ANÁLISE QUALITATIVA DA ATENÇÃO À PESSOA COM OBESIDADE NOS PLANOS MUNICIPAIS DE SAÚDE DE MATO GROSSO DO SUL: CONFORMIDADES E LACUNAS

Abstract

Obesity is a multifactorial condition with a high incidence in contemporary society and is considered a serious public health problem. In the context of Primary Health Care (PHC), there is a notable need to organize health care for individuals with obesity, especially within the Family Health Strategy, through actions focused on prevention, health promotion, and self-care. These actions and goals must be outlined in management instruments that ensure the development and implementation of public policies at the municipal level, with the Municipal Health Plan (PMS) serving as the main planning tool within Brazil's Unified Health System (SUS). This study aimed to evaluate the presence of obesity care in the PMS documents of municipalities in the state of Mato Grosso do Sul (MS). This is a documentary and exploratory study with a qualitative approach, based on Bardin (2016), which involved a pre-analysis of content through reading and organizing text segments containing the term "obesity" and its variations. The IRAMuTeQ software was used for textual analysis, allowing for the identification of key word co-occurrences and the formation of thematic categories based on the application of Descending Hierarchical Classification (DHC), Correspondence Analysis (CA), and Similarity Analysis. Content analysis was grounded in Technical Note No. 5/2017 from the Mato Grosso do Sul State Health Department, which guides the construction of the PMS, and in Ministerial Ordinance No. 424/2013, which organizes the care pathway and defines guidelines for managing overweight and obesity. PMS documents from 78 municipalities were analyzed, representing 98.7% of the total; of these, 53% mentioned the term "obesity" or its variations. The results showed that the mere presence of the term in the documents did not ensure the effective inclusion of obesity care in the PMS, as the topic was neither prioritized as a public health issue nor logically integrated into the situational analysis or into the definition of guidelines, objectives, and goals. Furthermore, none of the documents referenced budgetary planning specifically directed toward obesity care. Therefore, the invisibility of obesity in health planning instruments results in fragmented care in PHC, with insufficient investment and the perpetuation of institutional neglect toward the issue.