Guinea-Bissau is a small state in West Africa with a population of around 1.8 million. It is rich in natural resources (fisheries, forestry and agriculture) and biodiversity. Economic activity is, however, dominated by the production and sale of unprocessed cashew, which is also the main source of income for more than two thirds of households. Guinea-Bissau is host to a large variety of ethnic groups, languages and religions, with communal and ethnic-based violence remaining low. The country has a history of political and institutional fragility dating back to its independence from Portugal in 1973. Since independence, four successful coups have been recorded, with another 16 coups attempted, plotted, or alleged. Political fragility has been manifesting itself in frequent government turnover. Political instability has been responsible for large drops in output and government expenditure. After almost three years of political gridlock, a new consensus government came to power in April 2018. In sum, Guinea-Bissau has been caught in a vicious cycle of poor governance, fragmented elites, weak public sector capacity, and a poorly diversified economy. The objective of the Guinea-Bissau Public Expenditure Review (PER) is to analyze government expenditure, fiscal revenue, and public financial management in selected sectors (education, health, and security). The PER is a follow-up to the World Bank’s (2017) Public Expenditure Analysis that provided an overall review of public finances in Guinea-Bissau (see Annex I). It contains a wide range of analyses, with some chapters examining public spending trends and outcomes, while others are more process oriented and place a strong emphasis on PFM systems, at macro- and micro-levels. The education and health chapters go beyond the confines of traditional World Bank PERs—namely the efficiency, effectiveness, and equity of spending. Both of these chapters also review the PFM systems in the respective line ministries with a view to identifying options for reform. Further, the PER analyzes the fiscal implications of continuing to spend over 15 percent of the budget on the security sector and nearly 9 percent of GDP on wage and nonwage compensation.