Faculdade de Nutrição, Universidade Federal Fluminense. Rua Mário Santos Braga 30/413, Centro. 24020-140 Niterói RJ Brasil.
Departamento de Nutrição Social, Universidade Federal Fluminense. Niterói RJ Brasil.
Cien Saude Colet. 2024 Apr;29(4):e01502023. doi: 10.1590/1413-81232024294.01502023. Epub 2023 Jun 16.
The present study aimed to analyze how these changes, both at the national and state levels, could affect the conditions of the implementation of obesity prevention and control (OCP) actions in primary health care (PHC) in the Rio de Janeiro State from 2014 to 2021. This study was based on policy analysis methods that emphasize the understanding of the implementation contexts, as well as the induction mechanisms and government incentives for the development of actions and integration of two projects that analyzed the OPC actions in PHC in the 92 municipalities of RJS between 2014 and 2018 (PPSUS-RJS) and between 2019 and 2021 (PEO-RJS). The results indicate that, by 2016, it was possible to observe the positive impacts of the structuring of PHC and the federal induction mechanisms in RJS. However, inflections in the expansion and funding of PHC contributed to the weakening of units, teams, and strategies, and led to retraction of resources for both state and municipal actions. Between 2016-2018, RJS's political and financial scenario deteriorated due to national crises, and the positive counterpoints since then were the induction mechanisms and federal resources that remained, in addition to the technical areas of the RJS-HD and state co-financing resources.
本研究旨在分析国家和州层面的这些变化将如何影响 2014 年至 2021 年里约热内卢州初级卫生保健中肥胖预防和控制 (OCP) 行动的实施条件。本研究基于政策分析方法，强调对实施背景的理解，以及对行动的诱导机制和政府激励措施的理解，该方法整合了两个项目，分析了 2014 年至 2018 年（PPSUS-RJS）和 2019 年至 2021 年（PEO-RJS）期间里约热内卢州 92 个城市的初级卫生保健中的 OPC 行动。结果表明，到 2016 年，已经可以观察到 RJS 中初级卫生保健的结构和联邦诱导机制的积极影响。然而，初级卫生保健的扩张和资金投入的变化导致了单位、团队和战略的削弱，并导致州和市两级行动的资源减少。2016-2018 年，由于国家危机，里约热内卢州的政治和财政状况恶化，此后的积极因素是仍然存在的诱导机制和联邦资源，以及 RJS-HD 的技术领域和州联合融资资源。
