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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
L01XA03 OXALIPLATIN MEDAC G Oxaliplatin - 100mg 100mg Injectable powder for solution 7,841,801 L.L
P01AB01 METRONIDAL G Metronidazole benzoate - 125mg/5ml 125mg/5ml Syrup 245,731 L.L
R05FB BRONCHOPHANE G Dextrometorphan HBr - 4.58mg/5ml, Diphenydramine HCl - 5mg/5ml, Ephedrine HCl - 7.5mg/5ml, Guaifenesin - 50mg/5ml Syrup 115,570 L.L
V03AC03 DEFEROXAL 360 G Deferasirox - 360mg 360mg Tablet, film coated 24,918,561 L.L
A02BC02 RAZON 40 G Pantoprazole (sodium) - 40mg 40mg Tablet, enteric coated 1,252,461 L.L
A11CC05 MEGAVIT-D 50 G Vitamin D3 - 50000IU 50000IU Capsule 3,687,248 L.L
B05XA03 SODIUM CHLORIDE G Sodium chloride - 0.9% 0.9% Injectable solution 167,780 L.L
C07AB07 B-COR 5 G Bisoprolol fumarate - 5mg 5mg Tablet, film coated 296,989 L.L
C09DA04 GIZLAN-PLUS G Irbesartan - 150mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 395,090 L.L
C10BA05 OTOREZA 10/10 G Atorvastatin - 10mg, Ezetimibe - 10mg Tablet, film coated 1,007,882 L.L
G01AF05 ECOREX 150 G Econazole nitrate - 150mg 150mg Ovule 280,863 L.L
H02AB02 DEXAMETHASONE MEDIS G Dexamethasone Phosphate - 4mg/1ml 4mg/1ml Injectable solution 1,154,361 L.L
J01DD08 MUREX 200 G Cefixime - 200mg 200mg Capsule 430,030 L.L
J02AC02 FONGINOX G Itraconazole - 100mg 100mg Capsule 174,060 L.L
L01XA03 OXALTIE G Oxaliplatin - 100mg 100mg Injectable lyophilised powder for solution 5,915,595 L.L
L04AX04 SOTIRA G Lenalidomide - 25mg 25mg Capsule 76,719,234 L.L
M05BA06 ADROMUX G Ibandronic acid - 150mg 150mg Tablet, coated 821,088 L.L
N03AX09 SEIZET 25 G Lamotrigine - 25mg 25mg Tablet, dispersible/ chewable 573,821 L.L
P01AB01 METROGYL G Metronidazole benzoate - 200mg/5ml 200mg/5ml Powder for suspension 456,091 L.L
R05FB02 MUCUS RELIEF DM G Dextromethorphan HBr - 20mg, Guaifenesin - 400mg Tablet 413,903 L.L
V03AC03 DEFERASIROX ARROW G Deferasirox - 360mg 360mg Tablet 18,379,327 L.L
A02BC02 GASTROPAN G Pantoprazole (sodium) - 20mg 20mg Tablet, enteric coated 568,445 L.L
A11CC05 ALTUM G Vitamin D3 - 50,000IU 50,000IU Capsule, hard 712,620 L.L
B05XA03 SODIUM CHLORIDE G Sodium chloride - 0.9% 0.9% Injectable solution 167,780 L.L
C07AB07 APO-BISOPROLOL G Bisoprolol fumarate - 5mg 5mg Tablet 923,220 L.L
C09DA04 CONVERIUM PLUS G Irbesartan - 150mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 395,090 L.L
G01AF05 ECONAZ G Econazole nitrate - 150mg 150mg Ovule 415,951 L.L
J02AC03 VORICONAZOLE STRAGEN G Voriconazole - 50mg 50mg Tablet, coated 15,808,184 L.L
L01CB01 ETOPOSIDE EBEWE G Etoposide - 100mg/5ml 100mg/5ml Injectable concentrated solution 768,678 L.L
L01XA03 OXALIPLATINO GP PHARM G Oxaliplatin - 100mg 100mg Injectable lyophilised powder for solution 6,199,145 L.L
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