If Lebanon were to visit a doctor for a head-to-toe physical, she might leave the appointment with a few prescriptions in hand. A check up on the overall robustness of the nation’s health infrastructure would show the vital signs of the country’s health sector as generally good, albeit with some lingering concerns, such as reports of malpractice and medical insurance fraud. This examination is in the context of Lebanon’s impromptu multi-year stress test—the unplanned influx of Syrian refugees that began accelerating in 2013, placing strain on its medical centers, hospitals, and primary health facilities—during which the country has not buckled.
The overall diagnosis is that the healthcare sector requires coordinated development between the public and the for-profit and non-profit private sectors (see overview story, page 16). The private sector needs to learn and develop on the basis of the experiences of public health institutions and the Ministry of Public Health (MoPH) in the last few years, adopting lessons learned and best practices.
On the public sector side, there are any number of improvements that still need to be made. This should begin with a restructuring of the MoPH, where manpower seems to be overstretched and has thus far not been reorganized due to political interference. Developing the issues that the ministry has not addressed—in terms of closing coverage gaps and eliminating structures that are producing inequalities in these areas—must also be prioritized. The ministry must also hone its ability to regulate and supervise, and it has made progress on that front. But more must still be done, especially in the provision capability of financial resources to cover real needs.
Both public and private health institutions need to create a better popular understanding amongst the population of the connections between their work and mutual collaboration, and the benefits to overall public health. The public relations in this regard seem to have not been coordinated between stakeholders, and private stakeholders are stuck in a sort of family business mentality when it comes to communication, or the lack thereof, with the media. Awareness building within the general population must become a greater priority, necessitating clear communication strategies and greater transparency from the private sector, the MoPH, and public health institutions.
Looking ahead toward the demands of the future, the health sector overall needs to upgrade and streamline its structures and mechanisms used to access financing (see story on healthcare financing). Whether that is best done through a compulsory scheme, or through accessing capital markets, or through institutionalizing more of the private sector providers, is still a question that must be answered. But the general impression is that what has been achieved so far was not on institutional terms in compliance with institutional planning, but more opportunistic and based on the strength of personal relationships. In the future, improvements in the Lebanese healthcare system need to be institutionalized, whether at the National Social Security Fund, or at the MoPH by granting it more autonomy from its role as regulator and the insurance payer of last resort.