Vigilância Alimentar e Nutricional para os povos indígenas no Brasil: análise da construção de uma política pública em saúde

Caldas, Aline Diniz Rodrigues; Santos, Ricardo Ventura

doi:10.1590/s0103-73312012000200008

Cited by 9 publications

(9 citation statements)

References 19 publications

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“…Data from the First National Survey of Health and Nutrition of Indigenous Peoples demonstrated the association between diarrhea and anemia in Indigenous children 37 , which finds support in the international literature 38 . It is also important to mention the National Iron Supplementation Program, an action developed in 2003 as part of the Indigenous Food and Nutrition Surveillance System (SISVAN Indígena) 39 and which for various reasons reaches less than half of the target population of Indigenous children under five years 6 .…”

Section: Discussionmentioning

confidence: 99%

Anemia e níveis de hemoglobina em crianças indígenas Xavante, Brasil Central

Ferreira

Santos

Souza

et al. 2017

Rev. bras. epidemiol.

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ABSTRACT:Objective: To evaluate the prevalence of anemia, mean hemoglobin levels, and the main nutritional, demographic, and socioeconomic factors among Xavante children in Mato Grosso State, Brazil. Methods: A survey was conducted with children under 10 years of age in two indigenous Xavante communities within the Pimentel Barbosa Indigenous Reserve. Hemoglobin concentration levels, anthropometric measurements, and socioeconomic/demographic data were collected by means of clinical measurements and structured interviews. The cut-off points recommended by the World Health Organization were used for anemia classification. Linear regression analyses with hemoglobin as the outcome and Poisson regression with robust variance and with the presence or absence of anemia as outcomes were performed (95%CI). Results: Lower mean hemoglobin values were observed in children under 2 years of age, without a significant difference between sexes. Anemia was observed among 50.8% of children overall, with the highest prevalence among children under 2 years of age (77.8%). Age of the child was inversely associated with the occurrence of anemia (adjusted PR = 0.60; 95%CI 0.38-0.95) and mean hemoglobin values increased significantly with age. Greater height-for-age z-score values reduced the probability of having anemia by 1.8 times (adjusted PR = 0.59; 95%CI 0.34-1.00). Presence of another child with anemia within the household increased the probability of the occurrence of anemia by 52.9% (adjusted PR = 1.89; 95%CI 1.16-3.09). Conclusion: Elevated levels of anemia among Xavante children reveal a disparity between this Indigenous population and the national Brazilian population. Results suggest that anemia is determined by complex and variable relationships between socioeconomic, sociodemographic, and biological factors.

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Section: Discussionmentioning

confidence: 99%

Anemia e níveis de hemoglobina em crianças indígenas Xavante, Brasil Central

Ferreira

Santos

Souza

et al. 2017

Rev. bras. epidemiol.

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“…Any intervention aimed at indigenous peoples in Brazil, however, must take into consideration this country’s enormous sociocultural diversity, with as many as 300 indigenous ethnic groups and over 200 indigenous languages living in diverse environmental settings. With so many distinctive societies within the Brazilian borders, it is all the more important to implement public health policies and measures aimed at reducing child undernutrition that incorporate sociocultural, economic, environmental, and biomedical dimensions of the problem (see Caldas and Santos [77] for a recent review of the development of nutrition policies aimed at indigenous peoples in Brazil).…”

Section: Discussionmentioning

confidence: 99%

Nutritional status of indigenous children: findings from the First National Survey of Indigenous People’s Health and Nutrition in Brazil

Horta

Santos

Welch

et al. 2013

Int J Equity Health

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IntroductionThe prevalence of undernutrition, which is closely associated with socioeconomic and sanitation conditions, is often higher among indigenous than non-indigenous children in many countries. In Brazil, in spite of overall reductions in the prevalence of undernutrition in recent decades, the nutritional situation of indigenous children remains worrying. The First National Survey of Indigenous People’s Health and Nutrition in Brazil, conducted in 2008–2009, was the first study to evaluate a nationwide representative sample of indigenous peoples. This paper presents findings from this study on the nutritional status of indigenous children < 5 years of age in Brazil.MethodsA multi-stage sampling was employed to obtain a representative sample of the indigenous population residing in villages in four Brazilian regions (North, Northeast, Central-West, and Southeast/South). Initially, a stratified probabilistic sampling was carried out for indigenous villages located in these regions. Households in sampled villages were selected by census or systematic sampling depending on the village population. The survey evaluated the health and nutritional status of children < 5 years, in addition to interviewing mothers or caretakers.ResultsHeight and weight measurements were taken of 6,050 and 6,075 children, respectively. Prevalence rates of stunting, underweight, and wasting were 25.7%, 5.9%, and 1.3%, respectively. Even after controlling for confounding, the prevalence rates of underweight and stunting were higher among children in the North region, in low socioeconomic status households, in households with poorer sanitary conditions, with anemic mothers, with low birthweight, and who were hospitalized during the prior 6 months. A protective effect of breastfeeding for underweight was observed for children under 12 months.ConclusionsThe elevated rate of stunting observed in indigenous children approximates that of non-indigenous Brazilians four decades ago, before major health reforms greatly reduced its occurrence nationwide. Prevalence rates of undernutrition were associated with socioeconomic variables including income, household goods, schooling, and access to sanitation services, among other variables. Providing important baseline data for future comparison, these findings further suggest the relevance of social, economic, and environmental factors at different scales (local, regional, and national) for the nutritional status of indigenous peoples.

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“…The National Survey is an important public health milestone in Brazil, as it provides for the first time information on the health and nutrition of indigenous peoples based on a nationwide representative sample. The data collected will serve as a useful resource for future evaluations of Brazil’s Indigenous Healthcare Subsystem, as well as providing a baseline for evaluating recent and future actions by the nutritional surveillance system attending the indigenous population [44]. For this reason, the findings selected for presentation in this article include health and socioeconomic indicators of comparative value relative to available data for the non-indigenous Brazilian population.…”

Section: Introductionmentioning

confidence: 99%

The First National Survey of Indigenous People’s Health and Nutrition in Brazil: rationale, methodology, and overview of results

et al. 2013

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BackgroundAlthough case studies indicate that indigenous peoples in Brazil often suffer from higher morbidity and mortality rates than the national population, they were not included systematically in any previous national health survey. Reported here for the first time, the First National Survey of Indigenous People’s Health and Nutrition in Brazil was conducted in 2008–2009 to obtain baseline information based on a nationwide representative sample. This paper presents the study’s rationale, design and methods, and selected results.MethodsThe survey sought to characterize nutritional status and other health measures in indigenous children less than 5 years of age and indigenous women from 14 to 49 years of age on the basis of a survey employing a representative probabilistic sample of the indigenous population residing in villages in Brazil, according to four major regions (North, Northeast, Central-West, and South/Southeast). Interviews, clinical measurements, and secondary data collection in the field addressed the major topics: nutritional status, prevalence of hypertension and diabetes mellitus in women, child hospitalization, prevalence of tuberculosis and malaria in women, access to health services and programs, and characteristics of the domestic economy and diet.ResultsThe study obtained data for 113 villages (91.9% of the planned sample), 5,305 households (93.5%), 6,692 women (101.3%), and 6,128 children (93.1%). Multiple household variables followed a pattern of greater economic autonomy and lower socioeconomic status in the North as compared to other regions. For non-pregnant women, elevated prevalence rates were encountered for overweight (30.3%), obesity (15.8%), anemia (32.7%), and hypertension (13.2%). Among children, elevated prevalence rates were observed for height-for-age deficit (25.7%), anemia (51.2%), hospitalizations during the prior 12 months (19.3%), and diarrhea during the prior week (23.6%).ConclusionsThe clinical-epidemiological parameters evaluated for indigenous women point to the accentuated occurrence of nutrition transition in all regions of Brazil. Many outcomes also reflected a pattern whereby indigenous women’s and children’s health indicators were worse than those documented for the national Brazilian population, with important regional variations. Observed disparities in health indicators underscore that basic healthcare and sanitation services are not yet as widely available in Brazil’s indigenous communities as they are in the rest of the country.

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Vigilância Alimentar e Nutricional para os povos indígenas no Brasil: análise da construção de uma política pública em saúde

Cited by 9 publications

References 19 publications

Anemia e níveis de hemoglobina em crianças indígenas Xavante, Brasil Central

Anemia e níveis de hemoglobina em crianças indígenas Xavante, Brasil Central

Nutritional status of indigenous children: findings from the First National Survey of Indigenous People’s Health and Nutrition in Brazil

The First National Survey of Indigenous People’s Health and Nutrition in Brazil: rationale, methodology, and overview of results

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