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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
B01AE07 PRADAXA B Dabigatran etexilate (mesilate) - 110mg 110mg Capsule, hard 1,603,204 L.L
G03DB01 DUPHASTON B Dydrogesterone - 10mg 10mg Tablet, film coated 935,314 L.L
J01DH02 MERONEM B Meropenem (trihydrate) - 1g 1g Injectable powder for solution 10,398,061 L.L
L01BC59 LONSURF B Trifluridine - 15mg, Tipiracil - 6.14mg Tablet, film coated 58,102,683 L.L
L04AD01 SANDIMMUN NEORAL SOFT GELATIN B Ciclosporin - 100mg 100mg Capsule, soft gelatin 8,264,592 L.L
N05AF05 CLOPIXOL ACUPHASE B Zuclopenthixol acetate - 100mg/2ml 100mg/2ml Injectable solution 857,372 L.L
N06AX26 BRINTELLIX B Vortioxetine - 10mg 10mg Tablet, film coated 4,345,987 L.L
R03AL03 ANORO ELLIPTA B Vilanterol - 25mcg, Umeclidinium bromide - 62.5mcg Inhalation powder 5,367,774 L.L
S01AE01 OFLOX B Ofloxacin - 3mg/ml 0.3% Drops solution 366,869 L.L
A06AD65 FORTRANS POUDRE POUR SOLUTION BUVABLE B Potassium chloride - 0.750g, Sodium chloride - 1460g, Sodium bicarbonate - 1680g, Sodium sulfate anhydrous - 5700g, Macrogol 4000 - 64.000g Powder for solution 1,136,891 L.L
B01AE07 PRADAXA B Dabigatran etexilate (mesilate) - 110mg 110mg Capsule, hard 3,205,064 L.L
D06BA51 IALUGEN PLUS B Silver sulfadiazine - 10mg/g, Sodium hyaluronate - 2mg/g Cream 1,064,323 L.L
G03DB08 VISANNE B Dienogest - 2mg 2mg Tablet 4,980,280 L.L
L04AD01 SANDIMMUN NEORAL B Ciclosporin - 100mg/ml 100mg/ml Solution 8,264,592 L.L
M02AA31 ROXONIN B Loxoprofen (Sodium) - 60mg 60mg Tablet 788,836 L.L
N05AG02 ORAP FORTE B Pimozide - 4mg 4mg Tablet 329,241 L.L
R03AL04 ULTIBRO BREEZHALER B Indacaterol - 110mcg, Glycopyronium - 50mcg Capsule, inhalation 4,031,528 L.L
S01AE01 OFLOX B Ofloxacin - 0.3% 0.3% Drops solution 366,869 L.L
A06AD65 MOVICOL B Potassium chloride - 0.0466g, Sodium chloride - 0.3507g, Sodium bicarbonate - 0.1785g, Macrogol 3350 - 13.125g Powder for solution 853,340 L.L
A10BD20 SYNJARDY B Empagliflozin - 12.5mg, Metformin HCl - 850mg 12.5mg/850mg Tablet, film coated 3,378,958 L.L
J02AX06 ECALTA B Anidulafungin - 100mg 100mg Injectable concentrated powder for solution 16,977,343 L.L
L04AD02 PROGRAF 1MG B Tacrolimus - 1mg 1mg Capsule 25,241,922 L.L
M02AA31 ROXONIN B Loxoprofen (Sodium) - 60mg 60mg Tablet 1,295,464 L.L
N05AH02 LEPONEX B Clozapine - 100mg 100mg Tablet 1,975,448 L.L
N06AX26 BRINTELLIX B Vortioxetine - 20mg 20mg Tablet, film coated 6,927,508 L.L
R03AL06 SPIOLTO RESPIMAT B Olodaterol HCl - 2.5mcg/puff, Tiotropium bromide monohydrate - 2.5mcg/puff Inhalation solution 5,087,788 L.L
A06AD65 MOVICOL PEDIATRIC PLAIN B Potassium chloride - 23.3mg, Sodium chloride - 175.4mg, Sodium bicarbonate - 89.3mg, Macrogol 3350 - 6.563g Powder for solution 624,887 L.L
A10BD20 SYNJARDY B Empagliflozin - 5mg, Metformin HCl - 850mg 5mg/850mg Tablet, film coated 3,378,958 L.L
B01AE07 PRADAXA B Dabigatran etexilate (mesilate) - 150mg 150mg Capsule, hard 3,031,709 L.L
C09AA03 ZESTRIL B Lisinopril (dihydrate) - 5mg 5mg Tablet 295,645 L.L
    5
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