Heedful of the future scale and implications of the socio-economic challenges in Lebanon’s health sector, and in consistence with his belief that health care is a legitimate right for every human being, the late PM Rafik Hariri initiated in 1999 a network of primary centers aimed at providing extensive preventive and therapeutic low cost health care over long haul, with total commitment to high standards and quality. Hence, the Directorate of Health and Social Services (DHSS) came to light as an exemplary model for health care providing magnetic medical cards to all patients across Lebanon, regardless of their nationality, affiliations and background. The magnetic cards are tantamount to passports allowing patients immediate access to the centers and to their personal electronic medical files.

Over half of the Lebanese lack any form of health cover and the Ministry of Public Health spends nearly 87% of its budget on hospitalization and medications. Hereby, the DHSS put the preventive health care at the very heart of its mission in order to reduce the substantial health care bill that results from resorting to secondary and tertiary health care (hospitalization).

Centers and Departments

The DHSS first health care center opened on January 3, 2000 in Tariq Al-Jdideh and the directorate has since expanded its centers to cover all regions in Lebanon. Today, the DHSS includes 28 automated centers that are of two types:

• Main centers distributed over the Mohafazas and offering check-ups, laboratory services, X-ray imaging and a wide array of specialty services.
• Secondary centers offering family medicine and pediatric and dental care.

The centers are usually set up after a Participatory Rapid Appraisal has been conducted to assess the health needs of the region or town in question. Some centers operate from 8:00 am until 8:00 pm and others until 4:00 pm depending on the demand for each center. The DHSS consists currently of 400 physicians and 300 staff and operates under the following departments: Dental Department, Medical Practitioners’ Department, IT Department, Health and Social Services Department, Accounting Department, Laboratory Department and X-Ray Department.

The DHSS has in each Mohafaza an administrative coordinator and a registered nurse in charge of coordination among physicians. The communication between all centers and departments is established through IntraMail.

Services

The DHSS provides a wide range of quality health care services including check-ups, follow-ups, laboratory tests, X-ray screenings, dental care, immunization and medications. It offers training opportunities for physicians, nurses and university students and is widely recognized for its superior nursing and specialized consultation services.

Furthermore, the DHSS offers social services and intervenes to assist the refugees or those injured in security conflicts by sending ambulances and furnishing free medical services, in addition to in-kind donations delivered to the widows and the orphans. Comprehensive health and environment programs (reproductive health programs, cleaning campaigns, green marathons…) fall also within the directorate’s framework not to mention its special clinics, which attend to diabetes, obesity, cardiac disorders, speech therapy, psycho-motor therapy, counseling and many others.

The DHSS coordinates and signs agreements with several local and international organizations to receive patients and treat them. It has its own drugstore and pharmacies, which provide medications for chronic and acute diseases. The DHSS imports its own drugs or acquires them from different local sources including the Ministry of Public Health and the Young Men’s Christian Association.

The directorate’s awareness and educational activity is also evident in the conferences and campaigns it organizes to promote efficient preventive practices and raise health care awareness within small and large communities, and thus encouraging people to assume their own responsibilities and be active players in improving their medical, mental and social status.

The School Health Program launched by the DHSS covers several schools across Lebanon and includes primary health care and oral and dental check-ups. Students are given a magnetic health card that allows them to benefit from the services of any center free of charge all year round. Complete health education is given both to teachers and parents, in addition to the environmental assessment and presentation of the appropriate recommendations to the school administration.

Awards

• Award of Excellence for the Electronic Health Records from the Arab Health Exhibition and Congress, Dubai.
• Microsoft has adopted the DHSS IT Division to implement health information system modules for various companies in Lebanon. The DHSS has started a partnership with Microsoft to promote and market its information system modules.
• WHO chose the DHSS in the top five experts in E-Health.
• Appreciation Award from the Ministry of Public Health for high quality primary health care system.
• Recognition awards and certificates from local organizations and ministries for several health programs.