[Federal Register Volume 72, Number 158 (Thursday, August 16, 2007)]
[Notices]
[Pages 46073-46082]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-16114]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES


Announcement of Availability of Funds for a Cooperative Agreement 
To Provide Basic Medical Education Supportive of Maternal-Child Health 
at Kabul Medical University (KMU) and Clinical Training in Obstetrics 
and Gynecology to Resident Physicians and Refresher Training to 
Attending Physicians at the Rabia Balkhi Women's Hospital

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 equitable and high quality obstetrical and 
gynecological and infant care at RBH and developing an evidence-based 
and culturally appropriate Obstetrical/Gynecological residency program 
and continuing education program for practicing physicians. Projects 
requesting funding should aim to expand the capacity of Kabul Medical 
University to develop and implement curriculum reform in support of 
evidence-based medical knowledge and practice in maternal-child health 
at Kabul Medical University and to provide leadership and clinical 
expertise to strengthen the Obstetric and Gynecology Residency Program; 
residency training refers to a sustainable training of physicians and 
specialists in obstetrics and gynecology based on Western accreditation 
standards that have been modified for the Afghan situation.
    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 
an estimated $625,000 in Fiscal Year (FY) 2007 funds is available for 
one cooperative agreement to expand the capacity of Kabul Medical 
University to develop and implement curriculum reform in support of 
evidence-based medical knowledge and practice in

[[Page 46074]]

maternal-child health at Kabul Medical University and to provide 
leadership and clinical expertise to strengthen the Obstetric and 
Gynecology Residency Program, approved by the Afghanistan Ministry of 
Public Health (MoPH) and improve health-care delivery at Rabia Balkhi 
Women's Hospital (RBH) in Kabul, Afghanistan. Residency training refers 
to a sustainable training of physicians and specialists in obstetrics 
and gynecology based on Western accreditation standards that have been 
modified for the Afghan situation. An emphasis will focus on clinical 
training, which will include the demonstration of direct patient care 
alongside Afghan health-care providers. All care will also reflect an 
interdisciplinary approach with full participation of the nurse 
midwifery staff in the delivery of care.
    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 equitable and high quality obstetrical and 
gynecological and infant care at RBH and developing an evidence-based 
and culturally appropriate Obstetrical/Gynecological residency program 
and continuing education program for practicing physicians. 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 grantee.

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).

Purposes 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 provide basic medical 
education and clinical training in Obstetrics and Gynecology to 
resident physicians and refresher training to attending physicians. The 
program will be for a program period of one year. Approximately a total 
of $625,000 will be available for this cooperative agreement.
    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 equitable and high quality obstetrical and 
gynecological and infant care at RBH and developing an evidence-based 
and culturally appropriate Obstetrical/Gynecological residency program 
and continuing education program for practicing physicians.
    A secondary goal is to support basic curriculum revision within the 
medical school in 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 Obstetrical/Gynecological licensing and 
certification program. The funding under this cooperative agreement 
will provide essential material resources within budgetary limitations 
for educational materials and for grant activities related to residency 
development and leadership.
    Alongside this support, HHS/OGHA is currently providing support for 
staff development and continuing education at RBH. This new agreement 
is anticipated to focus on the expansion of physician-directed clinical 
efforts, but could also involve clinical training of teams, including 
the allied health and nursing personnel but is expected. HHS/OGHA is 
also currently providing support for hospital management development 
and facility management. It is expected that collaboration among 
grantees must occur to effectively provide the didactic and clinical 
training in a supportive physical environment within the labor law 
requirements of the Afghanistan MoPH.
    Afghanistan has one of the highest maternal mortality rates (MMR) 
in the world with a rate of 1,600 maternal deaths per 100,000 live 
births. Preventable complications related to childbirth cause more than 
85 percent of deaths among women of childbearing age in Afghanistan. An 
estimated one in five children dies before reaching their fifth 
birthday.
    The government of Afghanistan has established improvement in women 
and child health as one of its highest priorities. The recovery from 
more than twenty years of civil unrest and war is underway but the 
restoration of the quality of the entire spectrum of health-care 
delivery, public health and health professional education remains a 
challenge.
    The United States along with other countries, international 
organizations and nongovernmental organizations (NGOs) have provided 
assistance in the restoration of essential health services in 
Afghanistan. Former HHS Secretary Tommy G. Thompson signed a Memorandum 
of Understanding (MOU) with the MoPH on October 2, 2002, pledging the 
support of American citizens to help in these efforts. In early 2003, 
HHS entered into collaboration with the MoPH to improve the maternal-
child health services in Afghanistan. Upon the request of Minister 
Sidiq, HHS's first efforts were directed toward the rehabilitation of 
RBH and the restoration of health services at RBH.
    RBH is the largest full-service women's hospital in Afghanistan. 
RBH was one of the referral hospitals for women under the Taliban and 
was declared the only women's hospital in 1997. It is located adjacent 
to a major bazaar in District 2 of Kabul and consists of a large two-
story building and two ancillary buildings within a courtyard. It has a 
theoretical inpatient capacity of 212 to 250 beds of which 80 to 100 
are designated for Gynecology and Obstetrics. Approximately 25 to 30 
deliveries occurred each day in 2003 and approximately 7,500 to 11,000 
babies were delivered there each year in the first years after the fall 
of the Taliban. The hospital continues to see approximately 300 to 400 
out-patients daily. It is a referral hospital with no formal relations 
with other maternity departments or pediatric hospitals. Its main 
partner for sick newborns is Indira Gandhi Children's Hospital (IGCH), 
also in Kabul.
    RBH, as well as most of the health-care hospitals in Afghanistan, 
continues to struggle with basic facility and human resource challenges 
that exceed those experienced in most other developing countries. 
Health-care professionals and support staff at RBH are working to 
provide quality health-care services in an environment which has been 
neglected during years of political upheaval and oppression. As a 
result, basic inpatient and outpatient services necessary to provide 
timely and accurate assessment and treatment of patients are frequently 
absent or in need of major improvement.
    The latest data from CURE International states that there are 384 
employees at RBH of which there are 19 attending physicians, 74 
physicians, 56 midwives, 35 nurses and 68 allied health professionals 
including pharmacists, anesthetists, lab technicians, radiologists and 
administrative staff. In addition, International Medical Corps (IMC) 
has 27 trainers. Both CURE data and MoPH data indicate approximately a 
1:1 total staff to bed ratio at RBH. In 2006, there were 13,275 live 
births. From January to March 2007, there were 3,542 births with 370 
caesarean sections and 3,172 normal deliveries at RBH. The Maternal

[[Page 46075]]

Mortality Rate (MMR) for RBH in 2006 was 137 per 100,000 live births.
    In April 2003, as a first step, HHS funded a clinical knowledge and 
skills refresher training program at RBH. The intent of this refresher 
training has been to update the knowledge and skills of the current RBH 
attending physicians and other professional staff. HHS provided 
focused, short-term training to the RBH staff to improve their basic 
knowledge levels and to update the clinical skills needed to respond to 
the critical needs of the high-risk patient community accessing care at 
the facility. Additionally, HHS, through the HHS/Centers for Disease 
Control and Prevention (CDC), provided expert technical guidance and 
advisory consultation for the continued development and implementation 
of a facility-based Health Management Information System (HMIS), 
Surveillance, Quality Assurance and Hospital Infection Prevention 
Program (HIPP) at RBH. Simultaneously, the Department of Defense (DOD) 
provided critical infrastructure improvements to the physical plant.
    In 2004, HHS provided funding to continue the RBH training program 
through a $2.2 million cooperative agreement with the implementing NGO, 
IMC. Through this cooperative agreement, IMC continues to support the 
provision of staff development and refresher training for clinical 
staff, including physicians, nurse-midwives and ancillary health-care 
workers and to work toward the development of a Residency program for 
Obstetrics and Gynecology. This agreement will conclude in October 
2007.
    During 2004 and 2005, many expatriate experts attempted to adapt a 
standard curriculum used in Obstetrical/Gynecological residency 
training programs in the United States to the Afghanistan environment. 
Early on, however, HHS and IMC recognized that it would take some time 
to assess its relevancy to the situation on the ground. Difficulties in 
recruiting qualified personnel to run a residency program and differing 
views on the appropriateness of a western-style program delayed plans 
for the residency program and IMC's efforts were therefore directed 
toward continuing education and refresher training A series of 
committed expatriate staff, working in collaboration with IMC, however, 
were able to develop of a four-year residency program equivalent to 
those seen in developing countries This curriculum was formally 
approved by the MoPH on November 30, 2007. Although the curriculum was 
approved, the implementation of this contemporary model for a four-year 
residency program has not occurred as IMC staff and their colleagues at 
the academic board of MoPH recognized that there were significant gaps 
in the knowledge and clinical capability of present Afghan practicing 
obstetrician/gynecologist educators preventing them from assuming 
responsibility for the teaching and clinical supervision of practice in 
areas acknowledged as important and essential to the current accepted 
standards of obstetrics and gynecology practice. Despite numerous 
attempts, the present grantee has been unable to recruit skilled 
educators and clinicians to provide the needed expertise to implement 
the adapted residency program. Most significantly, without the capacity 
to recruit skilled obstetrical/gynecological clinical educators, the 
program can not meet its program objectives or provide quality care to 
the mothers and infants seeking care at RBH.
    Though considerable renovation and rehabilitation of the physical 
plant was completed by 2005, there were still concerns surrounding the 
environment of care. In 2005, HHS sponsored an evaluative visit to the 
facility by members of the Interagency Advisory group. Upon their 
recommendation, a cooperative agreement was awarded in 2005 to CURE 
International to provide leadership and management development and 
consultation and facility management. Funding was also allocated to 
ensure a sufficient supply of materials, equipment and pharmaceuticals 
at RBH. As part of this effort, substantial work was completed in 
developing job descriptions and appraisals, which are necessary for the 
recruitment and retention of qualified staff. In 2006, the MoPH and 
CURE International signed a Memorandum of Understanding (MOU) for the 
operation of RBH. This agreement mandated payment of the Priority 
Reform and Restructure (PRR) salaries of all the staff including the 
resident staff. Subsequently, CURE implemented policies and procedures 
governing attendance and disciplinary action for lack of compliance 
with work responsibilities. Staffing requirements were been modified to 
ensure continuous coverage 24 hours a day, 7 days a week. Today, a 
basic environment of care, which can support a quality resident 
program, is present at RBH.
    Recognizing that the obstetrics/gynecology residents, though 
employed by the MoPH, are primarily products of the Kabul Medical 
University and that a quality residency program is built upon a strong 
foundation of medical education, it is essential to encourage 
collaboration between academia and the practice arena. Kabul Medical 
University has been engaged in curriculum reform and is modernizing its 
approach to teaching and learning with the help of many donors from the 
United States and the international community. The recipient of this 
cooperative agreement must recognize and embrace the opportunity to 
support change in both areas. It is expected that the award recipient 
will be actively engaged in the university to promote excellence in 
teaching and to ensure a solid foundation in the basic sciences, social 
sciences, supporting clinical courses and accompanying courses 
supportive of a professional identity. Finally, efforts to design and 
implement a system for licensure, certification and accreditation of 
residency programs at the MoPH should be supported by obtaining expert 
advice and implemented by developing the capacity within both the MoPH 
and the Ministry of Higher Education (MOHE) to create the systems to 
achieve the monitoring and evaluation functions.
    The primary role for the award recipient of this cooperative 
agreement will be to implement and support the continued development of 
the residency program and improve health-care delivery at RBH, 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 
existing MoPH operational funds, supplies, and staff, current HHS/CURE 
funding to ensure a supportive management structure and the provision 
of necessary equipment, supplies and pharmaceuticals to support quality 
patient care and, likely additional donations or in-kind contributions 
from international donors.
    This cooperative agreement is not anticipated to involve training 
of the non-physician clinical staff or training of administrative or 
executive management staff. The recipient will develop and upon award, 
implement a formal, mutually agreed-upon one-year work plan. The work 
plan must contain all of the 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 projected scope of 
service;
     Develop an annual operational and personnel budget, 
including a plan to

[[Page 46076]]

identify, optimize, consolidate and effectively utilize all available 
funding sources;
     Recruit and maintain qualified expatriate obstetrical/
gynecological faculty so that a constant presence is assured to 
implement and evaluate the residency program;
     Coordinate educational efforts to support the residency 
training with the presently funded CURE/IMC plan for clinical education 
and training. Include a discipline-specific needs assessment training 
plan with objectives using a variety of teaching methodologies, 
evaluation measures and timelines for competency skills assessment and 
testing;
     Create a plan for residency training, which may consist of 
planned exercises, mentoring by international experts and facilitation 
by peer networking. All efforts must build upon the MoPH-approved 
training program, complement MoPH efforts and reflect Institute of 
Health Sciences (IHS) and Kabul Medical School education/training 
standards.
     Provide a plan for the incorporation of the HHS/CDC-
developed Health Management Information System (HMIS), including MoPH 
patient record-keeping into the practice standards;
     Develop a system for incorporating and implementing 
evidence-based standards of care and best practices, including an 
interface with the RBH quality assurance and quality improvement 
programs;
     Develop a process for internal monitoring and evaluation 
to include, in collaboration with MoPH/RBH/CURE, output and outcome 
indicators;
     Establish a system for providing advisement and 
consultation to Kabul Medical University on curriculum reform;
     Document and assess the current process for faculty 
development, identifying areas of need and devising sustainable 
solutions for curriculum reform;
     Develop a system for providing faculty development within 
the faculty responsible for maternal-child health at Kabul Medical 
University;
     Assess the climate for instituting a state-of-the-art 
licensure process and certification system; and,
     Serve as a liaison between the MoPH and MOHE.
    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 the 
recipient 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 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), 
Pub. L. 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 for a total of $625,000 with 
continuation grants contemplated for FY 2008 and FY 2009. Continuation 
of this project from one 12-month budget period to the next 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:
     Organize an orientation meeting after the award is made 
with the award recipient to discuss applicable U.S. Government 
expectations as stated in this RFA, regulations, policies and key 
requirements, as well as report formats and contents.
     Review and approve the award recipient's work plan and 
detailed budget.
     Review and approve the award recipient's monitoring 
evaluation plan.
     Conference on a monthly basis with the award recipient to 
assess monthly progress and expenditures in relations to approved work 
plan, and modify plans, as necessary.
     Meet on an annual basis with the award recipient to review 
the progress report for each U.S. Government Fiscal Year.
     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 Government 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, MOHE and HHS.
    In addition to routine communications with the Afghan MoPH, MOHE 
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 Ministries 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 award recipient 
does not meet objectives, the report must include a statement of cause 
and a summary of corrective actions.

[[Page 46077]]

     Specific action(s) HHS and/or the Afghan MoPH or MOHE 
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 the MoPH, MOHE and HHS. At a 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 recipient 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 AKF is one of ten development 
agencies, institutions, and programs in the AKDN that work primarily in 
the poorest parts of Asia and Africa. The AKF strives to improve the 
health of vulnerable population groups, especially mothers and 
children, and promote health services development on the national and 
regional levels.
    The U. S. Government remains committed to supporting efforts to 
improve the health status of women and children, while assisting in 
further developing Afghanistan's overall health-care infrastructure. 
This proposal builds upon the extensive network of the AKDN and 
leverages the established relationships between the AKDN and the 
Government of Afghanistan.
    The AKDN has played a prominent role in the application of the 
Afghan government's Essential Package of Hospital Services (EPHS) and 
has been instrumental in its nationwide implementation. AKDN has also 
served as a key advisor to the Ministry of Health during the drafting 
of its National Policy on Human Resource Development for Health. Since 
2002, the AKDN, through the AKF, has assisted in the construction and 
rehabilitation of Afghanistan's health-care infrastructure and 
contributed to the improvement of education and health services. Key 
achievements of the AKDN and AKF include the construction or 
rehabilitation of over 48 schools, two teacher-training colleges and 20 
health facilities, the management of 24 health clinics and the 
establishment of 195 health posts.
    AKDN's health-care activities have emphasized training for 
professionals at all tiers of the Afghan health-care system, from 
community health-care workers and laboratory technicians to nurses and 
physicians. Since 2003, the AKDN, under Aga Khan Health Services 
(AKHS), has managed the Bamyan District Hospital, the only referral 
health facility for the seven districts in the province and trained its 
staff in emergency midwifery and obstetric complications. AKDN has also 
operated Community Midwifery Education Training Schools in Bayman Town, 
Faizabad and Kabul to address a major need for qualified, local, female 
health professionals and provided training to over 217 physicians, 161 
midwives, and 264 nurses through training and refresher training 
programs in Baghlan, Takhar, and Badakhshan, Afghanistan.
    Aga Khan University (AKU), with multiple campuses including Kabul, 
Afghanistan and Karachi, Pakistan has served as the primary training 
institution for refresher courses and training programs for Afghan 
physicians, nurses and midwives and for postgraduate medical education 
for Afghan physicians enrolled in residency programs. In the 
international arena, AKU has assumed a dual role as both a standard-
setting research institution and a disseminator of tested and 
replicable models and as such, has raised the bar for health-care in 
the developing world. In the Central Asian region, AKU has established 
itself as a major center for education, training and research in the 
health sciences and teacher education. Most significantly, AKU has also 
garnered a highly diverse faculty and student population in which at 
least 44 percent of AKU's faculty, many in senior posts and 50 percent 
of its students are female.
    Established in 1983, the Aga Khan Medical College located at the 
Karachi campus, offers various undergraduate and postgraduate programs. 
The College's curricular objectives include clinical competence both in 
community settings and hospitals, as well as the assessment of health 
and prevention of disease in communities through the primary health-
care programs that AKU monitors in a number of urban squatter 
settlements. The College has agreements with leading academic 
institutions, including Harvard University in the United States, McGill 
and McMaster Universities in Canada and Karolinska Institute in Sweden, 
which have contributed to faculty and curriculum development. Through 
these partnerships, AKU is able to offer higher training and research, 
specifically in areas where such opportunities are not currently 
available in Pakistan.
    In 1993, the AKU Institute for Educational Development (AKU-IED) 
was established to focus Aga Kahn's efforts on the development of 
educational systems in the developing world. Through its network of 
Professional Development Centres (PDCs) in Pakistan, Central Asia, and 
East Africa, AKU-IED functions as an outreach center and training and 
support facility for professional teachers and education managers. The 
Institutes focus primarily on improving the performance of teachers and 
other stakeholders through professional development, ultimately leading 
to school improvement and offer a series of professional development 
programs for teachers and other educators, as well as graduate 
programs.
    With funding from this cooperative agreement, AKF will be able to 
create a solid teaching hospital by utilizing the vast network of 
development agencies, institutions, and programs of the AKDN and 
building upon its previous educational and training efforts in 
Afghanistan. This effort will work toward developing an evidence-based 
and culturally appropriate Obstetrical/Gynecological residency program 
and continuing education program for practicing physicians. HHS, 
through this cooperative agreement, will augment the funding and 
services of the AKDN and AKF to foster equitable and high quality 
obstetrical and gynecological and infant care at RBH and promote the 
further development of Afghanistan's overall health-care 
infrastructure.

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.

[[Page 46078]]

3. Other--(If Applicable)

    N/A.

IV. Application and Submission Information.

1. Address To Request Application Kit

    An application kit 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 Grant Management. Applications must be prepared 
using Form OPHS-1, which can be obtained at the websites 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 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 (1) original and two 
(2) 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.

[[Page 46079]]

    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 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

[[Page 46080]]

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 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 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

[[Page 46081]]

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 and 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 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.
    (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

[[Page 46082]]

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 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, HHS1101 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 with questions 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. E7-16114 Filed 8-15-07; 8:45 am]
BILLING CODE 4150-38-P