Lebanon Health Resilience Project

Project Implementation Status

Project ratings: The rating of the progress towards achievement of the PDO was downgraded from Moderately Satisfactory to Moderately Unsatisfactory. Based on what is currently reported by the MoPH, the likelihood of some PDO indicators to meet their targets is low. For example, the number of vulnerable Lebanese with access to Primary Healthcare (PHC) essential care package is 39,000 (target is 210,000). The progress towards achievement of the PDO rating will be upgraded once (i) substantive progress is achieved; (ii) MoPH provides updates on the actual/ current value for each indicator by mid-July 2025; and (iii) the targets of the indicators are revised/ reduced under the proposed restructuring. The overall implementation progress (IP) rating was maintained as Moderately Unsatisfactory. There has been progress in project implementation during the last period. However, the IP rating will be

upgraded once (i) MoPH awards at least one procurement package; and (ii) MoPH submits a withdrawal application of at least US$10 million by end of September 2025.

Proposed restructuring: The MoPH plans to procure additional medical equipment for public hospitals using funds under component 4 of the project (Strengthen the Government’s capacity to respond to COVID-19). This requires reallocation of funds between components and expense categories. The Government of Lebanon (GOL) sent the WB an official restructuring request on July 3, 2025. This restructuring request will be discussed with WB senior management and the WB will respond to the GOL in

August 2025.

Progress by component:

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

There has been progress in the implementation of REAYA (PHC pilot) since the last reporting period. The MoPH targeted an additional 160,000 beneficiaries selected from the Emergency Social Safety Net (ESSN) database and 50,000 Internally Displaced Persons (IDPs) to increase enrollment, bringing the total number of targeted beneficiaries to 410,000. To date, 170,000 beneficiaries have been enrolled and 39,000 completed the first visit. 63 PHC centers (PHCCs) have been contracted under this pilot. These centers received a readiness 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. An evaluation of the REAYA pilot project will be conducted to assess the planning, implementation, sustainability, and scalability of this project. The evaluation is expected to be launched by August 2025 and will be concluded by February 2026.

• 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. The WB approved the MoPH request to recruit 3 consultants to work on (1) drafting the pathways for secondary-level services; (2) setting their protocols; and (3) costing them. The recruitment process for the first consultant is underway.

• Component 3: Strengthening project management and monitoring

The MoPH submitted to the WB the revised Project Operations Manual (POM) as well as the bi-annual progress report on June 30, 2025, which are under WB review. This component is used also to finance staffing, third-party agent (TPA) and PHC pilot evaluation. The Project Management Unit (PMU) is now staffed with (i) procurement officer who is acting as an interim project

coordinator; (ii) financial officer; (iii) financial assistant; (iv) interim financial assistant; (v) monitoring and evaluation officer; (vi) PHC technical coordinator; (vii) two administrative assistants; and (viii) E&S officer. Two biomedical engineers have been recruited to assist the PMU in developing technical specifications for medical equipment and evaluating proposals. There are two ongoing recruitments under the PMU. For the project manager, the revised evaluation report is expected to be submitted by July 18. As for the procurement assistant, the evaluation report is expected to be submitted by the end of July 2025.

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

The below five procurement packages of medical equipment are planned under this component. The requests for bids for these packages have been launched. The installation of all equipment is scheduled to take place at the designated public hospitals between January and February 2026. 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.

1. Pediatric Intensive Care Unit (PICU) and Neonatal Intensive Care Unit (NICU) equipment
2. Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET)
3. Radiology Equipment (including X-ray units and Digital fluoroscopy)
4. Hospital Furniture
5. Computed Tomography Scan (CT-scan)