Abstract
Objective:
to verify if national public policies and municipal programs contain elements that contribute to ensure the Human Right to Adequate Food (HRAF) of older adults undergoing home enteral nutrition therapy (HENT) and to propose the integration of these elements.
Method:
a qualitative study was carried out based on the content analysis of the documents of the National Policy for Older Adults (or PNI), the National Policy for the Health of Older Adults (or PNSPI) and the National Food and Nutrition Policy (or PNAN). Analysis of the relationships (co-occurrences) in programs of the 29 cities of the 2nd regional health region of Paraná to provide care for people with special dietary needs (SDN), such as older adults undergoing HENT, was also carried out. For the analysis of the relationships, the keywords older adult and right were used. Furthermore, the integration of national public policies and municipal programs was proposed.
Results:
the PNI, PNSPI and PNAN contain converging principles, guidelines and actions, but they are not fully integrated into the programs. Only seven cities with programs that aimed to organize care involving SDN were identified, documented in five protocols and two decrees. A co-occurrence was verified in three of the analyzed documents, but a relationship between the keywords older adult and right was not verified in the protocols and decrees. In the integration proposal, a network was described, based around the goal of reaching the center, which represents the HRAF for older adults undergoing HENT.
Conclusion:
national public policies contain elements to ensure the HRAF of older adults undergoing HENT, but the municipal programs do not include all these elements. A proposal to integrate the elements was created.
Keywords:
Public Policy; Health of the Elderly; Enteral Nutrition; Homebound Persons; Program
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Key: HRAF: Human Right To Adequate Food; HENT: Home Enteral Nutritional Therapy; 1. Duty of family, society and the State to ensure the rights of citizenship; 2. Human resources training; 3. Participation of older adult in policy cycle; 4. Health care for older adults; 5. Line of care and bidirectional flows - increase the quality and resolutive capacity of Primary Care; 6. Adequate physical infrastructure and supplies; 7. Technical skills; 8. Prevention, rehabilitation and recovery actions. Prevention and early intervention rather than curative interventions; 9. Multiprofessional care; 10. Wishes of older adults and their family; 11. Specific care for frail older adults; 12. Participation and strengthening of social control; 13. Social Security, Unified Social Assistance and Justice and Human Rights System; 14. Principles of National Health Service; 15. Food as an element of humanization; 16. Respect for diversity and food culture; 17. Strengthening of autonomy; 18. Social determination and the interdisciplinary and intersectoral nature of food and nutrition; 19. Organization of Nutritional Care, promotion of adequate and healthy food, food and nutritional surveillance. 20. Management of Food and Nutrition Actions; 21.Participation and Social Control; 22. Workforce Training; 23. Food Control and Regulation; 24. Research, innovation and knowledge in food and nutrition; 25. Ministry of Health, Municipal and State (including the Federal District) Health Departments; 26. Promote nutritional care and general health care for people with special dietary needs; 27. Provision of commercial formulas for enteral nutrition; 28. Conducting home visits Source: authors.