaboration.
     Documented experience recruiting qualified medical 
personnel for projects of similar complexity and scope of activities.
    (3) Personnel Qualifications and Experience (20 points):
     Project Leadership--For the technical and administrative 
leadership

[[Page 46072]]

of the project requirements, the successful applicant must demonstrate 
documented training, expertise, relevant experiences, leadership/
management skills, and availability of a suitable overall project 
manager and surrounding management structure to successfully plan and 
manage the project. The successful applicant will provide documented 
history of leadership in the establishment and management of training 
programs that involve training of health-care professionals in 
countries other than the United States. Expertise in maternal and child 
health-care and services including documented training, expertise, 
relevant experience, leadership skills, and maternal and child health 
specific medical expertise. Documented managerial ability to achieve 
delivery or performance requirements as demonstrated by the proposed 
use of management and other personnel resources and to successfully 
manage the project, including subcontractor and/or consultant efforts, 
if applicable, as evidence by the management plan and demonstrated by 
previous relevant experience.
     Partner Institutions and Other Personnel--The applicant 
should provide documented evidence of availability, training, 
qualifications, expertise, relevant experience, education and 
competence of the scientific, clinical, analytical, technical and 
administrative staff and any other proposed personnel (including 
partner institutions, subcontractors and consultants), to perform the 
requirements of the work activities as evidenced by resumes, 
endorsements and explanations of previous efforts.
     Staffing Plan--The applicant should submit a staffing plan 
for the conduct of the project, including the appropriateness of the 
time commitment of all staff and partner institutions, the clarity and 
appropriateness of assigned roles, lines of authority. The applicant 
should also provide an organizational chart for each partner 
institution named in the application showing relationships among the 
key personnel.
     Administrative and Organizational Framework--Adequacy of 
the administrative and organizational framework, with lines of 
authority and responsibility clearly demonstrated, and adequacy of the 
project plan, with proposed time schedule for achieving objectives and 
maintaining quality control over the implementation and operation of 
the project. Adequacy of back-up staffing and the evidence that they 
will be able to function as a team. The framework should identify the 
institution that will assume legal and financial responsibility and 
accountability for the use and disposition of funds awarded on the 
basis of this RFA.
     Local Language Skills--The applicant should demonstrate 
the ability of employees to fluently speak Pashto and Persian.
    (4) Facilities and Resources (10 Points):
    The applicant must document the availability and adequacy of 
facilities, equipment and resources necessary to carry out the 
activities specified under the ``Program Requirements'' Section of this 
announcement.

2. Review and Selection Process

    The application will be reviewed, by a panel of peer reviewers. 
Each of the above criteria will be addressed and considered by the 
reviewers in assigning the overall score. The final award will be made 
by the Deputy Director, Asia and Pacific Division of the Office Global 
Health Affairs on the basis of score, program relevance and, 
availability of funds.

VI. Award Administration Information

1. Award Notices

    OGHA/HHS does not release information about individual applications 
during the review process until final funding decisions have been made. 
When a decision has been made, the applicant will be notified by letter 
regarding the outcome of its application. The official document 
notifying an applicant that an application has been approved and funded 
is the Notice of Award, which specifies to the awardee the amount of 
money awarded, the purpose of the agreement, the terms and conditions 
of the agreement, and the amount of funding, if any, to be contributed 
by the awardee to the project costs.

2. Administrative and National Policy Requirements

    The regulations set out at 45 CFR parts 74 and 92 are the 
Department of Health and Human Services (HHS) rules and requirements 
that govern the administration of grants. Part 74 is applicable to all 
recipients except those covered by part 92, which governs awards to 
state and local governments. The applicant funded under this 
announcement must be aware of and comply with these regulations. The 
CFR volume that includes parts 74 and 92 may be downloaded from http://www.access.gpo.gov/nara/cfr/waisidx_03/45cfrv1_03.html.

3. Reporting

    The project is required to have an evaluation plan, consistent with 
the scope of the proposed project and funding level that conforms to 
the project's stated goals and objectives. The evaluation plan should 
include both a process evaluation to track the implementation of 
project activities and an outcome evaluation to measure changes in 
knowledge and skills that can be attributed to the project. Project 
funds may be used to support evaluation activities.
    In addition to conducting their own evaluation of projects, the 
successful applicant must be prepared to participate in an external 
evaluation, to be supported by HHS/OGHA and conducted by an independent 
entity, to assess efficiency and effectiveness for the project funded 
under this announcement.
    Within 30 days following the end of each quarter, a performance 
report no more than ten pages in length must be submitted to OGHA/HHS. 
A sample monthly performance report will be provided at the time of 
notification of award. At a minimum, monthly performance reports should 
include:
     Concise summary of the most significant achievements and 
problems encountered during the reporting period, e.g. number of 
training courses held and number of trainees.
     A comparison of work progress with objectives established 
for the quarter using the grantee's implementation schedule, and where 
such objectives were not met, a statement of why they were not met.
     Specific action(s) that the grantee would like HHS/OGHA to 
undertake to alleviate a problem.
     Other pertinent information that will permit monitoring 
and overview of project operations.
     A quarterly financial report describing the current 
financial status of the funds used under this award. The awardee and 
OGHA will agree at the time of award for the format of this portion of 
the report.
    Within 90 days following the end of the project period a final 
report containing information and data of interest to the Department of 
Health and Human Services, Congress, and other countries must be 
submitted to HHS/OGHA. The specifics as to the format and content of 
the final report and the summary will be sent to the successful 
applicant. At minimum, the report should contain:
     A summary of the major activities supported under the 
agreement and the major accomplishments resulting from

[[Page 46073]]

activities to improve mortality in partner country.
     An analysis of the project based on the problem(s) 
described in the application and needs assessments, performed prior to 
or during the project period, including a description of the specific 
objectives stated in the grant application and the accomplishments and 
failures resulting from activities during the grant period.
    Quarterly performance reports and annual reports may be submitted 
to: Mr. Dewayne Wynn, Grants Management Specialist, Office of Grants 
Management, OPHS, HHS 1101 Wootton Parkway, Suite 550, Rockville, MD 
20852, phone (240) 453-8822. A Financial Status Report (FSR) SF-269 is 
due 90 days after the close of each 12-month budget period and 
submitted to OPHS-Office of Grants Management.

VII. Agency Contacts

    For assistance on administrative and budgetary requirements, please 
contact: Mr. DeWayne Wynn, Grants Management Specialist, Office of 
Grants Management, OPHS, HHS, 1101 Wootton Parkway, Suite 550, 
Rockville, MD 20852, phone (240) 453-8822.
    For assistance regarding program requirements, please contact: Dr. 
Christopher Hickey, Department of Health and Human Services, Office of 
the Secretary, Office of Global Health Affairs, Asia-Pacific Division, 
5600 Fishers Lane, Suite 18-101, Rockville, MD 20857, Phone Number: 
301-443-1410.

VIII. Tips for Writing a Strong Application

Include DUNS Number

    You must include a DUNS Number to have your application reviewed. 
An application will not be reviewed without a DUNS number. To obtain a 
DUNS number, access http://www.dunandbradstreet.com or call 1-866-705-
5711. Please include the DUNS number next to the OMB Approval Number on 
the application face page.

Keep Your Audience in Mind

    Reviewers will use only the information contained in the 
application to assess the application. Be sure the application and 
responses to the program requirements and expectations are complete and 
clearly written. Do not assume that reviewers are familiar with the 
applicant organization. Keep the review criteria in mind when writing 
the application.

Start Preparing the Application Early

    Allow plenty of time to gather required information from various 
sources.

Follow the Instructions in This Guidance Carefully

    Place all information in the order requested in the guidance. If 
the information is not placed in the requested order, you may receive a 
lower score.

Be Brief, Concise, and Clear

    Make your points understandable. Provide accurate and honest 
information, including candid accounts of problems and realistic plans 
to address them. If any required information or data is omitted, 
explain why. Make sure the information provided in each table, chart, 
attachment, etc., is consistent with the proposal narrative and 
information in other tables.

Be Organized and Logical

    Many applications fail to receive a high score because the 
reviewers cannot follow the thought process of the applicant or because 
parts of the application do not fit together.

Be Careful in the Use of Appendices

    Do not use the appendices for information that is required in the 
body of the application. Be sure to cross-reference all tables and 
attachments located in the appendices to the appropriate text in the 
application.

Carefully Proofread the Application

    Misspellings and grammatical errors will impede reviewers in 
understanding the application. Be sure pages are numbered (including 
appendices) and that page limits are followed. Limit the use of 
abbreviations and acronyms, and define each one at its first use and 
periodically throughout application.

    Dated: August 10, 2007.
Mary Lou Valdez,
Deputy Director for Policy, Office of Global Health Affairs.
[FR Doc. E7-16096 Filed 8-15-07; 8:45 am]
BILLING CODE 4150-38-P