Exploring the potential role of faith institutions as assets for innovative hypertension interventions in Lagos, Nigeria.

Background: Hypertension, although preventable, manageable and often treatable, remains the leading cause of death globally through cardiovascular diseases. Low income countries bear heavy burdens of hypertension complications and death, and their health-systems are among the least capable to prevent and manage hypertension. Nigerian faith-institutions wield influence in various development sectors, including healthcare. However, evidence and research are lacking on their role in developing and implementing hypertension interventions. Their powerful societal influence and past involvement in health initiatives position them as potential assets to address hypertension. This research adds evidence, potentially making innovative hypertension interventions by Lagos faith-institutions more achievable.

Methods: A convergent mixed-methods enquiry was utilised to address the literature gap and explore contextual perspectives of faith-leaders, healthcare-providers and faith-institution users on the role of faith-institutions in hypertension prevention and management. This involved a result-based convergent mixed-methods systematic review and three concurrent studies: 1) faith-institution leaders interviews; 2) healthcare-institution leaders' survey; and 3) faith-institution users survey. The findings were integrated.

Results: Systematic review evidence, predominantly from high-income countries, found that faith-institutions contribute contextualised lifestyle-linked health/disease, nutrition/physical-activity teaching, and blood-pressure measurement among others. These roles relied on faith-compatibility and relationships of trust. Integrated survey and qualitative findings indicate that: Health-system factors contribute to inadequate hypertension knowledge across socioeconomic groups. Congregations overestimate their hypertension knowledge and self-awareness, and pragmatically limit health system use, preferentially for treatment than prevention. Unfavourable attitudes for hypertension-health are more prevalent in Lagos than outside Lagos. Limited faith institution resources hinder hypertension mitigation. Faith-institutions are underutilised in customising education, behaviour intervention, hypertension screening and referrals. The prospects for collaborations appear promising within and outside Lagos.

Conclusion: Customising health education to the characteristics, settings, and locations of congregations, and tailoring screening to age and religious affiliations, present opportunities for multi-agency collaborations in Lagos, Nigeria and potentially, similar settings across Sub-Saharan Africa.