Luciene Burlandy

Changes in food consumption among the Programa Bolsa Família participant families in Brazil

OBJECTIVE To analyse changes and predictors of change in self-reported food intake among Brazilian families that benefitted from conditional cash transfer (CCT) implemented in the Programa Bolsa Família of the Brazilian Federal Government. DESIGN A cross-sectional survey. SETTING The study was conducted from September to October 2007 in a nationwide representative household sample of families included in the CCT. Socio-economic variables, perception of food consumption and food insecurity were evaluated via questionnaire, which was completed during face-to-face interviews. SUBJECTS Five thousand households were selected from the CCT registry. RESULTS Families reported increased consumption of all food groups analysed, mainly cereals, processed foods, meat, milk and dairy, beans and sugar. The degree of dependence on income from the CCT was positively associated with increased self-reported intake of food items such as sugar and soft drinks. A Poisson regression revealed that the fourth quartile of CCT dependence demonstrated a twofold increase in the self-reported intake of soft drinks (relative risk (RR) = 2·3, 95% CI 1·8, 2·9) and sugar (RR = 2·5, 95% CI 2·1, 3·1) compared with the first quartile of CCT dependence. CONCLUSIONS Greater purchasing power of poor families increases unhealthy food choices; thus public policies should emphasise the availability of healthy food.

Transferência condicionada de renda e segurança alimentar e nutricional

This paper analyses the relationship between Conditional Cash Transfer (CCT) programs and Food and Nutrition Security (FNS), based on a review of the literature. CCT programs spur outlays on food, particularly in dynamic markets, as well as investments in other goods affecting the nutritional wellbeing of families, including demands for healthcare and education. However, the impact on childrens nutritional status and early childhood growth is not clear, as other factors also affect this process, such as: the availability of public services (healthcare; education; sanitation) and the costs of accessing them; duration of the programs; transfer amounts; family sizes and intra-family rules for allocating resources. The program implementation process also warrants analysis, as this may have positive or negative effects on values, social relationships and practices that may deepen poverty and undermine food and nutrition security. As it is vital to integrate CCT programs with other projects in order to ensure their impact on FNS, Brazils National Food and Nutrition Security Council plays a strategic role through integrated policy planning in this field.

Programa bolsa família: nova institucionalidade no campo da política social brasileira?

The Family Grant Program was established by the Brazilian federal government in October 2003 to fight poverty and hunger and promote innovations in government social intervention. This article analyzes the programs design and tries to identify possible inflections contained within it, based on the following focus: conditions of access, conditionalities, decentralization, intersectoral factors and social control. The study analyzed official documents and legislation, and indicates the limits and potential for their operationalization. The changes planned are highlighted by the complex effort to expand the decision-making arena, in order to incorporate different government levels and spheres as well as civil society. Limitations were noted that were created by the restrictive mechanisms for the focalization of clientele and by the lack of definition of factors related to social control and shared management. The question of conditionalities is a central problem that deserves greater study.

A construção da política de segurança alimentar e nutricional no Brasil: estratégias e desafios para a promoção da intersetorialidade no âmbito federal de governo

This article analyzes institutional strategies of the Brazilian federal government that aim at promoting intersectorality in the field of Food and Nutrition Security (FNS), based on bibliographic review and document analysis. It is assumed that, although formal institutionality in this government level is not enough to promote intersectorality, it is important in process induction. It follows that the combination of different institutional mechanisms favors intersectorality, such as: the existence and location of councils integrated by government sectors and civil society in the presidency; political support by the presidency and inclusion of the issue as being strategic in the governmental agenda; assembly of institutional spaces that articulate the highest government spheres and that integrate technical levels; programs that integrate food production, commercialization, and consumption. Challenges concern interrelation with economic policy and the construction of budget agreed among sectors, integrated to policy management and monitoring.

Socioeconomic and demographic indicators and nutritional status of children in a rural land settlement in Rio de Janeiro

This study evaluated socioeconomic indicators and nutritional status in 201 children and adolescents in a rural land settlement in São José da Boa Morte, Rio de Janeiro. Nutritional deficit was defined as a value below -2 z score for the reference median from the National Center for Health Statistics (NCHS) for weight-for-age (W/A) and stature-for-age (S/A) for children under five years of age and weight-for-stature (W/S) and S/A for children from 5.0 to 9.9 years. For adolescents, the study used cut-off points at the 5th percentile (thin) and 85th percentile (overweight) from the distribution of body mass index (BMI) in the Brazilian population. According to the study, 53.8% of the households had 4 to 6 members, 34.5% had rudimentary cesspools, 31.2% had no running water, 11.0% had no bathroom, 58.2% burned or buried their garbage, and 13.6% of the mothers were illiterate. No case of nutritional deficit was found in the 0-4.9 year age bracket, and in the 5-9.9 year bracket there were one underweight and three overweight children. The authors concluded that the low prevalence of nutritional deficits in the study group, despite the exposure to risk factors, may be related to the presence of protective factors like access to health services, and that there was an important rate of overweight among adolescents (13.3%).

Acesso à alimentação escolar e estado nutricional de escolares no Nordeste e Sudeste do Brasil, 1997

Access by schoolchildren (7-10 years of age) to the School Food Program was investigated in a probabilistic sample of the Brazilian population living in the Northeast and Southeast regions in 1996-97. Among children enrolled in public schools, 87.4% had lunch at school: 77.9% in the Northeast, 93.7% in the Southeast, and 77.9% and 90.7% in the rural and urban areas, respectively. Stunting was observed in 13.2% of children (13.8% of boys and 12.6% of girls) and was most prevalent in the rural Northeast (22%) and least in the urban Southeast (8.5%). Stunting was more prevalent in children out of school (27.9%) or enrolled in schools that did not supply lunch (17.9%). Prevalence of overweight was relatively high (9.6%) and similar between boys and girls, but was more prevalent in children who had lunch at school (9.8%) as compared to children attending schools without lunch programs (5.5%). These data suggest inadequate geographic, economic, and biological criteria in the School Food Program.

Small farms and sustainable rural development for food security: The Brazilian experience

In the past few years, Brazil has made significant progress in reducing hunger and food and nutrition insecurity. By the end of 2009 it had met the first United Nations Millennium Development Goal of reducing poverty and malnutrition by half, six years ahead of the 2015 deadline. Much of this progress has been achieved through innovative policies and initiatives championed by civil society organisations for over two decades. This paper reviews some of the most important policies and initiatives which are having a beneficial impact on sustainable rural development and food security. Focusing on conditions for small family farmers, the authors describe the main elements of these government programmes as well as relevant civil society initiatives, and the possible lessons to be learned from them. The paper concludes by discussing the challenges the country faces in maintaining recent advances in sustainable rural development and food security.

Regulamentação da propaganda de alimentos infantis como estratégia para a promoção da saúde

The eating habits of the Brazilian population have been changing in recent decades and publicity is one of the factors contributing to this situation. The objective of this study was to evaluate the content of food publicity broadcast on television and addressed to children, from the standpoint of regulation. The publicity broadcast on the two major television stations during the school holidays was recorded on VHS tapes. Content analysis techniques were used and eight categories of analysis were defined based on the theoretical benchmark of the eating habits and their determining factors. The proposal for a Technical Regulation of Anvisa was used to conduct this analysis. 1018 advertisements were recorded, of which 132 (12.9%) that advertised foods targeted at children were selected, but only 12 different products were identified. According to the proposed regulation, all the material analyzed violated no less than three articles, among which the 4th, Sections III and VIb stand out. The pressing need for government regulation of the content of food advertisements for children, the consumption of which can be harmful to health, is clearly apparent because of its influence on the decision to purchase, both by the children themselves, and their parents.

Do direito incondicional à condicionalidade do direito: as contrapartidas do Programa Bolsa Família

This paper analyzes the concepts and challenges of the counterpart contributions demanded by Brazils Family Allowance Program, which requires mandatory school attendance for children and adolescents, and healthcare for children, pregnant women and breast-feeding mothers. These issues are prompting much discussion in Brazil and elsewhere in the world. This study charts theoretical aspects that underpin arguments for and against conditional cash transfer programs, through a review and systematization of the literature and a study of the related legislation. This analysis demonstrates that the opponents of counterpart obligations claim they breach unconditional rights to citizenship. Some supporters of these conditional transfers believe that a return is required for these benefits, while others see such requirements as a strategy for ensuring easier access to social welfare services, thereby breaking away from the cycle of poverty. Although latter view is present in Brazils original Family Allowance Program, the manner in which supplementary legislation defines the application of the conditions is coercive and remote from the concept of social insertion.

Desigualdades sociais, saúde e bem-estar: oportunidades e problemas no horizonte de políticas públicas transversais

The development of a distributive justice model that is responsive to new claims and demands in the social policy field requires in-depth examinations and critiques of the ways in which public policies are drawn up and implemented. Reconstituting and analyzing different institutional dynamics, decision contexts and program performances emerge as tasks that are crucial to the quest for alternatives ways of strengthening integration and empowerment experiences. The purpose of this article is to present these issues and help affirm commitments to transversal and convergent public actions combating poverty, social exclusion and unequal healthcare.