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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
A07EA06 BUDENOFALK B Budesonide - 3mg 3mg Capsule 8,554,692 L.L
A11CC05 BENTA D 10.000 G Vitamin D3 - 10,000IU 10,000IU Capsule 895,895 L.L
J01DD08 BETIXIM 400 G Cefixime (trihydrate) - 400mg 400mg Capsule 1,026,696 L.L
A11CC05 BIO-D3 25000IU G Vitamin D3 - 25000IU 25000IU Capsule 1,130,108 L.L
A11CC05 BIO-D3 25000IU G Vitamin D3 - 25000IU 25000IU Capsule 2,147,588 L.L
A11EX BECOZYM FORTE B Nicotinamide - 50mg, Calcium Pantothenate - 25mg, Biotin - 0.15mg, Vitamin B12 - 10mcg, Vitamin B6 - 10mg, Vitamin B2 - 15mg, Vitamin B1 - 15mg Capsule 290,270 L.L
J07AX BRONCHO-VAXOM CHILDREN B Lyophilized bacterial lysates of Haemophilus influenzae, Diplococcus pneumoniae, Klebsiella pneumoniae and ozaenae, Staphylococcus aureus, Streptococcus pyogenes and viridans, Neisseria catarrhalis - 3.5mg Capsule 1,988,887 L.L
J07AX BRONCHO-VAXOM ADULTS B Lyophilized bacterial lysates of Haemophilus influenzae, Diplococcus pneumoniae, Klebsiella pneumoniae and ozaenae, Staphylococcus aureus, Streptococcus pyogenes and viridans, Neisseria catarrhalis - 7mg Capsule 2,746,814 L.L
J01DB05 BIODROXIL G Cefadroxil (monohydrate) - 500mg 500mg Capsule 452,007 L.L
D03AX BEPANTHEN PLUS B Chlorhexidine HCl - 5mg/g, Dexpanthenol - 50mg/g Cream 319,835 L.L
D07AC01 BETNOVATE B Betamethasone (valerate) - 0.1% 0.1% w/w Cream 279,519 L.L
D07AC01 BETASONE G Betamethasone (valerate) - 1mg/g 1mg/g Cream 120,306 L.L
D07CC01 BETAFUCIN G Fusidic acid - 20mg/g, Betamethasone valerate - 1mg/1g Cream 210,983 L.L
D07CC01 BETASONE-N G Neomycin (sulfate) - 3.5mg/g, Betamethasone (valerate) - 1mg/g Cream 398,033 L.L
D07XC01 BETA-MICOTER G Betamethasone (dipropionate) - 0.5mg/g, Clotrimazole - 10mg/g Cream 415,951 L.L
A11A BEBE-VIT G Vitamin A - 1500IU/ml, Vitamin D3 - 400IU/ml, Vitamin E - 5mg/ml, Vitamin C - 40mg/ml, Vitamin B1 - 0.5mg/ml, Vitamin B2 - 0.6mg/ml, Vitamin B6 - 0.6mg/ml, Nicotinamide - 8mg/ml Drops 287,582 L.L
S01GX08 BRUNISTILL G Ketotifen - 250mcg/ml 250mcg/ml Drops solution 940,690 L.L
M01AC01 BRUXICAM B Piroxicam - 0.5% Drops solution 530,818 L.L
S01EA05 BRIMO G Brimonidine tartrate - 0.2% 0.2% Drops solution 658,483 L.L
S01EA05 BRIMOGAN G Brimonidine tartrate - 0.2% w/v 0.2% w/v Drops solution 483,783 L.L
S01EA05 BGLAU G Brimonidine tartrate - 0.2% 0.2% Drops solution 638,325 L.L
S01EA05 BRIMONIDINE BIOGARAN G Brimonidine tartrate - 2mg/ml 0.2% Drops solution 412,560 L.L
R05CB02 BROMHEXINE G Bromhexine - 4mg/5ml 4mg/5ml Elixir 176,619 L.L
R05X BROMEX G Pyrilamine Maleate (Mepyramine) - 12.5mg/5ml, Bromhexine HCl - 4mg/5ml Elixir 250,851 L.L
D02AX BIAFINE B Trolamine - 0.67g/100g 0.67g/100g Emulsion 524,099 L.L
D03AX06 BECAPLEX BioTech Becaplermin - 40mg 0.01% Gel 38,029,953 L.L
D10AE01 BENZAC AC G Benzoyl peroxide - 10g/100g 10% Gel 416,591 L.L
D10AE01 BENZAC AC G Benzoyl peroxide - 5g/100g 5% Gel 388,370 L.L
R03AC02 BUTO-ASMA G Salbutamol - 100mcg 100mcg Inhalation 237,860 L.L
R03AC02 BUTALIN G Salbutamol (sulfate) - 100mcg/dose 100mcg/dose Inhalation aerosol metered dose 145,135 L.L
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