Section 1: Project overview

Immunization remains one of the most cost-effective interventions for disease prevention. However, several African countries continue to grapple with challenges related to equity, access, and low immunization coverage, leaving a substantial portion of its population vulnerable to preventable diseases. In Cameroon, progress towards immunization targets have regressed in recent years, with the coverage of the third dose of diphtheria, pertussis and tetanus-containing vaccine (DTP-3) declining from 89% in 2013 to 79% in 2019. This negative trend extends to several other vaccines including the Human Papillomavirus (HPV) vaccine. By the end of 2022 (two years after introduction), HPV vaccination coverage stood at 20.3%, significantly short of the national target of 60%.
To address these low HPV vaccination rates, the Ministry of Public Health (MOH) initiated an enhanced HPV delivery strategy centered around community outreach, alongside the adoption of a single dose schedule for the HPV vaccine (as recommended by WHO’s Strategic Advisory Group of Experts) and the switch to a gender-neutral schedule. The execution of this strategy resulted in the vaccination of over 120,000 adolescent girls and boys (translated as an almost 15% increase in coverage) within six months. Despite these efforts, certain challenges continue to warrant active consideration, notably: 1) persistent low coverage in urban settings, particularly in the Centre, Littoral, and West regions, which all have impressive school attendance rates and widespread internet coverage 2) lack of concrete strategies for community outreach.
The aforementioned challenges highlight the need for culturally appropriate strategies that not only emphasize on service delivery but also incorporate engagement, advocacy and capacity building of local actors. This underscores the need to leverage structures such as Civil Society Organizations (CSOs) that are uniquely positioned to engage communities, dispel myths, advocate for policy changes, and bring a community-focused perspective that would help address barriers to immunization and bolster coverage. Additionally, CSOs have the agility and flexibility to operate at the grassroots level, bridging gaps where traditional healthcare systems may fall short.
While CSOs have the potential to make a significant impact on immunization, several limitations must be addressed. In a 2017 assessment of 728 CSOs in Cameroon, several weaknesses were identified including resource constraints, lack of specialized skills in certain critical areas (project design and implementation, financial stewardship, monitoring and evaluation, advocacy); lack of sustainability plans, fragmentation and duplication of efforts, and a lack of accountability and transparency frameworks amongst others.

Goal & scope of work
In its efforts to support the Cameroon EPI to improve vaccine coverage generally and HPV vaccination coverage specifically, CHAI has earmarked 300,000$ in funding to build the capacity of three CSOs and support them to conduct advocacy, sensitization, and communication with stakeholders (religious and traditional leaders) that hold considerable communication influence and consideration from the population.
Selected CSOs will be expected to implement work across one or more of the Centre, Littoral and West regions of Cameroon. The work is to be accomplished from the contract signature to December 31st, 2025 including technical and financial reporting.
Selected CSOs will leverage their influence to bridge the gap between medical knowledge and cultural sensitivities, fuse tradition and science, faith and fact, to nurture a collaborative dialogue that resonates deeply within communities and counter the barriers to immunization posed by misinformation, skepticism, and fear.
In addition, selected CSOs will benefit from technical support from CHAI throughout the grant implementation to enhance their performance management systems, including structures and processes for establishing goals and activity plans, as well as monitoring and reviewing progress towards these goals. This will help the CSOs to enhance their effectiveness, maximize their impact, and contribute more effectively to improving childhood vaccination rates, HPV vaccination rates particularly, in Cameroon.

Specific Objectives
Selected CSOs will have to:
•    Identify and assess the influence of key religious and traditional leaders within target communities, as well as their networks and communication channels, and organize workshops with these leaders to build rapport, and provide them with information about vaccine-preventable diseases and the importance of vaccination including HPV vaccination.
•    Develop culturally appropriate advocacy materials, such as videos, and posters, tailored to resonate with religious and traditional leaders and pass across complex medical information in a simplified manner.
•    Collect and share real-life stories and testimonials from community members who have benefited from vaccination.
•    Work with religious leaders to incorporate vaccine-related messages into sermons, talks, or community gatherings, and advocate for policies that support vaccination and ensure easy access to immunization services.
•    Forge partnerships with local healthcare providers, clinics, and schools to provide access to vaccination services.
•    Regularly assess the impact of advocacy activities through surveys, focused group discussions and feedback from community members and leaders.
•    Incorporate continuous learning and adaptation into the work plan to ensure the integration of lessons learned and feedback into ongoing advocacy efforts.
•    Organize events that bring together religious leaders, healthcare professionals and community leaders to foster collaboration.
•    Establish channels for religious leaders to provide feedback to the Ministry of Public Health in general and the EPI, in particular.

Bidders are expected to submit their completed bids to chaicameroonprocurement@clintonhealthaccess.org, no later than 5 pm on April 30th, 2024. Any inquiries or clarifications on the bid process should equally be directed to chaicameroonprocurement@clintonhealthaccess.org.
Bids will only be considered complete if they consist of the following documents:
•    A comprehensive technical proposal outlining the approach and strategies to be used by the bidders to achieve the defined project objectives. Bidders should indicate the specific region(s) of interest.
•    A work plan with detailed timelines for all major milestones, deliverables, and key activities.
•    A comprehensive budget that includes all relevant expenses, ensuring transparency and cost-effectiveness.
•    A completed and duly signed Conflict-of-Interest statement.
Bidders are expected to use predefined templates to prepare their application packages. These templates can be accessed via the link: Templates_HPV CSO_RFP