At Friday noon prayers on a steamy June day, a group of men at the Bhawal Purbopara Jame Mosque in Dhaka listen quietly as their Imam reads from a printed text in his hands.
“Let’s abide by those rules of the Quran and Hadith concerning food consumption, and encourage others to do the same,” he concludes.
The six-minute Khutbah, or sermon, encourages healthy food habits - and is now part of the weekly prayer service here and at 99 other mosques across the country. It was created and distributed by the Diabetic Association of Bangladesh (BADAS) as part of the project Diabetes Prevention through Religious Leaders in Bangladesh.
“The majority of people in Bangladesh are Muslim. Mosques are the common meeting place for Muslim people in Bangladesh, and Imams are respected and influential figures in the Muslim community,” explains Dr Bishwajit Bhowmik from BADAS, WDF’s partner on the project.
“People seek advice from Imams about all sorts of matters and trust them with personal and family issues. There is a great opportunity to seek the influence of Imams in creating community awareness about the prevention of diabetes and other NCDs.”
I guide them
The project builds on past WDF projects in the country, including one that introduced pre-conception counselling in Bangladesh. In addition to the Khutbah, the project provides diabetes training, establishes ‘Diabetes Corners’ in mosques, and distributes educational toolkits around the country.
“We have trained 100 Imams and established 100 Diabetes Corners with screening for diabetes, hypertension, and nutritional status, digital record keeping, and a referral network with sub-district NCD Corners and BADAS centres and hospitals,” Dr Bishwajit says.
A presentation in the Bhawal Purbopara Jame Mosque Diabetes Corner.
“The trained Imams now advocate, promote, and encourage a healthy lifestyle through religious sermons during congregation prayer. Besides the awareness activities, they love to run the Diabetes Corner,” he says – an observation endorsed by Mawlana Saleh Ahmed, Imam at the Bhawal Purbopara Jame Mosque.
“This training programme allows me to work with our people to promote a healthy lifestyle. Not only that, I check their glucose, blood pressure, and weight in my Diabetes Corner,” Mawlana Saleh Ahmed says.
“I also guide them on where they have to go … and I am also using the app for information collection. This training programme has increased respect for me in my community.”
Female assistants join the team
Every WDF project faces challenges, and Diabetes Prevention through Religious Leaders in Bangladesh is no exception.
Administrative procedures of the Islamic Foundation and NGO Affairs Bureau caused delays. The Islamic Foundation advised against using realistic images of human bodies in educational materials, requiring new approaches. The COVID pandemic interrupted project fieldwork, and a project extension was needed.
Most significantly, in Bangladesh only men go to mosques for congregation prayers. So the original project plan missed half of the Bangladeshi population - women.
To remedy this, a female assistant was included in each Imam team to reach the mosque’s female population. These assistants, who were local community members, received the same training as their male counterparts. They then assumed responsibility for outreach to local women.
To reach their target audience, the female assistants organise events for small groups, where they discuss the Khutbah’s messages about healthy lifestyle, supported by flipchart, leaflets, videos and other project materials.
Like their male counterparts, the female assistants collect sociodemographic, anthropometric, clinical, biochemical, and financial information. Then, using an app developed by the project, they upload this information to a central database linked to a national dashboard and the BADAS National Diabetes Registry.
Jui Akhtar addresses local women at an event outside the Bhawal Purbopara Jame Mosque.
“It was valuable training. It helped me change my lifestyle, and now I am promoting a healthy lifestyle to prevent diabetes,” says Jui Akhtar, a female Imam Assistant at the Bhawal Purbopara Jame Mosque.
“The best about this training is that I learned that diabetes could be prevented by practicing a healthy lifestyle, which is encouraged in Islam. Best of all, it allows me to work with our people. It helps to improve my influence in my community.”
The project successfully completed in April 2022, and its materials and approach are on track to make a lasting impact.
For example, Bangladesh’s Ministry of Religious Affairs and Ministry of Health and Family Affairs have endorsed the project’s materials for nationwide use. Today, 300,000 mosques are actively using the Khutbah, reaching around 20 million people nationwide.
Bangladesh’s Ministry of Foreign Affairs has agreed to circulate the Khutbah to the Organization of Islamic Countries, making it available outside the country as well.
Muhammad Rafiq-ul-Islam and Mads Holst Jensen review project materials in front of a poster summarising the diabetes Khutbah’s messages.
Mads Holst Jensen, WDF Programme Manager, says the project’s sensitivity to social and cultural mores is a key element of its success.
“Recent trends in health education and promotion emphasise the importance of integrating health interventions into the cultural and social realities of people’s everyday life, and this is a good example of that approach,” he says.
“This project addresses an urgent need, in Bangladesh and many other countries, of developing innovative ways to raise health literacy and help those in need of diabetes care.”