Publications & Documents

In the 30 years since the inception of the Unified Health System (Sistema Único de Saúde, or SUS), Brazil has reduced health inequalities, and improved coverage and access to health care. However, mobilising sufficient financing for the universal health coverage mandate of SUS has been a constant challenge, not helped by persistent inefficiencies in the use of resources in the Brazilian health system. Demographic and epidemiological changes, rising expectations from society, and the emerging needs of a post-COVID‑19 recovery period mean that continued adjustments and reforms are needed to ensure the sustainability of the health system. This review uses internationally recognised indicators and policy frameworks to examine the performance of Brazilian health system. The report points to key actions that Brazil should consider prioritising in the coming years to strengthen health system performance, especially improving efficiency and sustainability of financing, upgrading its health data infrastructure to leverage a digital transformation, and addressing major population risk factors such as overweight and harmful alcohol consumption. A companion publication with a review of primary health care in Brazil further examines the key role of primary health care to improve the performance of the Brazilian health system.

Primary health care in Brazil is well-organised, the result of sustained commitment to providing high quality primary health care for the whole population. Brazil has implemented a set of reforms over the past decades to improve the distribution of doctors, develop new forms of service organisation, introduce new financing models, and implement a range of quality improvement initiatives. This review uses internationally recognised indicators and policy frameworks to examine the performance of primary health care in Brazil. While the review points to notable successes, Brazil continues to face challenges as its population ages, risk factors such as obesity are on the rise, and emerging pandemic threats require resilience and adaptability. The report points to key actions that Brazil should consider in the coming years to strengthen performance of primary health care, especially screening and prevention for major non-communicable diseases, improve quality of primary health care provision, address workforce shortages and pursue a digital transformation. A companion publication with a health system review of Brazil examines the main challenges and approaches needed to improve the performance of the Brazilian health system.

Mainstreaming integrity policies throughout a public administration is a common challenge in many countries. Brazil’s Office of the Comptroller General (CGU) has implemented a series of measures to do so, including establishing the Public Integrity System of the Federal Executive Branch (SIPEF). This report analyses these recent developments and provides recommendations on how to better promote a culture of integrity through the Integrity Management Units with targeted support by the CGU. The report also highlights opportunities to improve the clarity and coherence of policies to promote public integrity and public ethics, manage conflicts of interest, and foster integrity risk management by streamlining these areas under the umbrella of public integrity.

Many Latin American countries have experienced improvements in income over recent decades, with several of them now classified as high-income or upper middle-income in terms of conventional metrics. But has this change been mirrored in improvements across the different areas of people’s lives? How’s Life in Latin America? Measuring Well-being for Policy Making addresses this question by presenting comparative evidence for Latin America and the Caribbean (LAC) with a focus on 11 LAC countries (Argentina, Brazil, Chile, Colombia, Costa Rica, the Dominican Republic, Ecuador, Mexico, Paraguay, Peru and Uruguay). Spanning material conditions, quality of life, resources for future well-being, and inequalities, the report presents available evidence on well-being both before and since the onset of the pandemic, based on the OECD Well-being Framework. It also identifies priorities for addressing well-being gaps and describes how well-being frameworks are used in policy within Latin America and elsewhere around the world, providing lessons for governments on what is needed to put people’s well-being at the centre of their action. The report is part of the EU Regional Facility for Development in Transition for Latin America and the Caribbean.

As 'market referees', regulators contribute to the delivery of essential public utilities. Their organisational culture, behaviour, actions and governance are important factors in how they, and the sectors they oversee, perform. The OECD Performance Assessment Framework for Economic Regulators (PAFER) looks at the institutions, processes and practices that can create an organisational culture of performance and results. This report uses PAFER to assess both the internal and external governance of Brazil’s Electricity Regulatory Agency (ANEEL). The review offers recommendations for the regulator to build upon its strong technical reputation and good practices. It proposes an integrated set of recommendations to help the regulator best fulfil its role as a key actor supporting sector modernisation.

Under Action 14, countries have committed to implement a minimum standard to strengthen the effectiveness and efficiency of the mutual agreement procedure (MAP). The MAP is included in Article 25 of the OECD Model Tax Convention and commits countries to endeavour to resolve disputes related to the interpretation and application of tax treaties. The Action 14 Minimum Standard has been translated into specific terms of reference and a methodology for the peer review and monitoring process. The peer review process is conducted in two stages. Stage 1 assesses countries against the terms of reference of the minimum standard according to an agreed schedule of review. Stage 2 focuses on monitoring the follow-up of any recommendations resulting from jurisdictions' stage 1 peer review report. This report reflects the outcome of the stage 2 peer monitoring of the implementation of the Action 14 Minimum Standard by Brazil.

Using household data from 15 countries in Latin America and Africa, this paper explores linkages between informality and education-occupation matching. The paper applies a unified methodology to measuring education-occupation mismatches and informality, consistently with the international labour and statistical standards in this area. The results suggest that in the majority of low- and middle-income developing countries with available data, workers in informal jobs have higher odds of being undereducated as compared to workers in formal jobs. Workers in formal jobs, in contrast, have higher chances of being overeducated. These results are consistent for dependent as well as for independent workers. They also hold for men and for women according to the gender-disaggregated analysis. Moreover, in the majority of countries considered in this paper, the matching-informality nexus is also related to the extent of informality in a given area: in labour markets with higher informality, informal workers in particular have a higher chance of being undereducated. The paper discusses policy implications of these findings.

This country policy profile on education in Brazil is part of the Education Policy Outlook series. Building on the first policy profile for Brazil (2015), it offers a concise analysis of where the education system stands today in terms of strengths and challenges, and how this compares to other systems. This profile also analyses the evolution of ongoing and emerging related policy efforts in Brazil, including education responses to the COVID-19 pandemic. It brings together over a decade's worth of policy analysis by the Education Policy Outlook, as well as recent OECD data, relevant thematic and country-specific work and other international and national evidence. The report also benefits from the Education Policy Outlook's ongoing comparative analysis of resilience and responsiveness in education policy. This profile is complemented by its companion report Education Policy Outlook: Brazil - with a focus on international policies (both also available in Portuguese).

This country policy profile on education in Brazil is part of the Education Policy Outlook series. Building on the first policy profile for Brazil (2015), it offers a concise analysis of where the education system stands today and how this compares to other systems. This profile offers relevant international policy examples that may serve as possible inspiration as policy makers work to address Brazil's key challenges and priorities, including in the post-COVID recovery. It brings together over a decade's worth of policy analysis by the Education Policy Outlook, as well as recent OECD data, relevant thematic and country-specific work and other international and national evidence. The report also benefits from the Education Policy Outlook's ongoing comparative analysis of resilience and responsiveness in education policy. This profile is complemented by its companion report Education Policy Outlook: Brazil - with a focus on national and subnational policies (both also available in Portuguese).

In light of recent education reforms, Brazil is currently considering a series of changes to the purpose and design of its Basic Education Assessment System (Sistema de Avaliação da Educação Básica, SAEB), which has been a critical source of information about student learning outcomes for the past 30 years. To inform these discussions, the OECD was invited to review a set of policy proposals for reforming the current SAEB so that it more closely aligns with Brazil’s new learning standards and provides data to support a range of education actors - from the classroom to the ministry – in their efforts to raise educational performance and reduce inequalities. The findings from this OECD Review are set out in the below policy perspective.