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Lebanon Health Resilience Project in Collaboration with the World Bank

 
Background
Achieving Universal Health Coverage is a main goal of the Ministry of Public Health (MoPH) National Health Strategy, and is based on the principles of justice, equity, poverty reduction and the rational use of resources. It requires providing quality health care for all, satisfying individual needs while alleviating the financial burden, on households, especially the poor.
 
Since the development of the national primary healthcare network, scaling up the primary healthcare system and reducing out of pocket payments have been a major goal for the MoPH.  However, the Syrian crisis has placed a large and additional burden on the healthcare system in Lebanon with the primary care system at the frontline.
 
Realizing the urgent need to address the emerging health crisis especially in underserved host communities, the MoPH developed an emergency program aimed at expanding Primary Health Care (PHC) coverage to the uninsured poor in Lebanon.  Accordingly, the MOPH developed a basic benefit package of essential preventive healthcare services (vaccination, screening visits...) and pilot tested this model through the World Bank supported project:

Emergency Primary Healthcare Restoration project (EPHRP) (2016-2019). The US$ 15 Million project targeted 150,000 poor Lebanese identified through the National Poverty Targeting Program (NPTP) developed by the Ministry of Social Affairs. Based on the successful implementation of the EPHRP, the MoPH is scaling up the program through a new Lebanon Health Resilience (LHR) Project.  LHR aims to ‎ increase access to quality health care services to poor Lebanese and displaced Syrians in Lebanon.‎ The main project beneficiaries are as follows:
 
  1. Poor Lebanese and displaced Syrians: These vulnerable populations will benefit from improved health services and a more comprehensive package of PHC services that addresses their health needs.
  2. Primary Health Care Centers. The project will benefit MoPH network by upgrading the capacity of the PHCCs and the skills of health workers and managers to effectively manage the increased demand for health care while delivering quality care during and after the crisis.
  3. Public hospitals. The project will benefit public hospitals by upgrading and refurbishing their equipment, training their staff, and improving the cash flow to enhance the quality and efficiency of their operation.
  4. The MoPH. The project will contribute to maintaining the MoPH’s commitment to deliver services to vulnerable populations and will build central-level capacity for planning and project management.
 
Project Objectives
  1. Scaling up the scope and capacity of the PHC Universal Health Coverage program:
 
  1. Increasing the number of beneficiaries from 150000 to 340,000 poor Lebanese provided with essential health services at primary healthcare centers
  2. Strengthening the capacities of all the 204 PHCCs in the National PHC Network for the provision of the basic benefit packages
 
  1. Provision of outpatient healthcare services in public hospitals
 
  1. Provide coverage for outpatient services to vulnerable Lebanese in public hospitals
  2. Strengthen of the technical and organizational capacities of participating public hospitals for provision of quality healthcare services
 
Environmental and Social Safeguards Management Framework
This section analyses the environmental and social impacts associated with activities undertaken by Lebanon Health Resilient Project (LHRP) and provides a framework for social and environmental management.
 
Restructuring of Lebanese Health Resilience Project
 
Lebanon Health Resilience Project (LHRP) was initiated by the Ministry of Public Health (MoPH) in 2017 with the support of the World Bank (WB). LHRP will undergo a restructuring to support the Government Of Lebanon (GOL) to mitigate the impact of the COVID-19 outbreak. The restructuring responds to a request from the GOL dated March 27, 2020 to add a new component to the Project on COVID-19 preparedness and response (Component 4) that will allow for immediate support to assess country preparedness, multi-sectoral response capabilities, and to finance the procurement of medical goods and equipment, and capacity-building and training of health workers and front-line responders. An Environmental and Social Management Framework (ESMF) was prepared for the Project, consulted on, disclosed and cleared by the World Bank (WB) in May 2019 [1]. The WB team requested an update of the ESMF in the form of an addendum that tackles the additional environmental, health and safety measures that need to be considered to cover the environmental and social risks under Component 4.

[1] The ESMF was disclosed as Environmental and Social Safeguard Framework (ESSF). In this document both terms ESMF and ESSF refer to the same report disclosed on May 2019 on the WB website....

Updated Addendum ESMF-LHRP - February 2021
Addendum ESMF-LHRP - July 2020
LEBANON HEALTH RESILIENCE
PROJECT
Original ESMF- May 2019
 
 Reports
 
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ATC Name B/G ↑ Ingredients Dosage Form Price
L01BA04 ALIMTA B Pemetrexed (disodium) - 500mg 500mg Injectable concentrated powder for solution 71,767,770 L.L
S01GX07 ALLERGODIL B Azelastine HCl - 0.5mg/ml 0.5mg/ml Drops solution 709,549 L.L
C05A ANTROLIN B Nifedipine - 0.3%, Lidocaine - 1.5% Cream 1,333,092 L.L
C09CA06 ATACAND B Candesartan cilexetil - 8mg 8mg Tablet 807,649 L.L
A02AF02 ACTONORM B Aluminium hydroxide - 220mg/5ml, Magnesium hydroxide - 200mg/5ml, Simethicone - 25mg/5ml Suspension 425,998 L.L
L01BA04 ALIMTA B Pemetrexed (disodium) - 100mg 100mg Injectable concentrated powder for solution 16,854,009 L.L
S01HA02 ANESTOCIL B Oxybuprocaine HCl (Benoxinate HCl) - 0.4% 0.4% Drops solution 442,124 L.L
C09CA06 ATACAND B Candesartan cilexetil - 16mg 16mg Tablet 1,077,762 L.L
C05BB02 AETHOXYSKLEROL B Polidocanol (Lauromacrogol 400) - 0.5% 0.5% Injectable solution 1,441,943 L.L
N02BG06 ACUPAN B Nefopam HCl - 20mg 20mg Injectable solution 365,525 L.L
C05BB02 AETHOXYSKLEROL B Polidocanol (Lauromacrogol 400) - 1% 1% Injectable solution 1,732,213 L.L
A07EC02 ASACOL B Mesalazine - 400mg 400mg Tablet, enteric coated 5,895,437 L.L
C05BB02 AETHOXYSKLEROL B Polidocanol (Lauromacrogol 400) - 3% 3% Injectable solution 2,576,146 L.L
G04CB02 AVODART B Dutasteride - 0.5mg 0.5mg Capsule 2,568,489 L.L
A07EC02 ASACOL B Mesalazine - 800mg 800mg Tablet 6,833,439 L.L
A07EC02 ASACOL B Mesalazine - 500mg 500mg Suppository 1,703,992 L.L
L04AD02 ADVAGRAF B Tacrolimus monohydrate - 3mg 3mg Capsule, prolonged release 68,645,618 L.L
L04AD02 ADVAGRAF B Tacrolimus monohydrate - 1mg 1mg Capsule, prolonged release 25,729,044 L.L
L04AD02 ADVAGRAF B Tacrolimus monohydrate - 5mg 5mg Capsule, prolonged release 85,485,667 L.L
L04AD02 ADVAGRAF B Tacrolimus monohydrate - 0.5mg 0.5mg Capsule, prolonged release 13,297,758 L.L
J02AA01 AMBISOME B Liposomal Amphotericin B - 50mg 50mg Injectable powder for liposomal dispersion 13,126,040 L.L
A07EC02 ASACOL B Mesalazine - 1g/100ml 1g/100ml Enema 2,748,158 L.L
A07EC02 ASACOL B Mesalazine - 1600mg 1600mg Tablet, modified release 8,454,523 L.L
A07EC02 ASACOL B Mesalazine - 1600mg 1600mg Tablet, modified release 12,310,378 L.L
M04AA03 ADENURIC B Febuxostat - 120mg 120mg Tablet, film coated 2,184,704 L.L
M04AA03 ADENURIC B Febuxostat - 80mg 80mg Tablet, film-scored 2,127,111 L.L
V01AA ACARIZAX 12 SQ-HDM ORAL LYOPHILISATE B Allergen extracts - 12 SQ-HDM Tablet, lyophilised 9,366,451 L.L
M04AA03 ADENURIC B Febuxostat - 40mg 40mg Tablet, film coated 1,687,866 L.L
C10BA05 ATOZET B Atorvastatin - 10mg, Ezetimibe - 10mg Tablet, film coated 4,632,225 L.L
N05AX12 ABILIFY MAINTENA B Aripiprazole - 400mg 400mg Injectable powder for suspension, prolonged release+solvent 29,491,998 L.L
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