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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
N01BB01 BUPIVACAINE AGUETTANT 2.5MG/ML G Bupivacaine HCl - 50mg/20ml 50mg/20ml Injectable solution 2,736,063 L.L
N03AX14 LEVIPRAM 250 G Levetiracetam - 250mg 250mg Tablet, film coated 1,087,873 L.L
N05CD08 MIDAZOLAM HAMELN G Midazolam (HCl) - 5mg/5ml 5mg/5ml Injectable solution 529,474 L.L
P02CB01 VERMIFUGE G Piperazine citrate - 1g/5ml 1g/5ml Syrup 148,463 L.L
V03AF03 CALCIUMFOLINAT EBEWE G Calcium folinate - 100mg/10ml 100mg/10ml Injectable solution 1,289,872 L.L
B05BB02 LO-SODIUM WITH POTASSIUM INJECTION G Potassium chloride - 0.149g/100ml, Sodium dihydrogenophosphate - 0.137g/100ml, Sodium lactate - 0.223g/100ml, Sodium chloride - 0.0585g/100ml, Dextrose monohydrate - 5g/100ml Injectable solution 165,727 L.L
C01DX12 MOLSIDOMINE BIOGARAN G Molsidomine - 2mg 2mg Tablet, scored 713,580 L.L
C09AA05 ACURIL G Ramipril - 2.5mg 2.5mg Tablet 497,222 L.L
C10AA01 VASCOR G Simvastatin - 40mg 40mg Tablet, scored 284,127 L.L
D06BB03 CIVAR G Aciclovir - 5% 5% Cream 507,972 L.L
G03GB02 CLOMIFERT G Clomifene citrate - 50mg 50mg Tablet 395,090 L.L
J01CA04 OSPAMOX G Amoxicillin (trihydrate) - 750mg 750mg Tablet, film coated 480,350 L.L
L01EA02 ELPIDA G Dasatinib - 70mg 70mg Tablet, film coated 127,364,905 L.L
L02BB03 BICAMIDE G Bicalutamide - 50mg 50mg Tablet, film coated 1,451,753 L.L
M01AB05 RAPIDUS G Diclofenac potassium - 50mg 50mg Tablet, coated 287,582 L.L
N01BB01 BUPIVACAINE AGUETTANT 5MG/ML G Bupivacaine HCl - 100mg/20ml 100mg/20ml Injectable solution 3,078,743 L.L
N05CD08 MIDAZOLAM NORMON. G Midazolam - 5mg/5ml 5mg/5ml Injectable solution 618,168 L.L
P02CB01 PIPERAZINE CITRATE G Piperazine citrate - 750mg/5ml 750mg/5ml Elixir 113,907 L.L
R06AB02 HISTAMED G Dexchlorpheniramine maleate - 1% 1% Gel 477,384 L.L
V03AF03 EUROFOLIC G Folic acid as Calcium Folinate Hydrate - 100mg/10ml 10mg/ml Injectable solution 5,872,592 L.L
A04AA05 PALONAN G Palonosetron HCl - 250mcg/5ml 250mcg/5ml Injectable solution 2,194,495 L.L
A10BD11 INAGLIMET G Metformin - 850mg, Linagliptin - 2.5mg Tablet, film coated 1,670,844 L.L
B05BB02 ELECTROLYE 67 G Calcium gluconate - 0.10g/100ml, Potassium chloride - 0.075g/100ml, Sodium chloride - 0.30g/100ml, Dextrose, H2O - 5.0g/100ml Injectable solution 165,727 L.L
C09AA05 APO-RAMIPRIL G Ramipril - 2.5mg 2.5mg Capsule 463,626 L.L
C10AA02 ATERKEY G Lovastatin - 20mg 20mg Tablet 1,053,573 L.L
D06BB03 CYCLOVEX G Aciclovir - 50mg/g 50mg/g Cream 267,489 L.L
G03GB02 CLOMIFERT G Clomifene citrate - 50mg 50mg Tablet 395,090 L.L
J01CA04 AMOXIDREX G Amoxicillin (trihydrate) - 250mg/5ml 250mg/5ml Powder for suspension 284,127 L.L
J01FA09 CLARIDAR DAR AL DAWA G Clarithromycin - 250mg/5ml 250mg/5ml Suspension 877,529 L.L
J05AR27 DOLUTEGRAVIR/LAMIVUDINE/TENOFOVIR DISOPROXIL FUMARATE G Lamivudine - 300mg, Tenofovir disoproxil fumarate - 300mg, Dolutegravir - 50mg Tablet 54,836,160 L.L
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    174
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