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.