Job Opening

Posting Title: SHA Account: advances and methodological proposals for analyzing health spending in Brazil from the perspective of international accounting
Department/Office: Economic Commission for Latin America and the Caribbean
Duty Station: BRASILIA
Posting Period: 21 December 2021 - 27 December 2021
Job Opening Number: 21-Economic Commission for Latin America and the Caribbean-171306-Consultant
Staffing Exercise N/A
United Nations Core Values: Integrity, Professionalism, Respect for Diversity
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Result of Service

Strengthening the institutional capacity to collaborate in the production and, especially, in the analysis of expenditure and financing of the Unified Health System using internationally validated methodologies, but adapted to the Brazilian case. From this expanded capacity, the institution will be able to collaborate even more with analyzes and evaluations of public policies related to health, as well as producing and making available statistics in partnership with other institutions involved in the preparation of health accounts in Brazil.

Work Location


Expected duration

540 Days

Duties and Responsibilities

In the early 2000s, projects were started to adapt methodologies used internationally for analyzing the financing and expenditure of health systems. This process advanced through inter-institutional partnerships between the Ministry of Health, the Oswaldo Cruz Foundation, the Brazilian Institute of Geography and Statistics, the Institute of Applied Economic Research and the National Health Agency. from the methodologies related to the National Accounts System (SCN/1993) of the United Nations with the implementation and publication of Health Satellite Accounts (CSS), generating several publications, the most recent being the satellite account for the period 2010-2017 ( IBGE, 2019). In 2016, the process of adapting the methodology of the Health Accounts System of the Organization for Cooperation and Development (System of Health Accounts -SHA/OECD) began, coordinated by Fiocruz in partnership with the Ministry of Health and support from other institutions. the first publication related to the SUS for the period 2010-2014 (Brasil, 2018).
In addition to continuing advanced in the production of CSS, the partnership for the production of the SHA Account now directly includes Ipea and ANS, with the generation of a new series of estimates for the period 2015-2019 being planned. In this process, methodological changes were proposed to the SHA-SUS Account, as well as methodologies to advance in the estimation of the supplementary health portion and the direct out-of-pocket expenditure (direct household expenditure). As part of this process, it is necessary to consolidate the changes made between the first publication of the health account using the OECD methodology and the one that is in the process of preparation. Furthermore, in the preparation process, even after the publication of the 2015-2019 data, there was a need to deepen the knowledge on topics that have not yet been adequately analyzed in this perspective of adaptation to international accounting. We know little about the public and private expenditure of closed clientele systems not regulated by the ANS, such as their own health care systems in states and municipalities, aimed at civil and military servants of the three powers. Deepening this discussion with methodological proposals for the Brazilian case will serve not only for a national analysis, but as a proposal for debate with other Latin American countries. Additionally, a second by-product of the SHA accounts is the possibility of revising the values in the Sigtap table considering the own resources contributed by states and municipalities and adding them to the federal resources allocated by the table procedures.
Studying these topics requires an in-depth knowledge of health accounting methodologies, particularly the SHA/OECD Accounts. The two objectives of the consultancy are: i) to consolidate the available knowledge about the methodological progress on the production on the SUS Accounts using the SHA/OCDE methodogy; and, ii) to propose new methodological advances for this purpose.

Qualifications/special skills

Academic Qualifications: PhD in Science/Public Health and/or Economics
Experience: • Minimum experience of 10 years in public health, health system and databases, in adapting methodologies and preparing health accounts according to its various methodologies.

• Articles published in the consultancy's object area
Language: - Fluency in Portuguese and English.

Additional Information

Outputs/ Works Assignment:
Product 1 – ECLAC's participation in the development of Health Accounts in Latin America and the Caribbean and the state of the art in the production of Health Accounts in the region be submitted 60 days after start date.
Product 2 - Descriptive technical report on methodological advances in the production of SHA-SUS Accounts for Brazil for the period 2010-4 and 2015-9. To be submitted 120 days after start
Product 3. Descriptive technical report containing a methodological proposal for adjusting the remuneration values of procedures in the SUS Table (SIGTAP) considering the tripartite contributions (federal, state and municipal) in SUS financing. To be submitted 300 days after start
Product 4. Descriptive technical report on health care systems for public servants in Brazil and proposal for measuring their expenditure. To be submitted 540 days after start

No Fee


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