Abstract
Nutritional counseling and growth follow-up are priorities when providing care to children; however, these have not been completely incorporated into primary health care. To know the difficulties for providing nutritional counseling and child growth follow-up, from a professional healthcare perspective. Qualitative study, using Donabedian as theoretical framework, developed by 53 professionals in the field of primary health care. Data was obtained from focal groups and submitted to content analysis. The main difficulties for nutritional counseling were clustered in the category of 'perceptions and beliefs related to child feeding'. The 'problems of infrastructure and healthcare' and 'maintenance of the hegemonic medical model' are the main difficulties for following-up growth. Besides investments in infrastructure, healthcare training is indispensable considering beliefs and professional experiences, so in fact, nutritional counseling and child growth follow-up are incorporated in primary health care. Aconselhamento nutricional e acompanhamento do crescimento são prioritários na assistência à criança, porém, ainda não estão plenamente incorporados na atenção básica. Conhecer as dificuldades para realizar aconselhamento nutricional e acompanhamento do crescimento infantil, na perspectiva de profissionais de saúde. Estudo qualitativo, fundamentado no referencial de Donabedian, desenvolvido com 53 profissionais de saúde da atenção básica. Dados foram obtidos por grupos focais e submetidos à análise de conteúdo. As principais dificuldades para o aconselhamento nutricional reuniram-se na categoria 'percepções e crenças relacionadas à alimentação infantil'. Para o acompanhamento do crescimento, as categorias 'problemas de infraestrutura e funcionamento dos serviços de saúde' e 'manutenção do modelo médico hegemônico' representaram as principais dificuldades. Além de investimentos na infraestrutura, é imprescindível que capacitações em serviço considerem crenças e experiências dos profissionais para que, de fato, o aconselhamento nutricional e acompanhamento do crescimento infantil sejam incorporados na atenção básica.
Highlights
Nutritional counseling and growth follow-up are priorities when providing care to children; these have not been completely incorporated into primary health care
Perceptions and beliefs related to child feeding
Regarding the difficulties in performing nutritional counseling, content analysis proved that the category ‘Perceptions and beliefs related to child feeding’ is related to the Process component
Summary
Nutritional counseling and growth follow-up are priorities when providing care to children; these have not been completely incorporated into primary health care. Final considerations: Besides investments in infrastructure, healthcare training is indispensable considering beliefs and professional experiences, so nutritional counseling and child growth follow-up are incorporated in primary health care. People in general have decreased their consumption of healthy foods, such as cereals and whole-grain products, as beans and vegetables, and have increasingly added more processed or ultraprocessed products, rich in saturated fats, sodium, and refined carbohydrates[1]. These changes have directly affected the nutritional profile of the general population, including important reflections on the health of children, such as increased nutritional disturbances and their consequences. There are enough evidences showing that nutritional disorders in childhood is linked to increased mortality, infectious diseases, decreased growth, and psychomotor development, decreased educational achievement, and lower productive capacity in adulthood[4]
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