Lebanon is a small middle-income country on the Eastern Mediterranean shore with a population of around 4 million Lebanese citizens, 1.2 million Syrian refugees, and half a million Palestinian refugees. It is at the third stage of its demographic transition characterized by a decline in both fertility and mortality rates.Sibai AM, Sen K, Baydoun M, Saxena P. Population ageing in Lebanon: current status, future prospects and implications for policy. Bull World Health Organ 2004;82:219-25. Moreover, Lebanon, like many countries in the Middle East is experiencing an epidemiological transition with an increasingly ageing population suffering from chronic and non-communicable diseases.Pierre-Louis AM, Ayodeji Akala F, Samaha Karam H. Public Health in the Middle East and North Africa: Meeting the Challenges of the Twenty-first Century. Washington D.C: World Bank Institute; 2004. Mortality related to non-communicable diseases is 404.4 deaths per 100,000 individuals, with an estimate of 45% due to cardiovascular diseases, making them the leading cause of death in Lebanon.World Health Organization (WHO). Lebanon. 2014. Available from: . [Accessed on September 8, 2018]. Lebanon has health indices that are close to those of more developed countries, with a reported life expectancy at birth of 80.1 years (81.4 years for women and 78.8 years for men) and an under-five mortality rate of 9.5 per 1,000 live births in 2016.Institute for Health Metrics and Evaluation (IHME). Lebanon. 2016. Available from: . [Accessed on September 8, 2018]. Since the end of the 15-year Lebanese Civil War in 1990, Lebanon's health indicators have significantly improved.
The Human Rights Measurement Initiative finds that Lebanon is fulfilling 85.1% of what it should be fulfilling for the right to health based on its level of income. When looking at the right to health with respect to children, Lebanon achieves 99.1% of what is expected based on its current income. In regards to the right to health amongst the adult population, the country achieves 98.9% of what is expected based on the nation's level of income. Overall, Lebanon falls between the "bad" and "fair" categories for the right to health because when evaluating the right to reproductive health, the nation is fulfilling only 57.2% of what the nation is expected to achieve based on the resources (income) it has available.
History Before independence in 1943, health care in Lebanon was given by charitable organisations, religious organizations, and private hospitals. The state played a limited role, and access was uneven across regions and social groups. After independence, the state started and expanded public health functions. It also began building the early public health insurance system, but private care stayed dominant. This dual structure, though fragmented and heavily reliant on out of pocked expenses, became a lasting feature of the system.
The civil war from 1975 to 1990 severely weakened the health sector. Many public facilities were damaged, medical personnel transport became dangerous, and the Ministry of Public Health lost most of its budget. The people of Lebanon increasingly relied on private hospitals and nongovernmental groups to keep services running. The Asfouriyeh Hospital, founded in 1896 in Lebanon, is considered the first modern mental health hospital in the Middle East, the impact of the Lebanese Civil War led to the hospital's closure in 1982. + Change in Lebanon's Health Indicators between 1974 and 2016: Indicator Value in 1974 (before the Lebanese civil war) Value in 1976 (during the Lebanese civil war) Value in 2016 Life expectancy at birth (years) 67.9 34.9 80.1 Under-five mortality rate (by 1,000 live births) 58.9 56.8 9.5 Fertility rate 4.53 4.36 1.71 Maternal mortality ratio (by 100,000 live births) No data 104 (1984 value) 16 (2013 value) Income (gross domestic product per capita) 15,000 4,370 13,000 Reform efforts in the 1990s and 2000s reduced some out-of-pocket costs, but care stayed highly privatized and unequal. Since 2019, Lebanon’s economic collapse, and the COVID-19 shock during shortages of medicines and staff, have weakened access to care. The 2020 Beirut explosion put more pressure on hospitals and public services. The result of all these factors has been a weaker health system where access to care depends on financial status and place of residence.
Health care system
Lebanon’s health care system lacks a coherent framework and is largely reliant on private providers. The World Bank Group describe Lebanon’s health financing as fragmented with weak insurance regulation. Funding comes from different sources, such as public expenditure, social and private insurance, donors, and a significant amount of out of pocket payments. The Ministry of Public Health supports Lebanon's primary health care network, much of which is operated by or supported by NGOs. The overall health system continues to face major challenges related to access and affordability, where public institutions play a limited role.
Public health care Publicly funded health care is central to more than half of the population living without other medical insurance coverage in Lebanon. The Ministry of Public Health (MoPH) runs the public sector hospitals and supports a national network of primary health care centers. Public primary care is delivered through a nationwide network of centers, many of them run by NGOs or municipalities under MoPH contracts.
Financing MoPH subsidizes hospital care in both public and private facilities, with patient co-payments that vary by hospital type and entitlement status. Recent reviews describe the public health sector's finances as resilient but under severe strain. They show uncoordinated financing of the public health care system that's dependant on private sector delivery, and rising out of pocket costs, which causes limited access to care for vulnerable groups.
Refugees In 2015, there were 452,669 registered Palestinian refugees in the country; more than half live in 12 Palestinian refugee camps. They are ineligible for state social services, including health care. Further adding to the issue is the amount of Syrian refugees, totalling almost one for every four Lebanese. These people are often forced to live in squalid conditions due to a lack of government resources. More often than not, these people are also subject to discrimination in certain aspects of life. This includes medical treatment, to which they have no legal right to according to Lebanese law.
Private health care Lebanon’s private health care sector is the main provider of medical care in the country. The Ministry of Public Health regulates the sector through licensing and accreditation, while professional oversight is also handled by syndicates and other non governmental organisations. WHO has described Lebanon’s private hospital network as large and highly concentrated geographically, with most beds located in Beirut and Mount Lebanon, containing the great majority of inpatient care capacity. WHO also puts the private hospital total at 133 facilities and about 12,000 beds, or roughly 83% of national capacity.
For state subsidized hospitalization, patients usually face a co payment, while the ministry covers most of the charge under its reimbursement rules. Access is uneven because treatment often depends on the patient’s ability to pay.
Health status
Fertility rate The World Bank Group estimated Lebanon’s total fertility rate in 2024 to be 2.2 children per woman. In the same year, the Ministry of Public Health recorded 91,150 live births. UN and WBG datasets show Lebanon moving from well above five births per woman in the 1960s to near replacement level today. Peer reviewed research has linked lower fertility to socioeconomic change, especially women’s higher education, financial hardships, and increased use of contraception. The decline is part of a demographic transition.
The Ministry of Public Health says its sexual and reproductive health programme, run with UNFPA through primary health care, provides family planning, prenatal care, and birth control to improve health during pregnancies and to support the prevention of unintended pregnancies.
Life expectancy Lebanon’s life expectancy at birth has improved over time, but WHO and WBG data show a decline during the COVID-19 period. The same sources estimated life expectancy at around 76 years in 2020, 73 in 2021, 78 in 2022, and 77 in 2023. However, it is also note that life expectancy numbers for Lebanon are modelled because complete and reliable data on deaths in the country are limited, especially for adults and seniors.
Maternal mortality rate Since the early 1990s, Lebanon has brought its maternal mortality ratio down from more than 70 deaths per 100,000 live births to roughly 15–26 in the early 2000s, a drop of over three quarters. This shift placed the country among those that ultimately met global targets for reducing maternal deaths. From 2004 statistics became based on national hospital data, the Ministry of Public Health began to include sexual and reproductive health in primary care, and in 2011 it set up notification system where public and private hospitals report births, and maternal and neonatal deaths, every month through an online system.
Analyses of maternal deaths consistently identify postpartum bleeding as the leading direct causes, followed by hypertensive disorders of pregnancy, eclampsia, infections and embolism, reflecting the global pattern of preventable obstetric labor complications. The data show that women die because they do not receive timely, good‑quality obstetric treatment, especially in poorer areas and among those who cannot easily afford care or lack proper legal status.
Health conditions and risk factors Lebanon’s health profile has shifted over the past decades, 2021 WHO reported 53% of deaths result from noncommunicable disease. Cardiovascular disease is the leading NCD group, and WHO and related Lebanese sources place it at the top of the mortality profile. Cancer is a major contributor and more people die from cancer every year. Kidney disease, diabetes, and dementia also contribute meaningfully to mortality, although they are smaller components than cardiovascular disease and cancer. This pattern is closely linked to major risk factors, including tobacco use, raised blood pressure, obesity, and physical inactivity. Limited access to medical care has also made chronic disease control more difficult, especially as Lebanon’s health system has faced economic and structural strain.
Women's health conditions and risk factors Women have adequate access to gynecological and other female health facilities in Lebanon, excluding contraceptives. Abortion is illegal except in cases where the woman's life is at risk, under Lebanon's Penal Code of 1943.
Non communicable diseases
Cardiovascular diseases Cardiovascular diseases represent the leading cause of morbidity and mortality in Lebanon and are also the primary cause of hospital admission.Deek H, Newton P, Inglis S, et al. Heart health in Lebanon and considerations for addressing the burden of cardiovascular disease. Collegian 2015;22:333-9. In 2012, it was estimated that 31% of all deaths in Lebanon were due to ischemic heart disease.World Health Organization (WHO). Lebanon: WHO statistical profile. 2015. Available from: .[Accessed on September 8, 2018]. This high cardiovascular disease incidence can be attributed to several risk factors. For example, 42% of the Lebanese people are smokers, 29.4% are obese, 22.8% are diabetic, and 29.8% suffer from hypertension.Fahs I, Khalife Z, Malaeb D, Iskandarani M, Salameh P. The Prevalence and Awareness of Cardiovascular Diseases Risk Factors among the Lebanese Population: A Prospective Study Comparing Urban to Rural Populations. Cardiol Res Pract 2017;2017:3530902.
Cancers