when care misses culture: why healthcare systems must better support muslim patients during ramadan
culturally safe care isn’t a “nice to have.” it’s a standard of care that recognizes that each person brings their own cultural identity into a healthcare interaction
4 minute read
when healthcare providers don’t fully understand ramadan or are unsure how to discuss it, patients are often left to figure things out on their own.
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every year, more than 1.8 billion muslims around the world observe ramadan, a sacred month of fasting, prayer, and community. for nearly a full lunar month, muslims refrain from eating and drinking from dawn until sunset. it’s a deeply spiritual practice that affects nutrition, hydration, medication timing and physical energy.
for muslims living in western countries, navigating this holy month while managing chronic conditions, attending medical appointments, or even undergoing treatment becomes a balancing act. the healthcare system, in theory, should help.
but a growing body of evidence shows that it often doesn’t.
a recent review of published studies reveals that many healthcare professionals in western countries lack the knowledge, comfort, and training needed to provide appropriate care to muslim patients who fast during ramadan. it’s not just about medical advice—it’s about culturally safe care: care that respects a person’s beliefs, traditions and lived experience.
and in this case, that kind of care is falling short.
what ramadan means—and what it requires
to understand why this matters, you must first understand what ramadan is.
fasting from food and drink daily for nearly 30 days changes the body’s functions. sleep is adjusted. meal timing shifts dramatically. people must find ways to stay hydrated, maintain energy, and continue work or physical activity without eating for most of the day.
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for those living with chronic illnesses, like diabetes, high blood pressure, or digestive disorders, this creates unique challenges. medications may need to be timed differently. nutritional needs change. and advice that works during non-fasting months may no longer apply.
that’s why culturally informed care matters. muslim patients need healthcare providers who understand ramadan, medically and contextually.
they need to feel safe discussing their decisions to fast, and confident that their care will reflect medical best practices and their spiritual values.
review of what’s missing
to determine how well western countries’ healthcare systems support this need, researchers reviewed the available literature. out of 42 articles reviewed in full, only eight were directly relevant, underscoring how little research has been done in this area.
even within those eight, the studies revealed a common thread: most healthcare professionals knew about ramadan, but very few felt confident providing care during it. some lacked resources. others had never received any formal training. and many felt unsure about how to approach conversations around fasting with their muslim patients.
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this knowledge gap isn’t limited to one field, either. it spans across healthcare professions—including doctors, nurses and dietitians. in canada specifically, the research is fragile.
why it matters for patients
when healthcare providers don’t fully understand ramadan or are unsure how to discuss it, patients are often left to figure things out on their own.
that can mean stopping medication without proper guidance, skipping important appointments for fear of being told not to fast, and eating meals that feel culturally unfamiliar because there is no tailored dietary advice.
ultimately, it can mean worse health outcomes. but it also leads to something more subtle: mistrust. when patients feel their values aren’t respected, or their experiences aren’t understood, they’re less likely to engage with care systems.
that’s a public health issue. and it’s preventable.
cultural safety isn’t optional
culturally safe care isn’t a “nice to have.” it’s a standard of care that recognizes that each person brings their own cultural identity into a healthcare interaction, and that good care accounts for that identity rather than ignoring it.
for muslim patients who fast during ramadan, this can mean something as simple as being asked, “will you be fasting this month?” rather than being told, “you can’t fast.” it means adjusting nutrition plans to suit meal times before sunrise and after sunset. it means reviewing medication schedules and making collaborative decisions about timing and dosage.
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above all, it means creating an environment in which patients don’t feel they have to choose between their health and their faith.
where healthcare training falls short
one of the review’s most important findings is that the current training healthcare professionals receive rarely includes anything about ramadan or culturally tailored care.
this isn’t about blaming individual practitioners. most want to do the right thing. but they’re left to guess without education, tools or guidance. and in medicine, thinking isn’t good enough.
incorporating basic cultural competency training into medical, nursing, and dietetic education can make a real difference. so can providing quick-reference resources, scripts for everyday conversations, and access to culturally specific dietary planning.
these changes aren’t complicated. but they can be transformative.
call for more research—and more action
the review also makes clear that more research is needed—not just about healthcare providers’ knowledge and attitudes, but also about what muslim patients actually want and need from their care teams during ramadan.
too often, assumptions are made without involving the community. what’s needed now is collaboration. researchers, healthcare leaders, and muslim communities should be working together to create guidelines that are both medically sound and culturally relevant.
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only then can western healthcare systems say they offer inclusive, equitable care.
building a better model of care
at its heart, this is about respect.
respect for faith. respect for personal autonomy. and respect for the idea that good healthcare doesn’t treat everyone equally—it treats everyone fairly.
as the number of muslims living in western countries continues to grow, so too does the responsibility to meet their needs. that starts with listening, continues with education, and ends with systems that reflect the diversity of the people they serve.
because every patient deserves care that understands them, not just medically, but culturally.
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