(P20-079-24) Assessment of Food Insecurity Risk in Primary Health Care: The Brazilian Government Experience

Objectives: Food is a constitutional right; thus, society (through our democratically elected governments) has a duty to provide it for the population when they lack resources necessary to obtain adequate food. In Brazil, food and nutrition are combined into one definition: “the realization of everyone's right to regular and permanent access to quality food, in sufficient quantity, without compromising access to other essential needs, based on health-promoting dietary practices that respect cultural diversity and that are socially, economically and environmentally sustainable. The Organic Law on Food and Nutritional Security determines that monitoring food security/insecurity is a responsibility of public authorities. Food insecurity (FI) negatively impacts the health and well-being of individuals, with short- and long-term consequences. Considering Brazil's return to the Hunger Map this study aimed to describe the Brazilian experience of including food insecurity risk assessment in the routine of primary health care (PHC) services.

Methods: This is a descriptive study on the process of developing the first national recommendations for the organization of care after FI risk is identified in PHC. Between August and October 2021, two listening sessions and one validation workshop were held with professionals and managers from the Brazilian universal health system (SUS) and universal social assistance system (SUAS) at municipal, state, and federal levels, and FI researchers. The 2-item screen “Triagem para Risco de Insegurança Alimentar” (TRIA) was adopted to identify households at risk for FI.

Results: In November 2021, the Ministry of Health published recommendations: 1) incorporate TRIA into the PHC routine; 2) use the International Classification of Primary Care Z02 code in the electronic health record (e-SUS); 3) assess food consumption and nutritional status; 4) promote adequate and healthy eating; 5) prioritize referrals to SUAS. The manual also highlights the need for intersectoral planning and the importance of publicizing care protocols for the entire population.

Conclusions: Due to its national coverage, adding TRIA into PHC is strategic to identify households at risk for FI, and for organizing timely referral to other services, programs, and actions within the food and nutrition security network.

Funding Sources: N/A