1. May 2011

2. General Overview 260,000-280,000 Palestine Refugees live in Lebanon High Poverty Level: 66.4% are poor and 6.6% are extremely poor. High rate of unemployment: 56% are jobless. No social or health insurance: 95% do not have any health insurance. Bad Living Conditions: 66% of houses suffer from dampness and leakage, resulting in psychological and chronic illnesses

3. Why Health is a priority? High prevalence of chronic diseases (31%). Extremely High costs of health care services in Lebanon (Total Health expenditures per capita is $599). UNRWA currently covers only 10% of the total health expenditures on health per capita ($59 out of $599); YET UNRWA is the main health care provider. How Do They Manage? Tour organizations begging for help Forego Treatment: suffer and die…..

4. How to address this Gap? Improve Quality of Services at primary care Higher Quality Consultation by Doctors More Responsive to the Needs of the community Improve accessibility to quality hospitalization services Improve coverage of Tertiary Care

5. Quality of Primary Care Governance: improve the management of the program. Human Resources: the right skill mix and building capacity of health staff. Service Delivery: Strengthen existing programs (MCH, NCD) Consider adding new services (Mental Health, Pulmonary) Improve the structure of the health centers Improve the workflow (appointment system, triage) Health Information System: for better documentation and planning. Community Participation and more health awareness campaigns Partnership with governmental and non-governmental organizations

6. Accessibility to Quality Hospitalization Improved Contracts with hospitals Wider geographical distribution of hospitals Contract Accredited Lebanese Hospitals (governmental & private) Quality Standards for PRCS Hospitals Wider coverage of services Emergency Room Services Intensive Care Services under secondary coverage Better Control & Monitoring Enhance the functioning of the hospitalization unit Performance Indicators Measurement

7. Improve Tertiary Care Coverage Increase UNRWA coverage of tertiary care services Aim is to cover 85% of the cost of all hospitalization services (similar to MoPH coverage for Lebanese). Interim Solutions An increase to an average of 40% for tertiary care hospitalization. Agreement with MoPH for the provision of medications for catastrophic conditions at discounted rates (15-70% discount). Establishment of CARE program that aims at improving access to care and decreasing financial burden for patients suffering from catastrophic conditions.