Evaluability assessment of the Brazilian National Food and Nutrition Policy, Fortaleza, Ceará, 2011-2022

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Abstract
Objective: To conduct an evaluability assessment of the Brazilian National Food and Nutrition Policy in Fortaleza, Ceará, and to present the outcomes. Methods: This evaluability assessment was conducted between March 2023 and March 2024. A series of semi-structured interviews was conducted, and an analysis of legal, regulatory, and technical documents relating to the period from 2011 to 2022 was undertaken. The outcomes of the policy, according to key informants, were assessed through time trend analysis, with the calculation of the Annual Growth Rate (AGR) and its respective 95% confidence interval (95%CI), using the Prais-Winsten regression model. Results: A total of 24 key informants (managers, health professionals, and users) involved in the implementation of the policy participated in the study. The four components of the policy’s theoretical-logical model-food and nutrition surveillance; prevention of nutritional deficiency-related conditions; promotion of adequate and healthy eating; and comprehensive care for individuals with chronic diseases and/or special nutritional needs-were selected based on their relevance and recurrence in official documents and key informant interviews. Among the impacts attributed to the policy, the reduction in childhood malnutrition was particularly noteworthy, and the analysis of temporal trends revealed a decrease in severe thinness (AGR -4.94%; 95%CI -7.74; -2.05) in children aged 5 to 10 years, as well as an annual reduction of 4.94% in prevalence. Conclusion: The Brazilian National Food and Nutrition Policy is currently being implemented. The development of the theoretical-logical model has provided an opportunity to reflect on the challenges involved in its implementation, including internal and external contexts.

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