I.Simplification and Automation of the Administrative Procedures 
 

1. The adoption of Transactions and Workflow System – TWFS 

The Ministry of Public Health has adopted since 2005 the Transactions and Workflow System (TWFS) to automate the registration and the workflow process of the daily transactions. An electronic serial number is given to the transactions registered in the different departments.

The Main Objectives are:

• Relieving citizens from the burden of administrative procedures
• Providing a better and faster service to citizens
• Improving the performance of the ministry operations
• Increasing the productivity and the effectiveness in a transparent public sector
• Empowering the MOPH administration in performing its duties and functions with minimal effort, high efficiency and productivity

This system helps simplify the administrative procedures and improve transparency in terms of the provision of information on the administrative transactions and makes them available to the Ministry’s officials as well as for the citizens, which may limit corruption and information monopolies.
 

2. Standardization and automation of application forms related to the administrative transactions 

In the context of the efforts exerted to simplify the administrative procedures and provide the citizens with better services, and within the administration modernization and development plan, the Ministry of Public Health completed the automation of the application forms for the services provided by MoPH in collaboration with OMSAR and were adopted by the Ministry after the official approval of the Research and Guidance administration.

These forms include the required documents and the relevant list of Regulations & References and are published on the official website of the ministry and on Ehealth Lebanon mobile App. with the relevant information needed for the submission of the applications in a transparent way, i.e where to apply, the required documents, the conditions, the fees to be paid, the days of submission, the duration of the procedure…
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3. The One Stop Shop 

Within the framework of the application of e-Government and following the approval of the Research and Guidance administration No. 2920 dated 9/12/2016 to go paperless with the registration of transactions, the Ministry of Public Health has adopted a one stop shop to receive, register and deliver all administrative transactions in one place without the need for the citizen to follow-up the transaction within the different departments. The main objectives are to simplify administrative procedures and to facilitate and speed up the completion of services provided.

Paper-based registration was canceled in all administrative units following Minister Decision number 1/45 date 26/1/2017and replaced with the TWFS system.

The one stop shop includes at the present time the Registry of the Diwan, the Pharmacy and the medical professions departments and will include at a later stage the remaining departments of the ministry.

This achievement is the outcome of the simplification of administrative procedures project done in collaboration with OMSAR within context of the Good governance at the ministry of public health that helps clarify and facilitate the transactions and relies on transparency in decision-making and transactions follow-up.
 

4. Development of the Electronic Services Platform:  

           https://www.moph.gov.lb/en/e-services 

In 2016 a new decision number 998 was issued on 6/8/2016 by Minister Wael Abou Faour to implement the e-services platform on MoPH’s website including 27 services from 6 different departments integrated with TWFS system.

This platform has been upgraded in 2018 to digitize 100 services and which enables any citizen to apply online for a certain service to MoPH.  By digitizing processes and making organizational changes, governments can enhance services, save money and improve citizens’ quality of life.
The main aim of MoPH is to develop a multi-channel service delivery to maximize outreach capacity.

The citizen can now benefit from better services through the fastest means by submitting his application and the scanned documents through the internet. The application is automatically registered into the TWFS and the citizen can track it from MoPH’s website. Once a form is submitted, it is stored on the web server, then sent to the MoPH e-services server for manual validation, if the application is valid, it is then manually forwarded to the TWFS server. User will be notified whether his application was completed or failed to pass any validation.

The citizen will only head to the Ministry with the original documents to retrieve the transaction upon completion.
 

5. Interoperability with the Customs Administration 

An electronic connection between the Ministry and the Customs Department through a single window allow the possibility for MoPH staff to access "NAJM" electronic system to be able to lift the restrictions or not filed or take any administrative action on goods imported or exported and restricted by the Ministry of Public Health Application Within the deadlines set in the Memorandum of Understanding signed in September 2017.

Customs clearers are no longer obliged to appear in person at the Ministry of Health to determine the restrictions on the goods subject to the customs declaration.
 
II.The website of the ministry www.moph.gov.lb 

The Ministry of Public Health was one of the first institutions in Lebanon to develop its website on the internet in the mid-1990s. Since then, the Ministry is doing its best to improve the site and introduce the latest available information in line with its policy to strengthen transparency and relieve the citizens from the burden of administrative procedures.

Using the latest technology, the Ministry has recently released a new version that constitutes a reference to all the citizens and all stakeholders with regard to the latest developments in the healthcare sector.

One of the main functions of the National E-Health Program is to manage the digital communication platforms of MoPH mainly the website and the social media channels: Facebook, YouTube, Instagram, Twitter and others tools to reach a wider audience and to increase the visibility of the health achievements and work being done by MoPH.

This visibility will strengthen awareness among the public hence will increase the credibility and access to the health services provided by the MoPH. Moreover it will promote Accountability and Transparency through publishing documents and information reaching out to citizens and the different stakeholders in implementation of the law of the Right of Access to Information issued in 19 January 2017.

The main information published on the Ministry’s website includes:
 

1. Information about the ministry including strategic plans – latest Laws and Regulations – information on the administrative services provided by MoPH with details on documents needed and procedures – recent publications – latest News and Events –  Education and Awareness materials  – all previous and ongoing programs and projects – recent statistics and health indicators- list of all products and facilities permitted and registered by MoPH to ensure quality and safety- Complaints platform to report fraudulent actions 
2. In Track your Document section the website visitor can login to the website and can track the status of his transactions. Once the transaction is completed an sms is sent to him in order to pick the final document. 
3. Recently a new platform related to digital services (50 services) was added to the website which enables any citizen to apply online for a certain service and submit his application form with the required documents scanned.  The citizen will only head one time to the Ministry with the original documents to retrieve the transaction upon completion. 
4. The National Database of the Drugs Registered at the ministry is published on the website allowing citizens and health professionals to:

• Search for drugs using different criteria : Drug's name / Laboratory / Agent / Country of origin
• Download the complete list of drugs with their public price based on the foreign currency rates  and according to the Resolution 51/1 issued in 2006
• View the list of conversion of authorized prices of the imported medicine products to public prices in Lebanon
• View the table of discounts of conversion of the selling prices in the country of origin into comparison price in US$
• Search for drugs that have been recalled from the Lebanese market
• Drugs Registration administrative Procedures
• A notification via the mobile App. And an instant e-mail is sent to concerned parties when publishing new Drugs Pricing Index is issued or new Drugs were Recalled.

5. The website features also the locations of all the health facilities, such as hospitals, laboratories and radiology center, as well as all the relevant information, in particular the health care services provided by each facility.The information is updated daily on the website in collaboration with all MoPH departments.

 
III.The Introduction of a Unified Complaints Mechanism 

To activate accountability, the MOPH exerts all possible efforts in order to strengthen its relationship with the citizen and build a strong bond based on confidence, by enabling the citizen to submit any complaint and express his opinion regarding any issue that caused marginalization, injustice or suffering.

In 2014, the Ministry of Public Health in Lebanon initiated work on a comprehensive grievance redress mechanism for the whole ministry.  The MOPH aimed to enhance transparency and accountability with the public by ensuring that suggestions and grievances are promptly reviewed and responded. The MOPH set-up multiple uptake channels for grievance including a hotline, mobile application, and website, the registration office at the Diwan in addition to taking calls from the MOPH main office.

Internally, the MOPH has set-up grievance focal points in each department to follow-up on grievances. All grievances received are documented and automated.

In line with the global shift towards grievance redress and citizen engagement more countries are opting to implement and scale up their grievance redress systems. Lebanon was one of the very few countries that were able to successfully roll-out a GRM mechanism. By implementing this grievance system, and according to the World Bank, the MOPH in Lebanon became a benchmark and leader when it comes to grievance redress. Many of the techniques employed by the MOPH for grievance redress and particularly at the primary healthcare department are now considered best practices not only at the regional but at the international level.

Grievance Redress System in Primary Healthcare
In 2016, and during the implementation of the emergency primary healthcare restoration project at the MOPH, a joint program with the World Bank, the primary healthcare department developed its grievance redress mechanism even further. The PHC department developed internal standard operating procedures for grievance handling including categorization of grievances, documentation, and time-frames and roles and responsibilities to respond to grievances.
 
Additionally, the MOPH-PHC department went beyond passively receiving grievances from the public and actively engaged beneficiaries through patient satisfaction phone calls, which helped illicit suggestions and grievances. These innovative and cost-effective techniques helped the MOPH-PHC department achieve its targets for the grievance system.
So far, the PHC department has been able to address over 90% of the grievances, 70% of which were addressed within three days.
 
Table 1 GRS key performance indicators, 2016-2019
 

Total number of grievances registered (cumulative)	5,685 grievances (290 centrally)
% Grievances addressed (within 3 days)	72%
% Grievances closed	98%
Average time to resolve grievance	2.83 Days

In addition to streamlining grievance redress mechanisms at the central level, the MOPH-PHC department works closely with PHCCs within the network on upgrading their own mechanisms. It builds the capacity of the primary healthcare centers to respond to grievances, making sure they have functional suggestions and complaint boxes and grievance redress processes. In addition to training, the MOPH (i) conducts thorough field Follow-up to ensure proper documentation of grievances, (ii) distributes standardized suggestions and complaints cards to PHCC; and (iii) provides communication material to promote the use of grievance redress uptake channels.
 
IV.The promotion of transparency in the pharmaceutical sector 

The Ministry of Public Health has been working several years ago on the reform of the pharmaceutical sector and this has led to positive impact on the quality, safety and efficacy of pharmaceutical products and therefore on the Health Status in Lebanon.

The ministry of public health has taken major steps for the promotion of transparency in the pharmaceutical sector since 2007 in collaboration with the World Health Organization in the context of the Good Governance in medicine:

The achievements include:

• The implementation of an electronic pricing tool for registered drugs and all price variations related to drugs prices is implemented in the National E-Health Program following Minister’s decision number 1364 date 16/7/2018.
• The constitution of a national committee for the national programme of drugs good management and the promotion of transparency in the pharmaceutical sector by the minister’s decision No.812/1.
• The adoption of internal regulations for the technical committee responsible for the registration of drugs.
• The development of a guide on the drugs and pharmaceutical products registration procedures in Lebanon.
• The publication of the agenda and decisions of the technical committee.
• The publication of the lists of submission of applications for drugs registration in chronological order
• The update of the drugs good manufacturing practices guidelines
• The development of the administrative transactions procedures guide at the pharmaceutical service, including the licensing of pharmaceutical facilities
• The development of the administrative transactions procedures guide at the drugs import and export department
• The development of the administrative transactions procedures guide at the pharmacy inspection department
• The development of the administrative transactions procedures guide at the narcotics department
• The development of drug pricing procedures guide in Lebanon 

 All the information mentioned above are published on the ministry’s website.
 
V.Pharmaceuticals Traceability System using 2D barcode: MediTrack Implementation 

In an effort to increase patient safety and the need to adopt standards for processes related to Pharmaceutical Automated Identification, the MoPH has started from March 2018 the pilot phase of the Pharmaceuticals Traceability System urging pharmaceutical manufacturers and importers to use standardized barcodes on all pharmaceutical products for identification and traceability purposes.

All the registered pharmaceutical companies or manufactures registered at  the MOH, which intend to import or produce pharmaceutical products, should ensure the adoption of the 2D Matrix Barcode, as per the standards of the “Global Standards One”  GS1,  on the outer pack of all the registered/under-registration pharmaceutical products at the MOH.

The main objectives of this project are to create common standards for pharmaceutical products identification across healthcare sector in Lebanon.

The key benefits are:

• Increasing patient safety through the avoidance of preventable medication errors by automated (barcode) verification methods.
• Traceability of pharmaceuticals across the supply chain from manufacturing to patient level
• Reducing counterfeited and illegal drugs at the national level
• Allowing the MoPH to have visibility on the size of pharmaceuticals market in Lebanon.
• Allowing Fast recall of a batch of pharmaceuticals from the Lebanese market and notifying all the concerned parties.
• Allowing real-time and accurate information flow between stakeholders.
• At a later stage it will be a tool to Speed-up the Reimbursement procedure and control fraud at the third party payers (NSSF, Army, MOH, Cooperatives of Public Officers, Private Insurance Companies…) 

VI.Mobile Health 

1. Ministry of Public Health mobile application www.moph.gov.lb/app 

To keep up with the latest technologies and take advantage of innovation in the ICT field, the Ministry of Public Health was one of the first administrations to develop a mobile application for smart phones in 2013 for better health services providing to citizens.

This application is available on App store and Play Store and allows the citizen to get informed on the following:

• Get the latest of Coronavirus Updates
• Emergency cases management and Referrals to Nearest Available Hospital
• Drugs Public Price list (new tool to scan the 2D barcode)
• Geographic distribution of Public/Private Hospitals and PHC Centers
• Latest News & Media Gallery
• Complaints platform to report fraudulent actions
• Rules and Guidelines concerning disbursed expensive and chronic diseases drugs 

The MOPH won the Pan Arab Excellence Award for this application for two consecutive years (2015 and 2016).