U.S. AGENCY FOR INTERNATIONAL DEVELOPMENTBUREAU FOR MIDDLE EAST

WASHINGTON, D.C. 20523

Request for the Amendment ofInitial Environmental Examination (IEE)

for Integrated Health Services and Resiliency Amendment (1)

PROGRAM/ACTIVITY DATA:

Country Code: 278

Country or Region: Jordan

Development Objective: Social Sector Quality Improved

Program Objective: Health Status Improved

Program Name: Integrated Health Services & Resiliency (IHSR)         

Funding Begin:August 10, 2015

Funding End:September 30, 2023

LOP Amount:$265,400,000

IEE Amendment Prepared by:  Rawan Qurashi Date: August 15, 2018IEE Amendment (Y/N):  Y If “Yes,” Number & Date of Original IEE:

ME 15-68 IEE Integrated Health Services & Resiliency; September 17, 2015

ENVIRONMENTAL ACTION RECOMMENDED: (Place X where applicable)Categorical Exclusion:    X Deferral:Positive Determination: Negative Determination:    XWith Conditions:   X Exemption:

Amendments:The purpose of this amendment is to reflect the updates on the Project Appraisal Document for the Integrated Health Services and Resiliency (IHSR) Project. 1. This amendment includes updates to the LOP amount from $182,000,000 to

$265,400,000 and the funding period from 2015-2021 to 2015-2023.

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2. This amendment also includes the following revisions to Table 1:

a. Removal of closed/planned activities:

Closed Activities: ● Strengthening Health Outcomes Through the Private Sector (SHOPS);

07/2010-9/2015● Health Systems Strengthening II (HSS II) Bridge; 10/2014-10/2015● Jordan Census Project (JCen Project); 04/2011-09/2016

Planned Activities:● Integrated Health Service Delivery (IHSD) Activity; 2016-2021● Health Sector Sustainability & Resiliency (HSSR) Activity; 2016-2021● Buy-in to Youth Broad Agency Announcement (Mission or USAID/W)

b. Addition of new and planned activities:

New Activities:● Health Service Delivery (HSD) Activity; 03/2016-03/2021● Human Resources for Health (HRH 2030) Activity; 12/2015-08/2020 ● Health Financing and Governance (HFG) Activity; 11/2016-11/2021 ● PREDICT; 02/2017-09/2019● Public Health Surveillance; 09/2016-09/2020 ● Al-Bashir Hospital Emergency Department Expansion Project; 06/2018-

04/2020

Planned Activities: ● Capacity Building for MOH (Vaccines & Family Planning); 09/2018-08/2023 ● Immunization Support Activity Procurement and Introduction of a new

vaccine, the Pneumococcal Conjugate Vaccine (PCV); 10/2018-09/2021 ● Al-Bashir Hospital Accreditation Support Activity; 09/2018-09/2-21 ● Multi-Donor Account; TBD ● PREDICT Follow-on Activity

c. Revisions to existing ongoing and planned activities: ● Rehabilitation of Princess Rahma Pediatric Hospital; Extending the funding

period till April 2019; LOP amount changed from $7,000,000 to $11,000,000 (On-going)

● Rehabilitation of Targeted Public Sector Health Facilities; Activity name changed into “Construction and rehabilitation of Priority Health Facilities”; period of implementation shifted into 01/2019- 12/2021; LOP was defined as $20,000,000 (Planned)

● Nutrition; activity name changed into “Community Health & Nutrition”; period of implementation was defined as 2019/2024; LOP amount was defined as $20,000,000 (Planned)

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Updated Table 1: Ongoing and Planned Population and Family Health Activities

1.A On-going Activities

Ongoing Projects Types of Activities Status DeterminationJordan Communication, Advocacy, and Policy (J-CAP)Abt Associates08/01/2014 - 07/31/2019 LOP: $29,999,868

J-CAP works to increase demand for maternal and child health services through enabling a more supportive policy environment thereby ensuring a healthy future for Jordanian households. J-CAP applies an interactive mix of demand generation and enabling environment interventions to achieve sustainable gains in maternal and child health. Interventions emphasize the integration of female empowerment and male engagement, and aim to increase youth involvement.

Activities:Education, Technical Assistance, or Training including: strategic planning, data analysis, technical consultation, surveys, knowledge and information transfer, meetings, technical material development, outreach programs, and training services.

Ongoing CE

Health Service Delivery (HSD)Abt Associates03/2016-03/2021 LOP: $50,254,872

The purpose of this activity will be to bring into effect sustainable, positive health outcomes in Jordan in both the public and private sectors through increased use of high quality, integrated health services. HSD works closely with the GOJ (at national, as well as local levels), private sector, civil society and other donors and partners. This mechanism provides technical assistance to MOH and other service delivery partners to identify, pilot, scale-up, and institutionalize/sustain best practices and innovative approaches in the areas of reproductive, maternal, neonatal, and child health. HSD analyzes data in these technical areas, identifies barriers to accessing services, and tests innovative approaches to increasing delivery of quality services and strengthening technical capacity of the MOH to monitor delivery of services.

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Activities:Education, Technical Assistance or Training, Analysis, Studies, Academic or Research Workshops and Meetings, Document and Information Transfers, Projects or activities intended to develop the capability of recipient countries and organizations.

Ongoing CE

Activities:Training service providers on using Family Planning methods

Ongoing NDC

Activities:Procurement of medical equipment, supplies, furniture and/or office equipment.

Ongoing NDC

Activities:Small-scale rehabilitation activities.

Ongoing NDC

Human Resources for Health 2030(HRH 2030) (field support)

Chemonics

12/2015-08/2020 LOP (Jordan contribution):

This activity will increase the competency, distribution, and number of health workers and improve public sector leadership in health. This will include development of human resources systems and processes to ensure recruitment, hiring, retention, employee support systems, policies and programs are functioning at consistent and high quality standards to meet continuing workforce demands. Interventions will be at both the central and facility level, and will improve the capacity of the workforce to prepare for and effectively respond to crises.Activities: Ongoing CE

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$12,000,000 Education, Technical Assistance, or Training including: strategic planning, data analysis, technical consultation, surveys, knowledge and information transfer, meetings, technical material development, outreach programs, and training services.Activities:Research and Development including: health-related research and development activities aimed at advancing knowledge and technology, including research and evaluation, monitoring and surveillance programs, pilot studies, case studies, and assessments.

Ongoing CE

Health Finance and Governance(HFG)

Palladium

11/2016-11/2021 LOP: $23,000,000

This Activity will improve health sector sustainability and resilience, including achieving universal health coverage (UHC). The activity aims to increase spending efficiency of public resources for health in support of the GOJ’s UHC goal; and strengthen governance of the health sector to more effectively coordinate, plan, manage and monitor the health system.Activities:Education, Technical Assistance, or Training including: strategic planning,

Ongoing CE

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data analysis, technical consultation, surveys, knowledge and information transfer, meetings, technical material development, outreach programs, and training services.

Activities:Research and Development including: health-related research and development activities aimed at advancing knowledge and technology, including research and evaluation, monitoring and surveillance, programs, pilot studies, case studies, and assessments.

Ongoing CE

PREDICT (field support)

Eco Health Alliance

02/2017-09/2019 LOP (Jordan contribution): $600,000

Part of USAID’s Emerging Pandemic Threats program, this field support activity is developing a global early warning system to detect, track, and predict the emergence of new zoonotic pathogens from wildlife that could pose a threat to human health.

This activity has a global IEE that will expire in September 2019

Ongoing NDC

Rehabilitation of The purpose of this activity is to expand and renovate Princess

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Princess Rahma Pediatric Hospital Project

Host Country Contracts

LOP: $11,000,00005/2014-04/2019

Rahma Pediatric Hospital in Irbid to respond to the critical needs resulting from the influx of Syrian refugees and increased demand for health services in Jordan’s Northern Governorates. The new expansion will increase the hospital capacity by approximately 35% and will upgrade some of the existing critical hospital functions.

This activity has an amended IEE that will expire in April 2019

Ongoing CE, NDC

Public Health Surveillance (field support)

World Health Organization (WHO)

09/2016-09/2020 LOP (Jordan contribution): $2,500,000

The objective of this project is to improve the status and functioning of the national public health system in Jordan; and to monitor the epidemiological trend of priority diseases, health conditions and events among refugees and host communities. WHO will also strengthen health systems for UHC in Jordan by enhancing the health governance role of the MOH.

Activities:Health related data collection and analysis including research and evaluation, monitoring and surveillance.

Ongoing CE

The Demographic & Health Surveys (DHS) (field support)

ICF International09/2013- 09/2018 (current iteration with an excepted mission contribution in the next iteration awarded in Fall 2018) LOP (Jordan contribution): $3,500,000

Under the DHS Program, USAID is supporting the implementation of the 2017-2018 Jordan Population and Family Health Survey (JPFHS). This survey will be the seventh Demographic Health Survey to be conducted in Jordan. The main objective of the survey is to provide comprehensive data on fertility, mortality, family planning, and fertility preferences, as well as maternal and child health and nutrition. For the first time, the survey will take into consideration men and the health and fertility status of the Syrian refugees so that can be used by program managers and policy makers to evaluate and improve existing programs.

The activity has a global IEE that will expire on30 September 2018

Ongoing CE, NDC

Al-Bashir Hospital Emergency

MOH health facility capacity is critically inadequate in meeting the needs of the fast growing Jordanian population and

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Department Expansion Project

ConstructionLOP: $22,306,33106/2018-02/2020

Architectural and Engineering SupervisionLOP: $1,274,00006/2018-04/2020

EquipmentLOP: $4,000,00007/2015-12/2021

significant influx of Syrian refugees. As a result, USAID is providing support to rehabilitate and equip select health facilities in order to provide high-quality health care to Jordanians and Syrian refugee families.

The activity has an IEE that will expire inDecember 2020

Ongoing CE, NDC

1.B “Planned Activities”:Planned Projects Types of Activities Determinati

on Action Required

Construction and rehabilitation of Priority Health Facilities

Multiple Host Country Contracts

01/2019- 12/2021

LOP: $20,000,000

MOH health facility capacity is critically inadequate in meeting the needs of the fast growing Jordanian population and significant influx of Syrian refugees. As a result, USAID is providing support to rehabilitate and equip select health facilities in order to provide high-quality health care to Jordanians and Syrian refugee families.

Activities:Architectural/ Engineering Services

Planning activities such as collection and review of information, meetings, and analysis

Preparation of architect/engineering (A/E) designs and

CE

NDC

No action required.

The conditions are for the A/E services contractor to ensure following environmentally

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services related to construction supervision

sound designs, including mitigation measures identified in climate risk screening, as applicable, use of an Environmental Monitoring and Mitigation Plan (EMMP), ensure use of best management practice (BMPs) to minimize dust, noise, debris, waste production, flooding, traffic disturbance, risks to workers and community safety, and to properly dispose of debris and waste.

Activities:Construction and renovation

NDCThe awardee should ensure implementation of environmentally sound designs, ensure use of an EMMP, ensure use of BMPs to minimize dust, noise, debris, waste production, flooding, traffic disturbance, risks to workers and community safety, and to property dispose of debris and waste. The EMMP shall be approved by the Contracting Officer’s Representative (COR) and Mission Environmental Officer (MEO) and shall be included in any procurement instruments

Activities:Procurement of medical equipment, supplies, furniture and/or office equipment.

CE, NDC The implementer is required to ensure that equipment, commodities (see also ADS 312) and materials are procured from certified retailers; environmental safety and quality certificates conforming with national and/or international standards are available; equipment and

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materials are used in an environmentally sound and safe manner, properly disposed of when applicable at the end of their useful life in a manner consistent with best management practices according to USG, European Union or equivalent standards acceptable to USAID.

Capacity Building for MOH (Vaccines and Family Planning)

Government to Government (G2G)/Partner Government Systems (PGS) ActivityLOP: $50,000,00009/2018 - 08/2023

Through the PGS, USAID will support the MOH with two critical activities: 1) Introduction of a new vaccine to the national Expanded Program on Immunizations (EPI), the Pneumococcal Conjugate Vaccine, and 2) To strengthen MOH’s Family Planning, Reproductive, Newborn, and Child Health (RMNCH) capabilities, policies and programs to sustain the activities with its own resources.

Activities: Education, Technical Assistance or Training, Analysis, Studies, Academic or Research Workshops and Meetings, Document and Information Transfers, Projects or activities intended to develop the capability of recipient countries and organizations.

CE No action required.

Activities:Procurement, storage, management and disposal of public health commodities (Vaccines).

NDC Consignees for all pharmaceutical drugs procured under this funding will be advised to store products according to the information provided on the manufacturer’s Materials Safety Data Sheet (MSDS). These are supplied by the manufacturer, and can also be found on the internet by using active ingredients and MSDS as search terms. If

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disposal of these pharmaceutical drugs is required, due to expiration date or other reasons, the consignee will be advised that the preferred method of disposal is to return the product(s) to the manufacturer. If this is not possible (e.g., if the expired or spoiled pharmaceuticals are considered hazardous and, if transferred across frontiers, become regulated and subject to the Basel Convention on the trans-frontier shipment of hazardous wastes) then follow the guidelines in the WHO document Guidelines for Safe Disposal of Unwanted Pharmaceuticals During and After Emergencies, (www.who.int/water_sanitation_health/medicalwaste/unwantpharm.pdf.) At the request of the Mission, MOH use project funds implement needed monitoring and mitigation measures to facilitate the disposal of expired drugs under this activity to mitigate the impact of medical waste. Packaging and disposal of other public health commodities will be treated using the guidelines provided in Environmental Guidelines for Small-Scale Activities in Africa (EGSSAA) 2nd Edition, Chapter 15: Solid Waste (http://www.encapafrica.org/EGSSAA/Word_English/solidwaste.doc).

MOH should also comply with their own regulations for medical waste management as

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a result of the vaccination process:http://www.moh.gov.jo/AR/Documents/Medical%20waste.pdf

Immunization Support Activity Procurement and Introduction of a new vaccine, the Pneumococcal Conjugate Vaccine (PCV)

TBCLOP: $14,500,00010/2018 - 09/2021

USAID will strengthen Jordan’s National Expanded Program on Immunizations (EPI) by supporting the procurement and introduction of the Pneumococcal Conjugate Vaccine (PCV) to protect vulnerable populations. With this investment, USAID will support the GOJ to immunize all infants born in Jordan – including refugees – against the deadly and contagious pneumococcal infections.Note: May be done only through the FARA mechanism or may be a combined PIO for years 1 &2 and FARA for subsequent years.

Activities:Procurement, storage, management and disposal of public health commodities (Vaccines).

NDC Consignees for all pharmaceutical drugs procured under this funding will be advised to store products according to the information provided on the manufacturer’s Materials Safety Data Sheet (MSDS). These are supplied by the manufacturer, and can also be found on the internet by using active ingredients and MSDS as search terms. If disposal of these pharmaceutical drugs is required, due to expiration date or other reasons, the consignee will be advised that the preferred method of disposal is to return the product(s) to the manufacturer. If this is not possible (e.g., if the expired or spoiled pharmaceuticals are considered hazardous and, if transferred across frontiers, become regulated and subject to the Basel Convention on the trans-frontier shipment of hazardous wastes) then follow the guidelines in the WHO

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document Guidelines for Safe Disposal of Unwanted Pharmaceuticals During and After Emergencies, (www.who.int/water_sanitation_health/medicalwaste/unwantpharm.pdf.) At the request of the Mission, MOH use project funds implement needed monitoring and mitigation measures to facilitate the disposal of expired drugs under this activity to mitigate the impact of medical waste. Packaging and disposal of other public health commodities will be treated using the guidelines provided in Environmental Guidelines for Small-Scale Activities in Africa (EGSSAA) 2nd Edition, Chapter 15: Solid Waste (http://www.encapafrica.org/EGSSAA/Word_English/solidwaste.doc).

Al-Bashir Hospital Accreditation Support Activity

Health Care Accreditation CouncilLOP: $3,074,91209/2018 – 09/2021

Al-Bashir Hospital is Jordan’s largest public hospital and the only one designated as a “hospital of last resort” for some of the country’s poorest and most vulnerable populations. Accreditation is a standardized review process that allows health care establishments to demonstrate their ability to meet regulatory requirements established by Jordan’s national accreditation organization. Accreditation can be the single most important approach for improving the quality of health care structures.Activities: Technical Assistance, Training, Analysis, Workshops and Meetings. Document and Information Transfers, Projects or activities intended to develop the capability of recipient countries and

CE No action required.

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organizations.

Activities:Small-scale renovation activities.

NDC Environmental Due Diligence (EDD) in the form of Environmental Review and Assessment Checklist (Annex 1) is required to identify environmental effects, develop Environmental Manual and Mitigation and Monitoring Plans when applicable, confirm/ neglect and mitigate a potentially significant adverse effect.

Community Health and Nutrition

TBDLOP:$20,000,000

2019/2024

USAID seeks to design a focused community health and nutrition activity targeting different community groups and those who are most vulnerable to support individuals, families, communities, institutions, and government in adopting and maintaining high impact health and nutrition behaviors and practices.

USAID expects that this activity will utilize a community health approach to improve both health and nutrition outcomes; reaching the most poor and vulnerable in Jordan with health/nutrition interventions at the community level. These initiatives may include efforts to bolster fortification of foods, as appropriate. USAID expects this effort will reduce different types of anemia and micronutrient deficiencies; promote good health and nutrition practices; create systems that are able to assess and address the health needs of the community; and work to promote the use of and access to health and capacity-building opportunities in a primary/preventive healthcare setting.

Activities: Education, Technical Assistance or Training, Analysis, Academic or Research Workshops and Meetings, Document and Information Transfers, Projects or activities intended to develop the capability of recipient countries and

CE No action required.

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organizations.Multi-Donor AccountTBDLOP: up to $15,000,000

Increasing the cost of health care for refugees is a major concern for USAID and other donors as it affects Jordan`s stability and threatens achievements made in the health sector to date. For that reason, USAID will lead an effort for the development of an MDA for health, which will provide services to Syrian refugees and increase the number of donors engaging in the bilateral health donor space.

ActivitiesEducation, Technical Assistance or Training, Analysis, Academic or Research Workshops and Meetings, Document and Information Transfers, Projects or activities intended to develop the capability of recipient countries and organizations.

CE No action required.

ActivitiesProvision of medical services that could generate medical waste

NDC The implementer should comply with MOH regulations for medical waste management:http://www.moh.gov.jo/AR/Documents/Medical%20waste.pdf

ActivitiesProcurement of medical equipment, supplies, furniture and/or office equipment.

NDC The implementer is required to ensure that equipment, commodities (see also ADS 312) and materials are procured from certified retailers; environmental safety and quality certificates conforming with national and/or international standards are available; equipment and materials are used in an environmentally sound and safe manner, properly disposed of when applicable at

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the end of their useful life in a manner consistent with best management practices according to USG, European Union or equivalent standards acceptable to USAID.

PREDICT Follow-on Activity (field support)

Eco Health Alliance

TBD LOP: TBD

USAID Jordan is planning to buy-in in the follow-on Emerging Pandemic Threats program; a field support mechanism that is developing a global early warning system to detect, track, and predict the emergence of new zoonotic pathogens from wildlife that could pose a threat to human health.

Activities:- Procurement,

storage, management and disposal of public health commodities, including laboratory supplies and reagents.

- Action that directly or indirectly result in the generation and disposal of hazardous or highly hazardous medical waste (e.g., laboratory diagnosis, wildlife surveillance, etc.)

- Actions associated with establishing a wildlife surveillance capacity in selected countries and regions that target specific microbial agents.

- Outbreak response planning and implementation.

NDC A separate IEE will be developed for PREDICT follow-on Activity defining in details the required actions.

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Climate Risk Management (CRM) As per the ADS 201mal, USAID should factor climate resilience into international development programs and investments. Therefore, the design team and/or implementing partner will identify expected climate change impacts over the life of the project’s expected benefits and (if appropriate) demonstrate how those risks will be reduced in order to ensure sustainability of the project's objectives. An initial climate risk screening for this PAD amendment has been completed and is available in Annex 6. The screening identified the activities under this PAD amendment that require additional CRM screening at the award (or sub-award) level. This shall be done by the design team and/or implementing partner, and approved by the A/COR and mission Climate Integration Lead (CIL) prior to implementation.

Revisions As with all USAID-funded projects, and pursuant to 22 CFR 216.3(a)(9), if new information becomes available which indicates that any of the proposed actions to be funded by this activity might be “major” and their effects “significant”, the threshold decision for the actions listed above will be reviewed and revised by the originator(s) of the program and projects and submitted through the MEO to the Bureau Environmental Officers, ME, for approval and, if warranted, an environmental assessment will be prepared by the Mission as appropriate. It is the responsibility of the AOR to keep the Mission Environmental Officer and the BEO informed of any new information or changes in the activity that mighty require revision of the IEE.

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APPROVAL OF RECOMMENDED ENVIRONMENTAL ACTIONS - IEE:REQUEST FOR AMENDMENT #1 OF THE INITIAL ENVIRONMENTAL EXAMINATION FOR: Integrated Health Services and Resiliency

Director, Population and Family Health Office

Clearance: ___________DMS_______________ ______8/30/2018_______ Dan Sinclair Date Acting Mission Environmental Officer

Clearance: ___________FM_______________ _______9/3/2018_______ Farid Musmar Date Acting Director, Program Office

Clearance: ____________JM______________ ______9/3/2018________ Jessica Morrison Date Regional Legal Officer

Clearance: ____________JM____________ _______8/30/2018______ Jeffrey Meyers Date

Regional Environmental Adviser

Clearance: ____________SE_____________ _______9/5/2018________ Suzanne Ebert Date

Acting Mission Director

Approval: __________________________ _____________________ Nancy Eslick Date CONCURRENCE:Bureau Environmental Officer

Concurrence: __________________________ _____________________

John Wilson Date

Approved: Disapproved:

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Disapproved:

ATTACHMENT: Original Integrated Health Services and Resiliency IEE

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DISTRIBUTION:Mission Environment OfficerAssistance and Acquisition OfficeIEE File

Drafted by Rawan Qurashi, August 28, 2018

P:\PFHPUB\PFH Program Wide\Planning, Reporting, Learning\Project Design (PAD)\PAD 2017\IEE updated

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Annexes:

Annex 6: Climate Risk Screening Table

Defined or anticipated project elements (Activity/mechanism/Intervention)

Implementation period

CRM Exempt?

Explanation and/or related climate risks

Further analysis

required?

Jordan Communication, Advocacy, and Policy (J-CAP)

8/2014 – 7/2019

Yes Activity commenced before 10/1/2016

No

Health Systems Strengthening II Bridge

10/2014 – 10/2015

Yes Activity commenced before 10/1/2016 and activity completed

No

Princess Rahma Pediatric Hospital Expansion - Construction/renovation(Phase I)

7/2015 – 2/2017

Yes Activity commenced before 10/1/2016 and will end soon.

No

Princess Rahma Pediatric Hospital Expansion - Construction/renovation(Phase II)

4/2018-12/2018

NoActivity commenced after 10/1/2016 but contract is awarded. No opportunity to inform implementation.

No

Princess Rahma Pediatric Hospital Expansion - Equipment 7/2015 –

12/2021Yes Activity commenced before

10/1/2016 and contract is awarded existing UNOPS award

No

Construction Management and Supervision

7/2015 – 4/2019

Yes Activity commenced before 10/1/2016 and will end next year

No

MEASURE Demographic & Health Surveys (DHS)

9/2013 – as needed

Yes Activity commenced before 10/1/2016

No

MEASURE U.S. Census Bureau 1/2011 – 9/2017

Yes Activity commenced before 10/1/2016 and activity completed

No

Health Service Delivery (HSD) 3/2016 – 3/2021

Yes Activity commenced before 10/1/2016

No

Human Resources for Health Activity (HRH 2030)

12/2015 – 8/2020

Yes Activity commenced before 10/1/2016

No

Health Financing and Governance (HFG)

11/2016 – 11/ 2021

No Activity commenced after 10/1/2016; however contract is awarded.

No

Al-Bashir Hospital ER Expansion: Construction

4/2018 – 4/2019

No Activity commenced after 10/1/2016; however, contract is already awarded on 6/12/2018 with designs complete. Little opportunity for CRM to influence implementation.

No

Al-Bashir Hospital ER Expansion: Supervision

4/2018 – 7/2020

No Activity commenced after 10/1/2016; however, contract is

No

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already awarded on 6/11/2018 with designs complete. Little opportunity for CRM to influence implementation.

Al-Bashir Hospital ER Expansion: Equipment

7/2015 – 12/2021

Yes Activity commenced before 10/1/2016. Contract awarded on 7/22/2015 under existing UNOPS furniture award

No

Construction and Renovation of Priority Health Facilities

1/2019 – 12/2021

No Activity commenced after 10/1/2016, and there is an opportunity for CRM screening to inform design

Yes

PREDICT 2/2017 – 9/2019

No Activity commenced after 10/1/2016 as part of a global agreement. Activity awarded.

No

Public Health Surveillance (WHO)

9/2016 – 9/2020

Yes Activity commenced before 10/1/2016. Activity awarded.

No

Capacity Building for MOH (Vaccines & Family Planning) 6/2018 –

5/2023 No

Activity commenced after 10/1/2016, and there is an opportunity for CRM screening to inform design

Yes

Immunization Support Activity: Procurement and Introduction of a new vaccine, the Pneumococcal Conjugate Vaccine (PCV)

2/2018 – 1/2021 No

Activity commenced after 10/1/2016, and there is an opportunity for CRM screening to inform design

Yes

Al-Bashir Hospital Accreditation Support Activity

6/2018 – 4/2021

No Activity commenced after 10/1/2016, and there is an opportunity for CRM screening to inform design

Yes

Monitoring and Evaluation 7/2015 – 9/2023

Yes Activity awarded before 10/1/2016 and focused on internal USAID M&E

No

Community Health and Nutrition

TBD No Activity currently in design phase

Yes

Multi-donor Account TBD No Activity currently in design phase Yes

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