Adherence to the use of the NutriSUS strategy for child food fortification in municipalities of Goiás

Abstract

Introduction: The high demand for nutrients in children under five years of age, added to low nutritious diets, makes them vulnerable to micronutrient deficiencies. The NutriSUS Strategy, launched as part of the School Health Program (PSE) in 2014, aims to combat these deficiencies through the distribution of micronutrient sachets. The effectiveness of this strategy in Goiás, considering the weaknesses in the municipalities, needs to be evaluated. The objective of this study was to verify adherence to the NutriSUS Strategy in municipalities in the state of Goiás and the list of sachets used by agreed and added day care centers. Methods: A retrospective observational study analyzed data on micronutrient supplementation provided by the NutriSUS Strategy in the state of Goiás, between 2017 and 2019. The database available on the Ministry of Health website was used to identify adherence and coverage of the program in 10 regional health departments. The inclusion criteria were municipalities that implemented the strategy during the period studied, while those that did not adhere or did not show interest were excluded. The analysis was performed using absolute and relative frequencies in the EPI Info 7.2.6.0 program. Results: The NutriSUS Strategy was implemented in 35 (14.23%) of the total municipalities (n=246). Micronutrient supplementation targets were constant throughout the period from 2017 to 2019, with some cities, such as Araguapaz, Britânia, and Santa Helena de Goiás, exceeding their supplementation targets in some of the periods, while others, such as Aragarças, Hidrolândia, Piracanjuba, São Luís de Montes Belos, and Buriti Alegre, did not reach the expected targets. The analysis, by semester of supplementation coverage in daycare centers, showed significant fluctuations: a drop in 2017 from 45.44% to 32.60% from the first to the second semester. In 2018, the percentage was 34.43% in the first half of the year, but there was a significant increase to 52.37% in the second half of the year. In 2019, coverage rose to an average of 61.63% in the first half, followed by a drop to 35.74% in the second half. The data also revealed variations in standard deviation, reflecting fluctuations in program adherence. Conclusion: The NutriSUS Strategy showed a variable implementation in the municipalities of Goiás in the period studied, with fluctuations in supplementation coverage over time. The analysis highlighted both success in some locations and difficulties in others, highlighting the importance of continuously monitoring and adjusting supplementation strategies to ensure that all counties adequately benefit children from micronutrient supplementation.