Avaliação da atenção nutricional no âmbito dos núcleos de apoio à saúde da família no Brasil
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UFPB |
Texto Completo: | https://repositorio.ufpb.br/jspui/handle/123456789/13447 |
Resumo: | The Unified Health System (SUS, in portuguese) emerged amidst the political and social movements of Brazil. One of its components, Basic Care (AB), includes the Family Health Strategy (ESF), whose Family Health Support Centers (NASF) are linked and have, among their actions, nutritional care - AN. The National Program for Improving Access and Quality of Basic Care (PMAQ – AB), established in 2011, has External Evaluation (AE) as one of its phases, and its results can reorient health actions. This research aims to evaluate A within the scope of the NASF throughout Brazil, from the AE of the PMAQ – AB. This is a cross-sectional and analytical study, with a quantitative approach and a secondary basis. It consisted of seven steps, composed of statistical analyzes (descriptive analysis, Pearson's chi-square test and binary logistic regression). The AE questions related to the AN axis constituted the dependent variables, while the independent ones covered the other axes, selected after each methodological step. We disregarded the models with low determination coefficients and the independent variables omitted in the regression. The results are exposed under measures of effect (Odss Ratio - OR). Among the main findings, NASF support to the development of Food and Nutrition Surveillance (VAN) actions was favored by the provision of a shared office (OR = 0,704), analysis of the number of erroneous or unnecessary referrals for specialized care ( OR = 0,749) and monitoring of follow-up users at other points of attention (OR = 0.749). The least contributory aspect of VAN's actions was support to the provision of care for people with chronic diseases (OR = 6,431), who also competed with actions to Promote Adequate and Healthy Food (PAAS) (OR = 4,634); diseases related to food and nutrition (OR = 3.862) and to the intersectoral articulation, to guarantee Food and Nutritional Security – SAN (OR = 3.722). The qualification of referrals to other points of attention was the one that most strengthened the effectiveness of PAAS actions (OR = 0.679). The accomplishment of family orientations optimized the development of actions directed to the aggravations related to the feeding and nutrition (OR = 0,497). Concerning the actions of intersectoral articulation, in order to guarantee SAN, the following elements were highlighted: the existence of schedules or scales of use of the rooms (OR = 0,726), analysis of health indicators of the population of the territory (OR = 0,706) and monitoring of users at other points of attention (OR = 0,787). Through the external evaluation of the PMAQ – AB, it is inferred that the AN strengthened within the AB scope, mediated by the NASF professionals. However, and in line with its guidelines, it is still necessary to strengthen intersectoriality, articulation among NASF professionals, Family Health teams and users, as well as the training focused on SUS and the implementation of Permanent Education. This study can stimulate the analysis of new cycles of the PMAQ – AB, making possible the comparison of the results and fomentation to the strategic planning in health. |
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Avaliação da atenção nutricional no âmbito dos núcleos de apoio à saúde da família no BrasilAvaliação em saúdePolítica nutricionalAtenção básicaAcesso aos serviços de saúdeQualidade da assistência à saúdeHealth evaluationNutrition policyPrimary health careHealth services accessibilityQuality of health careCNPQ::CIENCIAS DA SAUDE::NUTRICAOThe Unified Health System (SUS, in portuguese) emerged amidst the political and social movements of Brazil. One of its components, Basic Care (AB), includes the Family Health Strategy (ESF), whose Family Health Support Centers (NASF) are linked and have, among their actions, nutritional care - AN. The National Program for Improving Access and Quality of Basic Care (PMAQ – AB), established in 2011, has External Evaluation (AE) as one of its phases, and its results can reorient health actions. This research aims to evaluate A within the scope of the NASF throughout Brazil, from the AE of the PMAQ – AB. This is a cross-sectional and analytical study, with a quantitative approach and a secondary basis. It consisted of seven steps, composed of statistical analyzes (descriptive analysis, Pearson's chi-square test and binary logistic regression). The AE questions related to the AN axis constituted the dependent variables, while the independent ones covered the other axes, selected after each methodological step. We disregarded the models with low determination coefficients and the independent variables omitted in the regression. The results are exposed under measures of effect (Odss Ratio - OR). Among the main findings, NASF support to the development of Food and Nutrition Surveillance (VAN) actions was favored by the provision of a shared office (OR = 0,704), analysis of the number of erroneous or unnecessary referrals for specialized care ( OR = 0,749) and monitoring of follow-up users at other points of attention (OR = 0.749). The least contributory aspect of VAN's actions was support to the provision of care for people with chronic diseases (OR = 6,431), who also competed with actions to Promote Adequate and Healthy Food (PAAS) (OR = 4,634); diseases related to food and nutrition (OR = 3.862) and to the intersectoral articulation, to guarantee Food and Nutritional Security – SAN (OR = 3.722). The qualification of referrals to other points of attention was the one that most strengthened the effectiveness of PAAS actions (OR = 0.679). The accomplishment of family orientations optimized the development of actions directed to the aggravations related to the feeding and nutrition (OR = 0,497). Concerning the actions of intersectoral articulation, in order to guarantee SAN, the following elements were highlighted: the existence of schedules or scales of use of the rooms (OR = 0,726), analysis of health indicators of the population of the territory (OR = 0,706) and monitoring of users at other points of attention (OR = 0,787). Through the external evaluation of the PMAQ – AB, it is inferred that the AN strengthened within the AB scope, mediated by the NASF professionals. However, and in line with its guidelines, it is still necessary to strengthen intersectoriality, articulation among NASF professionals, Family Health teams and users, as well as the training focused on SUS and the implementation of Permanent Education. This study can stimulate the analysis of new cycles of the PMAQ – AB, making possible the comparison of the results and fomentation to the strategic planning in health.NenhumaO Sistema Único de Saúde (SUS) emergiu em meio aos movimentos políticos e sociais do Brasil. Um de seus componentes, a Atenção Básica (AB), inclui a Estratégia Saúde da Família (ESF), cujos Núcleos de Apoio à Saúde da Família (NASF) vinculam-se e possuem, dentre suas ações, a atenção nutricional – AN. O Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ – AB), instituído em 2011, possui a Avaliação Externa (AE) como uma de suas fases, podendo seus resultados reorientarem as ações em saúde. Esta investigação objetiva avaliar a AN no âmbito do NASF em todo Brasil, a partir da AE do PMAQ – AB. Trata-se de estudo transversal e analítico, com abordagem quantitativa e base secundária. Dotou-se de sete passos, compostos por análises estatísticas (análise descritiva, teste quiquadrado de Pearson e regressão logística binária). As indagações da AE, referentes ao eixo da AN, constituíram as variáveis dependentes, enquanto as independentes abarcaram os demais eixos, selecionadas após cada passo metodológico. Desconsideraram-se os modelos com coeficientes de determinação baixos e as variáveis independentes omissas na regressão. Os resultados estão expostos sob medidas de efeito (Odss Ratio – OR). Dentre os principais achados, têm-se que o apoio do NASF ao desenvolvimento de ações de Vigilância Alimentar e Nutricional (VAN) foi favorecido pela disponibilização de consultório compartilhado (OR = 0,704), análise do número de encaminhamentos equivocados ou desnecessários para atenção especializada (OR = 0,749) e monitoramento dos usuários em acompanhamento em outros pontos de atenção (OR = 0,749). O aspecto menos contributivo para as ações de VAN foi o apoio à oferta do cuidado às pessoas com doenças crônicas (OR = 6,431), que também competiu com ações de Promoção da Alimentação Adequada e Saudável – PAAS (OR = 4,634); com às voltadas aos agravos relacionados à alimentação e nutrição (OR = 3,862) e à articulação intersetorial, para garantia da Segurança Alimentar e Nutricional – SAN (OR = 3,722). A qualificação dos encaminhamentos para outros pontos de atenção foi o que mais fortaleceu a efetivação das ações de PAAS (OR = 0,679). A realização de orientações familiares otimizou o desenvolvimento de ações voltadas aos agravos relacionados à alimentação e nutrição (OR = 0,497). Concernente às ações de articulação intersetorial, para garantia da SAN, destacaram-se como elementos propulsores: a existência de cronogramas ou escalas de utilização das salas (OR = 0,726), a análise de indicadores de saúde da população do território (OR = 0,706) e o monitoramento dos usuários em outros pontos de atenção (OR = 0,787). Mediante a avaliação externa do PMAQ – AB, infere-se que a AN fortaleceu-se no escopo da AB, intermediada pelos profissionais do NASF. Todavia, e em consonância com suas diretrizes, ainda se faz necessário fortalecer a intersetorialidade, articulação entre profissionais do NASF, equipes de Saúde da Família e usuários, assim como a formação voltada ao SUS e a efetivação da Educação Permanente. Este estudo pode suscitar a análise de novos ciclos do PMAQ – AB, viabilizando a comparação dos resultados e fomento ao planejamento estratégico em saúde.Universidade Federal da ParaíbaBrasilCiências da NutriçãoPrograma de Pós-Graduação em Ciências da NutriçãoUFPBVianna, Rodrigo Pinheiro de Toledohttp://lattes.cnpq.br/3915051035089861Araújo, Thaise Anataly Maria de2019-02-14T18:23:32Z2019-02-142019-02-14T18:23:32Z2018-07-24info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesishttps://repositorio.ufpb.br/jspui/handle/123456789/13447porAttribution-NoDerivs 3.0 Brazilhttp://creativecommons.org/licenses/by-nd/3.0/br/info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UFPBinstname:Universidade Federal da Paraíba (UFPB)instacron:UFPB2019-02-15T06:03:43Zoai:repositorio.ufpb.br:123456789/13447Biblioteca Digital de Teses e Dissertaçõeshttps://repositorio.ufpb.br/PUBhttp://tede.biblioteca.ufpb.br:8080/oai/requestdiretoria@ufpb.br|| diretoria@ufpb.bropendoar:2019-02-15T06:03:43Biblioteca Digital de Teses e Dissertações da UFPB - Universidade Federal da Paraíba (UFPB)false |
dc.title.none.fl_str_mv |
Avaliação da atenção nutricional no âmbito dos núcleos de apoio à saúde da família no Brasil |
title |
Avaliação da atenção nutricional no âmbito dos núcleos de apoio à saúde da família no Brasil |
spellingShingle |
Avaliação da atenção nutricional no âmbito dos núcleos de apoio à saúde da família no Brasil Araújo, Thaise Anataly Maria de Avaliação em saúde Política nutricional Atenção básica Acesso aos serviços de saúde Qualidade da assistência à saúde Health evaluation Nutrition policy Primary health care Health services accessibility Quality of health care CNPQ::CIENCIAS DA SAUDE::NUTRICAO |
title_short |
Avaliação da atenção nutricional no âmbito dos núcleos de apoio à saúde da família no Brasil |
title_full |
Avaliação da atenção nutricional no âmbito dos núcleos de apoio à saúde da família no Brasil |
title_fullStr |
Avaliação da atenção nutricional no âmbito dos núcleos de apoio à saúde da família no Brasil |
title_full_unstemmed |
Avaliação da atenção nutricional no âmbito dos núcleos de apoio à saúde da família no Brasil |
title_sort |
Avaliação da atenção nutricional no âmbito dos núcleos de apoio à saúde da família no Brasil |
author |
Araújo, Thaise Anataly Maria de |
author_facet |
Araújo, Thaise Anataly Maria de |
author_role |
author |
dc.contributor.none.fl_str_mv |
Vianna, Rodrigo Pinheiro de Toledo http://lattes.cnpq.br/3915051035089861 |
dc.contributor.author.fl_str_mv |
Araújo, Thaise Anataly Maria de |
dc.subject.por.fl_str_mv |
Avaliação em saúde Política nutricional Atenção básica Acesso aos serviços de saúde Qualidade da assistência à saúde Health evaluation Nutrition policy Primary health care Health services accessibility Quality of health care CNPQ::CIENCIAS DA SAUDE::NUTRICAO |
topic |
Avaliação em saúde Política nutricional Atenção básica Acesso aos serviços de saúde Qualidade da assistência à saúde Health evaluation Nutrition policy Primary health care Health services accessibility Quality of health care CNPQ::CIENCIAS DA SAUDE::NUTRICAO |
description |
The Unified Health System (SUS, in portuguese) emerged amidst the political and social movements of Brazil. One of its components, Basic Care (AB), includes the Family Health Strategy (ESF), whose Family Health Support Centers (NASF) are linked and have, among their actions, nutritional care - AN. The National Program for Improving Access and Quality of Basic Care (PMAQ – AB), established in 2011, has External Evaluation (AE) as one of its phases, and its results can reorient health actions. This research aims to evaluate A within the scope of the NASF throughout Brazil, from the AE of the PMAQ – AB. This is a cross-sectional and analytical study, with a quantitative approach and a secondary basis. It consisted of seven steps, composed of statistical analyzes (descriptive analysis, Pearson's chi-square test and binary logistic regression). The AE questions related to the AN axis constituted the dependent variables, while the independent ones covered the other axes, selected after each methodological step. We disregarded the models with low determination coefficients and the independent variables omitted in the regression. The results are exposed under measures of effect (Odss Ratio - OR). Among the main findings, NASF support to the development of Food and Nutrition Surveillance (VAN) actions was favored by the provision of a shared office (OR = 0,704), analysis of the number of erroneous or unnecessary referrals for specialized care ( OR = 0,749) and monitoring of follow-up users at other points of attention (OR = 0.749). The least contributory aspect of VAN's actions was support to the provision of care for people with chronic diseases (OR = 6,431), who also competed with actions to Promote Adequate and Healthy Food (PAAS) (OR = 4,634); diseases related to food and nutrition (OR = 3.862) and to the intersectoral articulation, to guarantee Food and Nutritional Security – SAN (OR = 3.722). The qualification of referrals to other points of attention was the one that most strengthened the effectiveness of PAAS actions (OR = 0.679). The accomplishment of family orientations optimized the development of actions directed to the aggravations related to the feeding and nutrition (OR = 0,497). Concerning the actions of intersectoral articulation, in order to guarantee SAN, the following elements were highlighted: the existence of schedules or scales of use of the rooms (OR = 0,726), analysis of health indicators of the population of the territory (OR = 0,706) and monitoring of users at other points of attention (OR = 0,787). Through the external evaluation of the PMAQ – AB, it is inferred that the AN strengthened within the AB scope, mediated by the NASF professionals. However, and in line with its guidelines, it is still necessary to strengthen intersectoriality, articulation among NASF professionals, Family Health teams and users, as well as the training focused on SUS and the implementation of Permanent Education. This study can stimulate the analysis of new cycles of the PMAQ – AB, making possible the comparison of the results and fomentation to the strategic planning in health. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-07-24 2019-02-14T18:23:32Z 2019-02-14 2019-02-14T18:23:32Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://repositorio.ufpb.br/jspui/handle/123456789/13447 |
url |
https://repositorio.ufpb.br/jspui/handle/123456789/13447 |
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por |
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por |
dc.rights.driver.fl_str_mv |
Attribution-NoDerivs 3.0 Brazil http://creativecommons.org/licenses/by-nd/3.0/br/ info:eu-repo/semantics/openAccess |
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Attribution-NoDerivs 3.0 Brazil http://creativecommons.org/licenses/by-nd/3.0/br/ |
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openAccess |
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Universidade Federal da Paraíba Brasil Ciências da Nutrição Programa de Pós-Graduação em Ciências da Nutrição UFPB |
publisher.none.fl_str_mv |
Universidade Federal da Paraíba Brasil Ciências da Nutrição Programa de Pós-Graduação em Ciências da Nutrição UFPB |
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reponame:Biblioteca Digital de Teses e Dissertações da UFPB instname:Universidade Federal da Paraíba (UFPB) instacron:UFPB |
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UFPB |
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Biblioteca Digital de Teses e Dissertações da UFPB |
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Biblioteca Digital de Teses e Dissertações da UFPB |
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Biblioteca Digital de Teses e Dissertações da UFPB - Universidade Federal da Paraíba (UFPB) |
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diretoria@ufpb.br|| diretoria@ufpb.br |
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