USAID's $21.2M Health Services Contract for Liberia Shows Mixed Value and Limited Competition

Contract Overview

Contract Amount: $21,257,274 ($21.3M)

Contractor: Management Sciences for Health, Inc.

Awarding Agency: Agency for International Development

Start Date: 2015-02-27

End Date: 2021-12-29

Contract Duration: 2,497 days

Daily Burn Rate: $8.5K/day

Competition Type: FULL AND OPEN COMPETITION

Number of Offers Received: 4

Pricing Type: COST PLUS FIXED FEE

Sector: Other

Official Description: IGF::CL,CT::IGF (THE GOAL OF THE CSHSS CONTRACT IS TO IMPROVE THE HEALTH STATUS OF LIBERIANS , AS LAID OUT IN USAID/LIBERIA S HEALTH STRATEGY, AND COUNTRY DEVELOPMENT COOPERATION STRATEGY (CDCS) DEVELOPMENT OBJECTIVE 3 (DO3).)

Plain-Language Summary

Agency for International Development obligated $21.3 million to MANAGEMENT SCIENCES FOR HEALTH, INC. for work described as: IGF::CL,CT::IGF (THE GOAL OF THE CSHSS CONTRACT IS TO IMPROVE THE HEALTH STATUS OF LIBERIANS , AS LAID OUT IN USAID/LIBERIA S HEALTH STRATEGY, AND COUNTRY DEVELOPMENT COOPERATION STRATEGY (CDCS) DEVELOPMENT OBJECTIVE 3 (DO3).) Key points: 1. The contract's cost-plus-fixed-fee structure may lead to cost overruns, impacting overall value for money. 2. Limited competition, with only four bidders, raises concerns about price discovery and potential for inflated costs. 3. The contract's duration of nearly 7 years suggests a significant, long-term investment in Liberia's health sector. 4. Performance context is crucial, as the contract aims to improve Liberia's health status, aligning with strategic development goals. 5. The 'All Other Professional, Scientific, and Technical Services' NAICS code indicates a broad scope of work, requiring careful performance monitoring. 6. The absence of small business set-asides means opportunities for smaller firms were not explicitly prioritized.

Value Assessment

Rating: fair

The contract's total award of $21.2 million over nearly 7 years represents a substantial investment. However, the cost-plus-fixed-fee (CPFF) pricing structure inherently carries risks of cost escalation, making a definitive value-for-money assessment challenging without detailed performance and cost data. Benchmarking against similar health sector development contracts in post-conflict regions would be necessary to determine if the pricing is competitive.

Cost Per Unit: N/A

Competition Analysis

Competition Level: full-and-open

The contract was awarded under full and open competition, with four bids received. While this indicates an attempt at broad solicitation, the relatively low number of bidders for a contract of this magnitude and duration could suggest barriers to entry or a niche market. This level of competition may not have driven the most aggressive pricing.

Taxpayer Impact: A limited number of bidders can result in higher prices for taxpayers, as the government may have less leverage to negotiate favorable terms. It also raises questions about whether the most innovative or cost-effective solutions were fully explored.

Public Impact

Beneficiaries include the population of Liberia, who are expected to experience improved health status. Services delivered encompass a broad range of professional, scientific, and technical support aimed at enhancing the health sector. The geographic impact is focused on Liberia, supporting USAID/Liberia's health strategy and development objectives. Workforce implications could include the engagement of local Liberian health professionals and support staff, as well as international experts.

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Warning Flags

Cost-plus-fixed-fee contracts can incentivize contractors to increase costs to maximize their fee, potentially leading to reduced value for money.
The limited number of bidders (4) suggests potential market concentration or high barriers to entry, which could lead to less competitive pricing.
The broad NAICS code (541990) makes it difficult to assess the specific services rendered and their effectiveness without further detail.
The contract's long duration (nearly 7 years) increases the risk of scope creep or misalignment with evolving health needs if not actively managed.

Positive Signals

The contract directly supports USAID/Liberia's Health Strategy and Country Development Cooperation Strategy, indicating alignment with established development goals.
Awarding under full and open competition, even with a limited number of bidders, demonstrates an effort to engage a wide range of potential contractors.
The contract's objective to improve the health status of Liberians is a critical and impactful public service goal.

Sector Analysis

This contract falls within the Professional, Scientific, and Technical Services sector, specifically under NAICS code 541990. This broad category encompasses a wide array of services, including research, consulting, and technical assistance. In the context of international development, such contracts are common for implementing complex programs in sectors like healthcare, education, and governance. Comparable spending benchmarks would depend heavily on the specific technical services provided and the geographic region, but large-scale health sector support contracts in developing nations often run into tens of millions of dollars.

Small Business Impact

There is no indication that this contract included small business set-asides, as the 'sb' field is false. This suggests that opportunities for small businesses were not specifically prioritized through set-aside provisions. Subcontracting opportunities may exist, but their extent and benefit to the small business ecosystem would depend on the prime contractor's strategy and the nature of the services required.

Oversight & Accountability

Oversight for this contract would primarily fall under USAID's contracting officers and program officials. The Inspector General of USAID is responsible for auditing and investigating fraud, waste, and abuse within USAID programs and contracts. Transparency would be enhanced by public reporting on contract performance and expenditures, though detailed information on specific deliverables and outcomes may be limited.

Related Government Programs

USAID Health Sector Support Programs
Global Health Security Initiatives
International Development Assistance Contracts
Country Development Cooperation Strategies

Risk Flags

Potential for cost overruns due to CPFF structure
Limited competition may lead to suboptimal pricing
Broad service category lacks specificity for performance assessment
Long contract duration increases risk of misalignment over time

Frequently Asked Questions

What is this federal contract paying for?

Agency for International Development awarded $21.3 million to MANAGEMENT SCIENCES FOR HEALTH, INC.. IGF::CL,CT::IGF (THE GOAL OF THE CSHSS CONTRACT IS TO IMPROVE THE HEALTH STATUS OF LIBERIANS , AS LAID OUT IN USAID/LIBERIA S HEALTH STRATEGY, AND COUNTRY DEVELOPMENT COOPERATION STRATEGY (CDCS) DEVELOPMENT OBJECTIVE 3 (DO3).)

Who is the contractor on this award?

The obligated recipient is MANAGEMENT SCIENCES FOR HEALTH, INC..

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 $21.3 million.

What is the period of performance?

Start: 2015-02-27. End: 2021-12-29.

What specific health services and technical assistance were delivered under this contract, and how were they measured?

The contract's broad NAICS code (541990) and description indicate a wide scope of 'All Other Professional, Scientific, and Technical Services' aimed at improving Liberia's health status. Specific deliverables likely included technical expertise, program management, policy advice, capacity building for local health institutions, and potentially support for health infrastructure or supply chains. Performance metrics would have been defined in the contract's statement of work, potentially tracking indicators such as vaccination rates, maternal and child health outcomes, disease surveillance capabilities, or the strengthening of the Liberian Ministry of Health. Without access to performance reports and detailed task orders, a precise accounting of services and their measured impact remains elusive.

How does the $21.2 million total award compare to similar USAID health contracts in other West African nations?

Comparing the $21.2 million award for this nearly 7-year contract requires context regarding the specific health challenges, program scope, and operational costs in Liberia versus other West African nations. USAID implements numerous health programs globally, with funding levels varying significantly based on country needs, strategic priorities, and the duration of engagement. Contracts for large-scale health system strengthening, disease-specific initiatives (like HIV/AIDS or malaria control), or emergency health responses can range from a few million to tens or even hundreds of millions of dollars. To provide a precise benchmark, one would need to identify contracts with similar objectives (e.g., broad health system improvement), duration, and geographic focus, while accounting for inflation and differing cost structures across countries.

What are the primary risks associated with the Cost Plus Fixed Fee (CPFF) contract type used here?

The primary risk with a Cost Plus Fixed Fee (CPFF) contract is that the contractor is reimbursed for all allowable costs incurred, plus a predetermined fixed fee representing profit. This structure can incentivize contractors to increase costs, as their fee (profit) is a percentage of or addition to the costs. While the fixed fee itself doesn't increase with costs, the overall expenditure for the government can escalate significantly if costs are not tightly controlled. This necessitates robust oversight from the government to ensure costs are reasonable, allocable, and allowable. For the contractor, the risk lies in underestimating costs, which could lead to the fixed fee being insufficient to cover their efforts.

Given the contract's objective to improve Liberia's health status, what evidence exists regarding its effectiveness?

Assessing the effectiveness of this contract requires access to USAID's performance monitoring and evaluation reports specific to this award. The contract's stated goal is to improve Liberia's health status, aligning with USAID/Liberia's Health Strategy and Country Development Cooperation Strategy (CDCS). Evidence of effectiveness would be demonstrated through improvements in key health indicators within Liberia during the contract period (2015-2021). This could include metrics related to maternal and child mortality, disease prevalence (e.g., malaria, HIV), healthcare access, the capacity of the Liberian health workforce, and the functionality of the health system. Without specific evaluation data, the effectiveness remains an assumption based on the contract's intended purpose.

How has spending on 'All Other Professional, Scientific, and Technical Services' (NAICS 541990) by USAID trended over the past decade?

USAID's spending on NAICS code 541990, 'All Other Professional, Scientific, and Technical Services,' has likely been substantial and potentially variable over the past decade, reflecting the diverse nature of its development assistance programs. This category is a catch-all for services not specified elsewhere, often encompassing crucial technical assistance, research, consulting, and program management support for sectors like health, education, agriculture, and governance in partner countries. Trends would be influenced by global development priorities, specific country needs, and shifts in USAID's operational strategies. Analyzing historical spending data would reveal if there's been a consistent investment in these types of services or a notable increase/decrease tied to specific initiatives or geopolitical events.

What is the track record of Management Sciences for Health, Inc. (MSH) in managing large-scale international health contracts?

Management Sciences for Health, Inc. (MSH) is a well-established global health non-profit organization with a long history of implementing health programs and managing large-scale contracts in developing countries, including many funded by USAID. They have extensive experience in areas such as health systems strengthening, infectious disease control, maternal and child health, and health workforce development. MSH has managed numerous complex projects across Africa, Asia, and Latin America. Their track record generally indicates a capacity to handle significant budgets and challenging operational environments. However, like any large implementing organization, specific project performance can vary, and detailed reviews of their past contracts would be needed for a comprehensive assessment.

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

Offers Received: 4

Pricing Type: COST PLUS FIXED FEE (U)

Evaluated Preference: NONE

Contractor Details

Address: 200 RIVERS EDGE DR, MEDFORD, MA, 02155

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

Financial Breakdown

Contract Ceiling: $21,257,274

Exercised Options: $21,257,274

Current Obligation: $21,257,274

Actual Outlays: $2,241,914

Subaward Activity

Number of Subawards: 1

Total Subaward Amount: $86,042

Contract Characteristics

Multi-Year Contract: Yes

Commercial Item: COMMERCIAL ITEM PROCEDURES NOT USED

Cost or Pricing Data: YES

Timeline