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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
M03AX01 BOTOX BioTech Clostridium botulinum type A neurotoxin complex - 100U 100U Injectable powder for solution 18,625,995 L.L
L01XG01 BORTEZOMIB ACCORD G Bortezomib - 3.5mg 3.5mg Injectable powder for solution 13,007,658 L.L
L01XG01 BORTEZOMIB GP PHARM G Bortezomib - 3.5mg 3.5mg Injectable powder for solution 13,007,658 L.L
L01XG01 BORTEZOMIB SPC G Bortezomib - 3.5mg 3.5mg Injectable powder for solution 15,743,401 L.L
L01DC01 BLEO-CELL G Bleomycin (sulfate) - 15mg 15mg Injectable powder for solution 3,054,554 L.L
B02BD04 BENEFIX BioTech Nonacog alfa (recombinant coagulation factor IX) - 500IU 500IU Injectable powder for solution+diluent 27,390,281 L.L
B02BD04 BENEFIX BioTech Nonacog alfa (recombinant coagulation factor IX) - 500IU 500IU Injectable powder for solution+diluent L.L
L01FB01 BESPONSA FOR INJECTION BioTech Inotuzumab Ozogamicin - 0.9mg 0.9mg Injectable powder for suspension 921,176,511 L.L
L03AX03 BCG-MEDAC G BCG seed RIVM derived from seed 1173-P2 - 2x10? to 3x10? viable units Injectable powder for suspension+diluent 13,873,850 L.L
S01LA06 BEOVU BioTech Brolucizumab - 120mg/ml 120mg/ml Injectable solution 68,669,378 L.L
L01FG01 BEVACIREL BioTech Bevacizumab - 400mg/16ml 400mg/16ml Injectable solution 49,744,595 L.L
L01FG01 BEVACIREL BioTech Bevacizumab - 100mg/4ml 100mg/4ml Injectable solution 14,719,570 L.L
V03AB35 BRIDION B Sugammadex - 100mg/ml 100mg/ml Injectable solution 54,230,830 L.L
M05BA06 BONVIVA B Ibandronic acid - 3mg/3ml 3mg/3ml Injectable solution 3,144,591 L.L
V03AF03 BENDAFOLIN G Calcium folinate - 200mg/20ml 200mg/20ml Injectable solution 3,584,028 L.L
B03XA01 BINOCRIT BioTech Erythropoietin recombinant human (Epoetin alfa) - 2,000IU/ml 2,000IU/ml Injectable solution 6,195,623 L.L
B03XA01 BINOCRIT BioTech Erythropoietin recombinant human (Epoetin alfa) - 4,000IU/0.4ml 4,000IU/0.4ml Injectable solution 5,582,795 L.L
B03XA01 BINOCRIT BioTech Erythropoietin recombinant human (Epoetin alfa) - 10,000IU/ml 10,000IU/ml Injectable solution 17,590,239 L.L
B03XA01 BINOCRIT BioTech Erythropoietin recombinant human (Epoetin alfa) - 40,000IU/ml 40,000IU/ml Injectable solution 11,726,826 L.L
A10AE04 BASAGLAR KWIKPEN BioTech Insulin glargine - 100U/ml 100U/ml Injectable solution 4,114,846 L.L
A11EA BECOZYME B Vitamin B5 - 6mg/2ml, Vitamin B6 - 4mg/2ml, Vitamin PP - 40mg/2ml, Vitamin B2 - 5.47mg/2ml, Vitamin B1 - 10mg/2ml Injectable solution 662,514 L.L
N01BB01 BUPIVACAINE AGUETTANT for spinal anaesthesia G Bupivacaine HCl - 20mg/4ml 20mg/4ml Injectable solution 1,554,826 L.L
N01BB01 BUPIVACAINE HEAVY PANPHARMA G Bupivacaine HCl - 20mg/4ml 20mg/4ml Injectable solution 2,586,897 L.L
N01BB01 BUPIVACAINE AGUETTANT 2.5MG/ML G Bupivacaine HCl - 50mg/20ml 50mg/20ml Injectable solution 2,736,063 L.L
N01BB01 BUPIVACAINE AGUETTANT 5MG/ML G Bupivacaine HCl - 100mg/20ml 100mg/20ml Injectable solution 3,078,743 L.L
G03DA04 BIOGEST BioTech Progesterone, bio-identical - 100mg/2ml 100mg/2ml Injectable solution 2,328,879 L.L
L01FG01 BEVACIREL BioTech Bevacizumab - 400mg/16ml 400mg/16ml Injectable solution L.L
L01FG01 BEVACIREL BioTech Bevacizumab - 100mg/4ml 100mg/4ml Injectable solution L.L
L03AB07 BLASTOFERON BioTech Interferon beta-1a - 44mcg 44mcg Injectable solution 55,847,685 L.L
L03AB07 BLASTOFERON BioTech Interferon beta-1a - 22mcg 22mcg Injectable solution 40,725,735 L.L
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