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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
J05AR03 TRUVADA B Emtricitabine - 200mg, Tenofovir disoproxil - 245mg Tablet, film coated 20,507,286 L.L
M01AB55 DIFEN B12 G Diclofenac potassium - 50mg, Betamethasone - 0.3mg, Cyanocobalamin - 5mg Tablet 503,941 L.L
A03CB01 RESTROPINAL PEDIATRIC B Butobarbital - 2mg/ml, Methyl hyoscine nitrate - 0.1mg/ml Drops 197,097 L.L
B05BB01 RINGER'S INJECTION, USP G Calcium chloride, 2H2O - 0.33g/l, Potassium chloride - 0.3g/l, Sodium chloride - 8.6g/l Injectable solution 154,450 L.L
C09DX01 LOTEVAN PLUS G Valsartan - 160mg, Amlodipine - 5mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 857,372 L.L
D06AX TRIPLE ANTIBIOTIC ORIGINAL OINTMENT Bacitracin - 400U, Neomycin (sulfate) - 3.5mg, Polymyxin B (sulfate) - 5000U 580,540 L.L
J05AR03 EMZAVIR G Emtricitabine - 200mg, Tenofovir disoproxil fumarate - 300mg Tablet, film coated 18,701,506 L.L
M01AB55 DIOXAFLEX B12 G Diclofenac sodium - 75mg, Betamethasone (sodium phosphate) - 2mg, Hydroxocobalamin sulphate - 10mg Injectable solution 1,104,639 L.L
A03DB04 PANADOL WOMAN B Paracetamol - 500mg, Hyoscine butylbromide - 10mg Tablet, coated 436,749 L.L
B05BB01 R-SOL G Calcium chloride, 2H2O - 0.033%, Potassium chloride - 0.03%, Sodium chloride - 0.86% Injectable solution 205,933 L.L
C09DX01 VIOSTAN AM PLUS 160/5/12.5 G Valsartan - 160mg, Amlodipine - 5mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 1,196,020 L.L
J05AR06 VITRICOMB G Emtricitabine - 200mg, Tenofovir disoproxil fumarate - 300mg, Efavirenz - 600mg Tablet, film coated 22,191,783 L.L
M01AB55 DIOXAFLEX B12 G Diclofenac sodium - 75mg, Betamethasone (sodium phosphate) - 2mg, Hydroxocobalamin sulphate - 10mg Injectable solution 620,855 L.L
N01BB52 DILOCAIN 2% G Lidocaine HCl - 20mg/1.7ml, Epinephrine (bitartrate) - 0.0125mg/1.7ml Injectable solution 2,768,316 L.L
R01AB01 VAPICIL MICRODOSER G Phenylephrine - 2.5mg/ml, Dimethindene maleate - 0.25mg/ml Spray 239,204 L.L
A03E ACTICARBINE G Activated charcoal - 70mg, Papaverine HCl - 14mg Tablet, coated 311,771 L.L
B05BB01 SERUFLEX RINGER'S INJECTION, USP G Calcium chloride, 2H2O - 0.33g/l, Potassium chloride - 0.3g/l, Sodium chloride - 8.6g/l Injectable solution 204,554 L.L
C09DX01 ANGIOSAR PLUS G Valsartan - 320mg, Amlodipine - 10mg, Hydrochlorothiazide - 25mg Tablet, film coated 1,689,210 L.L
J05AR10 KALUVIA G Lopinavir - 200mg, Ritonavir - 50mg Tablet, film coated 7,632,790 L.L
M01AB55 PANCLO B12 G Diclofenac sodium - 75mg, Betamethasone disodium phosphate - 2mg, Hydroxocobalamin sulphate - 10mg Injectable solution 1,158,392 L.L
N01BB53 MEDICAINE 2% WITH ADRENALINE G Mepivacaine HCl - 36mg/1.8ml, Epinephrine (tartrate) - 0.032mg/1.8ml Injectable solution 1,652,926 L.L
R01AB06 TRIOFAN B Xylometazoline HCl - 0.5mg/ml, Carbocysteine - 5mg/ml Spray, solution 608,761 L.L
A03E MEPHIGASTRYL G Belladone powder - 0.005g, Magnesium hydroxide - 0.1g, Meprobamate - 0.1g, Prochlorperazine maleate - 0.01g Capsule 296,925 L.L
B05BB01 SOLUFLEX RINGER'S INJECTION, USP G Calcium chloride, 2H2O - 0.33g/l, Potassium chloride - 0.3g/l, Sodium chloride - 8.6g/l Injectable solution 221,792 L.L
C09DX01 VIOSTAN AM PLUS 320/10/25 G Valsartan - 320mg, Amlodipine - 10mg, Hydrochlorothiazide - 25mg Tablet, film coated 1,881,380 L.L
J05AR12 TELADINE G Lamivudine - 300mg, Tenofovir disoproxil fumarate - 300mg Tablet 17,454,739 L.L
L02BB06 NUBEQA B Darolutamide - 300mg Tablet, film coated 452,633,527 L.L
M01AB55 DIFEN B12 G Diclofenac sodium - 75mg, Prednisolone sodium phosphate - 10.08mg, Hydroxocobalamin acetate - 10.44mg Injectable solution 978,317 L.L
R01AB06 TRIOFAN B Xylometazoline HCl - 1mg/ml, Carbocysteine - 10mg/ml Spray, solution 646,388 L.L
R06AE55 VOMINORE-JPM G Meclozine HCl - 25mg, Pyridoxine HCl - 50mg Tablet 259,362 L.L
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