USAID contract to John Snow, Inc. for Ugandan health services exceeds $62M, aiming to boost sustainable healthcare access

Contract Overview

Contract Amount: $62,381,041 ($62.4M)

Contractor: John Snow, Incorporated

Awarding Agency: Agency for International Development

Start Date: 2018-02-15

End Date: 2024-11-20

Contract Duration: 2,470 days

Daily Burn Rate: $25.3K/day

Competition Type: FULL AND OPEN COMPETITION

Number of Offers Received: 4

Pricing Type: COST PLUS FIXED FEE

Sector: Other

Official Description: RHITES N-LANGO: THE PURPOSE OF THIS CONTRACT IS TO INCREASE THE EFFECTIVE USE OF SUSTAINABLE HEALTH SERVICES IN THE LANGO REGION OF NORTHERN UGANDA THROUGH PROGRESS IN THE FOLLOWING KEY RESULT AREAS: 1. INCREASED AVAILABILITY AND ACCESSIBILITY OF HEALTH SERVICES IN FACILITIES AND COMMUNITIES; 2. IMPROVED HEALTH SYSTEM FOR QUALITY SERVICES IN FACILITIES AND COMMUNITIES; 3. INCREASED ADOPTION OF HEALTH BEHAVIORS BY COMMUNITIES AND INDIVIDUALS.

Plain-Language Summary

Agency for International Development obligated $62.4 million to JOHN SNOW, INCORPORATED for work described as: RHITES N-LANGO: THE PURPOSE OF THIS CONTRACT IS TO INCREASE THE EFFECTIVE USE OF SUSTAINABLE HEALTH SERVICES IN THE LANGO REGION OF NORTHERN UGANDA THROUGH PROGRESS IN THE FOLLOWING KEY RESULT AREAS: 1. INCREASED AVAILABILITY AND ACCESSIBILITY OF HEALTH SERVICES IN FACILITIES AND… Key points: 1. Focuses on improving health service availability, quality, and community health behaviors in Uganda's Lango region. 2. Contract duration is extensive, spanning over 2,000 days, suggesting a long-term commitment to program goals. 3. The contract type, Cost Plus Fixed Fee, allows for cost reimbursement plus a predetermined profit, potentially incentivizing efficiency. 4. Competition was full and open, indicating a broad search for qualified contractors and potentially competitive pricing. 5. The North American Industry Classification System (NAICS) code 541990 suggests a broad scope of professional, scientific, and technical services. 6. The contract's success hinges on measurable progress in key result areas related to health service delivery and adoption.

Value Assessment

Rating: good

The contract value of over $62 million for a period of approximately 6.8 years represents a significant investment in global health. Benchmarking this against similar USAID-funded health initiatives in sub-Saharan Africa would provide further context on its relative scale and cost-effectiveness. The Cost Plus Fixed Fee (CPFF) structure is common for complex, long-term projects where costs can be variable, but it requires careful oversight to ensure value for money.

Cost Per Unit: N/A

Competition Analysis

Competition Level: full-and-open

The contract was awarded under full and open competition, suggesting that multiple bidders likely vied for this opportunity. This competitive process is designed to ensure that the government receives the best possible value by leveraging market forces. The number of bidders and the specific evaluation criteria would provide a clearer picture of the intensity of the competition.

Taxpayer Impact: Full and open competition generally benefits taxpayers by driving down costs and encouraging innovative solutions from a wider pool of contractors, leading to more efficient use of public funds.

Public Impact

Beneficiaries include communities and individuals in the Lango region of Northern Uganda, who stand to gain improved access to sustainable health services. Services delivered encompass enhancing the availability and accessibility of health services, improving health system quality, and promoting healthier behaviors. Geographic impact is concentrated in the Lango region of Northern Uganda, addressing specific regional health challenges. Workforce implications may include the employment of local Ugandan health professionals and support staff, as well as international technical experts.

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Warning Flags

Potential for cost overruns inherent in Cost Plus Fixed Fee contracts if not rigorously managed.
Sustainability of health improvements beyond the contract period requires careful planning and local capacity building.
Measuring the true impact on health behaviors can be challenging and may require long-term, complex evaluation methodologies.

Positive Signals

Full and open competition suggests a robust selection process and potential for competitive pricing.
Clear key result areas provide a framework for performance measurement and accountability.
Long contract duration allows for sustained effort and potential for deep impact in the target region.

Sector Analysis

This contract falls within the broader 'Professional, Scientific, and Technical Services' sector, specifically focusing on public health and international development. USAID frequently engages in such contracts to implement health programs in developing nations. Comparable spending benchmarks would involve analyzing other large-scale health initiatives funded by USAID or similar international development agencies in regions with similar health system challenges.

Small Business Impact

Information regarding small business participation, including set-asides or subcontracting plans, is not explicitly detailed in the provided data. Typically, large prime contracts like this may include provisions for small business subcontracting to ensure broader economic impact. Further analysis would be needed to determine the extent of small business involvement.

Oversight & Accountability

Oversight is likely managed by USAID's program officers and contracting specialists, who would monitor performance against the key result areas and review financial expenditures. The Cost Plus Fixed Fee structure necessitates close financial oversight to ensure costs are reasonable and allocable. Transparency would be facilitated through regular reporting requirements from the contractor and potentially public dissemination of program outcomes.

Related Government Programs

USAID Global Health Security Agenda
USAID Maternal and Child Health Programs
PEPFAR (President's Emergency Plan for AIDS Relief)
Global Fund to Fight AIDS, Tuberculosis and Malaria

Risk Flags

Cost Overrun Risk (CPFF)
Sustainability of Impact
Measurement of Behavioral Change
Geopolitical Instability in Region

Frequently Asked Questions

What is this federal contract paying for?

Agency for International Development awarded $62.4 million to JOHN SNOW, INCORPORATED. RHITES N-LANGO: THE PURPOSE OF THIS CONTRACT IS TO INCREASE THE EFFECTIVE USE OF SUSTAINABLE HEALTH SERVICES IN THE LANGO REGION OF NORTHERN UGANDA THROUGH PROGRESS IN THE FOLLOWING KEY RESULT AREAS: 1. INCREASED AVAILABILITY AND ACCESSIBILITY OF HEALTH SERVICES IN FACILITIES AND COMMUNITIES; 2. IMPROVED HEALTH SYSTEM FOR QUALITY SERVICES IN FACILITIES AND COMMUNITIES; 3. INCREASED ADOPTION OF HEALTH BEHAVIORS BY COMMUNITIES AND INDIVIDUALS.

Who is the contractor on this award?

The obligated recipient is JOHN SNOW, INCORPORATED.

Which agency awarded this contract?

Awarding agency: Agency for International Development (Agency for International Development).

What is the total obligated amount?

The obligated amount is $62.4 million.

What is the period of performance?

Start: 2018-02-15. End: 2024-11-20.

What is John Snow, Incorporated's track record with USAID and similar international health contracts?

John Snow, Incorporated (JSI) is a well-established public health organization with extensive experience implementing health programs globally, often in partnership with USAID. They have a history of managing large-scale, complex projects focused on improving health systems, disease prevention, and health service delivery in various low- and middle-income countries. Their portfolio includes work in areas such as maternal and child health, infectious diseases, health workforce development, and health information systems. JSI's track record with USAID is generally strong, characterized by successful project execution and adherence to program objectives. However, as with any large implementing partner, specific contract performance can vary, and a detailed review of past performance evaluations and any past performance issues would be necessary for a comprehensive assessment.

How does the $62 million contract value compare to other USAID health initiatives in sub-Saharan Africa?

A contract value of over $62 million for a multi-year health program in sub-Saharan Africa is substantial, placing it among significant USAID investments in the region. USAID funds a wide array of health programs, ranging from smaller, targeted interventions to large, multi-country initiatives. Contracts of this magnitude are typically awarded for comprehensive, long-term projects aimed at systemic improvements in health service delivery, health system strengthening, or major disease control efforts. For instance, large-scale HIV/AIDS programs (like those under PEPFAR) or broad health system strengthening projects often reach or exceed this funding level. Smaller projects focusing on specific disease areas or localized interventions would naturally have lower values. Therefore, this contract appears to be a significant, strategic investment by USAID in addressing multifaceted health challenges within the Lango region.

What are the primary risks associated with a Cost Plus Fixed Fee (CPFF) contract of this nature?

The primary risks associated with a Cost Plus Fixed Fee (CPFF) contract, such as this one, revolve around cost control and ensuring value for money. While the fixed fee provides the contractor with a predictable profit margin, the 'cost plus' component means the government reimburses the contractor's allowable costs. If cost estimation is inaccurate or if project scope creeps without adequate adjustments, costs can escalate beyond initial projections. This necessitates robust oversight from the contracting agency (USAID) to scrutinize incurred costs, ensure they are reasonable, allocable, and allowable according to the contract terms. There's also a risk that the contractor might not be sufficiently incentivized to minimize costs, as their profit is fixed regardless of the final cost. Effective risk mitigation involves detailed cost proposals, regular audits, and strong performance monitoring.

How will the success of this contract be measured, given the stated key result areas?

The success of this contract will be measured against the three key result areas outlined: 1. Increased availability and accessibility of health services; 2. Improved health system for quality services; and 3. Increased adoption of health behaviors. USAID contracts typically require detailed monitoring and evaluation (M&E) plans. For this contract, success metrics would likely include quantifiable indicators such as the number of new health facilities established or upgraded, the number of health workers trained, patient visit volumes, availability of essential medicines, rates of specific health service utilization (e.g., antenatal care visits, childhood immunizations), and changes in community health practices (e.g., handwashing, safe water storage). JSI would be expected to provide regular performance reports detailing progress against these indicators, which USAID would then assess to determine overall contract success and impact.

What is the historical spending pattern for similar USAID health programs in Uganda or the Lango region?

Historical spending patterns for USAID health programs in Uganda have been substantial, reflecting the agency's commitment to supporting the country's health sector. USAID has been a major partner in Uganda, focusing on areas such as HIV/AIDS prevention and treatment, malaria control, maternal and child health, family planning, and health systems strengthening. Funding levels can fluctuate based on national priorities, global health initiatives, and the specific needs of the country. While specific spending data for the Lango region might be granular, overall USAID health funding to Uganda has historically been in the tens to hundreds of millions of dollars annually over the past decade. This contract's value aligns with the scale of USAID's typical investments in comprehensive health system support or major disease control programs within a country like Uganda.

Industry Classification

NAICS: Professional, Scientific, and Technical Services › Other Professional, Scientific, and Technical Services › All Other Professional, Scientific, and Technical Services

Product/Service Code: SUPPORT SVCS (PROF, ADMIN, MGMT) › PROFESSIONAL SERVICES

Competition & Pricing

Extent Competed: FULL AND OPEN COMPETITION

Solicitation Procedures: NEGOTIATED PROPOSAL/QUOTE

Solicitation ID: SOL-617-16-000011

Offers Received: 4

Pricing Type: COST PLUS FIXED FEE (U)

Evaluated Preference: NONE

Contractor Details

Address: 44 FARNSWORTH ST FL 7, BOSTON, MA, 02210

Business Categories: Category Business, Corporate Entity Not Tax Exempt, Not Designated a Small Business, Special Designations, Subchapter S Corporation, U.S.-Owned Business

Financial Breakdown

Contract Ceiling: $69,978,977

Exercised Options: $69,978,977

Current Obligation: $62,381,041

Actual Outlays: $43,871,689

Subaward Activity

Number of Subawards: 4

Total Subaward Amount: $4,712,147

Contract Characteristics

Multi-Year Contract: Yes

Commercial Item: COMMERCIAL PRODUCTS/SERVICES PROCEDURES NOT USED

Cost or Pricing Data: NO

Timeline