Hormonal IUD Introduction & Scale-Up COF

The Hormonal IUD Introduction & Scale-Up Catalytic Opportunity Fund (COF) is a flexible pool of funds to support catalytic activities that advance government-led introduction and scale-up of hormonal intrauterine device (H-IUD). The Hormonal IUD COF is administered by CHAI and stewarded by the Hormonal IUD Access Group.

The goals of the COF are to catalyze scale-up of quality-assured through government-led, catalytic activities defined as activities that either 1. enable increased efficiency and/or 2. effectiveness of product introduction and/or 3. are critical to achieving successful product introduction and scale-up.

The H-IUD COF is now accepting applications from organizations interested in pre-introductory activities, as well as introduction and scale-up work.

Eligibility and Requirements

  • Be implemented in a low- or lower-middle-income country as defined by the World Bank.

  • Already have made the decision to introduce hormonal IUD with country governments opting to introduce the product.

  • Be supported by the Ministry of Health (MoH) and must include an endorsement letter from the national Ministry of Health (MOH) from the relevant stakeholder who is guiding H-IUD introduction and implementation.

  • Demonstrate alignment with government priorities and build towards sustainable government-led, processes and systems to ensure sustainability

  • Demonstrate a clear funding need and that alternative funding sources are not available to support the proposed work

  • Demonstrate the work will catalyze scale-up per the definition of “catalytic” defined as:

    • Activities that enable increased efficiency and/or effectiveness of product introduction. Illustrative examples of activities are rolling out a cost-efficient training approach, and testing low-cost, innovative demand generation approaches.

    • Activities that are critical to achieve a successful product introduction. Illustrative examples are development of a costed national product introduction plan, training of national or master trainers to enable other committed investments in health care worker training to proceed.

  • Implementing timeframes will require no more than 12 months

  • Funding ceiling per application is a maximum of USD $250,000

  • Focus on public sector work. The H-IUD COF doesn’t support private sector work at this time.

  • Funds may only be granted to implementing partners and social enterprises.

  • Introduction efforts must focus on quality-assured H-IUD products only.

  • Projects that are focused on pilot projects designed to help the government make a decision whether to introduce hormonal IUD are not eligible.

For more details on the H-IUD COF and scoring rubrics that we use to assess applications, please see here: H-IUD COF Overview.

    • LMIC countries without a costed national plan for hormonal IUDs can apply for pre-introduction activities if the government has decided to pursue broader (e.g., national, etc.) introduction.

    • Countries eligible for COF funding must have already decided to introduce the quality-assured hormonal IUD.

    • Please note that pilot projects designed to help the government make the decision to introduce hormonal IUD are not eligible. Countries eligible for COF funding should already have made the decision to introduce hormonal IUD.

    • Eligible activities include supporting government planning or preparation for government-led introduction of the hormonal IUD. Activities may include support development of costed introduction plan, development of demand generation materials or demand generation plan, integration of hormonal IUD into HMIS/LMIS systems, support for quality-assured product registration, etc.

    • Strong government interest and provider readiness, indicated by a completed costed introduction plan from government.

    • Product registration completed, in progress, or a waiver possible for quality-assured hormonal IUD procurement.

    • Gap analysis that demonstrates the resource needs for the introduction and resource gaps

    • Initial product order(s) quantified and/or placed.

    • Demonstrate there is sufficient H-IUD stock available in the country and/or in the process of arriving in the country to support achieve the intended outcomes of the proposed project. If any of your project activities rely on commodities, you must describe the supply security situation in your proposal.

    • Introduction preparation activities underway (e.g., hormonal IUD included in HMIS, LMIS, training curricula updated, national costed plan is in place, etc.).

    • Possibility of leveraging existing domestic funding to support other introduction activities.

Submission Information

Applications are reviewed on competitive application cycle. Interested applicants should submit the materials listed here to the COF Team at COF@clintonhealthaccess.org before the stipulated deadline published on this website. 

  • Pre-Introduction Applications

    1. Application Narrative in Word document format (EN, FR)

    2. Project Budget for the proposed activities (EN, FR)

    3. Letter of recommendation, or defined informal equivalent, from the National Ministry of Health

    The intent behind this requirement is to ensure alignment of proposed projects to government plans and priorities. As you seek MOH endorsement, please engage in meaningful national coordination with key stakeholders and partners in-country to align on needs and project approaches prior to submission to avoid misalignment with government priorities and duplication of efforts.

  • Introduction and Scale-Up Applications

    1. Application Narrative in Word document format (EN, FR)

    2. Project Budget for the proposed activities (EN, FR)

    3. Letter of recommendation, or defined informal equivalent, from the National Ministry of Health

    The intent behind this requirement is to ensure alignment of proposed projects to government plans and priorities. As you seek MOH endorsement, please engage in meaningful national coordination with key stakeholders and partners in-country to align on needs and project approaches prior to submission to avoid misalignment with government priorities and duplication of efforts.

    4. Hormonal IUD costed national plan

    5. National government family planning or contraceptive supply plan for hormonal IUD (inclusive of estimated consumption from forecast and planned or funded orders)

    6. Latest resource mapping and gap analysis

    The intent of this requirement is to understand the local funding gaps against the plan and validate the funding need. Please engage in meaningful coordination with MOH and partners to harmonize resources and understand resource needs prior to application submission.

Resources

COF Project Directory

Interested in the projects and organizations supported by the COF? Click on the COF Project Directory for a list of past and current COF award recipients. This register includes project descriptions and points of contact. Please refer to this to ensure no duplication with existing or past awards, prompt local coordination with other partners, and build off of past work as relevant.

For more resources and information on best practices for HIUD introduction and scale-up, visit the HIUD Access Portal: https://www.hormonaliud.org/

Frequently Asked Questions

  • A: The maximum funding amount was decided based on our experience managing the first COF funding stream of Hormonal IUD where we found it was sufficient for all grants given the short-term and catalytic focus.

  • A: The requirement of a MOH letter should reflect the national/federal MOH for the most part with the intention of ensuring government-led, sustainable product introduction that is aligned to national priorities and plans. Depending on the country context, in some unique cases the COF will accept a subnational MOH endorsement letter for work proposed in that subnational geography for countries with a very large population and a decentralized health system (e.g. India, Nigeria, DRC). For all countries, if applicants are proposing national level work, you must have a national MOH letter to demonstrate alignment with central government priorities.

  • A: We do not have a limit on the number of times an organization can apply per calendar year, method, or cycle.

    However, we encourage organizations to carefully consider the COF's scoring rubric to ensure they have thoroughly evaluated the 'urgency' and 'impact' of each application. They should also consider why the application is timely and whether the proposed work is new, discrete, and catalytic. If multiple applications meet these criteria, organizations should assess whether the projects are interdependent and weigh any associated risks. For instance, there is no guarantee that multiple applications will be approved, and delays in one project could impact the duration or success of another if they are reliant on each other. Reviewers will take these factors into account when assessing applications. 

    If the number of applications recommended for funding exceeds the number of applications within a given 11-week cycle, the process will shift to competitive. If the process shifts to competitive, only 1 application per partner per cycle for a given scope of work (I.e., if two applications are submitted by the same partner for the same scope of work in separate geographies), then the COF would only accept one of these applications to be funded within the cycle.  

  • A: Yes, we encourage applicants to apply in future grant cycles. If we have provided feedback on your proposal, we strongly encourage applicants to review the feedback and update their proposal before resubmitting in the next funding cycle.

  • A: CHAI serves as the strategic steward of funds and administrator of the COF. While CHAI disburses funds to sub-grantees, CHAI is not the donor. The COF operates as a pooled donor funding mechanism with multiple donors, meaning that different grants within the COF are funded by various donors. As of December 2024, the various COFs are supported by donors BMGF, FCDO, CIFF, and MSD for Mothers.

  • A: Yes, organizations are eligible to submit new applications to the COF even if another COF award is currently active.

  • A: There are typically multiple grants available per cycle.

  • A: Yes, you may apply for multiple products under a single COF application package as long as they support COF eligible SRH products (H-IUD, DMPA-SC, and MA combipack). You may use one application narrative and budget for single submission. We recommend completing the product COF applications  that best represents the “majority” focus of your application. For example, if your project approach is to rollout DMPA-SC and HIUD in the public sector and majority of activities will focus on HIUD with integration of DMPA-SC where possible, you can apply to the HIUD COF.

    Although there are strong similarities in the COF criteria, application materials, processes across product funding streams, there are unique eligibility requirements that are by product-specific. Thus, applications should review COF criteria and eligibility for each product and know that reviewers will assess for eligibility for both.

    Lastly, we require your endorsement letter from government to indicate desire to introduce all relevant products in your proposal. For example, for an application with a proposed dual DMPA-SC and HIUD rollout, the MOH letter should indicate government desire to introduce both DMPA-SC and HIUD.

  • A: Yes, you can apply for multiple products under a single application. There is not one combined Application Narrative for both, please use the application for whichever product has greater emphasis in the activities. We request that applicants submit required materials (e.g. endorsement letter) for both. 

  • A:  For active introduction application, a costed introduction plan is required. It is not required for pre-introduction applications.

  • A: For-profit social enterprises are eligible for the COF but must support work that supports access in the public sector. We would need to see evidence of alignment to COF eligibility in the proposal, including how the proposed approach would catalyze broader, sustainable access and scale-up of H-IUD services in the country. At this time, the COF does not support work in the private sector.

  • A: Countries that do not have an introduction plan, but meet the other eligibility requirements of the pre-introduction plan (e.g., where H-IUD is approved and the government has endorsed expansion of H-IUD access, etc.) are eligible for pre-introduction COFs. Development of a costed introduction plan is an eligibility activity for pre-introduction proposals. For the H-IUD active introduction activities, a costed introduction plan is a requirement.

  • A: The biggest recent change has been that we’ve expanded country-eligibility to any low or lower-middle income country and have expanded eligibility to fund pre-introduction applications.. The Application questions, materials, and spirit behind the eligibility largely remains the same.

  • A: At this time, the H-IUD COF does not support work in the private sector. The COF supports widening public sector availability to H-IUD in line with the global market access strategy for the product. The H-IUD Access Group is working towards developing a total market strategy for HIUD and may update the COF in the future to support private sector access. Eligibility is open to private sector partners that propose work in the public sector.

  • A: Yes, organizations are eligible to submit new applications to the COF even if another COF award is currently active. However, the COF is designed to fund time-bound, catalytic projects, so applications should consider the following: whether the proposed activities are timely and whether they address a specific need or critical gap. As always, continued MOH endorsement is essential. We recommend sharing any available preliminary results from the ongoing project to support a new application. The application should clarify whether the new project will build on previous work or introduce a new scope. We encourage organizations to put forth applications that clearly demonstrate the urgency and impact of their proposed activities. The COF's Scoring Rubric provides insights into how Reviewers evaluate applications.

  • A: This will depend on the context, including the results of the current grant, need, and alignment of expansion to other geographies to government priorities. The COF is designed to be a flexible funding mechanism to enable grantees to pivot activities based on need, thus we’d encourage grantees to see if it would make sense to include additional geographies within the existing grant and funding envelope. If additional funding is needed, the organization must submit a new proposal and undergo the competitive application process.

  • A: The insertion procedure for copper IUD and hormonal IUD are similar in terms of technical and clinical skills required, however there are differences in the products, counseling, and provider knowledge needed for both methods. Providers who have received training on copper IUD but not hormonal IUD should receive training on hormonal IUD as the products are not fully “1 to 1”. For more information on the differences between the products and what this means for clinical procedure and insertion, please check out the HIUD Resource Library for more resources. https://www.hormonaliud.org/resource-library.

  • A: Applicants must be able to provide audited financial statements and satisfactorily complete a financial due diligence assessment.