Alice Teles de Carvalho

National School Feeding Program in a municipality of Paraíba state: a study under the viewpoint of those who benefit from the Program

OBJETIVO: Analisar a adesao e a aceitacao da alimentacao escolar e seus determinantes sob o ponto de vista dos beneficiarios do Programa Nacional de Alimentacao Escolar. METODOS: A amostra foi aleatoriamente composta por 240 alunos da quarta serie de 10 escolas municipais de Joao Pessoa, Paraiba. A analise das perguntas fechadas do questionario foi realizada utilizando-se frequencia simples e teste qui-quadrado. As questoes abertas foram categorizadas a partir do conceito central contido nas respostas. RESULTADOS: A maioria (87,0%) dos escolares considerou a alimentacao escolar importante e mais de 90% referiram aderir ao Programa. Desses, 137 (57,3%) consomem a merenda, as vezes, devido, principalmente, a inadequacao de algumas preparacoes ao habito alimentar. Quanto a aceitacao, 196 escolares afirmaram gostar da alimentacao, principalmente por ser saborosa. Tambem foram positivamente referidas as caracteristicas de: quantidade (79,8%), variedade (92,9%), temperatura (85,8%), tempo disponivel para se alimentar (63,0%) e a forma de distribuicao (66,5%) da alimentacao. Os baixos percentuais de escolares que referiram so frequentar a escola pela oferta da merenda (0,9%) e deixar de frequenta-la, caso o Programa de Alimentacao Escolar fosse extinto, (4,4%) merecem destaque. CONCLUSAO: A inadequacao ao habito alimentar e o sabor foram os principais motivos referidos pelas criancas para nao aderir e aceitar a alimentacao, respectivamente. A adequacao do cardapio aos habitos alimentares e a essencialidade do Programa para reduzir a evasao escolar sao fatores que requerem maior investigacao.

Programa de alimentação escolar no município de João Pessoa PB, Brasil: as merendeiras em foco

A escola e local privilegiado para desenvolver acoes educativas e o programa de alimentacao escolar excelente ferramenta para promocao de habitos alimentares saudaveis. Objetivou-se avaliar a percepcao das merendeiras acerca da producao e distribuicao da alimentacao escolar e seu papel neste contexto. Utilizou-se metodologia de grupo focal com merendeiras de 41 escolas publicas municipais de Joao Pessoa - Paraiba, Brasil. Desenvolveram-se as categorias: capacitacao e treinamento; processo de decisao na elaboracao dos cardapios; desgaste no processo de trabalho; alimentacao escolar e incorporacao de habitos alimentares saudaveis. Evidenciou-se estreita relacao de afeto entre merendeiras e escolares e valorizacao na oferta de alimentacao de qualidade com boa aceitacao. Foram observadas ausencia de treinamentos sistematicos e fragilidade no uso da alimentacao escolar na incorporacao de habitos alimentares saudaveis. Reafirmou-se a importância das merendeiras na utilizacao da alimentacao escolar como espaco permanente de aprendizado.

Participatory evaluation of the National Program for Vitamin A Supplementation in a municipality in Northeast Brazil

This study aimed to evaluate the National Program for Vitamin A Supplementation in a municipality (county) in Northeast Brazil, with participation by the parents or guardians of children under five years of age. This was a cross-sectional, population-based study using both qualitative and quantitative approaches. A total of 657 interviews were performed, and the vitamin A doses recorded on the childrens immunization cards were analyzed. The population has access to high doses of vitamin A. However, knowledge of the vitamin A supplementation program was limited, especially among parents with less schooling. The programs coverage fell short of the Ministry of Healths target, especially after 18 months of age. It is thus necessary to intensify the programs educational activities in order to raise awareness among families of under-five children on the importance of vitamin A, its supplementation, and the importance of eating natural sources of this nutrient for the childs health.

Cartografia do retardo estatural em escolares do Estado da Paraíba, Brasil

OBJECTIVE The study is part of a project financed by the United Nations (FAO) and the Ministry of Education of Brazil (Fundação de Assistência ao Escolar) which intends to evaluate the nutritional status of public schools students in order to estimate, giving emphasis to geographical aspects, the magnitude and distribution of statural deficit of this population in the Paraíba State, Northeastern Brazil. METHODS Schoolchildren, aged 6-9 years and enrolled in the first grade inall municipalities of Paraíba state went through a height survey. We consider as statural deficit values below -2 standard deviations according to the anthropometric pattern of National Center of Health Statistics. RESULTS A frequency of 14. 5% of statural deficit was found in the whole state, as well as 18. 7% in the semidesertic region (sertão), 13.8% in Agreste area, 11. 9% in Borborema region and 10.9% in Mata zone. In rural area, the prevalence of statural deficit was higher (17.8%) than for those living in urban area (11.8%). CONCLUSIONS The results reveal a process of inlanding of statural deficit, which contrasts with historical descriptions of the geographical distribution of this problem in the Northeastern region of Brazil

Métodos de análise em programas de segurança alimentar e nutricional: uma experiência no Brasil

O desenvolvimento de metodos que permitam analisar programas e politicas publicas e ponto chave para que os seus objetivos sejam alcancados. Este estudo apresenta uma experiencia brasileira de analise de dois programas de seguranca alimentar e nutricional, em municipios do nordeste do pais: Programa Nacional de Suplementacao de Vitamina A e acompanhamento das condicionalidades de saude do Programa Bolsa Familia. Adaptou-se metodologia proposta pela Organizacao das Nacoes Unidas para Agricultura e Alimentacao. As etapas metodologicas compreenderam a definicao dos programas a serem analisados, dos locais de coleta de dados, do publico participante da pesquisa e dos procedimentos de coleta e analise dos dados. A metodologia utilizada permitiu apreender a percepcao dos diferentes atores sociais envolvidos na operacionalizacao dos programas acerca destes, mostrando-se como uma importante ferramenta de insercao destes atores nao apenas como objetos de analise, mas principalmente como sujeitos de autoavaliacao.

Condicionalidades em saúde do programa Bolsa Família – Brasil: uma análise a partir de profissionais da saúde

Este estudo apresenta a percepcao de profissionais de equipes de Saude da Familia de municipios do Nordeste do Brasil acerca das mudancas na vida das familias participantes do programa Bolsa Familia, da relacao destas com os servicos de saude e do impacto na dinâmica de trabalho dos profissionais, a partir do acompanhamento das condicionalidades de saude do programa Bolsa Familia. As informacoes foram obtidas por meio de entrevistas semiestruturadas e encontros de grupo focal. Os profissionais acreditam que o programa ocasionou mudancas favoraveis na vida das familias participantes, como a reducao da pobreza, o aumento da frequencia escolar das criancas e mudancas positivas na relacao entre as familias participantes e os servicos de saude. No entanto, relataram dificuldades de carater organizacional no acompanhamento das condicionalidades, sobretudo devido ao aumento da demanda de trabalho. E importante que as condicionalidades de saude proporcionem oportunidades para a realizacao de acoes que visem ao empoderamento e autonomia dos sujeitos quanto ao autocuidado e desenvolvimento da cidadania.

Methods of analysis of food and nutritional security programs: an experience in Brazil

The development of methods that enable analysis of programs and public policies is a key point for their objectives to be attained. This study presents a Brazilian experience of analysis of two food and nutritional security programs in cities in Brazils northeast region, namely the National Program for Vitamin A Supplementation, and monitoring health conditions of those included in the Family Allowance Program. The methodological stages included the definition of programs to be analyzed, data collection locations, the population participating in the research, collection procedures and data analysis. The methodology used made it possible to ascertain the perception of the different social actors involved in the operationalization of these programs, proving to be an important tool for the insertion of these actors, not only as objects of analysis, but also mainly as subjects of self-evaluation.

Reflexões de agricultores familiares sobre a dinâmica de fornecimento de seus produtos para a alimentação escolar: o caso de Araripe, Ceará

Changes taking place in society today reflect directly on unhealthy food choices. As a consequence of this new eating pattern, overweight and obesity emerge, as well as noncommunicable chronic diseases. The National Programme for School Food (PNAE) constitutes an important strategy of the Federal Government to tackle this eating problem. Since its early resolutions, there is a continued search for menus increasingly healthy, regionalized, and adapted to the local culture. The latest standards of the program provide that the states and municipalities should purchase some of their food from rural family farmers. This study analyzes reflections by family farmers with regard to the dynamics of providing family farm products for school food. This is a case study, conducted according to the qualitative technique by means of a semi-structured interview in the town of Araripe, Ceara, Brazil, where fourteen farmers who provide foodstuffs for schools were interviewed. Two main categories were identified in the accounts: difficulties and benefits. We can notice that issues related to payment, transportation, and physical structure stood out as major obstacles to accomplish this practice. Regarding the benefits, the most recurrent thing was the job opportunity brought by this market. The results indicate the need for actions on the part of local management to recognize the agricultural potential of this region, in addition to establish partnerships with other agencies, in order to improve the training of these farmers and provide them with means to comply with the legal requirements. This may contribute to increase the income and quality of life among rural families.

School meals program in the municipality of João Pessoa, Paraíba, Brazil: school meal cooks in focus

A escola e local privilegiado para desenvolver acoes educativas e o programa de alimentacao escolar excelente ferramenta para promocao de habitos alimentares saudaveis. Objetivou-se avaliar a percepcao das merendeiras acerca da producao e distribuicao da alimentacao escolar e seu papel neste contexto. Utilizou-se metodologia de grupo focal com merendeiras de 41 escolas publicas municipais de Joao Pessoa - Paraiba, Brasil. Desenvolveram-se as categorias: capacitacao e treinamento; processo de decisao na elaboracao dos cardapios; desgaste no processo de trabalho; alimentacao escolar e incorporacao de habitos alimentares saudaveis. Evidenciou-se estreita relacao de afeto entre merendeiras e escolares e valorizacao na oferta de alimentacao de qualidade com boa aceitacao. Foram observadas ausencia de treinamentos sistematicos e fragilidade no uso da alimentacao escolar na incorporacao de habitos alimentares saudaveis. Reafirmou-se a importância das merendeiras na utilizacao da alimentacao escolar como espaco permanente de aprendizado.

Prevalence of hypovitaminosis D and associated factors in adolescent students of a capital of northeastern Brazil

BACKGROUND Hypovitaminosis D is a frequent problem in the world and can be influenced by several factors. OBJECTIVE To estimate the prevalence of hypovitaminosis D and associated factors in adolescent students of a capital city of northeastern Brazil. METHODS Cross-sectional epidemiological study assessing 220 school adolescents of both sexes aged 15 to 19 years. A questionnaire was applied to assess sociodemographic (skin color, mothers education and receiving social benefits) and behavioral data (number of hours of sleep per day, sun exposure, physical activity and dietary vitamin D intake). Anthropometric nutritional status was assessed by BMI (body mass index) for age. Serum 25 (OH) D concentrations, PTH and serum calcium were measured by blood samples. We identified individuals with hypovitaminosis D as those with 25 (OH) D < 30 ng/dL. The analysis of factors associated with hypovitaminosis D was performed by simple and multivariate Poisson Regression. RESULTS The prevalence of hypovitaminosis D was 57.3%. The female population had a significantly higher prevalence than the male. In the final adjusted model, the variable independently associated with hypovitaminosis D in females was the lowest serum calcium concentrations, and for males it was BMI, in which adolescents who had overweight/obesity were 2.4 times more likely to have hypovitaminosis D than the eutrophic ones. CONCLUSIONS The present study found a high prevalence of hypovitaminosis D in the analyzed population, especially in female adolescents. In addition, the factors independently associated with hypovitaminosis D were found to be overweight/obese in boys and low calcium concentrations in girls.