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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
B05XA03 0.9% SODIUM CHLORIDE INJECTION USP G Sodium chloride - 0.9% 0.9% Injectable solution 688,359 L.L
C07AB02 B-BLOK SDK G Metoprolol succinate - 25mg 25mg Tablet, controlled release 282,207 L.L
C09DA01 LOSANET-H FORTE G Losartan potassium - 100mg, Hydrochlorothiazide - 12.5mg Tablet 395,474 L.L
C10AB05 FENOFIBRATE ARROW G Fenofibrate - 160mg 160mg Tablet 639,669 L.L
D11AX TRIO-2000 G Hydroquinone - 4%, Tretinoin - 0.05%, Hydrocortisone acetate - 1% Ointment 2,495,068 L.L
J01DD04 AXONE 1G IM G Ceftriaxone (sodium) - 1g 1g Injectable powder for solution+diluent 438,093 L.L
L01BA04 PEMETREXED STRAGEN G Pemetrexed (disodium) - 500mg/20ml 500mg/20ml Injectable concentrate for solution 24,037,602 L.L
N02BE01 PARACETAMOL NORMON G Paracetamol - 1000mg/100ml 10mg/ml Injectable solution 9,633,134 L.L
N05AH03 APO-OLANZAPINE ODT G Olanzapine - 5mg 5mg Tablet, orally disintegrating 1,317,234 L.L
N06BA09 PMS-ATOMOXETINE G Atomoxetine (HCl) - 60mg 60mg Capsule 5,228,891 L.L
S01CA01 CO-AVAZIR G Tobramycin - 0.3%, Dexamethasone - 0.1% Drops suspension 193,513 L.L
A02BC05 ESOMEPRAZOLE BIOGARAN G Esomeprazole (magnesium dihydrate) - 40mg 40mg Capsule, gastro-resistant 513,348 L.L
A11CC05 MEGAVIT-D 25 G Vitamin D3 - 25000IU 25000IU Capsule 2,147,588 L.L
B03BA01 JECTIN-12 G Cyanocobalamin - 1000mcg/1ml 1000mcg/1ml Injectable solution 567,102 L.L
B05XA03 0.9% SODIUM CHLORIDE INJECTION USP G Sodium chloride - 0.9% 0.9% Injectable solution 144,797 L.L
C09DA01 LOSARTAN/HYDROCHLOROTHIAZIDE ARROW LAB G Losartan potassium - 100mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 470,345 L.L
C10AB05 FENOSUP LIDOSE G Fenofibrate - 160mg 160mg Capsule 774,053 L.L
D11AX01 ALOPEXY G Minoxidil - 20mg/ml 2% Solution 532,162 L.L
G04CB02 DUTASTERIDE ARROW LAB G Dutasteride - 0.5mg 0.5mg Capsule 1,166,455 L.L
J01DD04 CEFAXONE G Ceftriaxone - 1g 1g Injectable powder 403,153 L.L
J01XA02 TEICO MEDIS 200 G Teicoplanin - 200mg 200mg Injectable lyophilised powder 428,686 L.L
L01BA04 PEMETREXED STRAGEN G Pemetrexed (disodium) - 1000mg/40ml 1000mg/40ml Injectable concentrate for solution 40,480,209 L.L
M02AA10 ACHONID GEL G Ketoprofen - 2.5% 2.5% Gel 179,179 L.L
N02BE01 PARACETAMOL PANPHARMA G Paracetamol - 1000mg/100ml 10mg/ml Injectable solution 8,675,675 L.L
N05AH03 OLANZAX 5 G Olanzapine - 5mg 5mg Tablet, mouth dissolving 1,316,966 L.L
N06BA09 APO-ATOMOXETINE G Atomoxetine (HCl) - 40mg 40mg Capsule 4,114,846 L.L
R03BB01 IPRATROPIUM ARROW ADULTES G Ipratropium bromide - 0.5mg/2ml 0.5mg/2ml Inhalation solution for nebuliser 303,708 L.L
S01CA01 DEXATOBRIN G Dexamethasone - 1mg/ml, Tobramycin - 3mg/ml Drops suspension 239,204 L.L
L02BX03 ABLAX 250 G Abiraterone acetate - 250mg 250mg Tablet L.L
A02BC05 EXONAR G Esomeprazole (magnesium trihydrate) - 40mg 40mg Capsule, delayed release 639,925 L.L
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