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Resilient and Responsive Health Systems (RRHS) Initiative

  • Program Name:Resilient and Responsive Health Systems Initiative
  • Activity Code:UH6
  • Application Available:6/6/2016
  • Application Deadline:8/5/2016
  • Created By:Goldstine, Raymond
  • Created On:2/18/2016
  • Last Updated by:Wildberger, William
  • Last Updated On:7/15/2016
  • Estimated Project Start Date:1/1/2017

 Details of the changes posted in this announcement

Modification published on 07/15/2016
Modified July 15, 2016 to reflect the postponement of the competition for South Sudan.

Modification published on 06/06/2016
Posting Failed the 1st few times

Modification published on 06/06/2016
posting for 1st time

Modification published on 06/03/2016
first time posting


 Announcement Information

Announcement Number HRSA-17-007
Announcement Code
CFDA Number 93.266
Provisional No
Activity Code UH6
Competitive Yes
Fiscal Year 2017


This announcement solicits applications for the Resilient and Responsive Health Systems (RRHS) Initiative, a five-year program to strengthen human resources for health (HRH) in order to address public health challenges like HIV/AIDS, malaria and tuberculosis in the Democratic Republic of Congo (DRC), Liberia, Sierra Leone, and South Sudan and to achieve health system resiliency.  [IMPORTANT NOTE:  the competition for South Sudan has been postponed until further notice.  Applications to support activities in South Sudan will be accepted at a later time.]  This RRHS Initiative seeks to address fundamental health systems constraints that impede the availability of and access to quality health services by supporting the implementation of countries’ national health strategies and recovery plans to respond to emerging epidemics, prevent, manage and control HIV and other diseases, and improve population health outcomes. The resilience of a health system is its capacity to respond and adapt to planned and unplanned needs, and the ability to absorb shocks, such as a disease outbreak, natural disaster, or conflict.[1]  Decades of experience in health systems development in fragile states have demonstrated a need to address weaknesses in HRH, policy, leadership, management capacity, service delivery, and data collection and evaluation through the World Health Organization’s health system building blocks framework,[2] taking into consideration also the capacity, security situation, and state of health in each state.[3]  In fragile states, these core structural components of the health system are by definition weak and incomplete, often characterized by the inability to provide health services to a large proportion of the population; insufficient coordination, oversight and monitoring of health services; ineffective or nonexistent referral systems; inadequate management capacity; lack of health equity; lack of health infrastructure for delivering health services; a lack of mechanisms for developing, establishing and implementing national health policies; and non-operational health information systems.[4] Achieving an AIDS-free generation is dependent upon the ability of people at risk and/or living with HIV and AIDS to find and access quality health services, providers and products. A well-functioning and resilient health system meets these needs, effectively supporting prevention, care and treatment for HIV and AIDS, TB, malaria, and other diseases. In just eleven years, PEPFAR has moved from an emergency program to one squarely focused on controlling the epidemic.  PEPFAR has now entered what may be its most challenging, but exciting, phase yet—Phase III focusing on Sustainable Control of the Epidemic. To reach the Joint United Nations Programme on HIV/AIDS’ (UNAIDS) ambitious 90-90-90 global goals (90 percent of people with HIV diagnosed, 90 percent of them on ART and 90 percent of them virally suppressed by 2020), PEPFAR is pivoting the scale-up of resources and services towards health service delivery sites with moderate and high yield of patients, communities that link patients to those sites, and geographic areas with high burden of HIV.  Meeting demand in those settings requires an adequate supply and appropriate skills mix of Human Resources for Health (HRH) available to provide quality HIV services along the continuum of care. Between 2009 and 2014, PEPFAR strengthened countries’ health systems to address HRH bottlenecks to service delivery broadly, and HIV services in particular. However, PEPFAR’s current pivot requires a recasting of its HRH investment approach to more directly support HIV services and populations where the highest impact gains towards an AIDS-free generation (AFG) will be felt.  The RRHS supports this shift. By 2022, it is expected that the RRHS Initiative will contribute to achieving progress towards the following objectives in each country: Improved health outcomes, with a targeted focus on decreasing maternal, child mortality, decreasing new HIV infections, and improving HIV-related  health outcomes Improved use of HRH information in decision making Improved coordination and monitoring of HRH functions Improved HRH workforce performance and management To meet the aforementioned objectives, the RRHS Initiative will work with country stakeholders to collectively prioritize and develop sustainable and country-led solutions to address national priorities that include the following: [1] Campbell J. et al. Improving the resilience and workforce of health systems for women’s, children’s, and adolescents’ health.  BMJ 2015; 351 :h4148 [2] Jonnalagadda Haar, R. & Rubenstein, L. (2012). Special Report: Health in Post conflict and Fragile States. United States Institute for Peace. Retrieved from: [3] ibid [4] Witter, S., (2012). Health financing in fragile and post-conflict states:What do we know and what are the gaps?, Social Science & Medicine,

 Legislative Information

Public Law 108-25 (the United States Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003) [22 U.S.C. 7601, et seq.]; and Public Law 110-293 (the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis

 Application Information

Application Available 06/06/2016
Application Deadline 08/05/2016
Supplemental Application Deadline N/A
Explanation for Deadline N/A
Archive Date 09/30/2016
Letter of Intent Not required
Application Package SF424
Allow Applications to be Reopened in EHBs No
FOA Available Yes
Competitive Application Types Supported New
Allow Electronic Submission N/A
Page Limit for Application
Allow Multiple Applications
from an Organization from
Electronic Submission Instruction Electronic submission is/will be available in Grants.Gov

 General Information

Projected Award Date N/A
Estimated Project Period N/A
Estimated Project Start Date 01/01/2017
Estimated Project End Date 12/31/2022
Estimated Amount of this Competition $40,000,000.00
Estimated Number of Awards 4
Estimated Average Size of Awards $8,000,000.00
Cost Sharing No
Cooperative Agreement Yes

 Contact Information

Name Jose Rafael Morales
Phone Number 301-443-3650

 Download Information

Expand FOA (Guidance) Attachment (Maximum 1)
Document Name Size Date Attached Description
HRSA-17-007 final v4 HAB mod 7-14-16.pdf 203 kB 07/15/2016
Expand Application Package (Maximum 1)
No documents attached
Expand User Guide (Maximum 1)
No documents attached

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