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In a rural mosque in Bangladesh, a conversation about faith can now include a conversation about food, physical activity and the risk of type 2 diabetes. The health advice sounds familiar. What is different is who delivers it, where people hear it and how it is reinforced.
That distinction matters. Advice given during a brief clinic visit may be difficult to sustain once a person returns to everyday life. However, a message delivered through a trusted community leader, discussed with family and connected to local screening or referral may have a better chance of becoming part of daily routine.
According to the International Diabetes Federation (IDF), 13.9 million adults aged 20–79 were living with diabetes in Bangladesh in 2024, with age-standardised prevalence at 13.2%. By 2050, the number is projected to rise by approximately 66% to 23.1 million.
Against this background, the Diabetic Association of Bangladesh (BADAS), the Directorate General of Health Services (DGHS) and the Islamic Foundation developed the Diabetes Prevention through Religious Leaders programme. Initially delivered through more than 100 mosques, it trains religious leaders to share evidence-based health information, support community screening and counselling and refer people at high risk of developing type 2 diabetes to health services. It is now being broadened to include Hindu, Christian and Buddhist communities.
Advice given during a brief clinic visit may be difficult to sustain once a person returns to everyday life
What sets the Bangladesh experience apart is that it was tested in a cluster-randomised clinical trial. The trial enrolled 799 adults with prediabetes across eight rural mosque clusters in five districts of Bangladesh. During a 12-month mosque-based lifestyle programme, trained imams and female assistants delivered monthly sessions combining Islamic teachings about moderation and responsibility for health with structured guidance on diet, physical activity, and behaviour change. The control group received standard health advice, including a health leaflet and referral to local health services.
At 12 months, 9.8% of participants in the intervention group had developed type 2 diabetes compared with 17.1% in the control group. That represented an absolute reduction of 7.3 percentage points and a relative reduction of 42.5%. Participants in the intervention group also showed greater improvements in weight, glucose measures, physical activity, diabetes knowledge and quality of life.
These results appear impactful, but they need context. The study included only eight mosque clusters, some behavioural outcomes were self-reported, and follow-up lasted 12 months. The researchers call for further studies to assess long-term effectiveness and cost-effectiveness and to determine whether the intervention produces similar results in urban populations, non-Muslim communities and other settings.
Even with those limitations, the trial moves the discussion beyond whether faith institutions are simply convenient places to hold health activities. It suggests that when an intervention is culturally adapted, evidence-based, and linked to health services, faith institutions can be part of an effective diabetes prevention strategy.
At 12 months, 9.8% of participants in the intervention group had developed type 2 diabetes compared with 17.1% in the control group
Bangladesh is not the first country to explore this approach. In the United States, a cluster-randomised community trial, Fit Body and Soul adapted the established Diabetes Prevention Program lifestyle intervention for African-American churches, which involved 604 adults across 20 churches.
After 12 months, people receiving Fit Body and Soul had lost significantly more weight than those receiving health education alone. Nineteen per cent of participants in the faith-based intervention achieved at least 7% weight loss compared with 8% in the comparison group. Among the subgroup who had prediabetes at the start of the study, fasting glucose also improved.
Earlier feasibility research on Fit Body and Soul had also suggested that trained church leaders could successfully deliver a structured lifestyle intervention within their communities, with high levels of participation.
These studies do not show that simply adding a religious component to a programme will prevent type 2 diabetes. What they do show is the potential of taking interventions already grounded in prevention science and delivering them through community structures that people use and trust.
The answer may have less to do with theology than with social infrastructure.
Religious institutions often have regular contact with communities, physical meeting spaces and established volunteer networks. More importantly, faith leaders may already have something health systems often have to work hard to build: trust.
The World Health Organization (WHO) recognises religious leaders and faith-based organisations as potentially important public-health partners. WHO highlights their capacity to mobilise community action, share accurate, locally tailored health information, and reach marginalised or vulnerable people.
The Bangladesh model attempts to turn those advantages into a practical prevention pathway. Faith-aligned health messages are accompanied by screening, counselling and referral rather than presented as a substitute for medical care. The programme concept includes “Diabetes Corners”, blood glucose and blood pressure screening and referral links with BADAS and government services.
This also reflects a point made by National Professor Dr A.K. Azad Khan, President of BADAS: knowing that lifestyle change can reduce diabetes risk is not enough. Prevention also depends on finding the right way – and the right language – to communicate that message.
Faith-aligned health messages are accompanied by screening, counselling and referral rather than presented as a substitute for medical care
The same trust that makes faith institutions attractive health partners also makes safeguards essential.
The concerns identified in published research should not be interpreted as organised opposition to Bangladesh’s diabetes programme. Rather, studies of faith-based health promotion more broadly show why some health professionals, religious communities and members of the public may be cautious.
In interviews with Australian church leaders, some questioned whether health promotion belonged within the church’s role, particularly when it risked creating mistrust or blurring the boundaries between religious and public-health agendas.
Other research on collaborations between faith organisations and health agencies identified distrust on both sides, different institutional agendas, uncertainty over the separation of religious and public responsibilities, and even a lack of shared language between the two sectors. More recent research also emphasises that successful partnerships depend on mutual trust, transparency and an understanding of what each partner can and cannot contribute.
In Chicago, Muslim women taking part in a qualitative study said mosques could be useful places for health promotion, but they also pointed to practical barriers that could limit women’s participation. The findings suggest that mosque-based programmes need to reflect how women actually use these spaces and the circumstances that shape their access.
Bangladesh’s trial addressed this partly by using trained female assistants alongside imams.
There is also a wider equity question. Not everyone is religious, regularly attends a place of worship or feels represented by a particular faith institution. Faith-based prevention should therefore provide another route into health information and services, not become a gate people must pass through.
What can travel is the underlying idea: work with trusted community institutions, adapt evidence-based prevention to local realities and keep a clear boundary between health promotion and clinical care
The Dhaka Declaration on Faith-Based Diabetes Prevention, adopted in August 2026, makes this boundary explicit. One of its five guiding principles is “integration, not substitution”: faith-based interventions should complement formal health systems rather than replace them.
The Declaration calls for faith institutions to become partners in national diabetes and non-communicable disease prevention policies while also emphasising scientific evidence, accountability and transparent monitoring. Its proposed actions include standardised health education and sermon materials, health and wellness corners in places of worship, screening and referral, maternal and preconception health education and annual reviews of progress.
It is also deliberately multi-faith. Muslim, Hindu, Christian and Buddhist leaders are included in the framework, and a five-year regional roadmap for 2026–2030 is proposed to support implementation and learning across countries.
That evolution matters because health organisations cannot simply transfer a programme developed around mosques in rural Bangladesh to a church, temple or monastery elsewhere. Religious traditions differ, as do gender roles, community structures and health systems.
What can travel is the underlying idea: work with trusted community institutions, adapt evidence-based prevention to local realities and keep a clear boundary between health promotion and clinical care. The lesson from rural Bangladesh is that faith-based prevention works best when local religious leaders reinforce evidence-based health messages and connect people to formal health services.
A healthcare professional can identify risk and provide evidence-based advice, while a community leader may help make that advice understandable, repeatedly visible and socially supported. Screening in a familiar setting can help reach people who have little contact with the health system, and referral can then connect them with appropriate care.
Bangladesh’s experience suggests that this bridge can produce measurable results. Whether those benefits are sustainable over many years and reproduced across different countries, communities and faith traditions is now the bigger question.
But the principle reaches beyond religion. Health does not happen only in hospitals and clinics. It is shaped in homes, workplaces, markets, schools and places of worship.
If diabetes prevention is to reach more people, health systems may need to meet communities in those places – while keeping science, inclusion, personal choice and access to appropriate healthcare firmly at the centre.
