{
  "abstract": "Objectives To identify stakeholder perceived challenges and facilitators for implementing a clean fuel and clean stove intervention to reduce household air pollution and hypertension in Lagos, Nigeria.Design Qualitative study guided by the Exploration and Preparation phases of the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework, using focus group discussions and in-depth semi-structured interviews with inductive and deductive thematic analysis.Setting Peri-urban communities across the five administrative divisions of Lagos State, Nigeria.Participants 128 stakeholders from 32 communities, including community, religious, market and youth leaders, primary healthcare staff, and household decision makers. Approximately half were female.Interventions This was a pre-implementation needs assessment that included demonstrations of the clean stove and fuel.Primary and secondary outcome measures Thematic domains describing barriers and enablers to adoption and implementation, mapped to EPIS inner, outer, and bridging factors.Results Stakeholders reported barriers that included stove stacking, upfront stove cost, concerns about long-term fuel price and availability, equipment durability and maintenance, safety, mistrust of new technology, and uncertainty about stove performance for dishes requiring high heat and long cooking times. Reported facilitators included payment flexibility and subsidies, opportunities to test the stove, perceived benefits of cleaner and faster cooking with less soot, endorsement by community leaders, and interest in local retail and distribution to improve access.Conclusions Implementation planning for clean fuel and clean stove programmes should address affordability, reliable fuel supply chains, durability and service, culturally relevant cooking needs, and trust building through community leadership. These findings inform adaptation strategies for scale-up in similar low-resource settings.Trial registration number NCT05048147.",
  "authors": [
    {
      "affiliations": [
        "Section for Global Health, Institute for Excellence in Health Equity, NYU Grossman School of Medicine, New York, New York, USA",
        "Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA"
      ],
      "name": "Deborah O Onakomaiya"
    },
    {
      "affiliations": [
        "Section for Global Health, Institute for Excellence in Health Equity, NYU Grossman School of Medicine, New York, New York, USA"
      ],
      "name": "Shivani Mishra"
    },
    {
      "affiliations": [
        "Columbia University Mailman School of Public Health, New York, New York, USA"
      ],
      "name": "Calvin Colvin"
    },
    {
      "affiliations": [
        "Department of Community Health and Primary Healthcare, Lagos State University College of Medicine, Lagos, Nigeria"
      ],
      "name": "Riyike Ogunyemi"
    },
    {
      "affiliations": [
        "Department of Community Health and Primary Healthcare, Lagos State University Teaching Hospital, Lagos, Nigeria"
      ],
      "name": "Adedayo Ayodele Aderibigbe"
    },
    {
      "affiliations": [
        "Department of Community Health and Primary Healthcare, Lagos State University College of Medicine, Lagos, Nigeria"
      ],
      "name": "Temiloluwa Fagbemi"
    },
    {
      "affiliations": [
        "Section for Global Health, Institute for Excellence in Health Equity, NYU Grossman School of Medicine, New York, New York, USA"
      ],
      "name": "Mary Remi Adeniji"
    },
    {
      "affiliations": [
        "New Jersey Department of Health, Trenton, New Jersey, USA"
      ],
      "name": "Sarah Li"
    },
    {
      "affiliations": [
        "Section for Global Health, Institute for Excellence in Health Equity, NYU Grossman School of Medicine, New York, New York, USA"
      ],
      "name": "Nafesa Kanneh"
    },
    {
      "affiliations": [
        "Section for Global Health, Institute for Excellence in Health Equity, NYU Grossman School of Medicine, New York, New York, USA",
        "Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA"
      ],
      "name": "Angela Aifah"
    },
    {
      "affiliations": [
        "Section for Global Health, Institute for Excellence in Health Equity, NYU Grossman School of Medicine, New York, New York, USA",
        "Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA"
      ],
      "name": "Rajesh Vedanthan"
    },
    {
      "affiliations": [
        "Medicine, University of Chicago Division of Biological Sciences, Chicago, Illinois, USA"
      ],
      "name": "Christopher O Olopade"
    },
    {
      "affiliations": [
        "Department of Community Health and Primary Healthcare, Lagos State University College of Medicine, Lagos, Nigeria",
        "Department of Community Health and Primary Healthcare, Lagos State University Teaching Hospital, Lagos, Nigeria"
      ],
      "name": "Kikelomo Wright"
    },
    {
      "affiliations": [
        "Section for Global Health, Institute for Excellence in Health Equity, NYU Grossman School of Medicine, New York, New York, USA",
        "Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA"
      ],
      "name": "Gbenga Ogedegbe"
    },
    {
      "affiliations": [
        "Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA",
        "Ronald O. Perelman Department of Emergency Medicine, NYU Grossman School of Medicine, New York, New York, USA"
      ],
      "name": "Stephen P Wall"
    }
  ],
  "title": "Stakeholders’ perspectives on implementation of a clean fuel: clean stove intervention for reduction of household air pollution and hypertension in Lagos, Nigeria – a qualitative study",
  "uid": "c510061d-d88d-54ea-ab70-cfffeda44587"
}