Opportunity Information: Apply for 72066324RFA00012
The USAID/Ethiopia Health Financing Activity (HFA) is a competitive U.S. government grant opportunity designed to help Ethiopia move closer to Universal Health Coverage (UHC) by strengthening how the country raises, allocates, and protects people from the costs of health care. The core aim is to improve access to equitable, high-quality health services while reducing the risk that families will face catastrophic health expenditures. The activity is explicitly aligned with Ethiopia's national ambition to achieve UHC through a Primary Health Care (PHC) approach by 2035, meaning the work is expected to support the front-line health system where most people seek routine and essential services.
The opportunity builds on Ethiopia's long-running health financing reform agenda, which began in 1998 to address both quality and equity challenges in the health sector. Over time, Ethiopia introduced and expanded several key financing mechanisms, including allowing health facilities to retain and use revenue they generate (revenue retention), establishing fee-waiver systems for people who cannot afford services, standardizing exemptions for specific services, and rolling out health insurance schemes. These reforms are presented as having already contributed to improved service delivery and better financial protection for citizens, and the HFA is meant to deepen and institutionalize these gains rather than start from scratch.
USAID's focus under this award is on strengthening and embedding health care financing functions and systems so they reliably support universal access to quality PHC with fewer financial barriers. In practical terms, that typically implies improving the policies, institutional capacity, management systems, and accountability structures that determine how money flows through the health system, how resources are targeted to priority services and populations, and how risk protection tools like insurance and waivers actually work in day-to-day implementation. The activity is expected to leverage lessons learned from prior USAID-supported initiatives in Ethiopia, especially the five-year Health Financing Improvement Program (HFIP), and to translate those lessons into more durable, government-owned systems.
The expected results emphasize measurable, evidence-based progress in Ethiopia's ability to finance health care in ways that are sufficient (enough resources), equitable (fairly distributed and pro-poor), sustainable (stable over time), and efficient (used well with minimal waste). Success is framed less as short-term outputs and more as demonstrated increases in national capacity to plan, mobilize, allocate, and manage health financing for UHC, while improving financial risk protection so that seeking care does not push households into hardship.
From a funding and administrative perspective, this is a discretionary opportunity from USAID in Ethiopia (USAID/Addis Ababa) and will be awarded as a Cooperative Agreement, indicating substantial involvement by the funder during implementation. The funding opportunity number is 72066324RFA00012, and it is listed under the health activity category with CFDA number 98.001. Applicants are unrestricted, meaning any eligible organization is allowed to apply. USAID expects to make one award, with an award ceiling of $40,000,000. The opportunity was created on 2024-08-12, and the original closing date for applications was 2024-09-17.Apply for 72066324RFA00012
- The Ethiopia USAID-Addis Ababa in the health sector is offering a public funding opportunity titled "USAID/Ethiopia Health Financing Activity" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 98.001.
- This funding opportunity was created on 2024-08-12.
- Applicants must submit their applications by 2024-09-17. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- Each selected applicant is eligible to receive up to $40,000,000.00 in funding.
- The number of recipients for this funding is limited to 1 candidate(s).
- Eligible applicants include: Unrestricted.
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Frequently Asked Questions (FAQs) - USAID/Ethiopia Health Financing Activity (HFA)
What is the USAID/Ethiopia Health Financing Activity (HFA)?
The USAID/Ethiopia Health Financing Activity (HFA) is a competitive U.S. government grant opportunity intended to help Ethiopia move closer to Universal Health Coverage (UHC) by strengthening health financing systems. The activity focuses on how the country raises health funds, allocates resources, and protects people from the costs of health care, with the goal of improving access to equitable, high-quality services and reducing catastrophic health expenditures.
What is the main goal of the HFA?
The core aim is to improve access to equitable, high-quality health services while reducing the risk that families face catastrophic health spending. The activity emphasizes strengthening and embedding financing functions and systems so they reliably support universal access to quality Primary Health Care (PHC) with fewer financial barriers.
How does this opportunity relate to Ethiopia's Universal Health Coverage plans?
The HFA is explicitly aligned with Ethiopia's national ambition to achieve UHC through a Primary Health Care (PHC) approach by 2035. This alignment implies the work is expected to support the front-line health system where most people seek routine and essential services.
What does "Primary Health Care (PHC) approach" mean in the context of this opportunity?
Within this opportunity, a PHC approach means strengthening financing systems in ways that support the front-line health system and routine essential services. The intent is that financing reforms and systems improvements translate into fewer financial barriers and better access to quality PHC services.
Is HFA starting a new reform agenda, or building on existing reforms?
The HFA is meant to deepen and institutionalize gains from Ethiopia's long-running health financing reform agenda rather than start from scratch. Ethiopia's reform agenda began in 1998 and has introduced multiple financing mechanisms over time that are presented as contributing to improved service delivery and financial protection.
What prior health financing reforms in Ethiopia are referenced in this opportunity?
The opportunity references several key mechanisms introduced and expanded through Ethiopia's reforms, including revenue retention by health facilities, fee-waiver systems for people unable to afford services, standardized exemptions for specific services, and the rollout of health insurance schemes.
What is meant by "revenue retention" for health facilities?
As described in the opportunity, revenue retention refers to allowing health facilities to retain and use revenue they generate. This is highlighted as one of the health financing mechanisms Ethiopia has introduced as part of its reform agenda.
What are fee waivers and exemptions in this opportunity's context?
The opportunity notes that Ethiopia established fee-waiver systems for people who cannot afford services and standardized exemptions for specific services. These mechanisms are part of the broader financing reforms intended to improve equity and financial protection.
How does the HFA plan to strengthen health financing systems in practice?
In practical terms, the activity typically implies improving the policies, institutional capacity, management systems, and accountability structures that determine how money flows through the health system. It also implies improving how resources are targeted to priority services and populations and how financial risk protection tools like insurance and waivers function in day-to-day implementation.
What kinds of results does USAID expect from the HFA?
Expected results emphasize measurable, evidence-based progress in Ethiopia's ability to finance health care in ways that are sufficient (enough resources), equitable (fairly distributed and pro-poor), sustainable (stable over time), and efficient (used well with minimal waste). Success is framed as demonstrated increases in national capacity to plan, mobilize, allocate, and manage health financing for UHC, while improving financial risk protection so seeking care does not push households into hardship.
What does "financial risk protection" mean in this opportunity?
Financial risk protection, as framed in this opportunity, refers to reducing the likelihood that households will face catastrophic health expenditures or hardship as a result of seeking health care. It is a key part of the activity's focus on making health financing work better for UHC.
Does the opportunity emphasize short-term outputs or longer-term capacity?
The opportunity frames success less as short-term outputs and more as demonstrated increases in national capacity to plan, mobilize, allocate, and manage health financing for UHC, alongside improved financial risk protection.
What prior USAID-supported initiatives does HFA build on?
The activity is expected to leverage lessons learned from prior USAID-supported initiatives in Ethiopia, especially the five-year Health Financing Improvement Program (HFIP), and translate those lessons into more durable, government-owned systems.
Who is the funding agency and where is it administered?
The funding agency is USAID, and the opportunity is described as being from USAID in Ethiopia (USAID/Addis Ababa).
What type of award will be used for this opportunity?
This opportunity will be awarded as a Cooperative Agreement, which indicates substantial involvement by the funder during implementation.
What is the funding opportunity number for this grant?
The funding opportunity number is 72066324RFA00012.
What is the CFDA number listed for this opportunity?
The opportunity is listed with CFDA number 98.001.
What is the activity category for this opportunity?
The opportunity is listed under the health activity category.
Who is eligible to apply?
Applicants are described as unrestricted, meaning any eligible organization is allowed to apply, based on the eligibility rules that apply to this type of USAID opportunity.
How many awards does USAID expect to make?
USAID expects to make one award under this opportunity.
What is the maximum funding amount available (award ceiling)?
The award ceiling is $40,000,000.
Is this a discretionary grant opportunity?
Yes. The opportunity is described as a discretionary opportunity from USAID in Ethiopia.
When was this funding opportunity created?
The opportunity was created on 2024-08-12.
What was the original application closing date?
The original closing date for applications was 2024-09-17.
What problem is the HFA trying to address?
The HFA is designed to address challenges related to equitable access and financial protection in the health system by strengthening the health financing functions that influence how resources are raised and used, and by reducing the risk that households experience catastrophic health expenditures.
What does "equitable" mean in the expected results?
In the expected results description, "equitable" is defined as fairly distributed and pro-poor, meaning resources and financing benefits should reach priority populations and not disproportionately burden those with fewer means.
What does "efficient" mean in the expected results?
In the opportunity description, "efficient" is defined as resources being used well with minimal waste.
What does "sustainable" mean in the expected results?
In the opportunity description, "sustainable" is defined as stable over time, meaning financing approaches and systems should endure and continue supporting UHC progress rather than relying on short-lived efforts.
What does "sufficient" mean in the expected results?
In the opportunity description, "sufficient" is defined as having enough resources to finance health care and support progress toward UHC through PHC.
What is meant by "government-owned systems" in this opportunity?
The opportunity indicates the activity should translate lessons learned into more durable, government-owned systems, meaning systems embedded in national institutions and capable of being maintained and operated over time within Ethiopia's own structures.
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