A national census in Lebanon informed improvements in primary health care centres

STORIES |
Ministry of Public Health (Primary Health Care Unit), UNICEF and WHO Lebanon, in partnership with the Lebanese Red Cross and Sustainable Alternatives.
Country -
Lebanon

Demands on primary health centres in Lebanon were growing. A national assessment identified gaps and guided WASH improvements. Standards were drafted, solutions implemented and a national curriculum developed.

Trigger: Recognizing the growing demands being placed on primary health care centres (PHCs) by the influx of Syrian refugees (approximately 1.5 million beneficiaries), the Lebanese government conducted a national assessment of 166 PHCs, using JMP-aligned indicators. The results guided the development of a plan to improve WASH services.

What: The assessment revealed that 61.5% of surveyed PHCs had basic drinking water services (i.e., water from an improved source and available on premises) but only 45.2% of those sources were free from E. coli. Only 5.4% of PHCs met all the criteria for basic sanitation services since very few PHCs provide usable toilets for people with limited mobility. The government completed a situation analysis, which highlighted the need to include basic WASH requirements in national PHC specifications and accreditation standards.

Results:

  • WASH interventions prioritized. The country now evaluates WASH interventions based on need and uses cost estimates to support financing decisions.
  • WASH standards drafted. New WASH standards and 19 measures of quality have been integrated into Lebanon’s Primary Care Accreditation Standards to ensure that any operating PHC provides basic WASH services.
  • Interim solutions implemented. Where needs are greatest, bottled drinking water is being provided while safe piped supplies are planned and installed.
  • National curriculum developed. A national curriculum has been developed and is being delivered to ensure that personnel at PHCs receive annual training on the importance of improved WASH services at PHCs.

Challenges: PHCs face both financial and structural constraints that prohibit the provision of basic WASH services. When outdated water infrastructure threatened to contaminate public water supply, PHCs were required to provide bottled drinking water from certified brands, monitor the biological quality of the water, and consider installing water treatment units if needed.

Who: Ministry of Public Health (Primary Health Care Unit), UNICEF and WHO Lebanon, in partnership with the Lebanese Red Cross and Sustainable Alternatives.