Atuação do nutricionista na atenção primária em tempos de Covid-19: um enfoque nas doenças crônicas não transmissíveis

Abstract

This study was developed aiming of describing the frequency of food and nutrition actions at the primary level of health care, aimed at registered users with Chronic Non-Communicable Diseases (NCDs), specifically Systemic Arterial Hypertension, Diabetes, and Obesity, that was performed and recorded in the Health Information System for Primary Care by nutritionists working in the NASF-AP in Brazil, Alagoas and Maceió in the years 2019 and 2020, the latter configured as a pandemic year due to the spread of COVID-19 in worldwide proportions. The data extracted for developing the study are of unrestricted access and were structured in three categories: I - Individual activities by type of service; II - Collective activities; III - Types of conduct adopted after individual activities. The search resulted in five types of individual assistance, four types of collective activities, and nine types of conduct most adopted in both years. From the analysis of the data, a reduction in the frequency of most actions in the three categories was observed, presenting a reduction of more than 50% in individual activities in the geographical units of Brazil and Alagoas and 38% in Maceió. However, spontaneous demand for emergency care showed an increase in the frequency of 5% in the geographic unit Brazil and 140% in Alagoas in 2020. As for collective activities, the reduction in Brazil was 77%, Alagoas 80%, and Maceió 100%, and two of the four collective activities (Health Education and Social Mobilization) have not shown results in the information system since 2019 concerning geographical units Alagoas and Maceió. Referring to the adopted conducts, there was a reduction in frequency in most of them, except for the inter-sectoral referral, which showed an increase in the frequency of approximately 131% in the Alagoas geographical unit and 100% in Maceió in the year 2020 compared to 2019. From the results obtained in this investigation, it can be inferred that the pandemic of COVID-19, presents itself as a preponderant factor for the reduction and/or suspension of actions performed by NASF-AP nutritionists aimed at users of primary health care with Systemic Arterial Hypertension, Diabetes, and/or Obesity. The results of this investigation can assist in carrying out other studies that aim at a greater understanding of the care process of users with NCDs in Primary Health Care and structuring and strengthening policies to deal with NCDs at any time, aiming at the non-neglect of these diseases that require a vigilant and continuous action, especially in situations of public calamity and health emergencies, such as the current pandemic of COVID-19.