Planejamento e percepção sobre segurança alimentar e nutricional na atenção primária à saúde

Abstract

Introduction: Health policies use programs that contribute to the prevention and promotion of health, regardless of the form of care (individual or group), health professionals act strategically. The territorialization recommended by Primary Health Care provides understanding of the social and economic context of the population, the health professional establishes links with users, expanding the identification of inequities and comprehensive care of individuals, favoring the identification and monitoring of issues related to food and nutrition, as well as, enhances the promotion of Food and Nutritional Security. The complexity of promoting and guaranteeing Nutritional Food Security due to multifactorial nature, requires robust health planning, seeking the articulation of different sectors in order to establish common objectives, lines of action, goals and resources, monitoring and evaluation around of a common agenda. Objective: The present study sought to analyze the actions and perceptions of health professionals regarding Food and Nutritional Security within the scope of Primary Health Care. Methods: Sequential explanatory mixed methods study (QUAN→QUAL). The first phase consisted of documentary analysis, through a sensitivity index, of the municipal health plans of the municipalities that make up the 20th health region, in Rio Grande do Sul. The three municipalities with the highest and lowest sensitivity index were selected for the second phase. Semi-structured interviews were carried out with primary health care professionals and content analysis was used for categorization. Results: In the documentary analysis, chronic conditions gained prominence, such as systemic arterial hypertension, mentioned in nine plans, overweight and obesity appeared at least once in eighteen municipal plans. Actions with an intersectoral bias were concentrated on the Bolsa Família and School Health Programs. Only five municipalities mention the term Food and Nutritional Security in municipal health plans. One referred to the municipal Food and Nutritional Security policy and none mentioned aspects related to Food and Nutritional Insecurity. Weaknesses were found in the inclusion of food and nutrition and Food and Nutritional Security actions in municipal planning. The convergence between planning and execution of actions is centered on four axes: nutritional care, promotion of adequate and healthy eating, food and nutritional surveillance and intersectorality. Conclusions: Municipal health plans show low intentionality of actions to promote Food and Nutritional Security. Professionals, in turn, have a good understanding when referring to the concept of Food and Nutritional Security, however they have difficulties understanding its scope, inferring health status and including food and nutrition actions in the activities carried out by Primary Care to Health. The presence of a professional nutritionist in the preparation of the municipal health plan proved to be positive for the inclusion of food and nutrition objectives and targets.