Efetividade do Programa Criança Alagoana (Cria) sobre o estado nutricional e a insegurança alimentar em domicílios onde vivem crianças da cidade de União dos Palmares-AL

Abstract

Food and Nutritional Insecurity (FNI) in households is directly linked to socioeconomic factors in different parts of the country, mainly in the Northeast region, with FNA being the main factor for nutritional disorders, height deficits and cognitive and psychosocial development. Therefore, an alternative sought by the government of Alagoas to reduce cases of IAN in the state was the creation of the Criança Alagoana (CRIA) program. The objective of this study was to evaluate the effectiveness of the CRIA program on IAN in homes where children live in the city of União dos Palmares-AL. This is a prospective study carried out with users registered in the municipality's CRIA program in 2021, approved by the Ethics and Research Committee, with opinion number 4,641,472. Data were collected from telephone interviews with program users, using the socioeconomic and demographic questionnaire tool, classifying them as food insecure according to the score recommended in the Brazilian Food Insecurity Scale (EBIA), the information was consented by the interviewee after signing of the free and informed consent form (TCLE). 136 families were studied, where before the implementation of CRIA, 93.4% of them had some degree of AI, of which 28.6% were in mild AI, 41.9% in moderate AI and 27.2% in AI serious; after the intervention, the percentages of moderate and severe FI decreased equally to 25%, consequently increasing the percentage of food security to 5.1% and of mild FI to 44.84% (p=0.001). Regarding nutritional status, in the comparison before the intervention, it was seen that children who lived in households with moderate FI were more likely to have high weight for their age compared to those who lived in food security (prevalence ratio (PR ) = 1.315; 95% confidence interval (CI) = 1.068-1.618; p= 0.010). Regarding the length-for-age index, it was seen that children who lived in households with any degree of FI (mild, moderate or severe) were more likely to have low length-for-age when compared to those with food security (respectively: PR = 1.526 ; 95%CI = 1.204-1.933; p = <0.001; PR = 1.236; 95%CI = 1.001-1.526; p = 0.049; PR = 1.309; 95%CI = 1.044-1.642; p = 0.020). After the implementation of the CRIA program, children who lived in a situation of moderate AI became less likely to be overweight for their age compared to children who were food secure (PR = 0.683; 95%CI 0.497-0.939; p = 0.019). The results of this study highlight that there was a significant improvement in the prevalence between moderate and severe degrees of IA and an increase in family food security, in addition to positively affecting the nutritional status of children after the financial assistance received by the CRIA program, showing that the programs cash transfers are effective strategies for promoting food and nutritional security. This study contributes to the understanding of the dynamics involving IAN in specific contexts, providing support for the evaluation and improvement of policies to combat hunger and malnutrition.