Aid cuts and health system resilience in Lebanon
This brief analyses the impact of aid cuts on the Lebanese health system. It considers persistent structural constraints that limit Lebanon’s ability to respond to funding contracts, and makes recommendations as to how the country can transition to a more sustainable health system.
Background
Lebanon’s health system has long been characterized by a mixed public–private model in which private providers and non-governmental organizations (NGOs) play a dominant role in service delivery. Approximately 80% of hospitals are privately owned, and nearly 68% of primary healthcare (PHC) centres are managed by NGOs, a structure that has historically been associated with flexibility but has also entrenched fragmentation and reliance on private actors. Health financing has similarly been fragmented, with households bearing a substantial share of costs through out-of- pocket payments and insurance premiums.
Since 2019, this model has been severely destabilized by economic collapse, currency devaluation and erosion of financial protection mechanisms. There is a growing importance of external funding to compensate for declining domestic resources. At the same time, humanitarian funding has fluctuated in response to overlapping crises, including COVID-19 and the Beirut port explosion, while remaining insufficient. Although the share allocated to health increased over time coverage remains below sectoral requirements. Lebanon’s large refugee population has also place sustained pressure on service delivery and financing systems.
Further information
This brief is based on the study, Aid and health system resilience in fragile and shock-prone settings: reflections from ReBUILD for Resilience. There’s more on this research here, including a range of briefs from other contexts.
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