The perspectives of Lagos faith-institution leaders on health, hypertension, and faith-based hypertension interventions: a qualitative interview study.

INTRODUCTION

Hypertension remains a leading contributor to morbidity and mortality in Nigeria, where health system resources are constrained. Faith institutions wield considerable community influence and have supported previous health initiatives; however, their potential role in hypertension prevention and management remains critically understudied. This study explored the perspectives of faith-institution leaders in Lagos on health, hypertension, and the feasibility of faith-based interventions.

METHODS

We purposively sampled eight diverse faith leaders representing Sunni Islam, Pentecostal Christianity, African Traditional Religion, Ahmadiyya Islam, Judaism, and Catholicism in Lagos. Data were collected via remote semi-structured interviews and analysed using a purely inductive thematic analysis approach, involving open line-by-line coding, constant comparison of codes to refine categories, and iterative derivation of descriptive and analytical themes. Reporting adheres to the COREQ checklist.

RESULTS

Four overarching themes emerged: (1) health system deficiencies-encompassing inadequate infrastructure, socioeconomic pressures, and waning public trust-were perceived as a fundamental impediment to hypertension control; (2) faith leaders observed widespread poor hypertension knowledge and poverty-driven health-seeking behaviors leading to preventable deaths; (3) their institutions, although underutilized, possess trusted physical spaces and community networks suitable for health promotion; and (4) there was strong willingness among leaders to collaborate with government and NGOs to deliver congregation-tailored screening, education, and referral interventions.

DISCUSSION: Faith leaders in Lagos demonstrate a sophisticated understanding of the societal determinants of hypertension and express clear willingness to act as health assets. Their institutions represent a promising, yet currently underexploited, platform for integrating community-based NCD prevention into urban health systems. These findings offer transferable insights for leveraging faith-based networks in low-resource settings, contributing to the broader agenda of strengthening primary healthcare access (SDG 3.8) and reducing NCD burden in sub-Saharan Africa. To address the hypertension epidemic in Lagos, Nigeria, and beyond, leveraging faith institutions' unique influence, authority and assets requires recognising leaders' conditional willingness as a rational defence of their legitimacy-necessitating genuine, reciprocal partnerships that respect them as equal partners, not convenient access points.