Abstract

This study aimed to analyze the financial investment used for the procurement of food for the Brazilian National School Food Program (PNAE) in a city in the South of Brazil. The bidding process, the public calls and accountability reports of the PNAE were analyzed in the following variables: I) municipal financial complementation values; II) percentage of resources used to purchase foods from Family Farmer (FF), and Recommended, Restricted, Prohibited and others foods. The comparison of proportions was employed as a test to identify differences between investments. The municipal financial complementation was 65% of the total. The total amount used to purchase foods was distributed as follows: 65.5% for the Recommended, 27.9% for the Restricted, 6.5% for the Other and 0% for the Prohibited. The expenditure on Recommended foods was higher (p < 0.001) compared to the remaining groups. FF provided only Recommended foods, representing 12.1% of total (municipality and federal) expenditure and 29.5% of total federal funds. The direct purchase from FF contributed to the purchase of recommended foods. The municipal financial complementation was not geared to FA, which can compromise the potential of the school food program to promote healthy and sustainable food systems.

Public policies; Nutritional quality; Local development

Introduction

Increasing overweight and obesity rates have been observed in recent years, reflecting the general health status of the population and the incidence of Chronic Non-communicable Diseases¹1. Popkin BM. Global nutrition dynamics: The world is shifting rapidly toward a diet linked with noncommunicable diseases. Am J Clin Nutr 2006; 84(2):289-298.

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3. World Health Organization (WHO). Pan American Health Organization (PAHO). Plan of action for the prevention of obesity in children and adolescents. 154th Session of the Executive Committee. Washington: WHO; 2014. CE154/16, Rev. 1*.-⁴4. World Health Organization (WHO). Global status report on noncommunicable diseases 2014. Geneva: WHO; 2014. (CNCD), which are among the leading causes of death in Brazil⁵5. Brasil. Ministério da Saúde (MS). Secretaria de Vigilância em Saúde. Departamento de Análise de Situação de Saúde. Plano de ações estratégicas para o enfrentamento das doenças crônicas não transmissíveis (DCNT) no Brasil 2011-2022. Brasília: MS; 2011. p. 148. and worldwide⁶6. World Health Organization (WHO). Noncommunicable diseases. 2015. [cited 2015 Aug 5]. Available from: http://wwwwhoint/mediacentre/factsheets/fs355/en/
http://wwwwhoint/mediacentre/factsheets/... . The prevalence of overweight and obesity has more than tripled in 34 years⁷7. Brasil. Instituto Brasileiro de Geografia e Estatística (IBGE). Pesquisa de Orçamentos Familiares 2008-2009: Antropometria e Estado Nutricional de Crianças, Adolescentes e Adultos no Brasil. Rio de Janeiro: IBGE; 2010. among Brazilian children and adolescents. These changes are related to new eating habits, such as the increased consumption of processed foods with high levels of salt, sugar and fat¹1. Popkin BM. Global nutrition dynamics: The world is shifting rapidly toward a diet linked with noncommunicable diseases. Am J Clin Nutr 2006; 84(2):289-298.,⁷7. Brasil. Instituto Brasileiro de Geografia e Estatística (IBGE). Pesquisa de Orçamentos Familiares 2008-2009: Antropometria e Estado Nutricional de Crianças, Adolescentes e Adultos no Brasil. Rio de Janeiro: IBGE; 2010.

8. World Health Organization (WHO). Global Strategy on Diet, Physical Activity and Health. 57ª World Health Assembly. In: Eighth plenary meeting CA, editor. Geneva: WHO; 2004.-⁹9. Moodie R, Stuckler D, Monteiro C, Sheron N, Neal B, Thamarangsi T, Lincoln P, Casswell S; Lancet NCD Action Group. Profits and pandemics: Prevention of harmful effects of tobacco, alcohol, and ultra-processed food and drink industries. Lancet 2013; 381(9867):670-679.. In this context, the relevance of policies that limit the availability of these foods for schoolchildren⁸8. World Health Organization (WHO). Global Strategy on Diet, Physical Activity and Health. 57ª World Health Assembly. In: Eighth plenary meeting CA, editor. Geneva: WHO; 2004. is evident, especially since school is an essential environment for the establishment of eating habits that tend to remain throughout adulthood¹⁰10. Nicklas TA, Baranowski T, Baranowski JC, Cullen K, Rittenberry L, Olvera N. Family and child-care provider influences on preschool children’s fruit, juice, and vegetable consumption. Nutr Rev 2001; 59(7):224-235.

11. Skinner JD, Carruth BR, Bounds W, Ziegler PJ. Children’s food preferences: A longitudinal analysis. J Am Diet Assoc 2002; 102(11):1638-1647.

12. World Health Organization (WHO), Food and Agriculture Organization of the United Nations (FAO). Diet, Nutrition and the Prevention of Chronic Diseases. Rome, Geneva: Report of a Joint WHO/FAO Expert Consultation; 2002. WHO Technical Report Series 916.-¹³13. Ippolito-Shepherd J, Mantilla Castellanos L, Cerqueira MT. Escolas promotoras de saúde: fortalecimento da iniciativa regional estratégias e linhas de ação 2003-2012. Brasília: OPAS; 2003. (Série promoção da saúde n. 4.). It is also worth noting that, in 2014, the World Health Organization and the Pan American Health Organization established among their goals the improvement of meals provided by schools³3. World Health Organization (WHO). Pan American Health Organization (PAHO). Plan of action for the prevention of obesity in children and adolescents. 154th Session of the Executive Committee. Washington: WHO; 2014. CE154/16, Rev. 1*. through the Action Plan for the prevention of obesity in children and adolescents.

The implementation of the Brazilian School Food Program has been modified to improve the quality of food served in various aspects. Some concern about the adequacy of food habits and the inclusion of fresh food from the strengthening of the local economy has been noted since the beginning of the decentralization process in 1994¹⁴14. Sturion GL. Programa de alimentação escolar: avaliação do desempenho em dez municípios brasileiros [doutorado]. Campinas: Universidade Estadual de Campinas; 2002.. During this period, the management was transferred to the municipalities, which exceed 5,500 throughout the Brazilian territory¹⁵15. Instituto Brasileiro de Geografia e Estatística (IBGE). Indicadores sociais Municipais [Internet]. IBGE; 2000. Available from: http://www.ibge.gov.br/home/estatistica/populacao/indicadores_sociais_municipais/tabela1a.shtm
http://www.ibge.gov.br/home/estatistica/... . The supply of local foods began to stand out among the goals and guidelines of this policy¹⁶16. Vianna RPT, Tereso MJA. O programa de merenda escolar de Campinas: análise do alcance e limitações do abastecimento regional. Rev nutr 2000; 13(1):41-49.. However, the decentralization process was not sufficient to ensure the incentive to the local economy, respect for eating habits and assurance of the nutritional quality of school foods¹⁴14. Sturion GL. Programa de alimentação escolar: avaliação do desempenho em dez municípios brasileiros [doutorado]. Campinas: Universidade Estadual de Campinas; 2002.,¹⁷17. Vianna R. O Programa de merenda escolar: subsídios para o planejamento do programa em Campinas [mestrado]. Campinas: Universidade Estadual de Campinas; 1997..

In 2009, the National School Food Program (PNAE) suffered another critical change in its implementation. It has become mandatory to use at least 30% of the financial resources from the National Education Development Fund (FNDE) to purchase food from family farmer, as well as to prohibit and limit the acquisition of certain foods¹⁸18. Brasil. Fundo Nacional de Desenvolvimento da Educação (FNDE). Lei n° 11.947, de 16 de junho de 2009. Dispõe sobre o atendimento da alimentação escolar e do Programa Dinheiro Direto na Escola aos alunos da educação básica; altera as Leis nº 10.880, de 9 de junho de 2004, 11.273, de 6 de fevereiro de 2006, 11.507, de 20 de julho de 2007; revoga dispositivos da Medida Provisória nº 2.178-36, de 24 de agosto de 2001, e a Lei nº 8.913, de 12 de julho de 1994; e dá outras providências. Diário Oficial da União 2009; 17 jun.. The purchase of low-nutrition content beverages, such as soft drinks, artificial refreshments, guarana or gooseberry concentrates and ready-to-drink teas was forbidden. Also, a restriction was imposed on the application of financial resources for the acquisition of canned food, sausages, confectionery, compound foods, semi-prepared or ready-to-eat preparations and food concentrates¹⁹19. Brasil. Fundo Nacional de Desenvolvimento da Educação (FNDE). Resolução nº 38, 16 de julho de 2009. Dispõe sobre o atendimento da alimentação escolar aos alunos da educação básica no Programa Nacional de Alimentação Escolar - PNAE. Diário Oficial da União 2009; 16 jul.,²⁰20. Brasil. Fundo Nacional de Desenvolvimento da Educação (FNDE). Resolução/CD/FNDE nº 26, de 17 de junho de 2013. Dispõe sobre o atendimento da alimentação escolar aos alunos da educação básica no âmbito do Programa Nacional de Alimentação Escolar – PNAE. Diário oficial da União 2013; 18 jun..

The PNAE is one of the most comprehensive school food programs in the world, and by 2014 was responsible for providing daily meals to 42.2 million students²¹21. Brasil. Fundo Nacional de Desenvolvimento da Educação. Dados estatísticos. 2014.. In that same year, it counted on a federal budget from the FNDE, of approximately 3.7 billion Brazilian Reals per year²¹21. Brasil. Fundo Nacional de Desenvolvimento da Educação. Dados estatísticos. 2014.. Besides federal funds, the Program’s regulations establish the mandatory complementary financial investment from the municipal sphere²⁰20. Brasil. Fundo Nacional de Desenvolvimento da Educação (FNDE). Resolução/CD/FNDE nº 26, de 17 de junho de 2013. Dispõe sobre o atendimento da alimentação escolar aos alunos da educação básica no âmbito do Programa Nacional de Alimentação Escolar – PNAE. Diário oficial da União 2013; 18 jun., which contributes to the good implementation of the Program²²22. Melo MNT, Sá RMPF, Melo Filho DA. Sustentabilidade de um programa de alimentação escolar bem-sucedido: estudo de caso no Nordeste do Brasil. Cien Saude Colet 2016; 21(6):1899-1908..

The legal advances of the PNAE towards the promotion of a healthy diet for schoolchildren are observed, whose core is the central regulation of the application of the federal financial funds to the acquisition of foods. Nevertheless, a gap of scientific knowledge on the subject is noted, specifically studies that aim to verify and analyze how these guidelines are implemented at the local level (municipalities). In this perspective, and as per governmental guidelines for the financial implementation of the National School Food Program, the study aimed to analyze the financial investment for the purchase of food for the PNAE supply in a municipality in the south of Brazil.

Methods

A cross-sectional, descriptive, analytical and exploratory study was carried out based on consultations with secondary sources. The study was conducted in a municipality in the state of Paraná with approximately 30 thousand inhabitants, where the public school network had 23 elementary schools, responsible for the daily attendance of 4,031 students. Based on the documentary analysis, public calls (purchase modality used to acquire food from family farmers), bids (purchase from other suppliers) and the rendering of accounts of the 2010 program obtained from the responsible for the program were studied.

The study variables were: (I) Percentage of the financial resources used to purchase Recommended, Restricted, Prohibited and Other foods. (II) Percentage of the resource used to purchase food from family farmers. (III) Percentage of the amount of the municipal financial complementation (R$). The definition of the variables was based on the governmental recommendations for the financial implementation of the program (Law Nº 11.947/2009, Resolution Nº 26/2013).

The information of the financial investment from the FNDE, the municipality’s investment for the purchase of food and the amount of resources from the FNDE for the purchase of food from the family farmer were extracted from the rendering of accounts, called the Physical and Financial Implementation Summary Statement. The quantities (kg), unit values (R$) and origin (from family farmers and other suppliers) of the food purchased for the annual supply (two hundred school days) of the school food program were extracted from the bids and public calls.

The shopping lists were analyzed regarding the Method of Evaluation of the Procurement of Foodstuffs (AGA)²³23. Martinelli SS, Soares S, Fabri RK, Veiros MB, Cavalli SB. Qualidade da alimentação escolar: método para avaliação da Aquisição de Gêneros Alimentícios (AGA). In: Teo CRPA, Triches RM, editors. Alimentação escolar: construindo interfaces entre saúde, educação e desenvolvimento. Chapecó: Argos Editora; 2016. p. 411.. Based on current PNAE regulations and national healthy eating recommendations, the method facilitates the inspection of the adequacy of the school food shopping list to these standards and recommendations. Thus, the food shown in bids and public calls are grouped according to their origin and nutritional characteristics. Foods are divided into two categories according to nutritional characteristics: (1) Recommended Foods (included in a nutritionally healthy diet and quantitatively recommended by the PNAE legislation). (2) Restricted Foods (related to unhealthy and restricted or financially prohibited the PNAE legislation, they include foods with high concentrations of sodium, sugar, saturated/trans fats). In addition to that proposed by the AGA method, categories 3 and 4 were established: (3) Prohibited (with acquisition prohibited by the PNAE legislation: soft drinks, artificial refreshments, guarana or gooseberry concentrates, ready-to-drink teas and other similar beverages). (4) Other (foods that are not restricted by program legislation. However, their consumption in large quantities should not be encouraged). Each category, in turn, was divided into subcategories (Chart 1).

The total daily investment in Brazilian Reals for each food group was calculated to analyze the financial investment used to purchase recommended and controlled foods. Thus, the total amounts for each group were counted and were divided by the 200 school days. Subsequently, the corresponding proportions of each food category and subcategory were calculated against total expenditure.

The amounts of each food group were stratified by source (FF/OS), calculating the proportions for FF and OS (against the total of each group) to identify whether these resources were intended for family farmers (FF) or other suppliers (OS).

The financial figures from the FNDE and the municipality were calculated from the information provided in the rendering of accounts of the municipality. With the objective of exploring the use of each resource in the purchase of food from the FF, the percentage of the investment of the FNDE’s resources in the rendering of accounts was used as a reference. The financial amount spent on public calls that exceeded this percentage was considered to be from municipal resources.

A descriptive analysis of the data and a test for comparing proportions were performed to identify statistically significant differences between the percentage spent on public calls (family farmers) and on bids (other suppliers) against the total daily amount spent, as well as between the amounts spent on Recommended, Restricted and Prohibited foods. A significance level of p<0.05 was considered. Data were typed in spreadsheets and analyzed in Stata 11.0 software (StataCorp., CollegeStation, TX, 2011).

Results

Table 1 shows the daily means of the financial expenditure on the purchase of food in each of the categories and subcategories of the study, as well as the result of the contrast of proportions. We observed a daily investment of around R$ 3,482 for the purchase of food. Most of the investment was allocated to the purchase of recommended foods (65.6%). The expenses with restricted foods arrived at 27.9%, and with the other foods that did not enter the previous classification 6.5%. The acquisition of low nutritional value drinks that are foods prohibited by the PNAE legislation was not identified.

Among the recommended foods, the groups with the highest financial investment were fruits, followed by lean meats and cereals. Among the restricted foods were the acquisition of foods with high sugar content (sweet biscuit, cereal bar and sugary corn cereal); high fat and sodium sausages (sausage, formed ham and smoked sausage); food concentrates or powdered food for dilution (milk drink preparation mix, gelatin powder, pudding powder and chicken stock) and canned food (canned corn and pea).

Table 2 shows the financial resources from the FNDE and the municipality for the acquisition of food and the respective percentages directed to family farmers. The municipality invested approximately four hundred and fifty-six thousand Reals, almost twice the amount transferred by FNDE (R$ 240,000.00) during 2010 for the implementation of the Program.

The purchase from family farming accounted for 12.1% of the total food expenditure. It was observed that 29.5% of the resources from the FNDE and 2.9% of the financial complementation by the municipality were allocated to the FF purchase. It should be noted that the total amount of funds allocated to the purchase of FF food was used to purchase recommended foods.

Discussion

The amount invested in the purchase of restricted foods was within limits stipulated by FNDE’s regulations, and all of these foods were purchased by bidding from other suppliers than family farmers. On the other hand, only recommended food from family farming was acquired, suggesting that this direct purchase can contribute to the school food quality. In this perspective, a low percentage of financial resources geared to the purchase of family farming food can jeopardize the promotion of Food and Nutrition Security (SAN) and the development of a local, sustainable and healthy food system.

The acquisition of restricted foods, even within limits imposed by legislation, may represent a risk to the health of the population. This is because their nutritional characteristics (higher energy density, saturated and trans fat, sugar and sodium content)²⁴24. Louzada MLC, Martins APB, Canella DS, Baraldi LG, Levy RB, Claro RM, Moubarac JC, Cannon G, Monteiro CA. Impact of ultra-processed foods on micronutrient content in the Brazilian diet. Rev Saude Publica 2015; 49:45., associated with their low cost²⁵25. Brasil. Ministério da Saúde (MS). Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Guia alimentar para a população brasileira: promovendo a alimentação saudável. Brasília: MS; 2014. and the increasing consumption of these foods by children and adolescents are related to increasing overweight and obesity cases in Brazil⁷7. Brasil. Instituto Brasileiro de Geografia e Estatística (IBGE). Pesquisa de Orçamentos Familiares 2008-2009: Antropometria e Estado Nutricional de Crianças, Adolescentes e Adultos no Brasil. Rio de Janeiro: IBGE; 2010..

On the other hand, in line with previous studies, the results suggest that the acquisition of foods from local agriculture can contribute to the supply and intake of healthy foods in schools²⁶26. Nicholson L, Turner L, Schneider L, Chriqui J, Chaloupka F. State Farm-to-School Laws Influence the Availability of Fruits and Vegetables in School Lunches at US Public Elementary Schools. J Sch Health 2014; 84(5):310-316.

27. Bontrager Yoder AB, Liebhart JL, McCarty DJ, Meinen A, Schoeller D, Vargas C, LaRowe T. Farm to Elementary School Programming Increases Access to Fruits and Vegetables and Increases Their Consumption Among Those With Low Intake. J Nutr Educ Behav 2014; 46(5):341-349.-²⁸28. Santos F, Fernandes PF, Rockett FC, Oliveira ABA. Avaliação da inserção de alimentos orgânicos provenientes da agricultura familiar na alimentação escolar, em municípios dos territórios rurais do Rio Grande do Sul, Brasil. Cien Saude Colet 2014; 19(5):1429-1436.. This is because only the purchase of recommended food from family farms has been observed, and these are associated with a healthy diet⁸8. World Health Organization (WHO). Global Strategy on Diet, Physical Activity and Health. 57ª World Health Assembly. In: Eighth plenary meeting CA, editor. Geneva: WHO; 2004.,²⁵25. Brasil. Ministério da Saúde (MS). Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Guia alimentar para a população brasileira: promovendo a alimentação saudável. Brasília: MS; 2014.. Thus, the approximation of family farming production with school food consumption seems to be an essential policy for the promotion of a healthy diet and can contribute positively to the fight against the increasing childhood obesity rates. Also, by providing stable markets to farmers, buying via a public call can generate positive impacts on agriculture²⁹29. Becker C, Anjos FS. Segurança alimentar e desenvolvimento rural: limites e possibilidades do Programa de Aquisição de Alimentos da agricultura familiar, em municípios do sul gaúcho. Segurança Alimentar e Nutricional 2010; 17(1):61-72.

30. Pandolfo MC. O programa de aquisição de alimentos como instrumento revitalizador dos mercados regionais. Revista Agriculturas 2008; 5(2):14-17.

31. Turpin ME. A alimentação escolar como fator de desenvolvimento local por meio do apoio aos agricultores familiares. Segurança Alimentar e Nutricional 2009; 16(Supl. 2):20-42.-³²32. Vogt SPC, Souza Rd, editors. Mercados institucionais locais como instrumento de fortalecimento da agricultura familiar: uma análise do Programa de Aquisição de Alimentos na Região Celeiro–RS. Anais XLVII Congresso da Sociedade Brasileira de Economia, Administração e Sociologia Rural; 2009., while contributing to the development of sustainable local agrifood systems³³33. Rosset P. The multiple functions and benefits of small farm agriculture. Food First Policy Brief 1999; 4:1-22.,³⁴34. Rosset P. Preventing hunger: Change economic policy. Nature 2011; 479(7374):472-473..

However, the low percentage of global investment (12.1%) identified for the acquisition of FF food may jeopardize the potential of the benefits of this food purchase. This result could be explained by the fact that the FNDE guidelines for the financial implementation of the program refer only to the use of FNDE resources²⁰20. Brasil. Fundo Nacional de Desenvolvimento da Educação (FNDE). Resolução/CD/FNDE nº 26, de 17 de junho de 2013. Dispõe sobre o atendimento da alimentação escolar aos alunos da educação básica no âmbito do Programa Nacional de Alimentação Escolar – PNAE. Diário oficial da União 2013; 18 jun. and not from the municipality, stipulating a minimum investment value of 30% for the purchase of family farm. Also, the short time elapsed since the implementation of current program regulations and data collection, coupled with the organizational hindrances of the processes of change for their implementation could explain this result.

Supporting policies to draw family production closer to food consumption in schools positively and internationally highlights Brazil’s SAN policy³⁵35. Maluf RS, Burlandy L, Santarelli M, Schottz V, Speranza JS. Nutrition-sensitive agriculture and the promotion of food and nutrition sovereignty and security in Brazil. Cien Saude Colet 2015; 20(8):2303-2312. and evidences the efforts of the Brazilian government to support more sustainable forms of production/consumption. Although this policy is a significant advance, it seems necessary to articulate and add different purchase criteria and agrifood policies to the existing policies to enable the consolidation of healthier and sustainable food systems. Also, other medium- and long-term studies are required to identify the effects generated by the normative modifications of PNAE in local food systems.

According to Government guidelines, food classification represented a difficulty in conducting this study due to the lack of clear categorization criteria. However, the use of the AGA method enabled such classification, facilitating the clustering of foods according to nutritional features and their origin. The information analyzed in the documents was not recorded by the researchers, which should be considered when interpreting the results. However, they are official sources of the municipality’s food purchase records, prepared homogeneously for all purchases made and recorded by the responsible professionals. Also, public calls and bids used as information sources are purchase planning tools and may be modified during the implementation of the program. However, the financial values extracted from these instruments were contrasted with those in the municipal rendering of accounts, which enabled the analysis of how the financial resources allocated to the purchase of foods are being used at the municipal level.

Conclusively, the purchase of food from family farmers in this municipality contributed to the acquisition of healthy food. However, the financial complementation of the municipality seems not to be directed at this productive segment, which may compromise the PNAE’s potential to promote local, sustainable and healthy agrifood systems.

Acknowledgments

We are grateful to CAPES for the Ph.D. scholarship granted to P Soares. This paper is a product of his training process in the Ph.D. Program in Health Sciences of the University of Alicante (Spain) and will be used as part of the material presented in his thesis in a compendium of papers.

References

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