Program Expansion Supplement: Capacity Building through Training/Mentoring for Treatment, Care and Support; Health System Strengthening; and Voluntary Medical Male Circumcision in Zambia under PEPFAR | Apply Online

Frequently Asked Questions (FAQs)

1) What is the title of this grant opportunity?

The opportunity is titled "Program Expansion Supplement: Capacity Building through Training/Mentoring for Treatment, Care and Support; Health System Strengthening; and Voluntary Medical Male Circumcision in Zambia under PEPFAR."

2) Which U.S. agency is funding this opportunity?

This is a U.S. Department of Health and Human Services (HHS), Centers for Disease Control and Prevention (CDC)-funded discretionary opportunity.

3) What type of funding mechanism is being used?

The opportunity is offered under a cooperative agreement mechanism, which generally indicates substantial CDC involvement in program design, monitoring, and technical direction during implementation.

4) What is the overall purpose of the grant in Zambia?

The grant is designed to strengthen Zambia's HIV response under PEPFAR by expanding workforce capacity, improving service quality, strengthening health system functions, and accelerating voluntary medical male circumcision (VMMC) in CDC-supported regions.

5) What broader initiative does this grant align with?

This opportunity sits within the broader U.S. President's Emergency Plan for AIDS Relief (PEPFAR) effort in Zambia.

6) Why is this opportunity needed (what problem is it addressing)?

The notice describes HIV as a major public health issue in Zambia, citing an adult HIV prevalence around 14 percent and an estimated 1.1 million people living with HIV. While PEPFAR has supported major scale-up, the announcement notes persistent gaps that continue to limit epidemic control.

7) What progress does the notice cite from prior PEPFAR support?

The notice states that since 2004, PEPFAR support helped scale HIV treatment to roughly 500,000 people (described as about 80 percent of HIV-infected adults in need at the time) and expand PMTCT services across approximately 1,200 sites (with around 720 co-located with ART services). It also notes universal PMTCT coverage helped reduce mother-to-child transmission in breastfeeding populations to about 12 percent at 12 months.

8) What key gaps or challenges is the grant meant to help address?

Challenges described in the notice include low pediatric treatment coverage (about 38 percent of children in need receiving treatment), suboptimal retention in care, low HIV status awareness among adults (about 13 percent knowing their status as stated), limited couples testing, low VMMC uptake, insufficient delivery of optimal care packages for TB/HIV co-infected patients, and problems with data quality and broader quality assurance.

9) What are the main program areas described in the opportunity?

The opportunity describes two main program areas: Program Area A (training and capacity building for treatment, care and support, and health system strengthening) and Program Area B (technical assistance and service delivery to expand VMMC coverage).

10) What is Program Area A focused on?

Program Area A centers on training and capacity building to support consistent adherence to Zambia's national HIV guidelines, with the goal of improving and sustaining the quality of HIV treatment, care, and support services.

11) Why does the notice emphasize adherence to national HIV guidelines?

The notice frames guideline adherence as essential for improving and sustaining care quality. It also highlights that Zambia's HIV guidelines have been revised repeatedly over the past decade, including a major revision in February 2014, which increases the need for continuous updates in clinical practice.

12) What training approach is expected under Program Area A?

The awardee is expected to support cost-efficient training systems and use a "blended learning" approach that combines methods such as distance learning and e-learning with structured on-the-job training materials. The goal is to refresh skills without relying only on resource-intensive off-site workshops.

13) Which Zambian ministries are expected partners for the training work?

The notice states the awardee is expected to support the Ministry of Health (MOH) and the Ministry of Community Development, Mother and Child Health (MCDMCH).

14) Does the opportunity address human resources constraints in Zambia?

Yes. The notice references a serious human resources for health crisis, high staff turnover, and attrition, and describes training systems that can keep pace in that environment.

15) What does the notice say about pre-service training?

The awardee is expected to collaborate with medical and paramedical training and regulatory bodies in Zambia to integrate the latest national guidelines into pre-service curricula so new graduates enter the workforce prepared to deliver guideline-concordant care.

16) What role does continuous professional development (CPD) play in the opportunity?

The notice highlights CPD systems and links them to re-licensure and career advancement, intending to create ongoing incentives for providers to maintain competencies as policies and best practices evolve.

17) Beyond training, what capacity-building outcomes are emphasized?

The opportunity emphasizes strengthening supervisory and technical capacity at national, regional, and district levels by building health management teams, trainers, and local organizations so they can provide post-training follow-up, mentorship, and supportive supervision.

18) Is the expectation only knowledge transfer, or are service improvements emphasized?

The notice emphasizes that the intent is not only knowledge transfer but measurable improvements in provider skills and attitudes that translate into better clinical and program quality.

19) What is Program Area B focused on?

Program Area B focuses on technical assistance and service delivery to expand VMMC coverage as a proven HIV prevention intervention, particularly in CDC-supported regions under PEPFAR.

20) What kind of support is expected for VMMC scale-up?

The awardee(s) will assist the Government of Zambia in increasing VMMC uptake through a mix of hands-on technical assistance and direct service delivery.

21) How does the notice describe the technical assistance model for VMMC?

The model is described as capacity-building and time-bound: the awardee is expected to provide the level of support districts need to scale safely and effectively, then gradually reduce external input as districts meet milestones and institutionalize capacity.

22) How does decentralization factor into the VMMC approach?

The notice links the approach to Zambia's decentralization strategy, implying a transition from partner-led operations toward district-owned planning, implementation, monitoring, and quality management over time.

23) What CFDA number is associated with this opportunity?

The opportunity is listed under CFDA 93.067.

24) How many awards are expected?

The notice indicates a single expected award.

25) What is the award ceiling for this opportunity?

The award ceiling is $1,324,575.

26) When was the opportunity originally posted?

The original posting date was July 29, 2016.

27) What was the original application closing date?

The original closing date was September 29, 2016.

28) What were the submission requirements and deadline time zone?

Applications required electronic submission by 11:59 p.m. Eastern Time on the due date.

29) Who is eligible to apply based on the information provided?

Eligibility is listed broadly as "Others," with additional eligibility details referenced in the full announcement.

30) What geographic focus is mentioned?

The notice references work in CDC-supported regions in Zambia, including district-level scale-up and capacity building.

31) What types of health system issues does the opportunity explicitly mention?

The notice points to gaps in retention in care, delivery of optimal TB/HIV co-infection care packages, data quality, and broader quality assurance, and frames the grant as helping convert service availability into stronger outcomes through these system elements.

32) Does the opportunity mention pediatric HIV specifically?

Yes. The notice describes low pediatric treatment coverage, noting only about 38 percent of children in need are receiving treatment.

33) Does the opportunity mention HIV testing and status awareness?

Yes. The notice cites low HIV status awareness among adults (about 13 percent knowing their status as stated) and limited couples testing as challenges.

34) What does the notice say about PMTCT and pediatric infections?

It states that universal PMTCT coverage helped reduce mother-to-child transmission in breastfeeding populations to about 12 percent at 12 months and that this has lowered new pediatric infections, while noting gaps still remain for overall epidemic control.

35) What is the underlying theory of change described for the grant?

Based on the notice, the grant aims to improve outcomes by strengthening workforce capacity and health system functions so patients are found, linked to care, treated correctly, retained, and monitored using reliable data, while also scaling VMMC as a prevention intervention.