Abstract
Municipalities in Lebanon represent local governments at the basic community level. The proximity of the municipality to the local community and its knowledge of available resources, can be crucial in easing the impact of any disaster. This study aimed to document the range of preparedness/reactivity of municipalities as COVID-19 swept through Lebanon. A qualitative case study was implemented to explore municipal response to control the epidemic, using in-depth semi-structured interviews with twenty-seven stakeholders from nine municipalities across all governorates in Lebanon. In each municipality, participants included mayors/deputy mayors, available members of municipal councils, prominent community leaders, health care professionals, and managers of local NGOs. The collected data were analyzed using the comparative thematic analysis. The socioecological model was adopted to illustrate the dynamic interplay between the barriers and facilitators at all ecological levels. The response to the pandemic differed significantly in volume and nature among different municipalities across regions, with rural areas clearly disadvantaged in terms of adequacy and completeness of response. Barriers consistently mentioned by most municipalities included economic collapse and poverty, shortage in resources, lack of support from the central government, stigma, lack of awareness, underreporting, flaws in the MOPH surveillance system, impeded accessibility to healthcare services, limited number and weak role of municipal police, increased mental illnesses, and political patronage, favoritism, and interference. On the other hand, increased donations, community engagement, social support and empathy, sufficient human resources, the effective role of healthcare systems, and good governance were identified as key facilitators. The socioecological model identified several multi-level facilitators and loopholes which can be addressed through a suggested strategic "roadmap" providing evidence-based interventions for future epidemics. It is crucial meanwhile that the central government strengthens the administrative and financial resources of municipalities in preparing and rapidly deploying the expected optimal response.
Highlights
The COVID-19 pandemic which started in China in the Fall of 2019, officially reached Lebanon in the second half of February 2020, and spread out across all regions, entailing large social, economic, and psychological consequences
Since the beginning of the COVID-19 crisis in Lebanon, the municipal councils have been entrusted with several tasks beyond their traditional services, to halt the community spread of the virus
This study was approved by the Institutional Review Board (IRB) at the American University of Beirut (AUB)
Summary
Municipalities and service delivery in Lebanon during the COVID-19 pandemic. The COVID-19 pandemic which started in China in the Fall of 2019, officially reached Lebanon in the second half of February 2020, and spread out across all regions, entailing large social, economic, and psychological consequences. Since the beginning of the COVID-19 crisis in Lebanon, the municipal councils have been entrusted with several tasks beyond their traditional services, to halt the community spread of the virus. In Tripoli, the largest city in Northern Lebanon, the population did not abide with the lockdown measures despite the governmental decision of “general mobilization” in March 2020. This was stated by the head of Tripoli’s municipality who attributed community resistance to the prevailing poverty, with more than 40% of the population below the poverty line, and the limited financial capacities of the city. Several municipalities in Mexico implemented “Mercomuna”, an initiative to facilitate community access to food items in urban markets, by providing special vouchers to families and small businesses to support them during the crisis [8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
