Protecting Life in Global Health Assistance (PLGHA)

DUE DILIGENCE CHECKLIST

Name of the Non-US Organization:

For IntraHealth use only: As part of your due diligence of non-US subrecipients, please confirm the legal status of the
organization. If the organization is a parastatal or government organization under USAID assistance, no further due
diligence is required, but funding may not be provided for abortion services or counseling. If the legal status is non-profit or
for-profit, due diligence must be performed. If the legal status is unclear, please, consult with CGP.

Country of Operation:
Please confirm the legal status of abortion in the country where activities will be implemented.

YES NO
Are abortion services legal in country?
If yes, under what conditions/circumstances?
Does the organization offer abortion services?
If yes, under what conditions/circumstances? Please provide a list of services offered.
Is there an official organizational policy on abortion services? If yes, please, attach a copy.

Do educational materials mention or promote abortion as a family planning method?

Include a list of materials reviewed, including a link to web site, if applicable. Attach a copy of materials, if
available.
Do clinic records include statistics on abortion services provided?

PLGHA allows for the provision of abortion in cases of rape or incest or to save the life of the mother, the
treatment of injuries or illnesses caused by legal or illegal abortions such as post abortion care. If abortions
are provided, is the reason appropriately and clearly documented?
If yes, please ask to have a copy of the clinical register or other documentation (with de-identified or
anonymized data only) scanned and shared.
Do healthcare personnel provide advice that abortion is a method of family planning, an available option or
encourage women to consider abortion information, counseling or referrals related to abortion as a family
planning method?
How is the information provided documented?
Does the organization promote or advocate for abortions as a family planning method – you may need to refer
to the definitions from the regulations (provided above)?

Does the organization provide financial support to foreign non-governmental organizations that provide
abortion services?

Will the subrecipient be furnishing assistance under this award to foreign parastatal or governmental
organizations?
If yes, please provide a list of the activities being performed.

Name and Title of Person Completing Form Title Date

By submitting this form, you affirm that you have reviewed the PLGHA
elements and you are a senior representative with authority to sign on
behalf of the organization.

Name and Title of IH Person Confirming Compliance Title Date

By submitting this form, you affirm that you have reviewed the PLGHA
elements with the organizational representative

11/14/2017