Lebanon Health Resilience Project

Project Implementation Status

Project ratings: Based on the August 2025 Implementation Status and Results (ISR) report prepared by the World Bank, the rating of the progress towards achievement of the PDO was downgraded to Moderately Unsatisfactory while the overall implementation progress rating was maintained as Moderately Unsatisfactory. This is due to: (i) the fact that the likelihood of some PDO indicators meeting their targets is low; and (ii) delay in implementation of project activities. The World Bank will reevaluate the ratings at the end of January 2026 based on the: (i) progress in the implementation of project activities, mainly awarding the procurement packages; (ii) anticipated submission of withdrawal application by end of January 2026; (iii) as well as the updates on the actual/ current value of the indicators under the Results Framework that will be provided by the Ministry of Public Health (MoPH) by mid-January 2026.

Project restructurings:

In September 2025, the World Bank approved the fifth restructuring of the project to reallocate funds to support the procurement of essential medical equipment for public hospitals.
Based on a request from the Government of Lebanon (GOL) in November 2025, the project is being restructured to expand the definition of hospitals that are eligible to receive Special Capitation Payments under Component 2.1 in the Loan Agreement to include private hospitals (currently includes public hospitals only); and to introduce changes to the Results Framework. The restructuring package was reviewed by the GCFF coordination unit and is expected to be processed by the World Bank by end of January 2026.

Progress by component:

Component 1: Scaling up the scope and the capacity of the primary health care (PHC) Universal Health Coverage program

The PHC pilot (REAYA) was launched in September 2024. This pilot targeted 410,000 vulnerable beneficiaries selected from the Emergency Social Safety Net (ESSN) DAEM database and from the Internally Displaced People (IDPs) list. Enrollment closed at the end of May 2025. 165,000 beneficiaries have enrolled to receive services at 61 PHC centers (PHCCs). October 31, 2025 was the due date for completing the first visit for enrolled beneficiaries. 63,512 beneficiaries completed their first visit to receive services under their assigned packages.

When designed, the PHC pilot was planned to cover 210,000 beneficiaries over a period of two years. However, due to the conflict in the country (which started in October 2023 and escalated to a war in September 2024), the MoPH had to shift its focus to the emergency response. This context led to a delay in the launch of the PHC pilot (which as a result only covers one full year of service coverage) and also in a lower uptake by beneficiaries. Accordingly, the target was reduced under the fifth restructuring from 210,000 to 70,000 beneficiaries.

The PHCCs received a readiness/enhancement grant (up to US$10,000 per center) to procure the required equipment (such as EKG, ultrasound, IT equipment) and recruit the needed staff (nurse, HIS officer, etc.) to be able to implement the PHC packages. Training activities have been provided to personnel at these centers as well. Training activities covered the design of the packages and the provider payment method, financial management procedures, procurement arrangements, environmental and social risks and mitigation measures, as well as using the electronic system for data entry. This has improved the technical and managerial capacities of these centers, improving their capacity to deliver quality PHC services and benefiting both Lebanese and displaced persons.

Component 2: Provision of health care services in public hospitals

The project financed 127,000 non-COVID-19 hospitalization claims, with the last payment processed in August 2024. There are no ongoing/ planned activities.

Component 3: Strengthening project management and monitoring

This component is used to finance the Project Management Unit (PMU) which consists of project coordinator, part-time procurement officer, senior financial officer, financial assistant, interim financial assistant, PHC technical coordinator, monitoring and evaluation officer, environmental and social officer and 3 administrative/ office assistants. Two biomedical engineers were also recruited under the project have provided substantial support to the PMU in advancing procurement processes.
The PMU continues to update the Project Operations Manual as needed, and to submit the bi-annual progress reports.
This component finances also the third-party agency (TPA) which reviews and validates all payments related to hospital claims, equipment purchases, and PHC activities.
This component is also financing the grievance mechanism (GM) at the MoPH.

Component 4: Strengthen the Government’s capacity to respond to COVID-19

Procurement of medical equipment is ongoing, with the installation of all equipment scheduled to take place at the designated public hospitals between January and February 2026. The procurement packages include Pediatric Intensive Care Unit (PICU) and Neonatal Intensive Care Unit (NICU) equipment, Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET), Radiology equipment and hospital furniture. The medical equipment will strengthen the operational capacity of public hospitals and improve access to quality care for vulnerable populations, including Lebanese and Syrian refugees. This, in return, will increase service demand and utilization.

The component has helped strengthen the capacity of the GOL to respond to the COVID-19 pandemic through (a) COVID-19 prevention awareness campaigns and community engagement; (b) procurement of Pfizer vaccine as well as supplies for vaccine deployment; (c) procurement of Polymerase Chain Reaction (PCR) machines and their kits, personal protective equipment, medical equipment for 45 hospitals, and regular and Intensive Care Unit beds; (d) maintenance of COVID-19 related equipment at hospitals; (e) installation of a containment ventilation system; and (f) support of the pharmacovigilance program at the MoPH.

Challenges: The implementation of the project faced several challenges. These challenges include the limited capacity at the MoPH and the PMU, caused by civil servant absenteeism due to the financial crisis, country instability and vacancies in key PMU positions. In addition, the conflict which impacted the country between October 2023 and November 2024 led to changes in the MoPH priorities, shifting their focus to emergency preparedness and response.