Hunger and its associated factors in the western Brazilian Amazon: a population-based study.

BACKGROUND: Hunger affects millions of people worldwide. In the current pandemic scenario of coronavirus Brazil has experienced an epidemic peak of hunger, amplifying existing prepandemic vulnerabilities, mainly in the North Region of the country. The aim of the present study was to investigate the prevalence of food insecurity and its associated factors in homes with children under 5 years of age in an urban area of a municipality of the western Brazilian Amazon. METHODS: A household survey was conducted with a probabilistic sample of 557 children and their families. Food insecurity (FI) was determined using the Brazilian Food Insecurity Scale. Associations between variables were analyzed based on the prevalence ratio (PR) and respective 95% confidence intervals (CI) calculated through multiple Poisson regression analysis. Variables with a P value < 0.05 after adjustments were considered significantly associated with the outcome. RESULTS: A prevalence of 76.5% (CI 1.36-2.67) food insecurity was found among the families in the study; 42.9% had moderate (CI 1.31-2.83) and severe (CI 1.10-1.83) food insecurity. Moderate and severe FI was associated with low family income (P = 0.00), participation in governmental income transfer programs (P = 0.01), and heads of household with less than 7 years of schooling (P = 0.02). Moreover, substantial frequencies of height deficit and being overweight were found among the children. CONCLUSIONS: The high prevalence of hunger and food insecurity and its associated factors reflects the context of geographic isolation and social exclusion in which these families live, suggesting that a substantial portion of the population under 5 years of age had experienced episodes of hunger in the 90 days prior to the survey. The prevalence of height deficit and being overweight among the children reveals a scenario of epidemiological/nutritional polarization, requiring the formulation of specific public policies for this population.

Health services, intersectoriality and social control: a comparative study on a conditional income transfer program.

The Bolsa Família Program (BFP) is one of the largest conditional cash transfer programs in the world, providing cash transfers and intersectoral actions. The aim of this study was to compare whether there is a difference in access to health services, intersectoral actions and social control, between families entitled or not, to the BFP. A cross-sectional study was carried out. A representative sample of a peripheral, socioeconomically vulnerable population from a large urban center in southeastern Brazil was calculated, totaling 380 families. Chi-square or Fisher's exact tests and multiple correspondence analysis were used to compare groups. Families entitled to the BFP had worse living conditions in general and greater access to health services, such as: medical care (p-value 0.009), community healthcare agent (p-value 0.001) and home visits (p-value 0.041). Being entitled or not affected the variability in the pattern of access to services by 31%; low access to intersectoral actions was identified in both groups; social control was incipient. There was an adequate focus on the program; greater access to health services was related to compliance with conditionalities; low access to intersectoral actions can restrict the interruption of the cycle of intergenerational transmission of poverty.

A system for occupational injury surveillance in Piracicaba, southeastern Brazil.

This article describes the experience of developing the Occupational Injury Surveillance System in the city of Piracicaba, in upstate São Paulo, Brazil. The system has the following characteristics: the information entered into the system is obtained directly, in real time, where the injured individuals receive medical treatment; the system has universal coverage, including all accidents occurring on the job in Piracicaba regardless of the worker's employment status, workplace, and place of residence; the health monitoring and promotion actions are activated in response to the identification of sentinel events; and the analysis of spatial distribution of occupational injuries is a basic tool for elaborating strategies for treating the injured as well as policies for accident prevention. The system began operating on November 1, 2003. 10,777 occupational injuries had been identified by October 31, 2005, corresponding to an annual incidence proportion of 3.8% in the city. We present a brief description of a detailed investigation of one of the injuries.

[A monitoring system for work-related accidents in Piracicaba, São Paulo, Brazil]. / O sistema de vigilância de acidentes do trabalho de Piracicaba, São Paulo, Brasil.

The authors report on the development of a work accident monitoring system in Piracicaba, São Paulo State, Brazil, with the following characteristics: information feeding the system is obtained in real time directly from accident treatment centers; the system has universal monitoring, covering all work-related accidents in Piracicaba, regardless of the nature of the worker's employment conditions, place of work, or place of residence; health surveillance and promotion of health initiatives are triggered by identification of sentinel events; spatial distribution analysis of work-related accidents is a basic tool in designing accident awareness strategies and accident prevention policies. The system was implemented in November 2003 and by October 2004 had identified 5,320 work-related accidents, or a 3.8% annual proportional incidence of work-related accidents in the municipal area. We illustrate spatial analysis of registered work-related accidents and present a detailed investigation of one example of a serious accident.