#FFI20: Nemia Bainivalu
Medical Officer for Tuberculosis and Leprosy Program at Ministry of Health and Medical Services in the Solomon Islands
FFI: How did you become interested in nutrition?
Bainivalu: My interest in nutrition is from a programmatic and strategic standpoint and direction. As a medical professional, I am acutely aware of the impact of nutrition in any person’s life and those around them at whatever age group. Nutrition not only begins in eating food, but is sewn into the very lifestyle, behavior, and environment a person lives in.
FFI: What inspired you to become involved with food fortification?
Bainivalu: It began with my interest in nutrition and its impact. When tasked to be involved in food fortification as part of my role as the Deputy Secretary for Health [in the Solomon Islands], I had oversight in the area of food safety and nutrition. I did not hesitate to chair the Food Fortification committee in the Ministry of Health and Medical Services.
FFI: How is your country prioritizing fortification?
Bainivalu: The country [Solomon Islands] has prioritized fortification by having a food fortification policy in place. There is also an MOU [memorandum of understanding] with the Ministry of Agriculture and other law enforcement agencies such as Customs and Excise in the monitoring and regulation of imports, which only allows fortified products such as rice and flour enter the country.
FFI: What health outcomes do you expect fortification to improve globally?
Bainivalu: The Solomon Islands has several concerning challenges with nutrition. Challenges include stunting in children under 5 years old, anemia in pregnancy, and micronutrient deficiencies in the general population, which is a rising NCD [non-communicable disease] epidemic in the Solomon Islands. It is with fortification that we can expect to improve on these indicators. It is expected that these indicators will not improve over a short period, but we have seen the improvement over a longer period of time, as detected through our health system indicators through the Ministry of Health and Medical Services Health Information System and population-based surveys such as the demographic health survey and population census.
FFI: In your experience what are the main components to a successful fortification program?
Bainivalu: There are several main components which are needed. Firstly, strong leadership is necessary to drive the fortification process. This leadership must be at all levels, from the Minister of Health and ministers of other government sectors to the program implementation level; strong leadership will be one of the main driving forces for the fortification program. Clear policy direction and legislative provision for mandates for fortification must occur in-country, and they must be accessible and updated with the latest information. Additionally, laboratory support is needed for verification purposes of monitoring the production and importation of fortified foods. Having established systems for the ongoing monitoring and implementation of fortification and maintaining the standards of requirement for fortification is key.
FFI: What are the greatest challenges you have encountered in planning or implementing fortification programs? And how did you address those challenges?
Bainivalu: The greatest challenges usually occur when a new initiative or program starts. There have to be consultations and awareness of all stakeholders at all levels. Resourcing was another issue, and also having the legal framework in place when starting fortification programs. In order to address these issues, the essential component is to have a well-articulated and time-bound plan of how the process of fortification will be implemented. In addition to the plan, SWOT [strengths, weaknesses, opportunities, and threats] analysis or risk analysis is needed to identify mitigation measures. One very important point is to have strong leadership to support the fortification process; leadership at political, ministry, program, and sector level is crucial.
FFI: What can we do as a society to continue strengthening fortification efforts?
Bainivalu: We need to create a demand for fortified foods. The demand will be created when all stakeholders play their part in educating the public on the importance of fortified foods in their diet, and the difference it can make in their lives. Making the public, and the generations that follow, make informed decisions to prioritize fortified food as part of their essential nutrition is the messaging that has to be promoted. Having a society brings forth development, progress, innovations, and wealth into a society. A healthy nation is a wealthy nation.
FFI: Is there anything else you would like to share?
Bainivalu: We must continue the work of fortification because this line of work does not bring praise or make heroes and heroines now. We do this work because we will raise a nation of new heroes and heroines for the future when they are healthy, wealthy, and wise.
This interview is part of the #FFI20 Champions campaign, a celebration of fortification heroes who have helped build a smarter, stronger, and healthier world by strengthening fortification programs over the past 20 years. To read interviews with other champions, visit the #FFI20 Champions campaign homepage.