WHO Plans a New Accounting Push for South Sudan’s Health Financing Flows
WHO is seeking an International Consultant to help South Sudan conduct its National Health Accounts for three financial years: 2023/2024, 2024/25, and 2025/2026. The assignment is built around a familiar problem in fragile health systems: money moves through multiple channels, but the system often lacks a complete, standardized map of where it comes from, who pools it, how it is spent, and whether it reaches care efficiently and equitably.
South Sudan’s financing profile makes that question especially urgent. Out-of-pocket spending stood at 34% in 2022, while government expenditure on health reached 2% in 2025, a level far below regional and global commitments. External donors continue to finance a substantial share of service delivery, leaving the health system exposed to volatility, fragmentation, and gaps in risk pooling. In practical terms, households still shoulder a heavy share of costs while the public sector tries to build a more durable financing base.
Why the National Health Accounts Matter Now
The Ministry of Health is pursuing Universal Health Coverage, strengthening primary health care, and implementing the Health Sector Strategic Plan 2023–2027. Those goals depend on much more than policy language. They require evidence on who pays, how much is spent, and whether resources are aligned with service priorities.
Without a detailed expenditure picture, budgeting becomes approximate, donor coordination becomes harder, and reform plans risk drifting away from actual spending behavior. A National Health Accounts exercise is designed to fix that blind spot. By tracking financial flows through the system, the process can show financing sources, pooling arrangements, purchasing mechanisms, management channels, and the eventual use of resources across the health sector.
This is not a theoretical bookkeeping exercise. In a setting with fragile institutions and dependence on external support, financial visibility shapes whether reforms can be sustained beyond a single budget cycle. If spending data remain fragmented, it becomes difficult to judge whether domestic spending is rising, whether donor funds are complementing or distorting public priorities, and whether the health system is moving toward more resilient financing.
The Consultant’s Role Extends Beyond Data Cleaning
The consultant will work under the overall guidance of the WHO Representative in South Sudan and the direct technical supervision of the Health Systems Development Cluster team lead. Close collaboration is expected with the Ministry of Health, including the Directorate of Policy, Planning, Budgeting, Research and M&E, as well as other directorates, partners, UN agencies, and relevant stakeholders.
The assignment covers the full NHA cycle. It begins with a desk review of the health financing landscape using policies, strategies, guidelines, data sources, and available reports. From there, the consultant is expected to develop a detailed workplan and implementation roadmap, set up a multi-stakeholder team, and map the institutions involved in the broader health financing space.
A strong technical exercise still depends on institutional buy-in. In South Sudan, that means orientation and advocacy with stakeholders, capacity-building for the National Health Accounts core team, and close coordination during data collection from financing agents and health providers. The consultant will also support data management, cleaning, coding, and analysis using SHA 2011 classifications, then guide consultative meetings, validation workshops, interpretation of findings, and preparation of the final NHA outputs.
A Standardized Framework Can Expose the Real Bottlenecks
The use of the System of Health Accounts 2011 framework gives the exercise methodological discipline. It allows comparability across time and across settings, which is especially important in countries where health financing data are often incomplete or collected through different administrative systems. A standardized account can reveal whether spending is concentrated in a few channels, whether households are bearing an excessive burden, and whether purchasing arrangements are fragmented enough to blunt the effect of available funds.
For a country working toward UHC, those details matter because financing structure affects access. Heavy reliance on out-of-pocket payment can delay care seeking, deepen inequity, and push families into financial distress. Weak risk-pooling mechanisms limit the system’s ability to spread costs across healthy and sick populations. Fragmented financing can also reduce the efficiency of purchases, leaving health facilities underfunded in some areas and overstretched in others.
The consultancy’s expected deliverables reflect that full sequence: an inception report and workplan, a South Sudan health financing landscape report, training reports, final data tools and protocols, a clean and validated NHA database, a draft and final NHA report, policy briefs, dissemination materials, an institutionalization plan, and a final consultancy report. Each step is tied to a different stage in the production of evidence, not merely to an administrative milestone.
A single line in the job description captures the broader ambition: routine production of health accounts within the Ministry of Health. If institutionalized, the process could move from a one-off technical exercise to a repeatable government function.
The Skills Profile Signals the Level of Technical Demands
WHO is looking for a candidate with a master’s degree in statistics, economics, health financing, health economics, public health, health policy, health systems, or a related field. The experience requirements are substantial: at least seven years supporting health expenditure tracking using SHA 2011 methodology, especially in African countries or lower-middle- or low-income contexts, along with competence in the Health Accounts Production Tool.
The profile also calls for at least 10 years of progressive experience in health systems strengthening, including health financing, particularly in sub-Saharan Africa. Experience in fragile and conflict-affected settings is listed as an advantage. Those criteria fit the realities of South Sudan, where financing reform has to proceed amid constrained fiscal space, limited data infrastructure, and a dependence on multiple financing actors.
Strong statistical and analytic skills are essential, but so are facilitation and report-writing skills. The consultant will need to translate complex financing data into actionable knowledge products for government decision-makers, partners, and technical teams. English fluency is required, as is the ability to work across a diverse set of institutions and stakeholders.
A Technical Exercise with Policy Consequences
The health accounts exercise is intended to inform government budgeting, resource mobilization, donor coordination, strategic purchasing, health financing reforms, and monitoring of UHC progress. Those are all policy functions, but they share one common dependency: credible data on how health money is flowing now.
South Sudan’s financing challenge is not only the size of available resources. It is also the way the resources are organized. When external support dominates, when domestic public investment remains low, and when households continue to pay directly at the point of care, the system remains vulnerable to disruption and inequity. A rigorous NHA can show whether current arrangements are sustainable or whether reforms need to be redirected toward stronger pooling, clearer purchasing, and better alignment between spending and health priorities.
The consultancy is set for three months, with remuneration linked to agreed deliverables and supported by daily subsistence allowance and round-trip economy airfare according to WHO rules. The short timeline suggests a concentrated technical assignment rather than a long-term advisory role. The larger question is whether the resulting evidence will move beyond documentation and into routine government use, where it can shape the next budget cycle and the next round of financing reform.