Multiplicity, heterogeneity, and coordination: the production of food and nutritional care based on inter-consultation support practices

Abstract

This ethnographic study aimed to understand the production process in food and nutritional care in the setting of primary healthcare, based on inter-consultation support practices. Fieldwork was conducted in two family health units and their respective territories, together with the team from the Expanded Center for Family Health and Basic Care. References for the data analysis were Deleuze and Guattari, Túlio Batista Franco, and researchers associated with Actor-Network Theory such as Annemarie Mol and John Law. The study found that the production of food and nutritional care emerged from links between multiple actors in dynamic and interconnected networks. The practices of care proved to be strongly linked to food's modes of insertion in the daily routines of health professionals and users, revealing paradoxes in the relations of mutual support and expansion of access to food in the territories. Comprising the material heterogeneity in the mediation of interactions, food has an outstanding capacity to spawn connections. Sharing meals mobilized subjectivities through the use of emotional and sensory modes of knowing, learning, and providing care. Experiencing inherent tensions, the relations between micro and macro policy, inter-consultation supporters, together with the other actors, coordinated the networks for the production of food and nutritional care in an open, dynamic, provisional, profuse, and shared process. This understanding can contribute to more active and conscientious positions that move towards shared responsibility in the struggle for the implementation and execution of public policies that guarantee the population's food and nutritional security.