Submission ID 130883
| Issue/Objective | Deaf sign language users in Malaysia experience persistent inequities in healthcare access, largely due to communication barriers, limited access to trained interpreters, and low cultural and linguistic competency among healthcare providers. These structural challenges contribute to delayed care, reduced engagement with health services, and poorer health outcomes. Despite growing recognition of these inequities, there remains a lack of scalable, accessible, and co-designed digital health solutions tailored to Deaf communities in low- and middle-income settings. This work addresses these gaps through the development and implementation of the Deaf in Touch Everywhere (DITE) mobile health (mHealth) platform. The objective was to co-create and evaluate an accessible digital tool that improves healthcare communication, strengthens health system responsiveness, and enhances autonomy for Deaf users. This work aligns with the conference theme by translating evidence into practical tools for equity-focused action in fragmented health systems. |
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| Methodology/Approach | This study adopted a community-engaged, implementation science approach over multiple phases. DITE was co-developed with Deaf individuals, Malaysian Sign Language (BIM) interpreters, and healthcare stakeholders through iterative design cycles to ensure linguistic accessibility and cultural appropriateness. The platform enables real-time interpreter linkage, supports healthcare navigation, and provides accessible health information tailored to Deaf users. Evaluation was conducted using a mixed-methods design, including usability testing, user satisfaction surveys, and qualitative interviews with Deaf users and healthcare providers. This was complemented by findings from prior research on communication barriers, health literacy gaps, and medical education deficiencies, including published work on provider attitudes, curriculum readiness, and mHealth feasibility. In parallel, cultural competency workshops for healthcare professionals were implemented to improve understanding of Deaf culture, communication strategies, and inclusive clinical practice. These workshops were informed by earlier empirical findings highlighting gaps in provider preparedness. |
| Results | DITE demonstrated high acceptability among Deaf users, with participants reporting improved communication access, greater confidence in seeking care, and reduced reliance on informal communication methods. Healthcare providers also reported improved awareness of Deaf communication needs following exposure to the platform and associated training. Qualitative findings highlighted that co-design was essential to ensuring usability, trust, and relevance. The integration of interpreter access within a digital platform was identified as a key facilitator of healthcare engagement. Cultural competency workshops led to measurable improvements in provider confidence and willingness to adapt communication practices for Deaf patients. Collectively, results indicate that combining digital innovation with capacity-building interventions produces synergistic effects in improving accessibility and user experience. |
| Discussion/Conclusion | This work demonstrates a scalable, co-produced model for translating evidence into actionable health system interventions for marginalized populations. The integration of the DITE mHealth platform with cultural competency training illustrates how digital tools and workforce development can jointly address structural barriers to healthcare access. The findings have important implications for implementation and accountability in global health systems, particularly in contexts where interpreter services and accessibility infrastructure are limited. The DITE model provides a practical framework for embedding equity into healthcare delivery through co-design, technology-enabled access, and provider training. Aligned with the conference theme of collectively reclaiming global health equity, this work underscores the importance of sustained community partnership, iterative implementation, and system-level integration to restore commitment to inclusive and equitable healthcare in fragmented and resource-constrained settings. |
| Presenters and Affiliations | Uma Devi M PALANISAMY Monash University Malaysia Sabrina Anne Jacob Monash University Malaysia Anthony Alexander VeeYee Chong Monash University Malaysia |
