Request for Proposal: 1578- XX

Facilitate Program Review Meetings and Advocacy Workshops on Zinc and ORS for the
treatment of childhood diarrhea among private practitioners and pharmaceutical
representatives in West Java, Banten and West Nusa Tenggara Provinces, Indonesia

Issued by Nutrition International NI (formerly known as the Micronutrient Initiative)

Deadline for receipt of proposals at the NI:

Friday, December 8th, 2017

17:00 West Indonesia Standard Time

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Contents

1. Request For Proposal Notice .........................................................................................................3

2. Introduction to the RFP ..................................................................................................................3
3. General instructions and considerations ........................................................................................4
4. Conflict of Interest ........................................................................................................................ 45
5. General Disclosures ......................................................................................................................5
6. Submission of Proposals ............................................................................................................. 56
7. Receipt, evaluation and handling of proposals ...............................................................................6
9. Guidelines for preparing Proposals .............................................................................................. 78
Part 1: Covering Letter and Declaration.......................................................................................... 79
Part 2: General and Technical Proposal ......................................................................................... 89
Part 3: Financial Proposal ............................................................................................................ 910
Annexure A. Terms Of Reference ................................................................................................... 1011
Annexure B. Template Of Budget ................................................................................................... 1437

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1. REQUEST FOR PROPOSAL NOTICE

1.1 Request for Proposals

Nutrition International, a non-profit organization dedicated to eliminating vitamin and mineral

deficiencies worldwide, invites proposals from competent Organizations or Agencies to Facilitate
Program Review Meetings and Advocacy Workshops on Zinc and ORS for the treatment of
childhood diarrhea among private practitioners and pharmaceutical representatives in West Java,
Banten and West Nusa Tenggara Provinces, Indonesia. The submission deadline is Friday,
December 8th, 2017 by 17:00 West Indonesia Time.

2. INTRODUCTION TO THE RFP

2.1 NI aims to generate innovative and sustainable solutions to reduce vitamin and mineral
deficiencies among women, newborns, and children. It builds on robust evidence-based
research and evaluation in order to demonstrate excellent return on investment of scaling-
up highly cost-effective micronutrient interventions. NI aspires to be a global center of
excellence in technical and programmatic support in this field.

In collaboration with key stakeholders such as governments, private sectors and civil
society groups, NI seeks to tackle the aforementioned problems that affects one third of
the worlds population. NI engages in tailoring health and nutrition strategies as well as up-
scaling existing program in various regions in the globe including Africa, Asia, the
Caribbean, Latin America and the Middle East. NIs international Board of Directors directs
its interventions that reach approximately 500 million people in more than 70 countries.

One of NIs key strategic goals is to enhance the global impact of micronutrient
interventions by generating cutting-edge knowledge and utilizing it to develop sound
policies and programs while consolidating political will to achieve its vision. NI aspires to
position itself as a global center of excellence in generating scientific research in the field
of micronutrient programs. It provides quality assurance for research and programs while
disseminating and translating new knowledge to influence and improve national and global
policies and programs. NI provides guidance and support on existing and future program
evaluations and coordinates the analysis and utilization of evaluation activity results.

Background and rationale:

The Nutrition International collaborated with the Hepatitis and gastrointestinal infections
(HISP) sub division of the Directorate General Communicable Disease and Environment
Health (CD&EH) of MoH for the implementation a demonstration project titled Zinc and
ORS pilot for the treatment of childhood diarrhea in Indonesia in selected districts of West
Lombok and East Lombok, West Nusa Tenggara Province in April 2011 until March 2014.
From 2014 onwards, NI replicated some the processes from the demonstration project that
worked to improve coverage and adherence of zinc and ORS in childhood diarrhea
treatment across West Nusa Tenggara province and thereafter to two other provinces,
Banten and West Java. During 2015, NI supported several trainings on Zinc and ORS for
childhood diarrhea treatment for the program officers and health workers at province,
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district and Puskesmas level. NI also continues to provide technical assistance to the
program officers of the diarrhea program at provincial and district level through NIs
province and district extenders.
In order to further support the programs, NI will undertake program review meetings among
DHO (District Health Office) and PHO (Province Health Office) Officers at province level
on coverage and adherence of zinc and ORS for childhood diarrhea treatment in three
provinces (West Java, Banten and West Nusa Tenggara) and advocacy meetings on Zinc
and ORS for childhood diarrhea among private practitioners and pharmaceutical
representatives to engage with the private sector to improve the coverageof zinc in two
provinces (West Java and Banten).

2.2 This Request for Proposals (RFP) and particularly the Guidelines for Preparing Proposals
that follow, are designed to help Respondents to produce proposals that are acceptable to
the NI, and to ensure that all proposals are given equal consideration. It is essential,
therefore, that respondents provide complete information, in the attached formats and on
the terms specified.

3. GENERAL INSTRUCTIONS AND CONSIDERATIONS

3.1. These instructions should be read in conjunction with information contained in the
enclosed Terms of Reference (TOR), and in any accompanying documents within this
package.

3.2. This Request for Proposals (RFP) is to support NI to Facilitate Program Review
Meetings and Advocacy Workshops on Zinc and ORS for the treatment of childhood
diarrhea among private practitioners and pharmaceutical representatives in West Java,
Banten and West Nusa Tenggara Provinces, Indonesia.

3.3. NI is not bound to accept the lowest priced, or any, proposal. NI reserves the right to
request any (or all) Respondent(s) to meet with the NI to clarify their proposal(s) without
commitment, and to publish on its website answers to any questions raised by any
Respondent (without identifying that Respondent).

3.4. Respondents are responsible for all costs associated with the proposal preparation and
will not receive any reimbursement from the NI.

4. Conflict of Interest

4.1. Respondents must disclose in their proposal details of any circumstances, including
personal, financial and business activities that will, or might, give rise to a conflict of
interest. This disclosure must extend to all personnel proposed to undertake the work.

4.2. Where Respondents identify any potential conflicts they must state how they intend to
avoid any impact arising from such conflicts. NI reserves the right to reject any proposals
which, in the NIs opinion, give rise, or could potentially give rise to, a conflict of interest.

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4.3. With respect to this condition, please be advised that the organizations that may fall within
the scope of this evaluation will include those below, with which any association must be
disclosed:

a. Nutrition International (NI)

b. The Donor who is the primary funding source for the procurement

5. General Disclosures
5.1. Respondents must disclose:
5.1.1. If they are or have been the subject of any proceedings or other arrangements
relating to bankruptcy, insolvency or the financial standing of the Respondent
including but not limited to the appointment of any officer such as a receiver in
relation to the Respondent personal or business matters or an arrangement with
creditors or of any other similar proceedings.

5.1.2. If they have been convicted of, or are the subject of any proceedings, relating to:
a. criminal offence or other offence, a serious offence involving the activities of
a criminal organization or found by any regulator or professional body to have
committed professional misconduct.
b. corruption including the offer or receipt of any inducement of any kind in
relation to obtaining any contract, with NI, or any other contracting body or
authority
c. failure to fulfil any obligations in any jurisdiction relating to the payment of
taxes.

6. SUBMISSION OF PROPOSALS
6.1 The Technical (only includes detail of meeting arrangement, team composition and timeline)
and financial proposal along with all requisite documentation must be received in English by
NI no later than December 8th, 2017.

6.2 The technical and financial proposal in two separate files shall be put into a covering email
specifically indicating with subject line Facilitate Program Review Meetings and
Advocacy Workshops on Zinc and ORS for the treatment of childhood diarrhea among
private practitioners and pharmaceutical representatives in West Java, Banten and West
Nusa Tenggara Provinces, Indonesia need to be sent to email:
vacancy.miindonesia@gmail.com

6.3 For any clarification required, please write an email on following email address:
vacancy.miindonesia@gmail.com

6.4 Only email bids will be accepted. Only those short-listed will receive an acknowledgment
and will be called for a personal interaction, at their own cost. The interaction will be held
at the NI office in Jakarta, Indonesia.

6.5 Late proposals will not be accepted in any circumstances. Proposals received after the
due date and time will not be considered.

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7. RECEIPT, EVALUATION AND HANDLING OF PROPOSALS

7.1. Once a proposal is received before the due date and time, NI will:

7.1.1. Log the receipt of the proposals and record the business information
7.1.2. Review all proposals and disqualify any non-responsive ones (that fail to meet the
terms set out in these instructions), and retain the business details on file with a
note indicating disqualification
7.1.3. Evaluate all responsive proposals objectively in line with the criteria specified
below
7.1.4. Inform Respondents within 10 business days of the evaluation decision being
made.

7.2. NI reserves the right:

7.2.1. To accept or reject any and all proposals, and/or to annul the RFP process prior
to award, without thereby incurring any liability to the affected Respondents or any
obligation to inform the affected Respondents of the grounds for NI's actions prior
to contract award, and
7.2.2. To negotiate - with Respondent(s) invited to negotiate - the proposed technical
approach, and the proposed price based on the Respondents proposals.
7.2.3. Amend this RFP at any time.

8. SELECTION CRITERIA
8.1. 40% of the evaluation weighting will be for the technical; and 60% for the financial
proposal.
8.2. The Evaluation Team may, in its sole discretion, establish a short-list of Respondents
based on the Technical Scores of the Respondents (the Short-listed Respondents) for
the purpose of conducting interviews. If MI short-lists the Respondents, it will short-list
the Respondents with the highest scores.
8.3. Only the Short-listed Respondents will be interviewed. The number of Respondents
short-listed for an interview is in the sole discretion of MI.
8.4. Interviews of Short-listed Respondents will be carried out by the Evaluation Team or a
sub-group of the Evaluation Team. The Evaluation Team will score each Short-listed
Respondent based on the quality of the Respondents interview (the Interview Score).
8.5. The successful Respondent will be expected to enter into a Contract with the MI
for the duration of the Work. In the event of a Contract award, all the terms and
conditions of the RFP, including the Respondents response, will normally form part
of the Contract.

Table 1: Proposal Scoring Criteria

Name of the Agency
Proposals
Assessment Category: Presentation and discussion Weights

Qualification of Agency (A) 50% 0.0 0.0 0.0 0.0 0.0

Experience of working with NGOs and collaboration
30%
with MoH, PHO and DHO.

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Communication skills (written and verbal). 20%

Demonstrated experience in facilitating
meeting/workshop/training on health issue 50%
with government.
Realistic Plan and ability to accomplish the task (B) 50%
Agency's plan for completing the activities 30%
Agency's ability to complete the task as per MI
30%
expectation mentioned in the TOR
Agency's realistic timelines to accomplish the entire
40%
work

Total Score - Technical Proposal (A+B) 100% 0.00 0.00 0.00 0.00 0.00

Overall weightage of Technical Proposal 40%

Assessment Category: Financial
Presented reasonable estimate of fees 25%

Takes into consideration all potential field expenses

30%
(i.e. no obvious omissions)

Presented realistic estimate for field expenses 25%

Reasonable estimate for completing the meeting,

20%
and report writing expenses
Total Score - Financial Proposal 100% 0.00 0.00 0.00 0.00 0.00
Overall weightage of Financial Proposal 60%
Total Weighted Score (Technical + Financial) 0.00 0.00 0.00 0.00 0.00

9. GUIDELINES FOR PREPARING PROPOSALS

9.1 Language: Proposals must be submitted in English.

9.2 Structure : Proposals must be set out in four main parts:

Part 1: Covering Letter and Declaration
Part 2: Executive Summary
Part 3: General and Technical Proposal
Part 4: Financial Proposal

Part 1: Covering Letter and Declaration

Proposals must be accompanied by a covering letter on company-headed paper showing the full
registered and trading name(s), trading and registered office address and business number of the
Respondent. The letter must be signed by a person of suitable authority to commit the Respondent
to a binding contract. It must quote the RFP number and title, and include the following
declarations:

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a. We have examined the information provided in your Request for Proposals (RFP) and
offer to undertake the work described in accordance with requirements as set out in the
RFP. This proposal is valid for acceptance for 6 months and we confirm that this
proposal will remain binding upon us and may be accepted by you at any time before
this expiry date.

b. We accept that any contract that may result will comprise the contract documents issued
with the RFP and be based upon the documents submitted as part of our proposal.

c. Our proposal (Technical and Financial) has been arrived at independently and without
consultation, communication, agreement or understanding (for the purpose of restricting
competition) with any other Respondent to or recipient of this RFP from the NI.

d. All statements and responses to this RFP are true and accurate.

e. We understand the obligations regarding Disclosure as described in the RFP Guidelines

and have included any necessary declarations.

f. We confirm that all personnel named in the proposal will be available to undertake the
services.

g. We agree to bear all costs incurred by us in connection with the preparation and
submission of this proposal and to bear any further pre-contract costs.

h. I confirm that I have the authority of [insert name of NGO/company/agency] to submit

this proposal and to clarify any details on its behalf.

Part 2: Executive Summary

A brief overview of the General and Technical proposal that summarizes how the Respondent will
use their competencies in the area to achieve the outputs/deliverables. Financial information should
not be included here; but the summary may indicate the level of effort proposed.

Part 3:

General and Technical Proposal

The General and Technical section should be structured as follows:

Section 1: Your understanding of the TOR provided with this RFP as Annexure A. You may
also propose qualifications to the TOR that you consider may enhance the value of the outcome
to the NI.

Section 2: Technical Response: a concise description of the methodology and approach that
are proposed for the delivery of the TOR and an implementation plan in the form of a work
breakdown analysis. This should describe the activities to be undertaken, the
deliverables/outputs and the milestone and completion dates (grouped by phase where

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appropriate). The dependency of any activities and associated results on earlier results needs
to be clearly indicated.

Section 3: Personnel Profile: names, designation and Curricula Vitae (CV) of personnel
assigned to work on the Project. CVs must not exceed 3 pages, but must include:
o a brief summary of the professional competencies of the individual relevant to the
Scope of Work/TOR
o a chronological list of relevant professional experience starting with the most recent
and showing key achievement /responsibilities
o brief details of qualifications educational / technical /professional / other
o language competencies other than English (if required to undertake the ToR)

Section 4: Personnel Inputs: include name of personnel, and person days with reference
to activity to be undertaken. Do not include any reference to fees. This will constitute a
confirmation that all personnel will be available to provide the required services for the
duration of the contract

Section 5: Company Information: proof of incorporation for registered incorporated

entities, proof of registration for registered entities.

Section 6: Previous experience: documentation demonstrating the Respondents

experience in the proposed area of work. This should include contact details for key clients
who may be contacted in respect of the Respondents relevant prior work.

Part 4: Financial Proposal

The Financial proposal must contain the expected budget for accomplishing the
complete work with detailed breakup. All amounts quoted must be in IDR. The
Respondent should provide a detailed budget, based on the format attached as
Annexure-B.

Fees should be inclusive of all VAT, Taxes, Insurance and standard training
management/overhead cost.

Please note that no fees are payable for travel days.

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ANNEXURE A
TERMS OF REFERENCE

Facilitate Program Review Meetings and Advocacy Workshops on Zinc and ORS for the
treatment of childhood diarrhea among private practitioners and pharmaceutical
representatives in West Java, Banten and West Nusa Tenggara Provinces, Indonesia

1. Background

The Nutrition International (NI) formerly known as the Micronutrient Initiative (MI), collaborated with
the Hepatitis and gastrointestinal infections (HISP) sub division of the Directorate General
Communicable Disease and Environment Health (CD&EH) of MoH for the implementation a
demonstration project titled Zinc and ORS pilot for the treatment of childhood diarrhea in Indonesia
in selected districts of West Lombok and East Lombok, West Nusa Tenggara Province in April 2011
until March 2014.
From 2014 onwards, NI replicated some the processes from the demonstration project that worked
to improve coverage and adherence of zinc and ORS in childhood diarrhea treatment across West
Nusa Tenggara province and thereafter to two other provinces, Banten and West Java. During
2015, NI supported several trainings on Zinc and ORS for childhood diarrhea treatment for the
program officers and health workers at province, district and Puskesmas level. NI also continues to
provide technical assistance to the program officers of the diarrhea program at provincial and district
level through NIs province and district extenders.
In order to further support the programs, NI will undertake program review meetings among DHO
(District Health Office) and PHO (Province Health Office) Officers at province level on coverage and
adherence of zinc and ORS for childhood diarrhea treatment in three provinces (West Java, Banten
and West Nusa Tenggara) and advocacy meetings on Zinc and ORS for childhood diarrhea among
private practitioners and pharmaceutical representatives to engage with the private sector to
improve the coverageof zinc in two provinces (West Java and Banten).

NI seeks to hire an agency to facilitate the above two activities for supporting Zinc and ORS for
childhood diarrhea treatment program.

2. Objectives

To facilitate program review meetings in 3 provinces (West Java, Banten and West Nusa Tenggara)
and advocacy meetings on zinc and ORS in childhood diarrhea treatment in 2 provinces (West Java
and Banten) in coordination with MoH.

A. Specific objectives of the program review meetings are:

1. Share update on implementation of zinc and ORS for childhood diarrhea treatment provided
at health center in each province.
2. Share the coverage of children with diarrhea who sought treatment at health center and got
treatment with zinc and ORS as well as the stock data on zinc and ORS within districts in
each province.

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3. Review and discuss the gaps and challenges in providing adequate treatment and reporting
the routine data at all levels and get feedback and recommendations from PHO and MoH to
DHO for further improvement.
4. Develop an action plan to improve the implementation as well as the support needed from
all levels (i.e. district, province level and MoH)

B. Specific objectives of the advocacy meetings are:

1. Share the experiences of West Nusa Tenggara Province in involving the private sector
audiences and pharmaceutical representatives to improve the coverage and compliance of
zinc and ORS for childhood diarrhea treatment
2. Advocate with the private practitioners and pharmaceutical representatives to support the
zinc and ORS for childhood diarrhea program particularly to ensure the zinc and ORS usage
for treatment childhood diarrhea and ensure continuous supply of zinc supplements and
ORS at the pharmacies in West Java and Banten provinces.

3. Expected Outputs
A. Output of the program review meetings are:

- Recommendations from MoH on how to support the improvement of supply zinc and ORS,
utilization of zinc and ORS for childhood diarrhea treatment at public as well as private
sector and to improve the reporting system.
- Plan of action from district health office and provincial level to ensure the coverage,
adherence of zinc and ORS as well as supply of zinc and ORS for childhood diarrhea
treatment is developed.

B. Output of the advocacy meetings are:

- Recommendations from private practitioners on how they can support the improvement of
zinc and ORS for childhood diarrhea treatment at the province and district levels.
- Plan of action of pharmaceutical representatives including estimation of the requirements
to ensure the supply of zinc and ORS to meet demands at the province and district levels
in 2018 and 2019 as shared by the Puskesmas/DHO/PHO/Hospitals.

4. Scope of Work

The selected agency will organize the training and the activities will be conducted as follows:
4.1. Program Review Meetings in 3 Provinces (West Java, Banten and West Nusa
Tenggara)
The program review meetings will be conducted for 2 days in each province and the
activities will include:
- Update from MoH about the online reporting system/SIHEPI, IEC materials on
diarrhea and the coverage of treatment provided for zinc and ORS for childhood
diarrhea at national level (2016-2017)
- PHO and representatives DHO will share current implementation of treatment
provided at health center for zinc and ORS for childhood diarrhea, district wise
coverage data from January to December 2017, the data of zinc and ORS supplies
in 2017 and the plan for 2018.
- Visit to select Puskesmas that has implemented treatment for childhood diarrhea as
required. During the visit, participants will observe the treatment provided for the
childhood diarrhea, learn from experiences in Puskesmas on how to provide
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appropriate treatment, management of adequate supplies on zinc and ORS,

challenges/practices in the recording and reporting
- Development of PHO and DHOs plan of action to improve the coverage and
adherence of zinc and ORS in treatment of childhood diarrhea based on the
recommendation from MoH.

4.2. Advocacy Meetings in 2 provinces (West Java and Banten)

The advocacy meetings will be conducted for 1 day in each province. The activities will
include:
- Update on national policy of Zinc and ORS for childhood diarrhea treatment
- Sharing experiences from West Nusa Tenggara Province in involving the private
sector and pharmaceutical representatives to improve the coverage and compliance
of zinc and ORS for childhood diarrhea treatment
- Develop action plan to ensure the zinc and ORS usage for childhood diarrhea
treatment and continuous supply of zinc supplements and ORS at the pharmacies in
West Java and Banten provinces.

5. Meeting participants

The participants to be invited include the following:

5.1. Program Review Meetings at province level: About 40 participants will attend meeting in
Banten province. Meanwhile the participants for the meeting in West Java province will
be about 70 persons. The participants will be include the following:
Ministry of Health (MoH) staff
Provincial Health Officers (HISP program manager, supervisor and data officer;
pharmacy unit, health promotion and MCHN division)
District Health Officers (diarrhea program officer and supervisor/manager)
Pharmaceutical representatives (zinc supplement producers) West Java and Banten
Nutrition International staff and extenders.

5.2. Advocacy Meetings at province level: About 40 participants will attend the advocacy
meeting in Banten and about 77 persons will attend the meeting in West Java province.
The participants will include the following:
Ministry of Health (MoH) staff
Provincial Health Officers (HISP program manager, supervisor and data officer;
pharmacy unit, health promotion and MCHN division)
District Health Officers (diarrhea program officer and supervisor/manager)
Representatives from Health Profession Organizations:
- Indonesia Pediatrician Association, West Java and Banten branch.
- Indonesia Physician Association, West Java and Banten branch.
- Indonesia Midwife Association, West Java and Banten branch.
- Indonesia Public Health Practitioners Association.
- Indonesian National Nurses Association West Java and Banten Branch
- PERSAGI (Nutritionist Association) West Java and Banten Branch
Pharmaceutical representatives (zinc supplement producers) West Java and Banten
Nutrition International staff and extenders.
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6. Organization
The meetings and workshops will be organized by the selected agency with funding support
from NI. The selected agency will have to closely coordinate with NI, MoH and PHOs for
technical guidance. All logistical arrangements for the meetings will be managed by the selected
agency based on guidance from NI.
7. Deliverables

- List of participants
- Report on process, the key highlights of all the meetings including a short summary. Format
of the report will need to be finalized in discussion with NI
- Training materials (Training agenda, PPT, copy of module, copy of the action plan)
- Meeting notes
- Financial report
- Photos of activities

8. Time Schedule

The activities will be held between December 2017- mid-March 2018

9. Experience and Qualifications of selected agency

Minimum 3 years of experience in facilitating events such as meetings, workshops, or

trainings with good track record with past clients
Minimal 3 years of experience in working with international NGOs, national/province/local
government offices or other public officials such as Puskesmas officers or schools.
Experience in the area of nutrition and public health will be an added advantage
Experience of working with PHOs and DHOs in WNT, West Java and Banten, and
previous experience of working with NI would be an asset
Experience of having developed good quality reports for international NGOs/government
programs.

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ANNEXURE B
TEMPLATE OF BUDGET

B.1 SUMMARY (Total Proposed Budget)

No Description Budget (IDR)
I Direct Cost
Preparation meeting with
A
PHO and MoH -
B Meeting in Banten
-
C Meeting in West Java
-
D Meeting in WNT
-
E Reporting
-
F Logistic
-
I Subtotal Direct Cost
-

II Indirect Cost
__% from Direct Cost
-

Total Cost
-
1$CAD=IDR
10.000
Total Cost in
$CAD -

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B.2. Detail Budget proposed:

Code Description Uni Duration/ frequency Unit price Total

t (IDR) Remarks
cost
A. Preparation meeting with PHO and MoH Rp -
A.1. Transport EO to meeting with MoH 1 ls 1 time Rp -
A.2 Preparation with PHO WNT
2.1 Flight for EO from Base to WNT 1 ls 1 time
(return)
2.1 Local transport for EO to visit WNT 1 ls 2 days
(base to airport, airport to hotel,
hotel to PHO WNT)
2.3 Car rental to survey Puskesmas for 1 car 1 day
field visit
2.4 Accommodation EO at Mataram, 1 room 2 night
WNT
Sub Total -
A.3 Preparation with PHO Banten
3.1 Transportation EO from Jakarta to 1 ls 1 time
Serang (return)
3.2 Accommodation EO at Serang (if 1 room 1 night
the EO from outside of Jakarta)
Sub Total -
A.4 Preparation with PHO West Java
4.1 Transportation EO from Jakarta to 1 ls 1 time
Bandung (return)
4.2 Accommodation EO at Bandung (if 1 room 1 night
the EO from outside of Jakarta)
Sub Total -
B 2 days of Review Meeting and 1 day of Rp -
advocacy meeting in Banten (total 3 days)
B.1 Allowance for participant from
DHO
1.1 Serang City 2 person 3 day
1.2 Serang 2 person 3 day
1.3 Cilegon 2 person 3 day
1.4 Pandeglang 2 person 3 day
1.5 Lebak 2 person 3 day
1.6 Tangerang City 2 person 3 day
1.7 Tangerang 2 person 3 day
1.8 Tangerang Selatan City 2 person 3 day
Sub Total -

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B.2 Allowance for participant from

PHO
2.1. Participant from PHO 9 person 3 days
2.2. Participant from Professional 6 person 1 day
organizations (IDI, IDAI, IBI,
PERSAGI, etc.)
Sub Total -
B.3 Allowance for participant from
MoH
3.1 Participant from MoH 3 person 3 day
Sub Total -
B.4 Transportation for DHO
4.1. Serang City 2 person 2 times
4.2 Serang 2 person 2 times
4.3 Cilegon 2 person 2 times
4.4 Pandeglang 2 person 2 times
4.5 Lebak 2 person 2 times
4.6 Tangerang City 2 person 2 times
4.7 Tangerang 2 person 2 times
4.8 Tangerang Selatan City 2 person 2 times
Sub Total -
B.5 Transportation for PHO
5.1 Participant from PHO 9 person 6 times
5.2 Participant from Professional 6 person 2 times
organizations (IDI, IDAI, IBI,
PERSAGI, etc.)
Sub Total -
B.6 Transportation for MoH
6.1 Participant from MoH 3 person 2 times
Sub Total -
B.7 Accommodation in Banten
7.1 Accommodation for participant 9 room 2 nights
from DHO
7.2 Accommodation for resource 3 room 3 nights
person from MoH
7.3 Accommodation for EO 2 room 3 nights
Sub Total -
B.8 Meeting package including the 36 person 2 day
venue and meals for review
meeting
8.1 Meeting package including the 43 person 1 day
venue and meals for advocacy
meeting
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Sub Total -
B.9 Fee Resource person and
Facilitator
9.1 Fee Resource person from MoH 3 person 2 session
9.2 Fee Resource person from Private 2 person 1 session
Organization (IDI/IDAI)
9.3 Fee Facilitator from PHO 2 person 3 session
9.4 Fee facilitator from 2 person 1 session
DHO/Puskesmas
9.5 Fee moderator from PHO/DHO 1 person 7 session
9.6 Fee MC 1 person 3 session
9.7 Fee Note taker 1 person 3 day
Sub Total -
B.10 Resource person from PHO WNT
10.1 Flight from WNT to Bandung 1 person 2 times
10.2 Fee resource person 1 person 1 session
10.3 Accommodation 1 person 2 days
10.4 Allowance 1 person 2 days
10.5 Local transportation 1 person 2 times
10.6 Sub Total -
B.11 Field Visit to Puskesmas
11.1 Rental car from venue to 5 car 1 day
Puskesmas including parking and
vehicle
11.2 Room rental in Puskesmas 1 ls 1 time
11.3 Snack meeting in Puskesmas 45 box 1 time
Sub Total -
C Meeting in West Java Rp -

C.1 Allowance for participant from DHO

1.1 Bandung City 2 Person 3 day
1.2 Bandung 2 Person 3 day
1.3 Bandung Barat 2 Person 3 day
1.4 Cimahi City 2 Person 3 day
1.5 Cianjur 2 Person 3 day
1.6 Purwakarta 2 Person 3 day
1.7 Subang 2 Person 3 day
1.8 Sumedang 2 Person 3 day
1.9 Garut 2 Person 3 day
1.10 Tasikmalaya 2 Person 3 day

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1.11 Tasikmalaya City 2 Person 3 day

1.12 Sukabumi City 2 Person 3 day
1.13 Sukabumi 2 Person 3 day
1.14 Bogor 2 Person 3 day
1.15 Bogor City 2 Person 3 day
1.16 Bekasi 2 Person 3 day
1.17 Bekasi City 2 Person 3 day
1.18 Depok City 2 Person 3 day
1.19 Karawang 2 Person 3 day
1.20 Indramayu 2 Person 3 day
1.21 Cirebon 2 Person 3 day
1.22 Cirebon City 2 Person 3 day
1.23 Kuningan 2 Person 3 day
1.24 Majalengka 2 Person 3 day
1.25 Banjar City 2 Person 3 day
1.26 Ciamis 2 Person 3 day
1.27 Pangandaran 2 Person 3 day
Sub Total -
C.2 Allowance for participant from
PHO
2.1 Participant from PHO 9 person 3 day
2.2 Participant from Professional 6 person 1 day
organizations (IDI, IDAI, IBI,
PERSAGI, etc.)
Sub Total -
C.3 Allowance for participant from
MoH
3.1 Resource person from MoH 3 person 4 day
Sub Total -
C.4 Transportation for DHO
4.1 Bandung City 2 Person 2 times
4.2 Bandung 2 Person 2 times
4.3 Bandung Barat 2 Person 2 times
4.4 Cimahi City 2 Person 2 times
4.5 Cianjur 2 Person 2 times
4.6 Purwakarta 2 Person 2 times
4.7 Subang 2 Person 2 times
4.8 Sumedang 2 Person 2 times
4.9 Garut 2 Person 2 times
4.10 Tasikmalaya 2 Person 2 times

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4.11 Tasikmalaya City 2 Person 2 times

4.12 Sukabumi City 2 Person 2 times
4.13 Sukabumi 2 Person 2 times
4.14 Bogor 2 Person 2 times
4.15 Bogor City 2 Person 2 times
4.16 Bekasi 2 Person 2 times
4.17 Bekasi City 2 Person 2 times
4.18 Depok City 2 Person 2 times
4.19 Karawang 2 Person 2 times
4.20 Indramayu 2 Person 2 times
4.21 Cirebon 2 Person 2 times
4.22 Cirebon City 2 Person 2 times
4.23 Kuningan 2 Person 2 times
4.24 Majalengka 2 Person 2 times
4.25 Banjar City 2 Person 2 times
4.26 Ciamis 2 Person 2 times
4.27 Pangandaran 2 Person 2 times
Sub Total -
C.5 Transport participant from PHO
5.1 Participant from PHO 9 person 6 times
5.2 Participant from Professional 6 person 2 times
organizations (IDI, IDAI, IBI,
PERSAGI, etc.)
Sub Total -
C.6 Transport for resource person from MoH
6.1 Resource person from MoH 3 person 2 times
Sub Total -
C.7 Fee for the facilitator/resource
person
7.1 Fee Resource person from MoH 3 person 2 session
7.2 Fee Resource person from Private 2 person 1 session
Organization (IDI/IDAI)
7.3 Fee Facilitator from PHO 2 person 3 session
7.4 Fee facilitator from 2 person 1 session
DHO/Puskesmas
7.5 Fee moderator from PHO/DHO 1 person 7 session
7.6 Fee MC 1 person 3 session
7.7 Fee Note taker 1 person 3 day
Sub Total -
C.8 Resource person from PHO WNT
8.1 Flight from WNT to Bandung 1 person 2 times
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8.2 Fee resource person 1 person 1 session

8.3 Accommodation 1 person 2 days
8.4 Allowance 1 person 2 days
8.5 Local transportation 1 person 2 times
Sub Total -
C.9 Accommodation in WJ
9.1 Accommodation for participant 27 room 3 nights
from DHO
9.2 Accommodation for resource 3 room 3 nights
person from MoH
9.3 Accommodation for EO 2 room 3 nights
Sub Total -
C.10 Meeting package

10.1 Meeting package including the 74 person 2 day

venue and meals for review
meeting
10.2 Meeting package including the 81 person 1 day
venue and meals for advocacy
meeting
Sub Total -
C.11 Field Visit to Puskesmas
11.1 Rental car from venue to 8 car 1 day
Puskesmas including parking and
vehicle
11.2 Room rental in Puskesmas (rent 1 ls 1 time
chairs, LCD, sound system)
11.3 Snack meeting in Puskesmas 91 box 1 time
Sub Total -
D. Meeting in West Nusa Tenggara Rp -

D.1 Transport for participant from DHO

1.1 Participant from West Lombok 2 Person 2 times
Barat to Mataram
1.2 Participant from North Lombok to 2 Person 2 times
Mataram
1.3 Participant from Central Lombok 2 Person 2 times
to Mataram
1.4 Participant from East Lombok to 2 Person 2 times
Mataram
1.5 Participant from Mataram city to 2 Person 2 times
venue meeting
1.6 Participant from Sumbawa Barat 2 Person 2 times
to Mataram
1.7 Participant from Sumbawa to 2 Person 2 times
Mataram
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1.8 Participant from Dompu to 2 Person 2 times

Mataram
1.9 Participant from Bima to Mataram 2 Person 2 times
1.10 Participant from Bima City to 2 Person 2 times
Mataram
Sub Total -
D.2 Transport for participant from PHO
2.1 Resource person from PHO 9 person 2 times
2.2 Participants from Professional 4 person 2 times
organization
Sub Total -
D.3 Transport for participant from MoH
3.1 Flight ticket from Jakarta to WNT 3 person 1 time
3.2 Local transport from home to 3 person 4 times
airport, airport to hotel
Sub Total -
D.4 Transport for EO
4.1 Flight ticket from Jakarta to WNT 3 person 1 time
4.2 Car Rental 1 car 3 days
Sub Total -
D.5 Allowance
5.1 Facilitator from Jakarta 3 person 3 days
5.2 Facilitator from Province 9 person 2 days
5.3 Participant from professional 3 person 2 days
organizations
5.4 Participant from outside Lombok 10 person 2 days
5.5 Participant from Lombok Island 10 person 3 days
Sub Total -
D.6 Fee
6.1 Fee Resource person from MoH 2 person 2 session
6.2 Fee resource person from 1 person 1 session
Professional organization
6.3 Fee Facilitator from PHO 2 person 3 session
6.4 Fee facilitator from DHO 2 person 1 session
6.5 Fee moderator from PHO/DHO 1 person 5 session
6.6 Fee MC 1 person 2 times
6.7 Fee Note taker 1 person 2 day
Sub Total -
D.7 Accommodation in WNT
7.1 Accommodation for participant 12 room 2 nights
from DHO

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7.2 Accommodation for resource 3 room 4 nights

person from MoH
7.3 Accommodation for EO 2 room 4 nights
Sub Total -
D.8 Meeting package including the 40 person 2 day -
venue and meals
Sub Total -
D.9 Field Visit to Puskesmas
9.1 Rental car from venue to 7 car 1 day
Puskesmas including parking and
vehicle
9,2 Room rental in Puskesmas 1 ls 1 time
9.3 Snack meeting in Puskesmas 40 box 1 time
Sub Total -
E Reporting Rp -
1.1 Report writing in English 3 provinc 1 ls
e
1.2. Printing report (6 set are for:MoH, 6 set 1 time
NI, Banten, WNT and West Java)
1.3 Communication including sending 3 provinc 1 ls
the invitation letter e
Sub-Total -
F Logistic Rp -
1.1 Backdrop/banner 5 pcs 1 time
1.2 workshop kit ( USB stick, bag, 170 person 1 set
Agenda)
1.3 Other supplies (photocopy 3 provinc 1 time
handout/others) e
1.4 Photographer 5 event 1 packag
e
Sub-Total -
Subtotal Direct Cost A + B+C+D+E+F Rp -

Indirect Cost -

Total Cost -

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