05 June 2009
The resource is aimed at healthcare professionals working with the Muslim community and Muslims living with diabetes.
The project was commissioned by the Tower Hamlets PCT to be used in the area’s surgeries and hospital. The resource was also disseminated into other community hubs such as libraries, internet cafes, mosques, halal butchers and the home.
Maslaha was commissioned by Tower Hamlets Primary Care Trust to produce a new resource to engage with Muslim patients. The PCT was concerned that there were low rates of access to healthcare within the Muslim community and poor management of the condition.
The priority for the project was to raise awareness of prevention and better management of the condition. Maslaha also sought to increase understanding of Islam’s affect on a patient’s behaviour and how they managed their condition.
How this service improves
The service improves because it breaks down the barriers between the Muslim community and healthcare providers.
The website enables healthcare professionals to gain a greater understanding to how Islam can influence all aspects of a Muslim patient’s life and how they can use this knowledge to gain the trust of their local community. A Muslim patient is more likely to visit a GP or nurse if they feel their beliefs and way of life are understood. Equally, religious guidance can be used to encourage Muslim patients to lead healthier lifestyles and better manage the condition. A recent article in the British Medical Journal demonstrated how knowledge of faith and culture helped healthcare practitioners working with British Bangladeshis with Type 2 diabetes.
Why this service is a good example of shared practice
Maslaha used a range of methods to ensure engagement with as wide a group as possible. There was an emphasis on listening to patients and working closely with practitioners to ensure resources were developed in a way that would be useful and meaningful to both. The website and DVD were designed so that they could be used within a health setting or at home. Careful consideration was given to style and design as well as to the DVD scripts and text on the website so that the information was accessible and attractive to the user.
The resources were greatly enhanced by building relationships with several partners.
- To break down the barriers leading to low rates of access to healthcare and poor diabetes management.
- To enable healthcare professionals to develop greater understanding of the influence of Islam on a patient’s life
- To enable healthcare providers to gain the confidence of the local Muslim community.
- To encourage patients to lead healthier lives and better self-management.
The Maslaha team worked with a wide range of stakeholders; including healthcare professionals involved in service delivery and patients. All were involved at different stages of the resource development, from initial interviews outlining their concerns and requirements, to ongoing consultation to inform and provide feedback, then working together to ensure the finished product had a significant impact.
The final products included a DVD which brought together local Imams (to provide advice from a religious perspective on the importance of taking personal responsibility for managing one’s health) and health practitioners to provide medical advice. The DVD was disseminated through the Maslaha website - which was linked to the Tower Hamlets PCT website. The information was presented in an accessible and easy to use format in English and Sylheti. A publicity campaign used knowledge of the local area to raise awareness of the new resources and engage with the target population, this included building relationships with local television channels, internet cafes, community organisations and popular community centres.
Feedback from patients and health practitioners has been extremely positive. Many have requested similar resources to be produced looking at other illnesses, in other languages, and providing more advanced information. The Diabetes in Tower Hamlets project was presented as an example of good practice at the 2008 NHS London conference – ‘Innovating for a World City’.
Our initial research and evaluation has involved feedback from both practitioners and patients.
Interviews were carried out with practitioners and patients who used the resources. Feedback was received from the website which extended beyond the local group.
Feedback has shown that the DVD, website and publicity campaign were extremely effective in providing advice and raising awareness of diabetes in the community. For many Muslims, Islam is a way of life that influences not only moral actions but also daily practical decisions. By using Islam you are communicating in a way that resonates with Muslim patients on a physical, emotional and spiritual level providing a lens through which to focus attention on essential medical advice.
This multi-pronged approach can then be strengthened by employing flexible and resourceful ways of presenting the information. For instance patients who were not shown the website during a GP consultation and did not have a computer at home, were provided with a DVD in English and Sylheti which combined medical and Islamic information about better managing diabetes.
Feedback from patients and service providers has been extremely positive. Many patients were very appreciative of an approach which incorporates faith and information in their first language, and expressed a desire for more resources covering other illnesses prevalent in the community, including: Asthma, Gastric problems, heart condition and depression. Healthcare professionals were particularly pleased to have been directly consulted, allowing them to inform the development of a useful resource. Their engagement with the project was instrumental in ensuring its relevance to everyday practice, and their feedback following the project will inform further improvements to this approach. The feedback facility on the Diabetes in Tower Hamlets website has also yielded positive comments from doctors and clinicians who have found the site of their own accord. These comments have offered support and praise for the site, in appreciation of a unique approach which they had been seeking.
As well as core staff, we have also used healthcare practitioners, patients, imams, calligrapher, film and editing staff, web designer and developer.
The overwhelming response from Muslim patients and health practitioners has been that they would like to see more resources like this which provide an Islamic perspective to medical advice covering other issues such as cardio-vascular disease, depression, maternity care, smoking cessation, alcohol and drug abuse, and asthma. Each of these conditions has been specifically asked after by patients and health practitioners, and resources in other languages besides Sylheti have also been requested (e.g. Somali and Urdu). Feedback from testing sessions and reflections on this work has allowed us to identify other areas for potential improvement and expansion.
Further tools could be produced with additional funding, such as materials for sessions in schools, and more advanced advice for people who have had diabetes for longer. Seeking further options to disseminate information even further to groups with very little access to information e.g. people who rarely leave their homes and may rely on home visits to receive treatment and advice. There is potential for more printed information (produced using Maslaha’s techniques) which can be handed directly to patients to fit in with limited time for consultations.
The website address for the resource is www.diabetesintowerhamlets.org.
The project has proved very successful with Birmingham East and North PCT having commissioned Maslaha to produce similar resources focusing on cardio-vascular disease and infant mortality. Other PCTs have also expressed an interest in working with Maslaha as well.
Maslaha has been profiled in The Guardian Newspaper, in a supplement focusing on social pioneering work, and highlighted as an example of good practice at the 2008 NHS London conference - ‘Innovating for a World City’.
Maslaha was also the subject of an hour long webinar, hosted by the Cities of Migration website, which broadcast to 100 people in 16 different cities across Europe, Canada and the US. You can listen back to the broadcast at https://admin.na4.acrobat.com/_a824650526/p63052584/