The USAID Health Systems Strengthening (HSS) Activity is focused on transforming the approach to health support in India, prioritizing inclusive and sustainable health system improvements. The primary goal of this activity is to enhance access to comprehensive primary healthcare, particularly for marginalized communities, and to reduce out-of-pocket healthcare expenditures (OOPE). The HSS activity aims to scale up proven, innovative healthcare models rather than incubating new ones. This includes working with both public and private healthcare sectors, leveraging digital health technologies, and integrating comprehensive healthcare approaches to address gender and social inequities.

The total funding for this grant is up to $20 million over a five-year period, divided into two phases. The initial two years have a funding limit of $6 million, with the potential for an additional $14 million for three more years, contingent on satisfactory progress. This is a Fixed Amount Cooperative Agreement, which will be milestone-based, focusing on specific, measurable outcomes. USAID may make a single award, but it has the discretion to make multiple or no awards, depending on the quality of applications and funding availability.

The HSS Activity emphasizes building connections between government institutions, private sector platforms, and non-profit networks to implement sustainable and scalable health interventions. It seeks to improve primary healthcare, public-private partnerships, and ensure climate resilience of health systems. The activity is not focused on direct healthcare service provision but aims to strengthen existing health systems through collaboration. It targets underserved populations, including urban poor, tribal groups, and LGBTQ+ communities, and emphasizes the importance of gender equity and social inclusion in healthcare delivery.

Eligible applicants include U.S., local, and international non-governmental organizations, including faith-based organizations. New applicants and those with limited previous funding from USAID are encouraged to apply. For-profit organizations may participate but cannot earn a profit from the award. Applicants must submit an 8-page concept paper by October 29, 2024, which will then be reviewed for eligibility. Selected applicants will go through an oral presentation phase and a co-creation workshop to refine the final program description. Only after the successful completion of these phases will a full application be requested.

The application process consists of multiple phases, beginning with a concept paper that outlines the approach, organizational capacity, and innovation strategies. This is followed by an oral presentation and a co-creation phase, where USAID and selected applicants collaborate to refine program plans. Evaluation criteria focus on the applicant's technical approach, management capability, and ability to establish partnerships with local stakeholders. The emphasis is on scaling effective healthcare models, ensuring inclusiveness, and leveraging resources beyond USAID funding.

To ensure a successful application, applicants need to register in SAM.gov to obtain a Unique Entity Identifier (UEI). Applications must be submitted through the specified email addresses by the stated deadlines. Compliance with the submission requirements, including adherence to page limits and formatting guidelines, is essential. The proposals will be reviewed based on merit, with USAID seeking applicants that can demonstrate strong capabilities in scaling health initiatives, fostering gender equity, and effectively engaging local communities and stakeholders.