USAID's $145M Haiti health services contract to Management Sciences for Health aimed to improve basic health services for 50% of the population

Contract Overview

Contract Amount: $144,943,475 ($144.9M)

Contractor: Management Sciences for Health, Inc.

Awarding Agency: Agency for International Development

Start Date: 2007-08-03

End Date: 2012-09-30

Contract Duration: 1,885 days

Daily Burn Rate: $76.9K/day

Competition Type: COMPETITIVE DELIVERY ORDER

Number of Offers Received: 2

Pricing Type: COST PLUS FIXED FEE

Sector: Other

Official Description: THE PURPOSE OF THIS TASK ORDER IS TO PROVIDE QUALITY BASIC HEALTH SERVICES SUPPORT TO HAITI AND SERVES AS THE PRIMARY IMPLEMENTATION MECHANISM TO ACHIEVE RESULTS UNDER USAID/HAITI?S SOCIAL SERVICES STRATEGY AND THE USG FOREIGN ASSISTANCE INVESTING IN LIVES OBJECTIVE. IN ORDER TO ACHIEVE RESULTS UNDER THE STRATEGY, MSH WILL SUPPORT THE DELIVERY AND USE OF AN INTEGRATED PACKAGE OF BASIC HEALTH SERVICES IN APPROXIMATELY 130 HEALTH CARE CLINICS THAT TARGET APPROXIMATELY 50% OF HAITI?S POPULATION, WITH A KEY FOCUS ON REACHING THE MOST VULNERABLE PEOPLE. IT IS ENVISIONED THAT BY THE END OF THE PERFORMANCE PERIOD, MEASURABLE ADVANCES WILL HAVE BEEN MADE IN THE USE OF KEY HEALTH CARE SERVICES. IN ADDITION, THE GOH WILL HAVE THE CAPACITY TO STRATEGICALLY PLAN AND OVERSEE NATIONAL AND SUB-NATIONAL HEALTH CARE DELIVERY UNDER THEIR ON-GOING EFFORTS TO DECENTRALIZE HEALTH CARE SERVICES. REBECCA ROHRER WILL BE THE CTO.

Plain-Language Summary

Agency for International Development obligated $144.9 million to MANAGEMENT SCIENCES FOR HEALTH, INC. for work described as: THE PURPOSE OF THIS TASK ORDER IS TO PROVIDE QUALITY BASIC HEALTH SERVICES SUPPORT TO HAITI AND SERVES AS THE PRIMARY IMPLEMENTATION MECHANISM TO ACHIEVE RESULTS UNDER USAID/HAITI?S SOCIAL SERVICES STRATEGY AND THE USG FOREIGN ASSISTANCE INVESTING IN LIVES OBJECTIVE. IN ORDER TO … Key points: 1. Contract focused on delivering integrated basic health services through 130 clinics, targeting vulnerable populations. 2. Performance period aimed for measurable advances in healthcare service utilization and government capacity building. 3. The contract was awarded competitively, indicating potential for price discovery and value for money. 4. The duration of nearly 5 years suggests a significant, long-term commitment to health sector support. 5. The cost-plus-fixed-fee structure incentivizes efficient cost management by the contractor. 6. This contract aligns with broader USG foreign assistance objectives for Haiti's social services strategy.

Value Assessment

Rating: good

The contract's value of approximately $145 million over nearly 5 years for comprehensive health services in Haiti appears reasonable given the scope. While direct comparisons are difficult without more specific service benchmarks, the scale of operations (130 clinics, 50% of the population) suggests a substantial undertaking. The cost-plus-fixed-fee (CPFF) contract type allows for cost reimbursement plus a predetermined profit, which can be effective for complex projects where costs are uncertain, but requires diligent oversight to ensure efficiency.

Cost Per Unit: N/A

Competition Analysis

Competition Level: full-and-open

The contract was awarded as a competitive delivery order, suggesting that multiple bidders likely vied for this work. A full and open competition generally allows for a wider range of potential contractors to participate, fostering a more robust bidding process. This competitive environment is expected to drive better pricing and service offerings as contractors strive to win the award.

Taxpayer Impact: A competitive award process is beneficial for taxpayers as it typically leads to more cost-effective solutions and encourages contractors to offer their best value propositions.

Public Impact

Approximately 50% of Haiti's population is intended to benefit from improved basic health services. The contract supports the delivery of integrated health services across approximately 130 healthcare clinics. Focus on vulnerable populations aims to improve health outcomes for those most in need. The initiative seeks to enhance the capacity of the Haitian government to plan and oversee national health services. Geographic impact is nationwide, covering a significant portion of Haiti's population. Workforce implications include potential employment for local healthcare professionals and support staff within the clinics.

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Warning Flags

Potential for cost overruns in a CPFF contract if not closely monitored.
Sustainability of health services beyond the contract period requires careful planning.
Security and logistical challenges in Haiti could impact service delivery and cost.

Positive Signals

Clear alignment with USG foreign assistance goals and USAID's strategy.
Competitive award process suggests potential for good value and efficient service.
Focus on capacity building aims for long-term positive impact on Haitian governance.

Sector Analysis

This contract falls within the broader 'Professional, Scientific, and Technical Services' sector, specifically related to public health and international development. The market for such services is characterized by a mix of large international NGOs, specialized consulting firms, and research institutions. Spending in this area is often driven by foreign aid budgets and global health initiatives. Comparable spending benchmarks would typically involve analyzing other large-scale health program implementations in developing countries funded by international donors.

Small Business Impact

Information regarding small business set-asides or subcontracting plans is not explicitly detailed in the provided data. However, given the scale and nature of the contract, it is common for prime contractors in international development to engage small businesses for specialized services or local support. Further analysis would be needed to determine the extent of small business participation and its impact on the small business ecosystem.

Oversight & Accountability

Oversight would typically be managed by USAID's mission in Haiti, with program officers monitoring performance against contract deliverables and objectives. Accountability measures would be embedded in the contract's reporting requirements and performance metrics. Transparency is generally facilitated through public reporting of foreign assistance activities, though specific contract-level details might be limited.

Related Government Programs

USAID Global Health Programs
US Foreign Assistance to Haiti
International Health Service Delivery
Public Health Infrastructure Development

Risk Flags

Operating environment risks in Haiti (security, logistics, political stability)
Sustainability of health services post-contract
Potential for cost overruns in CPFF contracts
Ensuring effective transfer of capacity to Haitian government

Frequently Asked Questions

What is this federal contract paying for?

Agency for International Development awarded $144.9 million to MANAGEMENT SCIENCES FOR HEALTH, INC.. THE PURPOSE OF THIS TASK ORDER IS TO PROVIDE QUALITY BASIC HEALTH SERVICES SUPPORT TO HAITI AND SERVES AS THE PRIMARY IMPLEMENTATION MECHANISM TO ACHIEVE RESULTS UNDER USAID/HAITI?S SOCIAL SERVICES STRATEGY AND THE USG FOREIGN ASSISTANCE INVESTING IN LIVES OBJECTIVE. IN ORDER TO ACHIEVE RESULTS UNDER THE STRATEGY, MSH WILL SUPPORT THE DELIVERY AND USE OF AN INTEGRATED PACKAGE OF BASIC HEALTH SERVICES IN APPROXIMATELY 130 HEALTH CARE CLINICS THAT TARGET APPROXIMATELY 50% OF HAITI?S POPULATION, WI

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 $144.9 million.

What is the period of performance?

Start: 2007-08-03. End: 2012-09-30.

What was the contractor's track record with similar USAID health initiatives prior to this award?

Management Sciences for Health (MSH) has a long history of working with USAID and other international donors on global health programs. Prior to this specific task order, MSH had established experience in implementing health system strengthening projects, improving access to essential medicines, and supporting maternal and child health initiatives in various countries. Their track record often includes managing large-scale, multi-year contracts with complex logistical and programmatic requirements. Assessing their past performance on similar USAID contracts, including adherence to budgets, timely delivery of results, and effective stakeholder engagement, would provide crucial context for evaluating the success of this Haiti-focused task order.

How does the per-beneficiary cost of this contract compare to similar USAID health programs?

Calculating a precise per-beneficiary cost requires detailed data on the total number of unique individuals reached and the total contract expenditure, accounting for the full performance period. With a total award of approximately $145 million and a goal to reach 50% of Haiti's population (which is roughly 11.4 million people), the theoretical maximum per-beneficiary cost could be around $12.70 if the entire population were reached. However, the actual number of direct beneficiaries and the intensity of services received would significantly influence this metric. Benchmarking against other USAID health programs requires comparing similar interventions (e.g., primary healthcare, maternal/child health) in comparable low-income settings, considering factors like local cost structures, program complexity, and the specific health indicators targeted. Without more granular data on service utilization and specific outcomes, a definitive comparison is challenging.

What were the primary risks identified during the solicitation and award process for this contract?

Given the operating environment in Haiti, key risks likely included political instability, security concerns affecting personnel and supply chains, logistical challenges in reaching remote areas, potential for corruption, and the sustainability of health services post-contract. USAID's risk assessment would have evaluated the contractor's proposed mitigation strategies for these factors. For a contract of this magnitude and duration, risks related to the effectiveness of the implemented health interventions, the capacity of local partners, and the ability to achieve measurable health outcomes would also be paramount. The competitive nature of the award suggests that bidders were expected to demonstrate robust risk management plans.

How effective was the contract in building the capacity of the Haitian government to manage health services?

The contract explicitly aimed to enhance the Haitian government's capacity to strategically plan and oversee national and sub-national health services. Assessing effectiveness would involve evaluating specific training programs conducted, the transfer of management tools and protocols, and the extent to which government entities assumed greater responsibility for service delivery and oversight by the end of the contract period. Metrics could include improved health sector planning documents, increased government budget allocation to health, or enhanced performance monitoring by Haitian health authorities. Without post-contract evaluations or follow-up reports, the long-term impact on government capacity remains an area for further investigation.

What was the historical spending trend for USAID health programs in Haiti leading up to this contract?

USAID has historically been a significant funder of health initiatives in Haiti, reflecting the country's persistent health challenges and the US government's commitment to development assistance. Spending trends would likely show a consistent, substantial investment in areas such as maternal and child health, infectious disease control (like HIV/AIDS and tuberculosis), and health systems strengthening. The scale of this $145 million contract suggests it represented a major component of USAID's health portfolio in Haiti during its performance period (2007-2012). Analyzing prior years' spending would reveal the evolution of priorities and the overall level of USG investment in Haiti's health sector.

Industry Classification

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

Product/Service Code: RESEARCH AND DEVELOPMENT › N – Health R&D Services

Competition & Pricing

Extent Competed: COMPETITIVE DELIVERY ORDER

Solicitation Procedures: NEGOTIATED PROPOSAL/QUOTE

Offers Received: 2

Pricing Type: COST PLUS FIXED FEE (U)

Evaluated Preference: NONE

Contractor Details

Address: 784 MEMORIAL DR, CAMBRIDGE, MA, 02139

Business Categories: Category Business, Corporate Entity Tax Exempt, Nonprofit Organization, Not Designated a Small Business

Financial Breakdown

Contract Ceiling: $444,566,334

Exercised Options: $444,566,334

Current Obligation: $144,943,475

Contract Characteristics

Commercial Item: COMMERCIAL ITEM PROCEDURES NOT USED

Parent Contract

Parent Award PIID: AIDGHSI000700006

IDV Type: IDC

Timeline