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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
N05AH03 ZYPREXA VELOTAB B Olanzapine - 5mg 5mg Tablet, dispersible 2,607,054 L.L
C03AA03 ESIDREX B Hydrochlorothiazide - 25mg 25mg Tablet 380,115 L.L
J07CA06 PENTAXIM 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, Tetanus toxoid (Prefilled syringe) - ?40IU, Diphtheria toxoid (Prefilled syringe) - ?30IU, H. Influenza type b polysaccharide(Vial) - 10mcg Injectable dry powder+suspension 2,558,676 L.L
L01EX03 VOTRIENT B Pazopanib HCl - 200mg 200mg Tablet, film coated 40,992,120 L.L
L04AA44 RINVOQ B Upadacitinib - 15mg 15mg Tablet, prolonged release 45,469,094 L.L
N05AH03 ZYPREXA VELOTAB B Olanzapine - 5mg 5mg Tablet, dispersible 2,607,054 L.L
A05AA02 URSOFALK B Ursodeoxycholic acid - 250mg 250mg Capsule 2,823,413 L.L
A10BD20 SYNJARDY B Empagliflozin - 12.5mg, Metformin HCl - 1000mg 12.5mg/1000mg Tablet, film coated 3,156,820 L.L
C03BA04 HYGROTON B Chlortalidone - 50mg 50mg Tablet 422,351 L.L
J07CA09 INFANRIX HEXA B Diphteria toxoid purified (Prefilled syringe) - ?30IU/0.5ml, Tetanus toxoid purified (prefilled syringe) - ?40IU/0.5ml, Bordetella pertussis antigen (Prefilled syringe) - toxoid 25mcg+filamentous haemaglutinin 25mcg+pertactin 8mcg/0.5ml, Poliomyelitis virus type 1 antigen (prefilled syringe) - 40D.U./0.5ml, Poliomyelitis virus type 2 antigen(prefilled syringe) - 8D.U./0.5ml, Poliomyelitis virus type 3 antigen (prefilled syringe) - 32D.U./0.5ml, HBs Antigen (prefilled syringe) - 10mcg/0.5ml, H. Influenza type b polysaccharide (Vial) - 10mcg/0.5ml Injectable suspension 4,230,416 L.L
L01EX05 STIVARGA B Regorafenib - 40mg 40mg Tablet, film coated 248,392,730 L.L
A05AA04 OCALIVA B Obeticholic acid - 10mg 10mg Tablet, film coated 224,503,943 L.L
A10BD20 SYNJARDY B Empagliflozin - 12.5mg, Metformin HCl - 1000mg 12.5mg/1000mg Tablet, film coated 3,156,820 L.L
C03BA11 FLUDEX B Indapamide - 1.5mg 1.5mg Tablet, sustained release 517,379 L.L
C09CA03 DIOVAN B Valsartan - 80mg 80mg Tablet, film coated 602,041 L.L
L01EX07 CABOMETYX B Cabozantinib - 20mg 20mg Tablet, film coated 401,478,618 L.L
A05AA04 OCALIVA B Obeticholic acid - 5mg 5mg Tablet, film coated 224,503,943 L.L
J01DC02 ZINNAT B Cefuroxime (axetil) - 250mg 250mg Tablet, film coated 349,399 L.L
J07CA11 DIPHTHERIA, TETANUS,PERTUSSIS, HEPATITIS B AND HAEMOPHILUS INFLUENZAE TYPE B CONJUGATE VACCINE B Diphteria Toxoid1 - ?25Lf (?30IU)/0.5ml, Tetanus toxoid1 - ?2.5Lf (?40IU)/0.5ml, Bordetella pertussis (Whole cell) - ?16OU (?4.0IU)/0.5ml, HBs Antigen (r DNA)1 - ?10mcg/0.5ml, H. Influenza type b, purified capsular polysaccharide2 - 10mcg/0.5ml, 1 adsorbed on aluminium phosphate, Al+++ - ?1.25mg , 2 conjugated to tetanos toxoid carrier protein - Injectable suspension 1,515,854 L.L
L01EX07 CABOMETYX B Cabozantinib - 40mg 40mg Tablet, film coated 401,478,618 L.L
S01EC04 AZOPT B Brinzolamide - 10mg/ml 10mg/ml Drops suspension 804,962 L.L
A10BD20 SYNJARDY B Empagliflozin - 12.5mg, Metformin HCl - 850mg 12.5mg/850mg Tablet, film coated 3,052,874 L.L
C03CA01 LASIX B Furosemide - 40mg 40mg Tablet 120,946 L.L
J01DC02 ZINNAT B Cefuroxime (axetil) - 250mg/5ml 250mg/5ml Granules for suspension 1,081,904 L.L
L01AA01 ENDOXAN B Cyclophosphamide (monohydrate) - 500mg 500mg Injectable powder for solution 764,646 L.L
L01EX07 CABOMETYX B Cabozantinib - 60mg 60mg Tablet, film coated 401,478,618 L.L
M01AX DORIXINA B Lysine clonixinate - 125mg 125mg Tablet 326,554 L.L
S01EC54 SIMBRINZA B Brinzolamide - 1%, Brimonidine tartrate - 0.2% Drops suspension 1,706,680 L.L
A06AB02 DULCOLAX B Bisacodyl - 5mg 5mg Tablet, sugar coated 520,067 L.L
A10BD20 SYNJARDY B Empagliflozin - 5mg, Metformin HCl - 850mg 5mg/850mg Tablet, film coated 3,052,874 L.L
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