Organizational readiness for implementation of food and nutrition surveillance in Brazilian primary health care: a cross-sectional study

BACKGROUND: Food and Nutrition Surveillance is a key strategy of Brazil's National Food and Nutrition Policy and plays a central role in the organization of nutritional actions in primary health care. Despite its strategic importance, food and nutrition surveillance implementation faces persistent challenges related to training gaps, funding discontinuities, and limited institutional support. This study assessed the organizational readiness of primary health care professionals for food and nutrition surveillance implementation via the Organizational Readiness for Implementing Change (ORIC) instrument. METHODS: This cross-sectional study was conducted in Mato Grosso do Sul, Brazil, during a state-level permanent education event in 2023. Eighty-five primary health care professionals from 49 municipalities responded to the Brazilian version of the ORIC instrument, adapted for the food and nutrition surveillance context. ORIC measures two core constructs: change commitment and change efficacy. The statistical data were analyzed and compared with the readiness levels by professional category (frontline representation) and health macroregion. RESULTS: The mean ORIC score indicated neutral to moderate readiness across participants (commitment: 3.65; efficacy: 3.71 on a 5-point Likert scale). Nurses and physical education professionals exhibited the highest levels of readiness, surpassing the threshold of 4.0 in both domains. In contrast, nutritionists-despite being the professional group most directly associated with the food and nutrition surveillance-scored lower. Geographic disparities were also evident: professionals from the Eastern Border and Southern Cone regions reported greater readiness than those from the Central and Pantanal macroregions did. CONCLUSIONS: The findings reveal important gaps in organizational readiness for food and nutrition surveillance implementation in primary health care, particularly among nutritionists and in certain territories, suggesting limited engagement or perceived capacity to implement the policy. These results emphasize the need for regionally tailored strategies, stronger integration with permanent education initiatives, and institutional support mechanisms. The ORIC instrument proved to be a useful tool for assessing team-level readiness and guiding implementation efforts. Applying implementation science frameworks may help foster greater alignment between health professionals' practices and policy goals, ensuring more equitable and sustainable integration of food and nutrition surveillance in primary health care.