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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
H02AB13 DEFAL B Deflazacort - 6mg 6mg Tablet 415,247 L.L
L01CE01 HYCAMTIN IV B Topotecan HCl - 4mg 4mg Injectable lyophilised powder for solution 52,580,031 L.L
L01XK04 TALZENNA B Talazoparib - 1mg 1mg Capsule 401,512,167 L.L
M01AB05 VOLTFAST B Diclofenac potassium - 50mg 50mg Powder for solution 545,600 L.L
N05AX16 REXULTI B Brexpiprazole - 2mg 2mg Tablet, film coated 13,433,051 L.L
A02BX13 GAVISCON DOUBLE ACTION MINT B Sodium alginate - 250mg, Sodium bicarbonate - 106.5mg, Calcium (carbonate) - 187.5mg Tablet, chewable 456,906 L.L
A12AX DECALCIT B Vitamin D3 - 500IU, Calcium - 600mg Tablet 348,055 L.L
C09DB01 EXFORGE B Amlodipine - 10mg, Valsartan - 160mg Tablet, film coated 1,333,092 L.L
D01BA02 LAMISIL B Terbinafine HCl - 250mg 250mg Tablet, scored 813,025 L.L
G03AD02 ELLAONE B Ulipristal acetate - 30mg 30mg Tablet 2,276,469 L.L
H02AB13 DEFAL B Deflazacort - 30mg 30mg Tablet 635,638 L.L
L01XK04 TALZENNA B Talazoparib - 0.25mg 0.25mg Capsule 133,836,699 L.L
N05AX16 REXULTI B Brexpiprazole - 1mg 1mg Tablet, film coated 13,433,051 L.L
A02BX13 GAVISCON DOUBLE ACTION MINT B Sodium alginate - 500mg/10ml, Sodium bicarbonate - 213mg/10ml, Calcium (carbonate) - 325mg/10ml Suspension 542,912 L.L
G03BA03 TESTOVIRON DEPOT B Testosterone Enantate - 250mg/ml 250mg/ml Injectable solution 456,906 L.L
N05BA01 VALIUM B Diazepam - 5mg 5mg Tablet, scored 200,233 L.L
V03AE03 FOSRENOL B Lanthanum Carbonate - 500mg 500mg Tablet, chewable 18,751,847 L.L
A02BX13 GAVISCON DOUBLE ACTION B Sodium alginate - 500mg, Sodium bicarbonate - 213mg, Calcium (carbonate) - 325mg Suspension 517,379 L.L
A12AX DECALCIT B Vitamin D3 - 750IU, Calcium - 600mg Powder 1,075,074 L.L
G03BB01 PROVIRON B Mesterolone - 25mg 25mg Tablet 391,058 L.L
H03AA01 EUTHYROX B Levothyroxine sodium - 25mcg 25mcg Tablet, scored 256,674 L.L
J01DH02 MERONEM B Meropenem (trihydrate) - 500mg 500mg Injectable powder for solution 10,398,061 L.L
J05AB14 VALCYTE B Valganciclovir (HCl) - 450mg 450mg Tablet, film coated 63,612,039 L.L
V03AE03 FOSRENOL B Lanthanum Carbonate - 750mg 750mg Tablet, chewable 24,138,283 L.L
A03A SPASMOBROM B Pipethanate Ethobromide - 20mg 20mg Tablet, coated 705,517 L.L
A12AX CALPEROS D3 A SUCER B Vitamin D3 - 400IU, Calcium - 500mg Tablet, chewable 667,890 L.L
C07BB07 CONCOR PLUS B Bisoprolol fumarate - 10mg, Hydrochlorothiazide - 25mg Tablet, film coated 1,202,314 L.L
G03CA03 OESTRODOSE B Estradiol (17 bêta estradiol anhydre) - 0.06% 0.06% Gel 642,357 L.L
H03AA01 EUTHYROX B Levothyroxine sodium - 50mcg 50mcg Tablet, scored 391,058 L.L
M09AX01 HYALGAN B Hyaluronic acid (sodium) - 20mg/2ml 20mg/2ml Injectable solution 3,407,985 L.L
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    152
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