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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
B05BA02 LIPIDEM G Triglycerides, Medium Chain - 100g/500ml, Soya bean oil - 80g/500ml, Omega-3 acid triglicerides - 20g/500ml Injectable emulsion 2,486,109 L.L
N04AA01 BENZHEXOL G Trihexyphenidyl - 5mg 5mg Tablet, scored 533,697 L.L
C01EB15 VASTAREL B Trimetazidine - 35mg 35mg Tablet, film coated, modified release 1,053,573 L.L
C01EB15 CARMETADIN G Trimetazidine - 35mg 35mg Tablet, film coated, modified release 631,606 L.L
J01EE01 BACTRIM FORTE B Trimethoprim - 160mg, Sulfamethoxazole - 800mg Tablet 344,024 L.L
J01EE01 CO-TRIMOXAZOLE G Trimethoprim - 160mg, Sulfamethoxazole - 800mg Tablet 7,529,090 L.L
J01EE01 CO-TRIMOXAZOLE G Trimethoprim - 160mg, Sulfamethoxazole - 800mg Tablet 183,019 L.L
J01EE01 PAEDIATRIC CO-TRIMOXAZOLE MIXTURE G Trimethoprim - 40mg/5ml, Sulfamethoxazole - 200mg/5ml Suspension 190,698 L.L
L02AE04 DECAPEPTYL LP B Triptorelin (pamoate) - 11.25mg 11.25mg Injectable powder for suspension+diluent 31,761,098 L.L
L02AE04 DECAPEPTYL LP B Triptorelin (pamoate) - 3mg 3mg Injectable powder for suspension+diluent 11,778,312 L.L
L02AE04 DECAPEPTYL B Triptorelin - 0.1mg 0.1mg Injectable lyophilised powder for solution+diluent 2,366,507 L.L
L02AE04 GONAPEPTYL CR B Triptorelin - 3.75mg 3.75mg Injectable powder for suspension+diluent 12,095,730 L.L
L02AE04 GONAPEPTYL B Triptorelin acetate - 0.1mg 0.1mg Injectable solution 4,637,600 L.L
D02AX BIAFINE B Trolamine - 0.67g/100g 0.67g/100g Emulsion 524,099 L.L
S01FA06 MYDRIACYL B Tropicamide - 1% 1% Drops solution 430,030 L.L
S01FA06 TROPICIL TOP G Tropicamide - 10mg/ml 10mg/ml Drops solution 200,233 L.L
G04BD09 SPASMEX B Trospium chloride - 30mg 30mg Tablet, film coated 2,564,051 L.L
G04BD09 SPASMEX B Trospium chloride - 30mg 30mg Tablet, film coated 2,564,051 L.L
B02BD02 NOVOEIGHT BioTech Turoctocog Alfa - 500IU 500IU Injectable powder for solution+diluent 29,783,973 L.L
B02BD02 ESPEROCT BioTech Turoctocog Alfa pegol (recombinant coagulation factor VIII) - 1000IU/Vial 1000IU/Vial Injectable powder for solution+diluent 69,025,408 L.L
B02BD02 ESPEROCT BioTech Turoctocog Alfa pegol (recombinant coagulation factor VIII) - 500IU/Vial 500IU/Vial Injectable powder for solution+diluent 38,126,657 L.L
D06AX08 TYROSUR G Tyrothricin - 1mg/g 1mg/g Gel 510,660 L.L
G03AD02 ELLAONE B Ulipristal acetate - 30mg 30mg Tablet 2,276,469 L.L
L04AA44 RINVOQ B Upadacitinib - 15mg 15mg Tablet, prolonged release 45,469,094 L.L
C02CA06 TACHYBEN G Urapidil - 25mg/5ml 25mg/5ml Injectable solution 1,439,255 L.L
G03GA04 FOSTIMON BioHuman Urofollitropin - 150IU 150IU Injectable lyophilised powder for solution+diluent 36,347,120 L.L
G03GA04 FOSTIMON BioHuman Urofollitropin - 75IU 75IU Injectable lyophilised powder for solution+diluent 15,744,000 L.L
A05AA02 URSOFALK B Ursodeoxycholic acid - 250mg 250mg Capsule 2,823,413 L.L
L04AC05 STELARA BioTech Ustekinumab - 130mg 130mg Injectable concentrate for solution 214,532,009 L.L
L04AC05 STELARA BioTech Ustekinumab - 45mg 45mg Injectable solution 143,682,251 L.L
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    169
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