Pesquisa Operacional (2015) 35(2): 353-361 © 2015 Brazilian Operations Research Society Printed version ISSN 0101-7438 / Online version ISSN 1678-5142 www.scielo.br/pope doi: 10.1590/0101-7438.2015.035.02.0353 ANALYTIC NETWORK PROCESS AND BALANCED SCORECARD APPLIED TO THE PERFORMANCE EVALUATION OF PUBLIC HEALTH SYSTEMS Marco Aur´ elio Reis dos Santos, Val´ erio Antonio Pamplona Salomon* and Fernando Augusto Silva Marins Received August 8, 2014 / Accepted December 9, 2014 ABSTRACT. The performance of public health systems is an issue of great concern. After all, to assure people’s quality of life, public health systems need different kinds of resources. Balanced Scorecard pro- vides a multi-dimensional evaluation framework. This paper presents the application of the Analytic Net- work Process and Balanced Scorecard in the performance evaluation of a public health system in a typical medium-sized Southeastern town in Brazil. Keywords: analytic network process, balanced scorecard, performance evaluation, public health systems. 1 INTRODUCTION The performance of public health systems is an issue of great concern (Harrison et al., 2004). After all, to assure or to improve people’s quality of life, huge and increasing amounts of public resourcesare needed (Caballer-Tarazona et al., 2010). However, traditional performance evalua- tion models are solely based on subjective and, in some cases, paternalistic aspects (Gomes & Andrade, 2012). Balanced Scorecard (BSC) provides a multiple-dimensional evaluation framework integrating concerns from four different perspectives: Financial, Customer, Internal Business Process, and Learning and Growth (Kaplan & Norton, 1992). Since some of these perspectives may conflict with one another (Wu et al., 2009), the BSC framework compromises a multi-criteria decision analysis (MCDA). Although the Analytic Hierarchy Process (AHP) is the MCDA method with the highest number of scientific publications (Wallenius et al., 2008), the Analytic Network Process (ANP) is a generalization of the AHP that deals with dependencies (Ishizaka & Nemery, 2013). Once there *Corresponding author. Universidade Estadual Paulista – UNESP, Guaratinguet´ a, SP, Brazil. E-mails: marcoaurelioreis@yahoo.com.br; salomon@feg.unesp.br; fmarins@feg.unesp.br