Strengthening National Menstrual Regulation Programme for

Reduction of Maternal Mortality and Morbidity in Bangladesh


Menstrual regulation services have been widely available in Bangladesh as part of its family planning programme through public, non-governmental organization (NGO) and private facilities for more than two decades. Women’s access to safe abortion has been significantly increased as a result. Despite these achievements, gaps in its reach have been noted and the quality of care is found to be uneven. With financial support from the Netherlands Ministry of Development Cooperation and in partnership with the Government of Bangladesh and MR NGOs, the World Health Organization (WHO) is launching the initiative to strengthen the national MR programme in order to contribute to the achievement of the MDG 5 target of improving maternal health.


The overall objective of the Initiative is to improve equitable access to services for the prevention of unsafe abortion, especially for underserved groups and in underserved areas in both rural and urban Bangladesh.


The main strategies of the Initiative are:

  • investing in a public-private partnership within the framework of Health, Nutrition and Population Sector Programme (HNPSP);
  • pro-poor orientation through a focus on demand-side barriers;
  • increasing attention to underserved groups such as, rural population, urban poor and adolescents with target group-specific intervention;
  • reducing the number/proportion of clients rejected for MR through Behavioural Change Communication and policy reform advocacy; and
  • improving the evidence base for informed policy and programme interventions.

Areas of focus:

The Initiative has focused its efforts in four key components, which are closely interlinked, as below:

  1. Scale up delivery of quality MR services;
  2. Generate rights-based demand from underserved women for quality MR services;
  3. Improve the knowledge/evidence base; and
  4. Strengthen the policy response.

THE CHALLENGE FUND                                                                                                   #

A Challenge Fund has been established to support innovative interventions that contribute to achieving the objective of the Initiative.

Candidate research and programme partners are encouraged to work collaboratively in considering the broad range of needs, challenges and potential interventions related to expanding successful models of MR service delivery, focused on meeting the needs of underserved populations and areas (e.g., rural poor; adolescents; unmarried women; ethnic minorities; and displaced persons).

Proposed interventions should seek to strengthen equitable access to, and quality of care in service delivery, paying special attention to the needs and perceptions of both providers and potential users of MR services. These should be strategically located, based on need and NGO human resource capacity, foster opportunities for public-private partnerships, and demonstrate sustainability. 

WHAT IS THE LEVEL OF FUNDING?                                                                               #

The size of the Challenge Fund is USD 2.73 million to support projects over the four-year period (2008-2011). The amount of funding available for each proposal will depend upon the overall size and coverage of the proposed intervention package and the total number of proposals selected for funding.

Availability of funds to support all four components of the Initiative is USD 690,000 for 2008, USD 1,379,000 for 2009, USD 475,000 for 2010, and USD 186,000 for 2011. The WHO reserves the right not to award all available funds.

As deemed appropriate, part of the funds will be used to contract out a suitable organization/institute to implement any selected activity, valued less than USD 150,000, by WHO directly, in consultation with the Ministry of Health and Family Welfare (MOHFW).

Size of a grant:

Any grant awarded under the Challenge Fund must not exceed USD 300,000 for activities to be implemented between September 2008 and September 2011.

The grant may cover proportion of the total eligible costs of the project in case of co-financing by the applicant’s or partner’s own resources or the entire costs of the project if this deemed essential to carry out.


The planned duration of a project must stay within 36 months and to be concluded latest by September 2011.

Number of proposals and grants per applicant:

An applicant may submit more than one proposal and may be awarded more than one grant under this call for proposals.

WHAT SORT OF PROPOSALS WILL BE FUNDED?                                                         #

WHO calls for proposals to be funded by the Challenge fund for implementation of activities in various areas of work as indicated in the following table for the first three components of the Initiative. If warranted, WHO will call for proposals for component 4, i.e. strengthen the policy response, in the future.

Areas of Work

Implementation Year





Component 1: Scaling up delivery of quality MR service

1.   Service delivery:

· Develop/update standardize national MR service guidelines

· Develop counseling materials

· Public-private partnership to improve access to and quality of MR service in rural areas and specific target groups in urban areas (as operation research to the extent possible)

· Improve management of MR service at district and below level, including strengthen:

Ø  quality improvement mechanisms

Ø  referral system,

Ø  logistics (e.g. review and upgrade MR kits, improve MR kit procurement, distribution and replacement system in public health system)

Ø management information system for MR service including routine recording-reporting system for: i) MR service and referral; ii) maternal deaths by cause


2.   Pre-service training:

· Develop and pilot test comprehensive MR training materials for incorporating into curricula of pre-service training of nurse, sub-assistant community medical officer and medical doctor.

· Establish quality improvement system for pre-service training









































































Component 2: Enhancing rights-based demand generation for safe MR service

· Implement innovative demand side activities

· Develop and introduce educational materials on prevention of unwanted pregnancy and unsafe abortion for women/community

· Develop and implement national campaign for preventing unwanted pregnancy, unsafe abortion and safe MR service















Component 3: Improving the knowledge and evidence base on SRH and rights issues

·  Rapid assessment and mapping of MR services

·  KAP study on demand side and barrier for the poor, adolescent and other underserved populations in accessing MR service

· Baseline epidemiologic studies on abortion and MR service

· Operational research on introduction of comprehensive MR services, training of new MR providers, implementation of best practices and effective interventions

· Monitor/assess research/interventions on demand side activity/ initiative, MR service related activities and studies on cost-effectiveness


































Component 4: strengthen the policy response

Will be called in the future, if warranted





Budget Ceiling of Challenge Fund (in thousand USD)





ELIGIBILITY OF APPLICANTS: WHO MAY APPLY?                                                       #

Public/private NGOs, professional organizations, research and academic institutions who meet the following criteria are eligible to apply for the grant:

·         hold a registration with the NGO Affairs Bureau and/or Social Welfare Department and/or be a 

          government or business undertaking able to receive foreign funds;


·         have a proven and documented track record of working successfully on Menstrual Regulation;

·         have an audited average annual turnover, over the last 3 years, of at least USD 50,000;

·         be directly responsible for the preparation and management of the project with their partners, not

          acting as an intermediary.

In addition, eligible applicants must declare in the application form in the section “Declaration by the applicant” (Annex A, Part A, section III for concept note and Part B, section VI for full application) that they fulfill all of the following conditions .

·         the applicant has the sources of financing and professional competence and qualifications to   

          undertake the project.


·         the applicant undertakes to comply with the obligations foreseen in the partnership statement of

          the grant application form and with the principles of good partnership practice.


·         the applicant is directly responsible for the preparation, management and implementation of the

          project with its partners and is not acting as an intermediary.


·         if selected, the applicant is in a position to deliver, upon request, the documents supporting its 

          legal and financial status.


·         the applicant and each partner (if any) meet the established eligibility criteria.

·         if recommended to be awarded a grant, the applicant accepts the contractual conditions  

          governed by rules and regulations of the World Health Organization (Annex E). 


·         the applicant and its partners are aware that, for the purposes of safeguarding the financial

          responsibility of the WHO, their personal data may be transferred to internal or external audit   


Applicants may act individually or with partner organizations.

Applicants’ partners participate in designing and implementing the project, and the costs they incur are eligible in the same way as those incurred by the grant Beneficiary. They must therefore satisfy the same eligibility criteria as applicants. The applicant will act as the lead organization and, if selected, as the contractual partner of the WHO (the "Beneficiary").

WHO reserves the right not to award the grant to the organizations which promote any one religious belief or political party, or practice any form of discrimination on the grounds of race, gender, sexual orientation, disability or religious or political beliefs.


Only "eligible costs" as detailed below can be taken into account for a grant. Note that the eligible costs would be settled on actual costs based on supporting financial documents as per prevailing WHO rules and regulation.

Eligible direct costs:

The support is limited to project activities and does not cover activities or staff unrelated to project activities.

Eligible direct costs are those costs which can be attributed directly to the project and are identified by the applicant as such, in accordance with its accounting principles and its usual internal rules acknowledging the invoices and other costs approving documents. This may include: direct costs related to organization of seminars, training, workshops, research activities, local travel. With regard to personnel costs, if warranted, only the costs of the actual hours worked/performance under the project may be charged.

Eligible indirect costs include only real indirect costs which cannot be identified as being directly attributed to the project but which is in direct relationship with the eligible direct costs and can be identified by its accounting system (phone costs, postal charges, bank fees, other office costs).

No flat rate/ overhead costs may be claimed within the proposed budget for the project.

Contributions in kind:

Any contributions in kind must be listed separately in Annex B (worksheet 2) of the application form. Contributions in-kind are not accepted as co-financing.

The cost of staff assigned to the project is not a contribution in kind and may be considered as co-financing in the budget of the project when paid by the Beneficiary or his partners. If the description of the project as proposed by the beneficiary foresees the contributions in kind, such contributions have to be provided.

Contributions involving real estate shall be excluded from the calculation of the amount of co-financing.

Ineligible costs:

Followings are expenses that are not permissible for reimbursement:

·         debts and provisions for losses or debts;

·         interest owed;

·         items already financed in another framework;

·         purchases of land or buildings

·         currency exchange losses;

·         taxes, including VAT, unless the Beneficiary (or the Beneficiary’s partners) cannot reclaim them   

          and the applicable regulations do not forbid coverage of taxes; and

·         credits to third parties.

Recommendations to award a grant are subject to the condition that the checking process which precedes the signing of the contract does not reveal problems requiring changes to the budget (for instance arithmetical errors, inaccuracies or unrealistic costs and other ineligible costs). The checks may give rise to requests for clarification and may lead WHO to request modifications or reductions to address such mistakes or inaccuracies. It is therefore in the applicant's interest to provide a realistic and cost-effective budget.

APPLICATION PROCESS                                                                   #

Proposals valued USD 150,000 and above:

The application process for the proposals valued USD 150,000 and above will undergo a two-stage process as follows:


Stage 1:    Project Concept Note

A maximum of 2-page concept note (in English) describing the objectives and proposed actions adhering to the structure in the Application Form for the Challenge Fund (Annex A, Part A).


Stage 2: Full Proposal Application

Only applicants whose concept notes were pre-selected by WHO at Stage 1 above will be invited to submit full project proposal using the structure of the Application Form for the Challenge Fund (Annex A, Part B).

Applicants whose project proposals were selected on conditional basis and required revision, will be given a chance to re-submit their proposals based on the evaluation feedback.  

Proposals less than USD 150,000:

The application process for the proposals less than USD 150,000 does not require submission of the concept note. Applicants are expected to submit full project proposals and, if advised by WHO, revised project proposals only.    

FORMAT OF A CONCEPT NOTE                                                                                        #

Applicants must submit the concept note as per “Guidance for the Drafting of the Concept Note” in the Application Form (Annex A, Part A).

In the Concept note, the applicants must provide an estimate only of the probable total cost of the project and of the requested amount from the Challenge Fund. Only the applicants invited to submit a full proposal in the second stage will be required to present a detailed budget. Please provide budget with round figures. This detailed budget may not vary from the initial estimate by more than 10%, while the applicant is free to adapt the percentage of co-financing required as far as the minimum and maximum amount of co-financing.


Applicants invited by WHO to submit a full application form following successful concept note application must do so by using the Part B of the Application Form (Annex A). Applicants should keep strictly to the format of the application and fill in the paragraphs and the pages in order.

The elements contained in the concept note cannot be modified in the full application form. The detailed budget (please provide budget with round figures) may not vary from the initial estimate by more than 10%, while the applicant is free to adapt the percentage of co-financing required as far as the minimum and maximum amount of co-financing.


Applications must be submitted using the standard Application Form (Annex A, Part B). Applicants should keep strictly to the format of the application and fill in the paragraphs and the pages in order. Please provide budget with round figures.

WHERE AND HOW TO SEND APPLICATIONS?                                                                 #

Applicants must submit their concept notes and applications in English. It is therefore of utmost importance that application set containing all relevant documentation and information concerning the project. No supplementary annexes should be sent at later date.

All applications (concept notes and all applications for proposals) must be submitted in a sealed envelope by registered mail, private courier service or by hand-delivery (a signed and dated certificate of receipt will be given to the deliverer) at the address below:

World Health Organization

House No.12, Road No.7

Dhanmondi Residential Area, Dhaka 1205

Tel.: (880-2) 861 4653-5, 861 6097-98

Fax: (880-2) 8613247 

Please clearly mark subject of correspondence as “Application for Challenge Fund”, including the outer envelope which must bear the full name and address of the applicant, and clearly marked either:

o    "Concept Note: Not to be opened before the opening session" – for proposal valued

       USD 150,000 and above, or


o    "Full Application: Not to be opened before the opening session" – for proposal less than

      USD 150,000, and for subsequent proposals valued USD 150,000 and above, as invited by      WHO, after successful concept note application.

Applicants may intimate to WHO by fax or e-mail for advance information that applications are being sent and followed by the dispatch of the original documents before the deadline.  

All applications including the Checklist for the Concept Note/Full Application as indicated in the Application Form, and the Declaration by the Applicant (Annex A) must be submitted in one original and 3 copies in A4 size, each bound.

All applications must be submitted as well in electronic format (CD-Rom or e-mail). The electronic format must contain exactly the same concept note/application form as the paper version enclosed.

Where an applicant sends several different applications/concept notes, each one must be sent separately.

Applicants must verify that their Application/Concept Note is complete using the Checklist(s) (Application Form, Annex A).  

DEADLINES FOR SUBMISSION                                                                                       #

The deadlines for the submission are as follows:

o        22 July 2008: for Concept Notes of proposal valued USD 150,000 and above and Full Applications for proposals below USD 150,000 -

o        15 September 2008: for Full Applications of successful Concept Note, as invited by WHO, for proposals valued USD 150,000 and above.

The date of submission should be evidenced by the date of dispatch, the postmark or the date of the deposit slip. In case of hand-deliveries, the deadline for receipt is at 14:00 hours local time as evidenced by the signed and dated receipt. Any Concept Note submitted after the deadline will automatically be rejected.

HOW THE APPLICATIONS WILL BE EVALUATED?                                                          #

Applications (Concept Notes and all Applications) will be examined and evaluated by the WHO. The assistance of external assessors and a special task force/working group (to be formed) will be sought as and when required (in particular for proposals of USD 150,000 and above).

Following the opening session and the administrative check, the WHO will send a letter to all applicants, indicating whether they have satisfied all the criteria mentioned in the checklist and whether their Concept Note or Application Form has been recommended for evaluation.  

In assessing full application form for grants, the following five groups of assessment criteria will be applied:

  1. Financial and operational capacity
  2. Relevance to national needs and local context
  3. Appropriate methodology
  4. Sustainability
  5. Budget and cost-effectiveness

The assessment criteria for the Concept Notes will cover the relevance of the project, its merits and effectiveness and sustainability.

The eligibility verification, based on the supporting documents requested by the WHO, may be performed for the proposals that have been provisionally selected within the available financial envelope. The Declaration by the applicant (Annex A, Part B, section VI,) will be cross-checked with the supporting documents provided by the applicant.

The expertise for evaluation of proposals will be drawn from WHO and, if required, from academic and research institutions. The WHO may involve independent experts to provide independent expert opinion in screening of proposals submitted for the Challenge Fund. Experts will perform their assessment on their personal capacity, not on behalf of their employer, or other entity. They must be impartial, objective and independent, with no potential interest in any of the proposals. Experts’ identity remains confidential. All the information made available to experts or arising during the assessment must be treated as strictly confidential. Under no circumstances may expert contact an applicant directly.  

A special task force/working group comprising of officials from the Ministry of Health and Family Welfare, NGOs (a non-voting member), WHO and donor agencies active in the field of reproductiv