Implementation of strategies and programs for breastfeeding, complementary feeding, and malnutrition of young children in Brazil: advances and challenges
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Cadernos de Saúde Pública |
Texto Completo: | https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8380 |
Resumo: | Malnutrition in all its forms has risen on global agendas due to the recognition of its magnitude and consequences for a wide range of human, social, and economic outcomes. Implementing strategies and programs with the needed scale and quality is a major challenge. The Brazilian National Survey on Child Nutrition (ENANI-2019) pointed out several advances but numerous challenges. In this paper, we reflect on the implementation progress of breastfeeding, complementary feeding and young children malnutrition strategies and programs in Brazil and how existing challenges can be overcome through the lens of implementation science. First, we present a brief history of such programs. Second, we selected two breastfeeding initiatives to illustrate and reflect on common implementation challenges. In these case studies, we used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework to analyze the implementation and scaling up barriers and facilitators. We found common barriers related to unclear goals about the reach of programs, challenges in assessing effectiveness and fidelity/quality during the real-world implementation, discontinuation or lack of funding, and lack of monitoring and evaluation impacting the sustainability of programs. We also discuss the use of implementation science to achieve adequate nutrition by 2030 and present critical elements for successful scale implementation of nutrition programs based on global evidence. Despite the investment to implement different actions aimed at facing infant feeding and malnutrition, high-quality implementation research must become a priority to catalyze progress in Brazil. |
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Implementation of strategies and programs for breastfeeding, complementary feeding, and malnutrition of young children in Brazil: advances and challengesImplementación de estrategias y programas de lactancia materna, alimentación complementaria y desnutrición en niños pequeños en Brasil: avances y desafíosImplementação de estratégias e programas de amamentação, alimentação complementar e desnutrição de crianças pequenas no Brasil: avanços e desafiosAleitamento Materno; Alimentação Complementar; Desnutrição; Programas de Nutrição; Sistema Único de SaúdeLactancia Materna; Alimentación Complementaria; Desnutrición; Programas de Nutrición; Sistema Único de SaludBreastfeeding; Complementary Feeding; Malnutrition; Nutrition Programs; Unified Health SystemMalnutrition in all its forms has risen on global agendas due to the recognition of its magnitude and consequences for a wide range of human, social, and economic outcomes. Implementing strategies and programs with the needed scale and quality is a major challenge. The Brazilian National Survey on Child Nutrition (ENANI-2019) pointed out several advances but numerous challenges. In this paper, we reflect on the implementation progress of breastfeeding, complementary feeding and young children malnutrition strategies and programs in Brazil and how existing challenges can be overcome through the lens of implementation science. First, we present a brief history of such programs. Second, we selected two breastfeeding initiatives to illustrate and reflect on common implementation challenges. In these case studies, we used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework to analyze the implementation and scaling up barriers and facilitators. We found common barriers related to unclear goals about the reach of programs, challenges in assessing effectiveness and fidelity/quality during the real-world implementation, discontinuation or lack of funding, and lack of monitoring and evaluation impacting the sustainability of programs. We also discuss the use of implementation science to achieve adequate nutrition by 2030 and present critical elements for successful scale implementation of nutrition programs based on global evidence. Despite the investment to implement different actions aimed at facing infant feeding and malnutrition, high-quality implementation research must become a priority to catalyze progress in Brazil.La desnutrición, en todos sus grados, es un tema que está presente en las agendas mundiales debido a su magnitud y consecuencias para una amplia gama de resultados humanos, sociales y económicos. La implementación de estrategias y programas con la escala y calidad requeridas es un gran desafío. El Estudio Nacional de Alimentación y Nutrición Infantil (ENANI-2019) apunta varios avances y numerosos desafíos. Este artículo reflexiona sobre el progreso en la implementación de estrategias y programas para la lactancia materna, la alimentación complementaria y la desnutrición infantil en Brasil y sobre cómo se pueden superar los desafíos existentes desde la implementación. En primer lugar, se presenta una breve historia de tales programas. A continuación, se seleccionan dos iniciativas de lactancia materna para ilustrar y reflexionar sobre los desafíos comunes de implementación. En este estudio de caso se utilizó el modelo RE-AIM (alcance, eficacia, adopción, implementación y mantenimiento) para analizar la implementación y ampliar las barreras y facilitadores. Se encontraron barreras comunes relacionadas con los objetivos poco definidos sobre el alcance de los programas, con los desafíos para evaluar la efectividad y la fidelidad/calidad durante la implementación, con la interrupción o falta de financiamiento y con la falta de monitoreo y evaluación que afectan la sostenibilidad de los programas. También se discutió el uso de la implementación para lograr una nutrición adecuada para 2030, mediante la presentación de elementos críticos para implementar con éxito los programas de nutrición basados en evidencia global. Si bien se promueve la implementación de diferentes acciones destinadas al combate de la alimentación infantil y la desnutrición, la implementación de gran calidad debe ser una prioridad en Brasil.A desnutrição, em todas as suas formas, cresceu nas agendas globais devido ao reconhecimento de sua magnitude e consequências para uma ampla gama de resultados humanos, sociais e econômicos. Implementar estratégias e programas com a escala e a qualidade necessárias é um grande desafio. O Estudo Nacional de Alimentação e Nutrição Infantil (ENANI-2019) apontou vários avanços, mas inúmeros desafios. Este artigo reflete sobre o progresso da implementação de estratégias e programas de amamentação, alimentação complementar e desnutrição de crianças pequenas no Brasil e como os desafios existentes podem ser superados através das lentes da ciência da implementação. Primeiramente, um breve histórico de tais programas é apresentado. Em seguida, duas iniciativas de amamentação selecionadas para ilustrar e refletir sobre os desafios comuns de implementação. Nesses estudos de caso, o modelo RE-AIM (alcance, eficácia, adoção, implementação e manutenção) foi utilizado para analisar a implementação e ampliar barreiras e facilitadores. Foram encontradas barreiras comuns relacionadas a metas pouco claras sobre o alcance dos programas, desafios na avaliação da eficácia e fidelidade/qualidade durante a implementação no mundo real, a interrupção ou falta de financiamento e a falta de monitoramento e avaliação que afetam a sustentabilidade dos programas. O uso da ciência da implementação para alcançar uma nutrição adequada até 2030 também foi discutido, apresentando elementos críticos para a implementação em escala bem-sucedida de programas de nutrição com base em evidências globais. Apesar do investimento para implementar diferentes ações voltadas para o enfrentamento da alimentação infantil e da desnutrição, a pesquisa de implementação de alta qualidade deve se tornar uma prioridade para catalisar o progresso no Brasil.Reports in Public HealthCadernos de Saúde Pública2023-10-02info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/xmlapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8380Reports in Public Health; Vol. 39 No. Suplemento 2 (2023)Cadernos de Saúde Pública; v. 39 n. Suplemento 2 (2023)1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZenghttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8380/18700https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8380/18701Copyright (c) 2023 Cadernos de Saúde Públicainfo:eu-repo/semantics/openAccessIsoyama Venancio, SoniaBuccini, Gabriela2023-12-19T16:47:50Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/8380Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:09:33.967344Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true |
dc.title.none.fl_str_mv |
Implementation of strategies and programs for breastfeeding, complementary feeding, and malnutrition of young children in Brazil: advances and challenges Implementación de estrategias y programas de lactancia materna, alimentación complementaria y desnutrición en niños pequeños en Brasil: avances y desafíos Implementação de estratégias e programas de amamentação, alimentação complementar e desnutrição de crianças pequenas no Brasil: avanços e desafios |
title |
Implementation of strategies and programs for breastfeeding, complementary feeding, and malnutrition of young children in Brazil: advances and challenges |
spellingShingle |
Implementation of strategies and programs for breastfeeding, complementary feeding, and malnutrition of young children in Brazil: advances and challenges Isoyama Venancio, Sonia Aleitamento Materno; Alimentação Complementar; Desnutrição; Programas de Nutrição; Sistema Único de Saúde Lactancia Materna; Alimentación Complementaria; Desnutrición; Programas de Nutrición; Sistema Único de Salud Breastfeeding; Complementary Feeding; Malnutrition; Nutrition Programs; Unified Health System |
title_short |
Implementation of strategies and programs for breastfeeding, complementary feeding, and malnutrition of young children in Brazil: advances and challenges |
title_full |
Implementation of strategies and programs for breastfeeding, complementary feeding, and malnutrition of young children in Brazil: advances and challenges |
title_fullStr |
Implementation of strategies and programs for breastfeeding, complementary feeding, and malnutrition of young children in Brazil: advances and challenges |
title_full_unstemmed |
Implementation of strategies and programs for breastfeeding, complementary feeding, and malnutrition of young children in Brazil: advances and challenges |
title_sort |
Implementation of strategies and programs for breastfeeding, complementary feeding, and malnutrition of young children in Brazil: advances and challenges |
author |
Isoyama Venancio, Sonia |
author_facet |
Isoyama Venancio, Sonia Buccini, Gabriela |
author_role |
author |
author2 |
Buccini, Gabriela |
author2_role |
author |
dc.contributor.author.fl_str_mv |
Isoyama Venancio, Sonia Buccini, Gabriela |
dc.subject.por.fl_str_mv |
Aleitamento Materno; Alimentação Complementar; Desnutrição; Programas de Nutrição; Sistema Único de Saúde Lactancia Materna; Alimentación Complementaria; Desnutrición; Programas de Nutrición; Sistema Único de Salud Breastfeeding; Complementary Feeding; Malnutrition; Nutrition Programs; Unified Health System |
topic |
Aleitamento Materno; Alimentação Complementar; Desnutrição; Programas de Nutrição; Sistema Único de Saúde Lactancia Materna; Alimentación Complementaria; Desnutrición; Programas de Nutrición; Sistema Único de Salud Breastfeeding; Complementary Feeding; Malnutrition; Nutrition Programs; Unified Health System |
description |
Malnutrition in all its forms has risen on global agendas due to the recognition of its magnitude and consequences for a wide range of human, social, and economic outcomes. Implementing strategies and programs with the needed scale and quality is a major challenge. The Brazilian National Survey on Child Nutrition (ENANI-2019) pointed out several advances but numerous challenges. In this paper, we reflect on the implementation progress of breastfeeding, complementary feeding and young children malnutrition strategies and programs in Brazil and how existing challenges can be overcome through the lens of implementation science. First, we present a brief history of such programs. Second, we selected two breastfeeding initiatives to illustrate and reflect on common implementation challenges. In these case studies, we used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework to analyze the implementation and scaling up barriers and facilitators. We found common barriers related to unclear goals about the reach of programs, challenges in assessing effectiveness and fidelity/quality during the real-world implementation, discontinuation or lack of funding, and lack of monitoring and evaluation impacting the sustainability of programs. We also discuss the use of implementation science to achieve adequate nutrition by 2030 and present critical elements for successful scale implementation of nutrition programs based on global evidence. Despite the investment to implement different actions aimed at facing infant feeding and malnutrition, high-quality implementation research must become a priority to catalyze progress in Brazil. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-10-02 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8380 |
url |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8380 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8380/18700 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8380/18701 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2023 Cadernos de Saúde Pública info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2023 Cadernos de Saúde Pública |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/xml application/pdf |
dc.publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
dc.source.none.fl_str_mv |
Reports in Public Health; Vol. 39 No. Suplemento 2 (2023) Cadernos de Saúde Pública; v. 39 n. Suplemento 2 (2023) 1678-4464 0102-311X reponame:Cadernos de Saúde Pública instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
instname_str |
Fundação Oswaldo Cruz (FIOCRUZ) |
instacron_str |
FIOCRUZ |
institution |
FIOCRUZ |
reponame_str |
Cadernos de Saúde Pública |
collection |
Cadernos de Saúde Pública |
repository.name.fl_str_mv |
Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ) |
repository.mail.fl_str_mv |
cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br |
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1798943399514996737 |