Food and Nutrition Surveillance in Primary Health Care: An intervention research project in northern Minas Gerais

Abstract

This mixed-methods intervention study analyzed challenges to implementing Food and Nutrition Surveillance in 15
socially vulnerable municipalities in northern Minas Gerais, Brazil. The study used secondary data from the Food and Nutrition Surveillance System and conducted a thematic analysis of interviews with 60 primary health care professionals. Findings informed an educational intervention comprising an online course, tutoring sessions, and in-person workshops. Nutritional assessments
were concentrated among children under 5 years, with limited inclusion of adolescents, adults, and older people. Three factors explained this pattern: absent protocols and care pathways, reflecting weak institutionalization of technical guidance and reliance on individual practices; the central role of community health workers, who expanded surveillance coverage but faced weaknesses in data collection and use; and fragmented multidisciplinary work, characterized by individual clinical consultations and limited
interprofessional coordination. Structural barriers intensified these difficulties, particularly in more vulnerable settings. The study identified structural, organizational, and training-related constraints that reduce surveillance effectiveness. It also showed that continuing education can improve practices, strengthen information use, promote coordinated care, and expand the contribution of nutritional surveillance to addressing health inequities in primary health care services across vulnerable territories, while
supporting locally adapted planning and more consistent implementation of national nutrition policies.