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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
A04AD GRAVOL B Dimenhydrinate - 15mg/5ml 15mg/5ml Liquid 258,018 L.L
A10BD19 GLYXAMBI B Linagliptin - 5mg, Empagliflozin - 10mg Tablet, film coated 4,162,216 L.L
B01AF01 XARELTO B Rivaroxaban - 2.5mg 2.5mg Tablet, film coated 4,045,168 L.L
D07XC01 DIPROSALIC B Salicylic acid - 30mg/g, Betamethasone (dipropionate) - 0.5mg/g Ointment 352,087 L.L
J07BM03 GARDASIL 9 HUMAN PAPILLOMAVIRUS 9- VALENT VACCINE RECOMBINANT B Papillomavirus (human type 6) - 30mcg/0.5ml, Papillomavirus (human type 11) - 40mcg/0.5ml, Papillomavirus (human type 16) - 60mcg/0.5ml, Papillomavirus (human type 18) - 40mcg/0.5ml, Papillomavirus (human type 31) - 20mcg/0.5ml, Papillomavirus (human type 33) - 20mcg/0.5ml, Papillomavirus (human type 45) - 20mcg/0.5ml, Papillomavirus (human type 52) - 20mcg/0.5ml, Papillomavirus (human type 58) - 20mcg/0.5ml Injectable suspension 14,139,396 L.L
L04AA37 OLUMIANT B Baricitinib - 4mg 4mg Tablet, film coated 68,053,864 L.L
M01AH05 ARCOXIA B Etoricoxib - 120mg 120mg Tablet, film coated 603,385 L.L
N06BA04 CONCERTA B Methylphenidate HCl - 18mg 18mg Tablet, extended release 3,133,841 L.L
A04AD GRAVOL B Dimenhydrinate - 50mg 50mg Tablet 163,949 L.L
J07CA LANTIGEN B B Streptococcus pneumoniae type 3 (antigenic extracts) - 63.2A.U./ml, Streptococcus pyogenes group A (antigenic extracts) - 126.2A.U./ml, Branhamella catarrhalis (antigenic extracts) - 39.9A.U./ml, Staphylococcus aureus (antigenic extracts) - 79.6A.U./ml, Haemophilus influenzae type b (antigenic extracts) - 50.2A.U./ml, Klebsiella pneumoniae (antigenic extracts) - 39.8A.U./ml Drops suspension 916,501 L.L
L04AA42 MAYZENT B Siponimod - 0.25mg 0.25mg Tablet, film coated 15,102,158 L.L
N02BE01 CHILDREN'S PANADOL 5-12 YEARS B Paracetamol - 240mg/5ml 240mg/5ml Elixir 356,118 L.L
R03BB06 SEEBRI BREEZHALER B Glycopyronium Bromide - 50mcg 50mcg Capsule, inhalation 2,687,685 L.L
S01EA05 LUMIFY B Brimonidine tartrate - 0.025% Drops solution 1,888,099 L.L
A04AD GRAVOL B Dimenhydrinate - 100mg 100mg Suppository 294,302 L.L
A10BD19 GLYXAMBI B Linagliptin - 5mg, Empagliflozin - 25mg Tablet, film coated 4,162,216 L.L
B01AF01 XARELTO B Rivaroxaban - 15mg 15mg Tablet, film coated 4,440,862 L.L
C02KX04 OPSUMIT B Macitentan - 10mg 10mg Tablet, film coated 201,006,231 L.L
J07CA02 TETRAXIM (Vaccin Diphterique, tetanique, coquelucheux acellulaire et Poliomyelitique inactivé adsorbé) B Diphteria toxoid purified - ?30IU, Tetanus toxoid purified - ?40IU, Poliomyelitis virus type 1 inactivated - 40D.U., Poliomyelitis virus type 2 inactivated - 8D.U., Poliomyelitis virus type 3 inactivated - 32D.U., Bordetella Pertussis Antigens: toxoid - 25mcg, Bordetella Pertussis Antigens: filamentous haemagglutinin - 25mcg Injectable suspension 1,628,737 L.L
L01EX02 NEXAVAR B Sorafenib - 200mg 200mg Tablet, film coated 78,439,230 L.L
L04AA42 MAYZENT B Siponimod - 0.25mg 0.25mg Tablet, film coated 124,258,444 L.L
R03BB08 YUPELRI B Revefenacin - 175mcg/3ml 175mcg/3ml Inhalation solution 3,104,276 L.L
S01EB02 MIOSTAT STERIL INTRAOCULAR B Carbachol - 0.01% 0.01% Solution 8,117,591 L.L
A10BD19 GLYXAMBI B Linagliptin - 5mg, Empagliflozin - 25mg Tablet, film coated 4,162,216 L.L
C02LA51 ADELPHAN ESIDREX B Reserpine - 0.1mg, Hydrochlorothiazide - 10mg, Dihydralazine - 10mg Tablet 371,157 L.L
C09CA01 COZAAR B Losartan potassium - 100mg 100mg Tablet 1,740,596 L.L
D07XC04 TRAVOCORT B Diflucortolone valerate - 0.1%, Isoconazole nitrate - 1% Cream 435,405 L.L
J07CA06 INFANRIX IPV + HIB B Poliomyelitis virus type 3 inactivated(Prefilled syringe) - 32D.U., Poliomyelitis virus type 2 inactivated(Prefilled syringe) - 8D.U., Poliomyelitis virus type 1 inactivated(Prefilled syringe) - 40D.U., Bordetella pertussis antigen(Prefilled syringe) - toxoid 25mcg+filamentous haemaglutinin 25mcg+pertactin 8mcg, Tetanus toxoid (Prefilled syringe) - ?40IU, Diphtheria toxoid (Prefilled syringe) - ?30IU, H. Influenza type b polysaccharide(Vial) - 10mcg Injectable dry powder+suspension 3,014,239 L.L
L01EX03 VOTRIENT B Pazopanib HCl - 400mg 400mg Tablet, film coated 81,982,780 L.L
L04AA42 MAYZENT B Siponimod - 2mg 2mg Tablet, film coated 124,258,444 L.L
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