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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
P01AB01 METRONIDAL G Metronidazole benzoate - 125mg/5ml 125mg/5ml Syrup 245,731 L.L
R05DB13 TUSSIN G Butamirate citrate - 7.5mg/5ml 7.5mg/5ml Syrup, sugar free 154,862 L.L
V03AC03 DIFIRAX G Deferasirox - 500mg 500mg Tablet, dispersible 38,637,010 L.L
A02BC05 EXONAR G Esomeprazole (magnesium trihydrate) - 40mg 40mg Capsule, delayed release 639,925 L.L
A11EA CAL-VIT G Riboflavine - 3mg, Cyanocobalamine - 60mcg, Pyridoxine HCl - 5mg, Thiamine mononitrate - 10mg, Inositol - 3mg, Calcium pantothenate - 3mg Tablet 142,063 L.L
B05XA03 SODIUM CHLORIDE 0.9% INJECTION USP G Sodium chloride - 0.9% 0.9% Injectable solution 156,288 L.L
H02AB06 PREDOXONE G Prednisolone sodium phosphate - 15mg/5ml 15mg/5ml Solution 417,231 L.L
J02AX05 MEGMENTO G Micafungin (sodium) - 100mg 100mg Injectable powder for solution 17,158,569 L.L
L01XG01 ALVOCADE G Bortezomib - 3.5mg 3.5mg Injectable powder for solution 14,169,600 L.L
L04AX07 MAROVAREX G Dimethyl Fumarate - 120mg 120mg Capsule, hard, gastro-resistant 9,838,676 L.L
M05BA07 PMS-RISEDRONATE G Risedronate sodium - 35mg 35mg Tablet 674,609 L.L
P01AB01 PHOSVIT G Metronidazole benzoate - 125mg/5ml 125mg/5ml Suspension 207,336 L.L
V03AC03 ENFEROX G Deferasirox - 500mg 500mg Tablet, dispersible 37,720,158 L.L
A02BC05 METAPRO G Esomeprazole - 40mg 40mg Tablet, gastroresistant 639,669 L.L
A11EA CAL-VIT G Riboflavine - 3mg, Cyanocobalamine - 60mcg, Pyridoxine HCl - 5mg, Thiamine mononitrate - 10mg, Inositol - 3mg, Calcium Pantothenate - 3mg Tablet 4,025,128 L.L
B05XA03 SODIUM CHLORIDE 0.9% INJECTION USP G Sodium chloride - 0.9% 0.9% Injectable solution 165,482 L.L
C09DA08 OLMENOR PLUS G Olmesartan medoxomil - 40mg, Hydrochlorothiazide - 25mg Tablet, film coated 653,107 L.L
H02AB06 XILONE FORTE G Prednisolone sodium phosphate - 15mg/5ml 15mg/5ml Solution 413,903 L.L
J01DD15 SEFARIN G Cefdinir - 125mg/5ml 125mg/5ml Suspension 1,695,929 L.L
L01XG01 BORCADE G Bortezomib - 3.5mg 3.5mg Injectable lyophilised powder 11,020,381 L.L
L04AX07 MAROVAREX G Dimethyl Fumarate - 240mg Capsule, hard, gastro-resistant 60,848,734 L.L
M05BA07 RISEDRONATE ARROW G Risedronate sodium - 35mg 35mg Tablet, film coated 671,921 L.L
N03AX09 LAMOTRIGINE ARROW LAB G Lamotrigine - 50mg 50mg Tablet, dispersible/ chewable 1,052,229 L.L
P01AB01 PHOZOLE G Metronidazole benzoate - 125mg/5ml 125mg/5ml Suspension 207,336 L.L
R05DB21 PRIVITUSS G L-Cloperastine - 708mg/100ml 708mg/100ml Suspension 801,186 L.L
V03AC03 DEFERASIROX ARROW G Deferasirox - 90mg 90mg Tablet 8,846,092 L.L
A02BC05 PUMPINOX G Esomeprazole - 40mg 40mg Tablet, enteric coated 649,076 L.L
A11EA COMBEDOX G Thiamine HCl - 100mg/2ml, Pyridoxine HCl - 100mg/2ml, Cyanocobalamin - 1000mcg/2ml, Dexpanthenol - 50mg/2ml, Nicotinamide - 100mg/2ml Injectable solution 374,996 L.L
B05XA03 SODIUM CHLORIDE 0.9% INJECTION, USP G Sodium chloride - 0.9% 0.9% Injectable solution 176,974 L.L
G02CB03 PROCTIN G Cabergoline - 0.5mg 0.5mg Tablet 350,679 L.L
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