Evolução do quantitativo de nutricionistas na Atenção Básica do Brasil: a contribuição dos Núcleos de Apoio à Saúde da Família e da Estratégia Saúde da Família de 2007 a 2013

Vasconcelos, Ivana Aragão Lira; Sousa, Maria Fátima de; Santos, Leonor Maria Pacheco

doi:10.1590/1415-52732015000400009

Cited by 14 publications

(14 citation statements)

References 22 publications

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“…Over the time period investigated, there were only two dietitians working in Primary Care. However, at the national level, the integration of this health professional at this level of care within the RAS remains more limited than that of the Secondary and Tertiary Care levels, despite the significant recent increase in the number of dietitians working in Primary Care [30,31].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of nutritional care of overweight adults from the perspective of comprehensive health care

2017

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Objective: Describe and evaluate the nutritional care provided for overweight adults by the Primary and Secondary Health Care services of Santos, São Paulo, Brazil. Methods: This study was carried out between 2013 and 2015 integrating quantitative and qualitative approaches; it was divided into two phases: (1) characterization and (2) evaluation. In phase 1, a census of Primary Health Care Units (n=28) and Secondary Health Care Units (n=4) was conducted using interviews with health service managers and/or health professionals. Data were analyzed using exploratory data analysis. In phase 2, in-depth interviews were conducted with health service managers and/or health professionals investigating a sample of the Primary Health Care services and the totality of Secondary Health Care services provided. Thematic analysis was carried out using the theoretical framework for comprehensive health care proposed by Pinheiro & Mattos. Results: A total of 40 professionals were interviewed: 36 in the primary health care services and 4 in the secondary health care services. Nutritional care in the Primary Care services is focused on individual care and referrals to other services; nutrition diagnosis and health promotion occur only when overweight is associated with another disease. It was observed that the referral and counter-referral system and intersectorial collaborations were ineffective. In Secondary Care services, nutritional care is focused on clinical care using traditional approaches to nutrition education. Limiting factors for promoting comprehensive care were identified at the two levels of care: unproductive actions, lack of actions for health promotion and protection, and little dialogue between the Primary and Secondary care services. Conclusion: Overweight is not an outcome based on Primary and Secondary Care, but rather on prescriptive practices, which are not very effective in promoting users’ autonomy. It is necessary to guide the actions taken in these two levels of care to ensure the promotion of effective nutritional care.

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Section: Discussionmentioning

confidence: 99%

Evaluation of nutritional care of overweight adults from the perspective of comprehensive health care

2017

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“…Another important event was the creation of the Núcleos de Apoio ao Programa Saúde na Família (NASF, Family Health Program Support Centers), with the objective of qualifying and expanding the breadth, scope and resolution of basic health care actions, through the insertion of different professionals in the family health teams, among them the nutritionist [35]. Vasconcelos et al [36] identified an increase in the number of nutritionists in Basic Health-Care clinics after the creation of NASF, although this number remains below health needs. Also, the insertion of the nutritionist into the NASF was an important step in boosting the organization of nutritional care in health services [35].…”

Section: Lula Era (2003-2010): Hunger Eradication (Fome Zero) and Assmentioning

confidence: 99%

Public policies of food and nutrition in Brazil: From Lula to Temer

et al. 2019

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Objective To analyze public policies on food and nutrition in Brazil, with emphasis on the last fifteen years (2003-2018). Methods Historical-documentary analysis based on a bibliographical survey on indexed bases and exploratory visits to websites of government agencies. Results The scientific and governmental findings were organized according to the Lula, Dilma and Temer governments. They explore the development of several public policies and welfare programs in food and nutrition, focusing mainly on Brazilian Hunger Eradication Program, Assistance for Needy Families Program, National Policy on Food and Nutrition Security, Food Acquisition Program, National School Nutrition Program, National Food and Nutrition Security Policy, National Food and Nutrition Surveillance System and Brazilian Misery Eradication Program. The centrality of the idea of the fight against hunger and misery in public policies during Lula’s first and second terms and Dilma’s first term stand out. Dilma’s second term is marked by the focus on healthy eating, as well as presenting the first signs of fragilization of public policies on food and nutrition. Currently, the Temer government is characterized by processes of institutional and programmatic rupture, budget cuts and setbacks in acquired rights. There is evidence of the need to activate national and international instruments to enforce the human right to adequate food and consequent strengthening of public policies on food and nutrition. Conclusion This period presents an expansion and qualification of public policies on food and nutrition, mainly in the Lula and Dilma administration, with setbacks in the Temer administration, in which continuous budget cuts weaken social, hunger reduction, poverty reduction and food and nutrition security policies.

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“…16,17 O desenvolvimento de competências e a construção de identidade profissional do nutricionista são aspectos problematizados na literatura, 15,18 apontando para a necessidade de fortalecer a formação voltada à APS. 13,19 No tocante à atuação nessa área, estudos apontam dificuldades relativas à inserção ainda insuficiente deste profissional para responder às demandas de atenção integral à saúde. 3,10,11 Desta forma, entender os desafios para a prática profissional na rede de Atenção Primária à Saúde, na perspectiva do profissional nutricionista, pode nortear ações mais efetivas e consoantes entre a formulação de políticas públicas e as práticas locais, além de poder guiar processos relacionados à formação acadêmico-profissional.…”

Section: Introductionunclassified

Nutricionistas Na Atenção Primária No Município De Santos: Atuação E Gestão Da Atenção Nutricional

Spina

Martins

Vedovato

et al. 2018

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Analisou-se a prática de nutricionistas na Atenção Primária à Saúde-APS de Santos/SP, utilizando abordagem qualitativa, com análise de conteúdo. Realizaram-se entrevistas semiestruturadas com o universo de nutricionistas (três). As entrevistadas relataram número insuficiente de profissionais nos 28 serviços, dificultando o trabalho em equipe e a qualidade das ações. Avaliaram desfavoravelmente seu processo de trabalho, por impossibilitar a atuação em linhas do cuidado e a criação de vínculo. Predominavam atividades em grupo, a maior parte em salas de espera, sem planejamento prévio e de natureza disciplinar. Revelou-se a premência de superar obstáculos, como o tempo reduzido de trabalho por serviço e a limitada infraestrutura para ações de prevenção/promoção. Conclui-se que o município não possui um número adequado de nutricionistas na APS, especialmente em áreas de maior vulnerabilidade social, inviabilizando os processos de trabalho e a efetivação da integralidade da atenção.

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Evolução do quantitativo de nutricionistas na Atenção Básica do Brasil: a contribuição dos Núcleos de Apoio à Saúde da Família e da Estratégia Saúde da Família de 2007 a 2013

Cited by 14 publications

References 22 publications

Evaluation of nutritional care of overweight adults from the perspective of comprehensive health care

Evaluation of nutritional care of overweight adults from the perspective of comprehensive health care

Public policies of food and nutrition in Brazil: From Lula to Temer

Nutricionistas Na Atenção Primária No Município De Santos: Atuação E Gestão Da Atenção Nutricional

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