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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
J01CR02 AUGMENTIN B Amoxicillin (trihydrate) - 875mg, Clavulanic Acid (potassium) - 125mg 1g Tablet 713,561 L.L
J07AL02 PREVENAR 20 B Pneumococcal polysaccharide for serotypes 1, 3, 4, 5 , 6A, 7F,8, 9V,10A, 11A, 12F, 14, 15B, 18C, 19A, 19F,22F, 23F, 33F (2.2mcg) Pneumococcal polysaccharide for serotypes 6B (4.4mcg)Conjugated to CRM197 carrier protein (approximately 51mcg) adsorbed on aluminium phosphate (0.125mg aluminium) - Injectable suspension 7,415,107 L.L
L01EF03 VERZENIO B Abemaciclib - 100mg 100mg Tablet 76,122,299 L.L
L04AA10 RAPAMUNE B Sirolimus - 1mg 1mg Tablet 12,907,489 L.L
N04BC09 NEUPRO B Rotigotine - 4mg/24h 4mg/24h Patch 7,292,823 L.L
R03AL01 ATROVENT COMP. HFA B Fenoterol Hydrobromide - 20mcg/actuation, Ipratropium bromide - 50mcg/actuation Inhalation aerosol metered dose 847,965 L.L
L04AD02 PROGRAF 1MG B Tacrolimus - 1mg 1mg Capsule L.L
A10BD07 JANUMET XR B Metformin HCl - 1,000mg, Sitagliptin - 50mg Tablet 4,777,360 L.L
B01AC06 ASPIRIN PROTECT B Acetylsalicylic acid - 100mg 100mg Tablet, enteric coated 146,479 L.L
J07AL02 VAXNEUVANCE B Pneumococcal polysaccharide for serotypes 1, 3, 4, 5 , 6A, 7F, 9V,14, 18C, 19A, 19F, 22F, 23F,33F (2mcg) Pneumococcal polysaccharide for serotypes 6B (4.4mcg) Conjugated to CRM197 carrier protein and adsorbed on aluminium phosphate adjuvant - Injectable suspension 6,988,413 L.L
L01EG02 AFINITOR B Everolimus - 5mg 5mg Tablet 131,002,184 L.L
N04BC09 NEUPRO B Rotigotine - 6mg/24h 6mg/24h Patch 9,427,593 L.L
R03AL02 COMBIVENT B Salbutamol (sulfate) - 2.5mg/2.5ml, Ipratropium bromide - 500mcg/2.5ml Inhaltion solution with nebuliser 745,833 L.L
L04AD02 PROGRAF 5MG B Tacrolimus - 5mg 5mg Capsule L.L
A10BD07 JANUMET XR B Metformin HCl - 1,000mg, Sitagliptin - 100mg Tablet 4,777,360 L.L
C01EB15 VASTAREL B Trimetazidine - 35mg 35mg Tablet, film coated, modified release 1,053,573 L.L
D07AC13 ELOCOM B Mometasone furoate - 1mg/g 0.1% Lotion 282,207 L.L
J07AP03 TYPHIM VI B Salmonella typhi polysaccharides - 0.025mg/0.5ml 0.025mg/0.5ml Injectable solution 1,118,077 L.L
L04AA13 ARAVA B Leflunomide - 10mg 10mg Tablet, film coated 2,230,779 L.L
M01AG01 PONSTAN FORTE B Mefenamic acid - 500mg 500mg Tablet, film coated 219,046 L.L
N04BC09 NEUPRO B Rotigotine - 8mg/24h 8mg/24h Patch 12,394,936 L.L
N06AX16 EFEXOR XR B Venlafaxine (HCl) - 150mg 150mg Capsule, sustained release 817,056 L.L
J07AP03 TYPHIBEV TYPHOID CONJUGATED VACCINE (MONOVALENT) B Salmonella typhi polysaccharides Vi purified - 25mcg of Vi-PS2/0.5ml Injectable suspension 4,020,777 L.L
L01EA04 BOSULIF B Bosutinib - 400mg 400mg Tablet, film coated L.L
A04AA01 ZOFRAN INJECTION B Ondansetron (HCl dihydrate) - 8mg/4ml 8mg/4ml Injectable solution 8,558,143 L.L
C01EB17 PROCORALAN B Ivabradin (HCl) - 5mg 5mg Tablet, film coated 1,890,786 L.L
C09BA03 ZESTORETIC B Lisinopril (dihydrate) - 20mg, Hydrochlorothiazide - 12.5mg Tablet 663,858 L.L
G04BE03 VIAGRA B Sildenafil (citrate) - 100mg 100mg Tablet, film coated 2,089,675 L.L
J07AX URO-VAXOM B Lyophilized bacterial lysates of E-Coli - 6mg 6mg Capsule 2,689,029 L.L
L01EG02 AFINITOR B Everolimus - 10mg 10mg Tablet 188,584,849 L.L
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