3 November 2017
Lebanon has been undergoing a
demographic and epidemiological transition for the past two decades. As such, Lebanon is a country with double
burden of disease; there is an increase in the incidence of non-communicable
diseases at a time where infectious diseases remain a public health risk1.
In order to respond to the country’s changing profile and health needs, the
ministry of public health in Lebanon has adopted prevention as a strategic
direction in the country’s health strategies, policies, projects and programs.
In 1991, the ministry of public
health held the first national conference on primary healthcare which led to
the elaboration of a national primary healthcare strategy2. At the
core of this strategy was the national primary healthcare network. The MOPH
collaborated with NGOs, civil societies and the private sector to identify
health centers and dispensaries and included them in the national network. These primary health care centers provide
services including promotive, preventive and palliative care
in addition to early diagnosis and treatment3 for reduced nominal
fees. The MOPH supports these PHCCs though providing training, medical
equipment and supplies, vaccines, essential medication, and a health
information system for continuous reporting.
To date the MOPH national primary
healthcare network encompasses 207 PHCCs across the country and serves around
1.4 million beneficiaries annually including both vulnerable Lebanese, and
displaced Syrians4. The MOPH national network has made leaps in
terms of prevention coverage in Lebanon as evidenced by the 95% vaccination
coverage rate for children and the maintenance of Lebanon’s Polio free status
despite the Syrian refugee crisis4. In addition to immunization
services, the national primary network offers several programs. One of the most
successful and pertinent programs at the MOPH national primary network is the Non
communicable disease (NCD) initiative.
Screening in Lebanon
In line with the epidemiological
transition in Lebanon, recent reports have shown that those whose ages are 65
years and over represent 10% of the population5. In fact, Lebanon
has the highest proportion of their population aged 65+ years among countries
in the Arab world6. With an aging population, the burden of
non-communicable diseases becomes even more prominent. NCDs are the leading
causes of disease and illness in Lebanon accounting for 85% of all deaths in
The Lebanese government subsidizes
access to tertiary and secondary care for uninsured and for those suffering
from NCDs, the cost of diagnosis and treatment but primary and preventive
services remain uncovered. In order to address this imbalance and encourage NCD
prevention in 2012, the Primary Health Care Department in collaboration with
WHO, launched a pilot initiative of Non-Communicable Diseases (NCD) in 26
Primary Health Care (PHC) centers.
By the year 2016, this initiative
was developed further and was integrated as a sustainable service into the package
of health care services provided by PHC centers a total of 189
PHCCs across Lebanon4.
This Initiative aims primarily at
the early detection of (i) diabetes, (ii) hypertension, (iii) dyslipidemia and
(iv) cardiovascular disease through screening beneficiaries of designated PHC
centers who are 40 years and above. It further aims at the prevention of these
diseases, promotion of health awareness, management of individuals with these
pre-existing diseases, and surveillance of cardiovascular diseases in the
Lebanese population. The risk for the development of diabetes, hypertension,
and dyslipidemia is assessed by calculating the cardiovascular risk of each
individual within the screening criteria. This risk is calculated using an algorithm
developed jointly by WHO and the International hypertension Society (HIS). Once
risk is calculated, education and referral for medical treatment as per PHC
protocol is performed accordingly.
During 2016, the NCD initiative
screened over 16,000 PHCC beneficiaries and referred 43% of those beneficiaries
to receive further lab tests4. The results of the screenings
demonstrated the prevalence of NCDs among screened beneficiaries as follows:
hypertension (91/1000), diabetes (85/1000), dyslipidemia (81/1000) cases4.
W, Health system and Reform in Lebanon, Ministry of Public Health, 2003.
W. Health Beyond Politics, Ministry of Public Health, 2009.
W., (2016): Health Strategic Plan; Strategic Plan for the medium term (2016 to
2020) (2017). Retrieved 2 June 2017
healthcare Department Annual Report, 2016.
Administration of Statistics. (2012). Population and housing
characteristics in Lebanon, Statistics In Focus (SIF), Beirut, Lebanon, Issue
S., Ajrouch, K. J., & Antonucci, T. C. (2014). Aging in Lebanon: challenges
and opportunities. The Gerontologist, 55(4), 511-518
Health Organization - Noncommunicable Diseases (NCD) Country Profiles , 2014.
Head ,Phc and social Health Department,MOPH
Coordinator,Universal health Coverage Project in collaboration with the World bank