Ensuring people’s constitutional rights to food and nutrition remains a challenge in Brazil. The national trend of food insecurity, which had receded between 2004 and 2013, worsened during the covid-19 pandemic and due to social policy restrictions. In this context, the health emergency affecting the Yanomami people is just one example, albeit a very serious one, of the complex contemporary Brazilian reality, where paradoxical problems related to overweight and obesity, hunger and malnutrition and specific nutritional deficiencies.
We know that the Brazilian health system needs innovations to offer, in an efficient and equitable manner, all of its actions to the population of more than 5,000 municipalities. However, the solid Brazilian collective health has relevant reflections. Among them is this launch by Editora Fiocruz, organized by professors who work with mastery in the areas of health assessment. In this work, Marly Marques da Cruz, Denise Cavalcante de Barros and Santuzza Arreguy Silva Vitorino bring together a network of 28 researchers and professionals in the field, with whom they share the authorship of six of the fourteen chapters, which contain the theoretical and methodological foundations for evaluation of food and nutrition policies and for the generation of knowledge and guidance on practices in this area.
Evaluation in public policies
In addition to the formulation and implementation stages, the follow-up stage must be guaranteed and institutionalized, so that a given policy is restored and improved. It is at this stage, often neglected, that the book focuses, in two parts. The first section, entitled “Theoretical and methodological foundations of the evaluation of food and nutrition policies in health”, provides the theoretical and conceptual bases of the evaluation, presenting a variety of approaches, including the normative perspective, with more traditional models, such as the use of classical epidemiological designs and an emphasis on the outcome of the intervention. The second, “Production of knowledge and practical experiences of evaluation in the field of food and nutrition in health”, deals with innovative evaluation experiences, such as collaborative and participatory approaches, the uses of which are still uncommon in the field of food and nutrition.
New paradigms in evaluation
The book proposes, in a second part, new evaluation and monitoring parameters, breaking with traditional evaluations, in order to respond to the particularities of the Brazilian food and nutritional scenario. According to the organizers, one of the contributions of the participatory evaluation “refers to the involvement of users, health professionals, managers, social movements, planners, donors and other potential actors in the intervention that will be evaluated” . An effective participatory survey therefore provides follow-up strategies, at all stages of the cycle, for all those linked to the policy in question.
Studies on participatory and collaborative approaches constitute a pioneering contribution to what is known as the evaluation of fourth generation, “more inclusive and responsive, particularly relevant in complex interventions, such as food and nutrition policy and food and nutrition security”, explain the organizers, presentation of the book. The work thus fills an important gap in the field of food and nutrition assessment in Brazil, especially for the SUS.
In the presentation of the volume, Zulmira Maria de Araújo Hartz explains the close relationship of this title with others on health assessment published by Editora Fiocruz. They are: “Evaluation in health: from conceptual models to practice in the analysis of program implementation” (Hartz, 1997); “Health Evaluation: From Theoretical Models to the Practice of Health Program and System Evaluation” (Hartz & Vieira da Silva, 2005); “Evaluation in Health: from theoretical models to the practice of evaluating programs to control endemic processes” (Moreira & Cruz, 2014), and “Evaluation: concepts and methods” (Brusselle et al., 2011).
Interesting reading for all actors in the public policy cycle at each of its stages ― managers, health professionals, academics, researchers, specialists ―, with encouraging and pleasant content, it introduces the reader to the different ways of evaluating public policies in order to to meet the challenges imposed by the complex Brazilian scenario.
About the organizers
Marly Marques da Cruz is a public health researcher and Professor in the Samuel Pessoa Department of Endemics (DENSP/ENSP). It is part of the Laboratory for the Evaluation of Regional Endemic Situations (LASER/DENSP/FIOCRUZ), whose performance emphasizes research, teaching and technical cooperation in health monitoring and evaluation. He also leads the CNPq research group Evaluation of endemic process control programs. He has training and research experience in the field of health evaluation, with a focus on STDs/AIDS, tuberculosis, leprosy, primary care, health care networks, the prison system, as well as in other social areas. He has already coordinated the Professional Master in Health Assessment. Develops international cooperation activities in monitoring and evaluation with Portuguese-speaking African countries and other countries.
Denise Cavalcante de Barros is a nutritionist, with a doctorate in public health from the National School of Public Health/Fiocruz. Coordinates the Food and Nutrition Teaching and Research Laboratory and the Distance Specialization Course in Food and Nutrition in Primary Care at EAD/Fiocruz, Advanced Course in Food and Culture. Member of the management group of the Food and Culture Network He is currently developing projects in the field of food and culture; promotion of healthy eating; care and nutritional assessment of pregnant women; in addition to professional training materials in anthropometry and nutritional surveillance with a focus on primary care.
Santuzza Arreguy Silva Vitorino is a nutritionist from the Federal University of Ouro Preto, holds a master’s degree in Nutrition Sciences from the Federal University of Viçosa and a doctorate in public health from the National School of Public Health Sérgio Arouca, from the Oswaldo Cruz Foundation. Has experience in the fields of collective health, in particular in the field of health assessment; and nutrition – with a focus on nutrition and public health, population nutrition analysis, school feeding, food and nutrition surveillance. Collaborating researcher at the Laboratory for the Evaluation of Regional Endemic Situations, Department of Endemic Diseases Samuel Pessoa, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, works in Latu and Stricto Senso postgraduate education and in research in the area of the program Evaluation, policies and health systems.
BRL89.00 (printed) | BRL53.40 (digital) | 369pages
Buy at the virtual bookstore
Buy from Scielo Books
First edition: 2023
ISBN (physical): 978-65-5708-144-0
ISBN (digital): 978-65-5708-179-2
I. Theoretical and methodological foundations of the evaluation of food and nutrition policies in health
1. Evaluation of food and nutrition policies: perspectives and theoretical-methodological and practical challenges
2. Contributions to the historical process of evaluating food and nutrition policies in the unified health system
3. From normative to participatory: the construction of the evaluation of the implementation of food and nutrition surveillance in primary health care in the state of Minas Gerais
4. Conceptions and processes of institutionalization of the food and nutritional surveillance system in the small municipalities of Minas Gerais: the point of view of health professionals and managers
5. The experience of dissemination: the case of the evaluation of the implementation of food and nutrition surveillance in primary health care in Minas Gerais
6. Assessing the uses and influences of food and nutrition research knowledge
II. Production of knowledge and practical experiences of evaluation in the field of food and nutrition in health
7. Evaluation of food and nutrition programs in primary health care: analysis of implementation
8. Evaluation of Food and Nutrition Actions in Primary Health Care: experience of participatory diagnosis
9. Food and nutrition surveillance in primary health care: the surveillance experience in the state of Minas Gerais
10. Evaluation of the ongoing process of health education in primary care: reflections for the field of food and nutrition
11. Use of mixed methods in the evaluation of the implementation of the national vitamin A supplementation program in Minas Gerais
12. Morbid obesity and access to health: a review of the scope of inequalities and coping strategies
13. Modeling the line of care for overweight and obesity in primary health care in Piauí: a shared construction
14. Breastmilk supply for preterm infants in the neonatal intensive care unit: assessment process