PRESENTATION Social InterMinisterial Committee Progress Report 3 Beirut

PRESENTATION Social Inter-Ministerial Committee Progress Report # 3 Beirut, Lebanon August 23, 2007 0

Today’s objective is to update your Excellencies on progress to-date against Commitment Documents completed by respective stakeholders Meeting Objectives 4 Brief on the status of issues raised in the previous IMC and on progress to-date of GR PCO planning and monitoring activities – Following the last IMC, 14 issues were raised, involving the National Social Security Fund, as well as the ministries of Social Affairs, Health and Education – To-date, 6 issues were resolved, 2 are in progress, and 6 are delayed 4 Highlight progress and status of implementation of short-term programs for each ministry: – Monthly Progress Report against programs charted in Commitment Documents – New and emerging issues 1

Table of Contents 4 GR PCO Planning & Monitoring 4 Monthly Progress Reports – Ministry of Social Affairs – Ministry of Education and Higher Education – Ministry of Health – Ministry of Labor – National Social Security Fund 4 Next Steps 2

The Paris III implementation planning process is generally on track, except for delays in the long term planning of the Ministry of Health and the NSSF Natural Owner Ministry of Social Affairs Ministry of Education and Higher Education Identification Prioritization of Initiatives ✓ ✓ Program Charters Development ✓ ✓ KPIs Setting ✓ ✓ Progress Commitment Report Document ✓ ✓ Ministry of Heath ✓ ✓ ✓ Ministry of Labor ✓ ✓ ✓ National Social Security Fund ✓ ✓ ✓ Immediate Next Steps 4 Finalize budgetary requirements with Ministry of Finance 4 Minister to commit on programs 4 Finalize budgetary requirements with Ministry of Finance 4 DG to commit on programs 4 Define and finalize budgetary requirements with Ministry of Finance 4 Minister to commit on programs 4 Finalize budgetary requirements with Ministry of Finance 4 Obtain NSSF Board of Directors’ endorsement of the short-term programs and approval on Commitment Document 4 DG to commit on short term programs 4 Finalize long-term programs and obtain endorsement of all NSSF stakeholders 3

Table of Contents 4 GR PCO Planning & Monitoring 4 Monthly Progress Reports – Ministry of Social Affairs – Ministry of Education and Higher Education – Ministry of Health – Ministry of Labor – National Social Security Fund 4 Next Steps 4

Monthly progress reports will highlight the status of each program – defined in a Commitment Document – along implementation, budget, and KPI dimensions Status and Budget Performance Definitions Status Implementation KPI 4 Completed on Time Budget Target 4 On Track 4 On Budget 4 Could be Delayed 4 Potential Over 4 Emerging Budget Issues 4 Delayed NS Budget 4 Not Started 4 Over Budget 4 N/A 4 On Target Budget Performance Initial Budget endorsed during an IMC Revised Budget adjusted using a Program Change Request Form endorsed during an IMC Actual Spent Amount spent until date of reporting Remaining Budget Requirements Estimate of the remaining budgetary requirements for the program 4 Off Target 4 N/A 5

Table of Contents 4 GR PCO Planning & Monitoring 4 Monthly Progress Reports – Ministry of Social Affairs – Ministry of Education and Higher Education – Ministry of Health – Ministry of Labor – National Social Security Fund 4 Next Steps 6

Program Dashboard Program Title: MSA-001: Restructure the Ministry of Social Affairs Natural Owner: Minister of Social Affairs Period: July 2007 IMC: Program Overall Status: Social Achievements Since Last Report Key Issues 4 Draft ministerial decision for criteria of welfare institutions prepared 4 Draft procedures for implementation of local development projects prepared New: 4 Need to recruit full time staff to follow up on restructuring of Mo. SA 4 Need to secure budget required (at least till mid 2008 – amounting to $38, 500) to initiate work related to Mo. SA mandate and restructuring Carried Over from Previous IMC: 4 None KPI Baseline (July 2007) Current Value Percentage of Mo. SA budget allocated for care programs 70% Development of new Mo. SA organizational structure Level of Ministry of Social Affairs automation (Departments and SDCs) Payment processing time Note: (*) Defined in the legend Org. structure of 2 departments revised 30% Mo. SA automation + 10 SDCs equipped More than 14 days Target Status (Closest Date) 60% (Dec. 2009) Mo. SA Mandate completed (Mar. 2008) 50% SW/HW installed (Mar. 2009) Less than 3 days (Sep. 2010) Budget Performance* Initial Budget $3, 440, 500 Revised Budget N/A Actual Spent N/A Remaining Budget Requirements Estimate N/A Status N/A 7

NS Completed On Track Could be Delayed NS Not started 8

Program Dashboard Program Title: MSA-002: Enhance Management of the Social Sector Natural Owner: Minister of Social Affairs Period: July 2007 IMC: Program Overall Status: Social Achievements Since Last Report Key Issues 4 Data on duplicated services and programs between Ministries of Education and Health collected 4 Mapping of Local Development Project completed and currently reviewed based on comments. Content and structure of database for Local Development Projects initiated. 4 Draft framework of Social Strategy elaborated – to be discussed with team of experts 4 Resources for implementation of program were fully mobilized from the Lebanon Recovery Fund New: 4 Continued cooperation and commitment of Ministries of Education and Health for elimination of duplication (provision of information and delegation of concerned staff to attend bilateral meetings) 4 Need to reach consensus on best party to undertake the coordination of local development initiatives (database, framework of needs and priorities, etc. ) Carried Over from Previous IMC: 4 Ministries of Education and Health to actively cooperate with Mo. SA staff for matters related to duplication KPI Percentage elimination of duplicated programs between Mo. SA, Mo. H and MEHE Establishment of local development projects database (implemented by Government institutions) Implementation of Social Strategy and related Action Plan Human Development Index ranking Note: (*) Defined in the legend Baseline (July 2007) Current Value 0% 0% No database No action plan Lebanon rank 78 Target (Closest Date) 20% (Dec. 2008) Database design and testing completed (Oct. 2007) Social strategy endorsed (Dec. 2007) Lebanon rank 76 (Dec. 2010) Status Budget Performance* Initial Budget $ 270, 000 Revised Budget N/A Actual Spent N/A Remaining Budget Requirements Estimate N/A Status N/A 9

NS NS Completed On Track Could be Delayed NS Not started 10

NS NS Completed On Track Could be Delayed NS Not started 11

Program Dashboard Program Title: MSA-003: Develop New Targeting Mechanisms for SSN Programs Natural Owner: Minister of Social Affairs Period: July 2007 IMC: Program Overall Status: Social Achievements Since Last Report Key Issues 4 Detailed plan for implementing piloting of targeting was completed New: 4 Need to mobilize resources for piloting the targeting (Proxy Means Testing). Total cost of piloting is $ 814, 530 out of which $ 197, 900 are made available through a World Bank grant Carried Over from Previous IMC: 4 PMT database should be hosted at Mo. SA for technical reasons Target Status (Closest Date) Implementation of Management PMT formula Absence of Information System (MIS) for targeting Absence of MIS elaborated MIS mechanism (Sep. 2007) 30% HH Percentage of households assessed to 0% HH assessed identify poor households assessed (Dec. 2008) 14 Safety Net Review of Elaboration of Safety net programs available SSN suggested (Mar. 2008) KPI Note: (*) Defined in the legend Baseline (July 2007) Current Value Budget Performance* Initial Budget $ 3, 180, 270 Revised Budget N/A Actual Spent N/A Remaining Budget Requirements Estimate N/A Status N/A 12

NS NS Completed On Track Could be Delayed NS Not started 13

Program Dashboard Program Title: MSA-004: Implement Prioritized Safety Nets Programs Natural Owner: Minister of Social Affairs Period: July 2007 IMC: Social Achievements Since Last Report Key Issues 4 Proposal for expanding proximity services to the disabled was submitted to the Lebanon Recovery Fund 4 Initiated assessment of alternatives for providing free health care/ hospitalization to the disabled KPI Number of services provided by RAIS program Poverty rate Number of children in welfare institutions New: 4 Safety Net programs that are directly linked to targeting (Cash assistance, exemptions to elderly, free hospitalization) cannot be initiated before completion of Program 3 4 Implementation of the other Safety Net programs are linked to either availability of funds or human resources (Scale up of inhouse care for the disabled, expansion of proximity services, school food program) Carried Over from Previous IMC: 4 Mo. SA requirements for budget to implement Safety Net program related to expanding proximity services. (Current required budget is $3 M. If LRF approves $1. 3 M for Mo. SA then the required budget for this Safety Net will be $1. 7 M) Baseline Target Current Value Status (July 2007) (Closest Date) 7, 000 services 10, 000 services delivered per per year (Mar. 2008) 24. 6% 23, 000 Program Overall Status: 24. 6% 23, 000 20. 9% (Dec. 2010) 18, 000 (Dec. 2009) Budget Performance* Initial Budget $ 33, 032, 000(1) Revised Budget N/A Actual Spent N/A Remaining Budget Requirements Estimate N/A Status N/A Note: (*) Defined in the legend (1) The complementary budget for Safety Nets programs is based on the Paris III Social Action Plan estimations, and would be refined later according to targeting outcome 14

NS NS Completed On Track Could be Delayed NS Not started 15

Sector / Natural Owner Issues Register Issue ID 001 002 003 004 005 Issue Level H H H Issue Description Raised by BAH based Communication of social aspects of on Press Paris III is deficient Monitoring Mo. SA requires recruitment of additional M&S staff The Proxy Means Testing database should be hosted and maintained in a way to allow access to several stakeholder Minister of Social Affairs H The identification of duplicated social services requires support from MEHE and Mo. H Minister of Social Affairs H Ministry of Social Affairs needs a budget of $ 1, 054, 000 to undertake Minister of short-term initiatives (This budget Social could be reduced, if Mo. SA obtains Affairs $1 million from Lebanon Recovery Fund) Date Assigned to Actions Needed 4 Prime Minister and all members of the Social IMC to stress the Social IMC social aspect of the Paris III Members Program in the press 17/05/2007 4 Appointment of a press attaché for the Social IMC GR PCO Deadline Status On-going In progress 15/06/2007 Completed PCM Comm Unit leveraged Delayed (Mo. F would transfer $50, 000 of Mo. SA budget to recruit UNDP staff) Completed (Mo. SA should host the database for technical reasons; Access rights would be granted by the Office of the Prime Minister) Delayed (Bilateral meetings to be undertaken with MEHE and Mo. H) 4 Minister of Finance to secure financing for the recruitment of Minister of M&S staff, from the $100, 000 15/05/2007 Finance budget dedicated to the Secretariat of the Social IMC 4 Mo. SA to host the Proxy Means Minister of Testing database, and allow Social access to relevant Ministries and Affairs and Public Institutions 06/07/2007 Prime Minister Office 12/08/2007 4 Ministries of Education and Health to actively cooperate with the Ministry of Social Affairs staff, in order to identify duplication in delivery of Social Services 4 Minister of Finance to review Mo. SA budgetary requirements and accordingly allocate TA and budget necessary to implement short-term initiatives 20/08/2007 Minister of Education 06/07/2007 and DG of Ministry of Health 06/07/2007 Minister of Finance 20/08/2007 31/07/2007 Delayed (Need for Mo. SA to communicate with Minister of Finance) 16

Table of Contents 4 GR PCO Planning & Monitoring 4 Monthly Progress Reports – Ministry of Social Affairs – Ministry of Education and Higher Education – Ministry of Health – Ministry of Labor – National Social Security Fund 4 Next Steps 17

Program Dashboard Program Title: EDU-001: Consolidate policy, planning and resource allocation Natural Owner: Minister of Education Period: July 2007 IMC: Social Achievements Since Last Report Key Issues 4 Draft of contract for Organizational Restructuring completed by MEHE 4 Currently finalizing TOR for TA assignment related to develop model for performance based budgeting 4 Decree issued to establish a committee responsible to develop a shadow budget 4 TOR for Education Management Information System (EMIS) connectivity developed 4 Contract for delivery of School Information System (SIS) equipment completed by CDR and signed KPI Baseline (July 2007) Current Value Percentage of educational policies and plans based on EMIS output 0% 0% Submission of a shadow Performance Based Budget for MEHE % decrease in number of days and processes required to complete a sample of 10 tasks Note: (*) Defined in the legend Program Overall Status: New: 4 No funds available to recruit consultants to develop capacity at MEHE to assist in the implementation of reform initiatives Carried Over from Previous IMC: 4 None Target Status (Closest Date) 100% (Dec. 2008) Performance Based Shadow Based Budget 50% decrease in total number of in total number of days (Dec. 2008) Budget Performance* Initial Budget $ 7, 716, 000 Revised Budget N/A Actual Spent $ 87, 000 Remaining Budget $ 7, 629, 000 Requirements Estimate Status 18

NS NS Completed On Track Could be Delayed NS Not started 19

Program Dashboard Program Title: EDU-002: Achieve Universal Basic Education (UBE) for ages 6 to 15 Natural Owner: Minister of Education Period: July 2007 IMC: Program Overall Status: Social Achievements Since Last Report Key Issues 4 None New: 4 No funds available to provide free textbooks to public school students Carried Over from Previous IMC: 4 None KPI Baseline (July 2007) Current Value Target (Closest Date) Percent increase in NER for grades 1 -6 97% 98% (Dec. 2009) Percent increase in NER for grades 7 -9 68. 5% 72. 5% (Dec. 2009) Percent increase in “Class Occupancy” for grades 1 -6 (cycle 1&2) Percent increase in “Class Occupancy” for grades 7 -9 (cycle 3) Percent increase in public students with free textbooks in cycles 1 & 2 Note: (*) Defined in the legend 0% 0% 0% 5. 88% from 17 to 18 (Dec. 2009) 10. 53% from 19 to 21(Dec. 2009) 100% (Dec. 2007) Status Budget Performance* Initial Budget $ 15, 000 Revised Budget N/A Actual Spent N/A Remaining Budget Requirements Estimate N/A Status N/A 20

NS Completed On Track Could be Delayed NS Not started 21

Program Dashboard EDU-003: Improve efficiency, Program Title: effectiveness and competence level Natural Owner: Minister of Education of the teaching workforce Period: July 2007 IMC: Social Achievements Since Last Report Key Issues 4 Remaining 300 out of 450 school principals have completed Leadership Development Program 4 16, 500 public school teachers already undergone professional training 4 Committee for institutionalization launched and preparation for legal procedures underway between MEHE and Faculty of Pedagogy for the training of the selected third promotion of 150 school principals during 2007 -2008 under the same methodologies used for the previous two promotions 4 TA consultant selected to develop evaluation tools for Continuous Instructors Development Program KPI Percentage of teachers without a bacc. & above 58: who are physically/psychologically disabled Percentage of PS Principals who have undergone professional dev. prog. to improve competence Number of teachers who have undergone professional development Note: (*) Defined in the legend Baseline (July 2007) 9. 6% Program Overall Status: Current Value 9. 6% New: 4 None Carried Over from Previous IMC: 4 None Target (Closest Date) 6. 9% (Dec. 2008) 10% 30% (Dec. 2007) 16, 500 teachers 20, 000 teachers (Dec. 2007) Status Budget Performance* Initial Budget $ 101, 863, 000 Revised Budget N/A Actual Spent $ 900, 000 Remaining Budget $ 100, 963, 000 Requirements Estimate Status 22

NS Completed On Track Could be Delayed NS Not started 23

Program Dashboard Program Title: EDU-004: Enhance quality of education Natural Owner: Minister of Education Period: July 2007 IMC: Social Achievements Since Last Report Key Issues 4 New Curriculum developed by ECRD for preschool and cycle 1 4 Phase 4 of development of evaluation glossary in English and French completed 4 Phase 1 of Exam Management System (EMS) development completed (Assessment of Current Situation - work plan) 4 Phase 1 of Question Bank System (QBS) development completed ( Inception report) 4 QBS to be tested on second session of official exams KPI Baseline (July 2007) Current Value Percent decrease in “Repetition Rate” for grades 1 -6 21% Average student repetition rate in grades 7 -9 Percent increase in NER for children aged 3 -5 enrolled in public KGs Percentage automation of public examination process and exams Note: (*) Defined in the legend Program Overall Status: 23% 21. 61% 0% 0% New: 4 None Carried Over from Previous IMC: 4 None Target Status (Closest Date) 19% (Dec. 2010) 21% (Dec. 2010) 29. 69% (Dec. 2010) 100% (Dec. 2008) Budget Performance* Initial Budget $ 9, 600, 000 Revised Budget N/A Actual Spent N/A Remaining Budget Requirements Estimate N/A Status N/A 24

Completed On Track Could be Delayed NS Not started 25

Program Dashboard Program Title: EDU-005: Enhance the utilization of educational facilities Natural Owner: Minister of Education Period: July 2007 IMC: Program Overall Status: Social Achievements Since Last Report Key Issues 4 Criteria for school consolidation established and priority unviable and receiving schools identified for consolidation 4 Draft decree issued by Minister for consolidation of 30 unviable schools New: 4 None Carried Over from Previous IMC: 4 None KPI Percent decrease number of nonviable schools or ecoles normales Baseline (July 2007) Current Value Target Status (Closest Date) 23. 1% (non 0% (non-viable schools) & 0% (Dec. 2007) & (ecoles 48. 5% (ecoles normales) (Dec. 2009) Budget Performance* Initial Budget $ 2, 200, 000 Revised Budget N/A Actual Spent $ 25, 000 Remaining Budget $ 2, 175, 000 Requirements Estimate Status Note: (*) Defined in the legend 26

NS NS Completed On Track Could be Delayed NS Not started 27

Program Dashboard Program Title: EDU-006: Rationalize vocational and Natural Owner: Minister of Education technical education Period: July 2007 IMC: Program Overall Status: Social Achievements Since Last Report Key Issues 4 None New: 4 No Capacity recruited to assist MEHE in implementing program 4 No funds available to launch initiatives related to the program Carried Over from Previous IMC: 4 None KPI Identification of number of VTE specializations that comply most with labor market needs Note: (*) Defined in the legend Baseline (July 2007) Current Value Target Status (Closest Date) 15 VTE 0 VTE specializations identified (Dec. 2009) Budget Performance* Initial Budget $ 200, 000 Revised Budget N/A Actual Spent N/A Remaining Budget Requirements Estimate N/A Status N/A 28

NS Completed On Track Could be Delayed NS Not started 29

NS Completed On Track Could be Delayed NS Not started 30

Program Dashboard Program Title: EDU-007: Develop Quality Assurance in higher education Natural Owner: Minister of Education Period: July 2007 IMC: Program Overall Status: Social Achievements Since Last Report Key Issues 4 None New: 4 No Capacity recruited to assist MEHE in implementing program 4 No funds available to launch initiatives related to the program Carried Over from Previous IMC: 4 None KPI Baseline (July 2007) Current Value Submission of standards compatible No unified set of with international patterns in quality of standards assurance in higher education and with submitted local requisites Note: (*) Defined in the legend Target Status (Closest Date) A unified set of standards submitted (Dec. 2009) Budget Performance* Initial Budget $ 1, 000 Revised Budget N/A Actual Spent N/A Remaining Budget Requirements Estimate N/A Status N/A 31

NS Completed On Track Could be Delayed NS Not started 32

Sector / Natural Owner Issues Register Issue ID 001 Issue Level Issue Description H Ministry of Education needs a budget of $ 500, 000 to undertake short-term initiatives Raised by Minister of Education Date Assigned to Actions Needed 4 Minister of Finance to review MEHE budgetary requirements and accordingly Minister of 06/07/2007 allocate TA and budget necessary to Finance implement short-term initiatives Deadline Status 31/07/2007 Delayed 33

Table of Contents 4 GR PCO Planning & Monitoring 4 Monthly Progress Reports – Ministry of Social Affairs – Ministry of Education and Higher Education – Ministry of Health – Ministry of Labor – National Social Security Fund 4 Next Steps 34

Program Dashboard Program Title: HEA-002: Upgrade Primary Healthcare (PHC) Services Natural Owner: Ministry of Health DG Period: July 2007 IMC: Social Achievements Since Last Report Key Issues 4 Desk research on quality assurance and performance improvement and respective measurement tools were undertaken by Balamand University 4 10 pilot health centers that will participate in the development process of the QAPI pilot program were identified by MOH and communicated to Balamand university 4 An action plan was prepared between Balamand University and Mo. H to start the consensus building process through a work group including representatives from Mo. H, Balamand, AUB, St Joseph University, and Lebanese University. The roles for each stakeholder were clarified according to the action plan 4 Number of contracted centers in the PHC network have increased to 125 from 85 KPI HEA-002 -01: Quality Assurance Performance indicators (QAPI) submitted to a national consensus meeting before end of 2007 HEA-002 -02: Number of contracted centers in the PHC network Note: (*) Defined in the legend Baseline (July 2007) No QAPIs 85 centers Program Overall Status: Current Value No QAPIs 125 centers New: 4 None Carried Over from Previous IMC: 4 None Target Status (Closest Date) Draft QAPIs list generated (Dec. 2007) 125 centers (Dec. 2007) Budget Performance* Initial Budget $ 1, 360, 000 Revised Budget N/A Actual Spent N/A Remaining Budget Requirements Estimate N/A Status N/A 35

NS NS Completed On Track Could be Delayed NS Not started 36

Program Dashboard Program Title: HEA-003: Follow-up Implementation Natural Owner: Ministry of Health DG of Quality Assurance Program Period: July 2007 IMC: Social Achievements Since Last Report Key Issues 4 Contract with Ecole Superieure des Affaires (ESA) has been finalized and approved by the Court of Accounts 4 Discussions on mobilization plan and schedule of activities have started in collaboration with the Haute Autorite de la Sante (HAS) and ESA to launch project activities by early September 4 Draft documents have been communicated informally by the HAS regarding training programs for public hospitals and the new accreditation procedure 4 A project committee has been formed at the Mo. H to coordinate and follow up implementation of the accreditation project activities KPI HEA-003 -01: Percentage of hospitals attending hands-on training program on hospital accreditation HEA-003 -02: Number of certification bodies selected HEA-003 -03: Percentage of public hospitals contracted by Mo. H based on accreditation Note: (*) Defined in the legend Baseline (July 2007) Current Value New: 4 Ability to mobilization of French experts in due time Carried Over from Previous IMC: 4 None Target Status (Closest Date) 0% 0% 100% (Dec. 2007) None Minimum 3 (Dec. 2007) 0% 100% (Dec. 2008) 0% Program Overall Status: Budget Performance* Initial Budget $ 400, 000 Revised Budget N/A Actual Spent N/A Remaining Budget Requirements Estimate N/A Status N/A 37

NS NS Completed On Track Could be Delayed NS Not started 38

Program Dashboard Program Title: HEA-004: Undertake Health Financing Reform Natural Owner: Ministry of Health DG Period: July 2007 IMC: Program Overall Status: Social Achievements Since Last Report Key Issues 4 Testing of the billing system in Daher el Bashek initiated and ongoing in Lebanese Canadian hospital (Stopped at Beirut University hospital) 4 Develop program to establish link between claims submitted by hospitals, bills audited and payments done by the accounting department at the MOH 4 5 COOP centers have been linked to beneficiary database at Mo. H 4 Discussions with the Army underway to start linking 6 Army centers to the beneficiary database at the MOH 4 Negotiations with the World Bank were launched to finance activities related to rationalization and control of health expenditures through a grant from the Trust Fund for Lebanon 4 Matrices for 2004 -2005 NHA under construction 4 Data from NSSF, ISF and Army forwarded to Mo. H for NHA 20042005 matrices New: 4 NSSF database is still incomplete. The Mo. H sent an official letter in this respect. The main issues relate to the information regarding the mother and father of NSSF main beneficiaries, families of the voluntary insurance beneficiaries and families of taxi drivers 4 Launching of the activities under the emergency social protection implementation support project financed by a World Bank grant are pending in light of the current negotiations with the NSSF 4 Data in public funds for NHA purposes is still manual 4 No sharing of information for NHA from private hospitals 4 Data on household expenditures for 2004 still not released by Central Administration of Statistics (CAS) KPI HEA-004 -01: Utilization review committee established at Mo. H HEA-004 -02: Hospital admissions criteria developed and adopted by Mo. H Note: (*) Defined in the legend Baseline (July 2007) Not Established None Current Value Not Established None Target Status (Closest Date) Established and functional (Dec. 2007) A number of criteria adopted & implemented (Jan. 2008) Budget Performance* Initial Budget $ 410, 000 Revised Budget N/A Actual Spent N/A Remaining Budget Requirements Estimate N/A Status N/A 39

NS NS Completed On Track Could be Delayed NS Not started 40

NS NS NS Completed On Track Could be Delayed NS Not started 41

Program Dashboard Program Title: HEA-005: Enhance Public Health Functions and Programs Natural Owner: Ministry of Health DG Period: July 2007 IMC: Social Achievements Since Last Report Key Issues 4 Reach Every District (RED) approach initiated in Bint Jbeil district and will be launched in Baalbeck on Aug. 17 and Hermel on Aug. 25 4 Hepatitis B zero dose campaign was organized in collaboration with all private hospitals 4 KAP survey initiated with the support of UNICEF: NGO partner identified questionnaire developed and to be launched mid august 4 Delivery of 27 vehicles for EPI from UNICEF 4 A WHO consultant conducted an assessment on 9 laboratories in different regions to evaluate their needs and capacities to support epidemiological surveillance in case of outbreaks 4 A new database on Access for the National Cancer Registry has been developed using national and international standardized codes. 4 Program budgeting have been developed by MOH and presented to MOF for 2008 budget for programs related to: EPI, PHC, Epidemiological surveillance and school and oral health KPI HEA-005 -01: Coverage rate of MCV 1 vaccine by 2007 through public sector HEA-005 -02: Initiation of Reach Every District (RED) approach Note: (*) Defined in the legend Baseline (July 2007) 48. 5% Not initiated Program Overall Status: Current Value 48. 5% Not initiated New: 4 RED approach initiation delayed in Akkar, Minieh and Denniyeh due to the current political situation. Cold chain equipment for EPI could not be delivered to these areas 4 To help implement program budgeting a workshop must be organized by the Finance Institute on subject and must include representatives of Mo. F, Mo. H and Court of Accounts Carried Over from Previous IMC: 4 Ministry of Health to determine clear eligibility criteria for services delivery – Eligibility criteria shall be determined by Mo. SA Target Status (Closest Date) 51% (Dec. 2007) Initiated in 4 districts (Dec. 2007) Budget Performance* Initial Budget $ 105, 000 Revised Budget N/A Actual Spent N/A Remaining Budget Requirements Estimate N/A Status N/A 42

Completed On Track Could be Delayed NS Not started 43

Program Dashboard Program Title: HEA-007: Undertake Pharmaceutical Natural Owner: Ministry of Health DG Reform Period: July 2007 IMC: Program Overall Status: Social Achievements Since Last Report Key Issues 4 30% of drug files in category A have been reviewed 4 Average decrease in drug prices resulting from this review is around 19% New: 4 The closing of the central laboratory is a major and serious problem for drug registration Carried Over from Previous IMC: 4 None KPI HEA-007 -01: Percentage of drugs files reviewed Note: (*) Defined in the legend Baseline (July 2007) 30% Current Value 30% Target Status (Closest Date) 100% (Oct. 007) Budget Performance* Initial Budget N/A Revised Budget N/A Actual Spent N/A Remaining Budget Requirements Estimate N/A Status N/A 44

NS Completed On Track Could be Delayed NS Not started 45

Sector / Natural Owner Issues Register Issue ID 001 002 Issue Level H M Issue Description The identification of duplicated social services requires support from MEHE and Mo. H Ministry of Health to determine clear eligibility criteria for services delivery Raised by Minister of Social Affairs Minister of Finance 003 L Not all Public hospitals are efficiently managed, whether in terms of budget or service levels 004 H Ministry of Health budget is mainly Ministry of represented in two lines items (for Health hospitalization and drugs) 005 H Fund disbursement for budgeted “National Immunization Programs and Public Health Programs” is cumbersome and delaying the process 006 H In addition to DPL, Ministry of DG of Health needs a budget of $ 20, 000 Ministry of to undertake short-term initiatives Health Minister of Finance Ministry of Health Date Assigned to Actions Needed Minister of 4 Ministries of Education and Health to Education actively cooperate with the Ministry of 06/07/2007 and DG of Social Affairs staff, in order to identify Ministry of duplication in delivery of Social Services Health 4 Ministry of Health to clarify to the IMC the eligibility criteria for benefiting from health DG of services 06/07/2007 Ministry of Health Deadline Status 20/08/2007 Completed 20/08/2007 Delayed Eligibility criteria shall be determined by Mo. SA 4 Ministry of Health to clarify to the IMC the efforts undertaken to improve the DG of efficiency of public hospitals (priority 06/07/2007 Ministry of reform program) Health 20/08/2007 Completed Training on management by Finance Institute + Accreditation DG of 4 Ministry of Finance to review Mo. H 20/08/2007 Completed Ministry of budgeting structure to allow for more Program 06/07/2007 Health / details in the key lines items (e. g. , public budgeting Minister of hospitals, private hospitals, etc. ) and presented to Finance reduce remaining line items MOF 4 Ministry of Finance to implement a new 20/09/2007 In progress performance-based budgeting process that Program Ministry of 06/07/2007 should streamline many of the current budgeting Finance budgeted funds disbursement steps presented to MOF 4 Minister of Finance to review Mo. H 31/07/2007 Delayed budgetary requirements and accordingly Discussions Minister of 06/07/2007 allocate TA and budget necessary to still underway Finance implement short-term initiatives with the World Bank 46

Table of Contents 4 GR PCO Planning & Monitoring 4 Monthly Progress Reports – Ministry of Social Affairs – Ministry of Education and Higher Education – Ministry of Health – Ministry of Labor – National Social Security Fund 4 Next Steps 47

Table of Contents 4 GR PCO Planning & Monitoring 4 Monthly Progress Reports – Ministry of Social Affairs – Ministry of Education and Higher Education – Ministry of Health – Ministry of Labor – National Social Security Fund 4 Next Steps 52

Table of Contents 4 GR PCO Planning & Monitoring 4 Monthly Progress Reports – Ministry of Social Affairs – Ministry of Education and Higher Education – Ministry of Health – Ministry of Labor – National Social Security Fund 4 Next Steps 63

Next Steps Actions Required 4 Ministry of Social Affairs: – Follow up with the Mo. F for the allocation of funds to hire additional M&S staff – Follow up with the Mo. F for the allocation of $1, 054, 000 to undertake short term initiatives – Resolve issue of hosting the Proxy Means Testing database – Compile and submit report on the duplicated social services between Mo. SA, MEHE and Mo. H 4 Ministry of Education and Higher Education: – Resolve program funding issues with Mo. F, particularly for securing $500, 000 to undertake short term initiatives 4 Ministry of Health: – Review budget structure with Mo. F to allow for more detailing of line items – Finalize long-term planning with the World Bank 64

Next Steps (cont. ) Actions Required 4 Ministry of Labor: – Assess budgetary needs with the assistance of Mo. F 4 National Social Security Fund: – Finalize long-term plan with Board of Directors, Technical Committee and the Minister of Labor 4 Sign Commitment Documents for all Social IMC Natural Owners 65