“The time of prescription has gone”: production of food and nutrition care at Primary Health Care Services

Abstract

The study aimed to understand how nutrition professionals experienced the production of food and nutrition (FN) care within the scope of Primary Health Care (PHC). An exploratory qualitative study was conducted based on semi-structured interviews with six nutritionists working in PHC and the Nutrition and Child Health Program coordinator of a medium-sized municipality in southern Brazil, contextualized with observations in the services. Thematic content analysis revealed that FN care in PHC was experienced in transitioning from the biomedical model (based on prescription) to the construction of practices based on ‘emancipatory’ care. Concepts presented in the definition of public policies have been adopted and expanded care initiatives have been developed; although, at times, they tended towards moralistic and individualizing perspectives. The production of emancipatory care was hampered by inadequate conditions and work overload, by the low receptivity of other professionals, and by the perception of distance in the team, which hindered work processes and patient-centered care contextualized in the territory. The urgent need to strengthen and qualify FN care in PHC from the perspective of social determinants and the promotion of autonomy is discussed.