Published in PLOS One on 2026-02-02, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Ezinne O Uvere, Carolyn Jenkins, Ezinne S Melikam, Oyedunni S Arulogun, Omotolani T Ajala, Adewale E Ayodele, Olayinka J Adebajo, Osimhiarherhuo Adeleye, Olumayowa Ogunronbi, Chukwuemeka Nwimo, Michelle Nichols, Oluwafemi A Popoola, Joshua O Akinyemi, Raelle Tagge, Rufus O Akinyemi, Onoja M Akpa, Ayodeji Salami, Olalekan J Taiwo, Ayodeji Adebayo, Paul Olowoyo, Temitope Ilori, Olanrewaju Olaniyan, Richard W Walker, Bruce Ovbiagele, Mayowa O Owolabi, Nishant K Mishra, Jianhong Zhou, Sarah Jose, I Gede Juanamasta
Source: PLOS One • DOI 10.1371/journal.pone.0322157
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Globally, stroke is a leading cause of mortality with higher incidence in low- and middle-income countries. However, stroke beliefs and knowledge among community partners are essential considerations for tailoring of interventions in West Africa.
To describe differences in beliefs, attitudes, and practices related to stroke risks, prevention, and care delivery from alternative/complementary providers/healers, orthodox/modern medicine/health care providers, community members and leaders in Nigeria.
Six focus groups with community members and leaders (n = 57) and key informant interviews with health providers (n = 24) from alternative/complementary and orthodox/modern medicine providers were conducted to qualitatively explore beliefs, attitudes, practices, and recommendations related to stroke in urban (Ibadan) and rural (Ibarapa) communities in Nigeria. The Socio-Ecological Model guided selection of participants, and the Health Belief Model guided the development of questions for participants.
Participants perceived stroke as disabling, though manageable, and having higher odds of repeat stroke for survivors. High blood pressure, stress, sleep issues, heredity, and lifestyle factors were some stroke risk factors perceived by participants from both sites although God, witchcraft/evil people were reported by rural participants. Hospital visits and consumption of herbal concoction, self-medication and visit to church for prayers were some actions taken to manage stroke by both urban and rural participants. Low literacy levels, limited funds, fear of and distance to hospitals, and absence of insurance were some barriers to uptake of recommendations from orthodox medicine practitioners which are drivers to unorthodox practitioners. To improve stroke care and prevention across communities, free risk factor screening, indigenous stroke awareness programs via print, audio-visual and electronic media were suggested by all participants.
Diverse beliefs and practices are related to stroke risk factors, prevention and care and barriers with obtaining care. There is need to work across systems to improve stroke prevention and care in communities.
Introduction
Stroke is one of the topmost determinants of death and disability worldwide [1,2], with increasing rates recorded across Africa [3–7]. In most high-income countries (HIC), stroke rates and outcomes, such as mortalities and impairments, are declining while rates among adults in Africa continue to rise [8–13]. There are several approaches towards addressing stroke related deaths and disabilities [14,15]. However, multiple and interrelated factors pose great challenges to access preventive services and adoption of evidence-based recommendations and therapeutic regimens towards mitigating the growing incidence of stroke [16]. Structures identified include demographic, personal, socio-economic, and traditional factors as impacting wellbeing [15]. Conceptual models have been utilized to understand the multi-dimensionality of human behavior and action. The Stroke Investigative and Research Education Network (SIREN) utilized the Health Belief Model (HBM), as well as some elements of Arthur Kleinman’s Explanatory Model of Illness [17] to unravel knowledge, beliefs, attitudes, and practices towards stroke prevention and care. Findings were organized by groups using the Social Ecological Model (SEM) [2,18,19].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider financing & policy desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Ezinne O Uvere, Carolyn Jenkins, Ezinne S Melikam, Oyedunni S Arulogun, Omotolani T Ajala, Adewale E Ayodele, Olayinka J Adebajo, Osimhiarherhuo Adeleye, Olumayowa Ogunronbi, Chukwuemeka Nwimo, Michelle Nichols, Oluwafemi A Popoola, Joshua O Akinyemi, Raelle Tagge, Rufus O Akinyemi, Onoja M Akpa, Ayodeji Salami, Olalekan J Taiwo, Ayodeji Adebayo, Paul Olowoyo, Temitope Ilori, Olanrewaju Olaniyan, Richard W Walker, Bruce Ovbiagele, Mayowa O Owolabi, Nishant K Mishra, Jianhong Zhou, Sarah Jose, I Gede Juanamasta. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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