The role of Nigeria's faith-based organisations in tackling health crises like COVID-19
eligion has continued to play an important role in the Nigerian public’s perception of the coronavirus disease and the willingness to take the newly developed vaccine. In an April 2020 NOI Poll Survey conducted to ascertain the public’s perception of the coronavirus pandemic and the Nigerian government’s initial response to the virus, 42% of respondents who stated that they were immune to coronavirus highlighted their belief in God as their reason, regardless of religious affiliation. Recent public opinion polls have also revealed that although Nigeria has surpassed over 100,000 coronavirus cases, more than a third of Nigerians who are aware of current scientific advances regarding the coronavirus vaccine are unwilling to take it whenever it is eventually made available nationwide. These respondents anchored their hopes on their faith, which for the Nigerian government could signal another public health risk in its efforts to curb the spread of the disease.
Religion is ingrained in Nigerians' national identity with 46.9% of the population identifying as Christian and 51.1% identifying as Muslim. Moreover, in a country where a third of its adult population is illiterate and where only 46% have internet access, religious leaders remain crucial in the transmission of information. These religious leaders include men, women and youth who hold formal or informal positions of spiritual and organisational authority. In fact, many Nigerians are more likely to listen and believe in the words of their religious leaders than government leaders given the general lack of trust between citizens and the political elite. Indeed, when the government first announced its lockdown measures in March last year, several religious leaders and organisations were suspended for violating the government’s directive that prohibited religious gatherings. They went ahead with religious services while contending that religious spaces should be considered an essential service and accorded the same privilege as markets, banks, and other businesses that were allowed to operate.
Global epidemics are not new to the African continent. As a result of globalisation, the geographic spread of infectious and parasitic diseases has continued to increase, with humans and animals acting as host agents. In Africa, however, weak surveillance systems and poor public health infrastructure and healthcare systems have contributed to the region’s long-lasting history of infectious diseases. This is particularly the case in Nigeria. The country's healthcare network continues to be rated among the worst in the world, ranking 142nd out of 195 countries.
Interestingly, faith-based organisations (FBOs) have become an emerging key stakeholder in the health development landscape. Defined as organisations that derive inspiration and guidance from the teachings and principles of a faith or from a particular interpretation or school of thought within a faith, FBOs are increasingly becoming essential partners in protecting public health and safety. During an epidemic, when governments are stretched thin and faced with hard decisions, FBOs can often pick up the slack in taking care of the needs of their local communities and can also be essential in disabusing erroneous health information, considering that these organisations are trusted by community members. In Nigeria, religious leaders possess massive influence and play significant roles in shaping attitudes, opinions and behavior of their local communities. These religious leaders and their FBOs not only provide spiritual guidance to their followers but are also able to influence health behaviours and reach the poorest and most vulnerable communities due to religious networks that are often found even in the absence of government services.
FBOs and Health Security
Influencing and shaping health behaviour: Considering that for many Nigerians, religious values and practices remain deeply entwined in the fabric of their daily lives, religious leaders remain critical stakeholders in influencing and shaping health behaviour. In the government's efforts to eradicate polio, for example, the engagement of Quranic school teachers and Muslim clerics in disseminating accurate information to non-compliant and hard to reach communities was essential in the uptake of polio vaccinations in northern Nigeria communities, where local populations at first boycotted the oral polio vaccine due to fears that it was unsafe. Religious leaders in Nigeria have also facilitated the uptake of contraceptives and have been at the forefront of shaping opinions and influencing behaviours in the fight against infant and maternal mortality through awareness campaigns. Thus, deploying religious leaders as change agents was crucial to increasing family planning adoption and promoting family health in Nigeria.
Local networks: FBOs in Nigeria additionally can reach the poorest and most vulnerable because of the various types of religious networks built in communities where FBOs are located. Indeed, FBOs constitute the largest non-state provider of welfare and health-care services and are considered an important partner in health-systems strengthening and assuring equity of access to healthcare. This is because religious leaders are often able to leverage their local networks in communities to reach marginalised populations. The largest and oldest FBO in Nigeria, the Christian Health Association of Nigeria (CHAN), for example, operates throughout the country via its member churches, and provides approximately 40% of primary health care in rural areas spread across 4000 facilities.
Community-organising capabilities: In the face of weak and inefficient health institutions that cannot provide appropriate healthcare to citizens, FBOs have remained important stakeholders in supplementing and complementing the government's efforts in addressing epidemics. During the Ebola outbreak in West Africa, FBOs played a critical role in Nigeria’s coordinated response. To increase congregational awareness of preventative measures, religious leaders spread sensitisation messages, ensured the tracking down of escapee contacts, reported suspect cases, promoted hand-washing and social distancing measures and encouraged community members to cooperate with healthcare workers. FBOs have also continued to play a prominent role in Nigeria’s public health response to the HIV/Aids epidemic, offering HIV screening, counselling, and treatment services to people living with HIV/Aids. Estimates from the National Agency for the Control of Aids (NACA) show that over 1000 FBOs have been involved in the fight against HIV/Aids in Nigeria since 2000. This integral role of FBOs is further demonstrated by their inclusion in the current National HIV/Aids Strategic Plan.
However, religious leaders have been able to impede public health responses, especially when they obstruct preventative measures by misinforming or promoting false beliefs among their congregation. In the context of the current COVID-19 pandemic in Nigeria, certain religious leaders have vocally opposed the government’s confinement measures, claiming to have miracle cures and healing powers for the disease and asserting that the government’s measures to curtail the pandemic are an attempt to cripple religion.
Opportunities for the Nigerian government to leverage FBOs in the uptake of the coronavirus vaccine
In his May 2020 high-level address titled The Role of Religious Leaders in Addressing the Multiple Challenges of COVID-19, UN Secretary General Antonio Gutteres implored religious leaders to actively challenge inaccurate and harmful messages, by leveraging their networks and communication capacities to support governments in promoting World Health Organization-recommended public health measures. So far, some Nigerian FBOs have joined the effort to curb the spread of COVID-19 by promoting precautionary measures, suspending gatherings, donating medical equipment andrelief materials and providing funding to support the government’s public health response and measures. But Nigeria, like many other countries, faces the challenge of combating erroneous religious beliefs around the use of effective vaccines against coronavirus. As certain religious leaders have continued to promote religiously grounded misinformation that encourage practices that put their communities at risk, the Nigerian government must engage and encourage FBOs and their religious leaders to actively counter these narratives as part of the national strategy to increase the uptake of the vaccine.
The Nigerian government must consider:
- The integration of religious leaders in the planning, decision-making and implementation of the ongoing coronavirus public health response at the local, state and federal government levels. This will create and encourage platforms that support the design and development of key health messages that are tailored and appropriate to local religious teachings and practices.
- Campaigns that show prominent religious leaders publicly taking the vaccine to allay the fears of citizens. For instance, in the United States, some church leaders have received the first dose of the vaccine, which in turn has encouraged congregation members to do the same in order to curb the spread of the disease.
- The implementation of risk communication training programs and/or seminars that can provide FBOs and religious leaders with appropriate resources to educate their constituents on the safety, effectiveness and possible side effects of the coronavirus vaccine.
- Once trust is established with faith-based groups and community gatekeepers, government officials can, for example, utilise worship centres in rural and urban areas as community vaccination sites in efforts to reach the poorest and most vulnerable communities.
As Nigeria navigates its plans for vaccine acquisition and distribution for its 200 million citizens, government must begin engaging FBOs and religious leaders as crucial stakeholders in an integrated national response in order to ensure effective and equitable distribution of vaccines and protect the health and safety of its citizens.
The opinions expressed in this article are those of the author(s) and do not necessarily reflect the views of SAIIA.
(Main image: A priest holds a pack of face masks outside the Christ Church Cathedral in Lagos, following the reopening of churches and lifting of restrictions on religious gatherings by the government as precaution to check the spread of COVID-19, on 9 August 2020. – Pius Utomi Ekpei/AFP via Getty Images)