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Factors associated with health service utilization among Iranian pilgrims during the 2023 Arbaeen pilgrimage in Iraq: a cross-sectional study[1]

Ghanbari V, Rostamnia L, Rezaeian S, Zahabi H, Janatolmakan M · 2026 · BMC Public Health

Summary

Cross-sectional survey of 461 Iranian pilgrims at the 2023 Arbaeen Walking Ceremony (one of the largest annual mass gatherings): 49.9% used health services during the pilgrimage — non-prescription medication (21.5%), outpatient examination (16.5%), wound dressing (15.6%) — and 31.5% sought further care AFTER returning home. Utilization predictors varied by travel phase: outbound, older age and public-transport use; return, specific border crossing (Khosravi, aOR 1.84), longer duration (6-10 days), and prior pilgrimage experience. General health and fitness scores were NOT associated with utilization. Concludes tailored services and pre-travel guidance are needed.

So what

One of very few quantitative datasets on Arbaeen — an event larger than Hajj that the English-language literature barely covers — and the headline is workload shape: half of pilgrims used care, dominated by low-acuity walking-related needs (dressings, OTC medication), which is the podiatry-and-pharmacy posture rather than the resuscitation posture. The 31.5% post-return care figure extends the post-event surge concept (PoshtMashhadi's 4-12h window) to a weeks-scale tail landing on the HOME country's health system - a planning frame MGMI's hospital-interface pages should note for pilgrimage catchment areas.

Key findings

  • 461 pilgrims, 2023 Arbaeen: 49.9% used health services during the event
  • Case mix low-acuity: OTC meds 21.5%, outpatient exams 16.5%, wound dressings 15.6%
  • 31.5% sought care AFTER returning home - weeks-scale surge tail on home health systems
  • Predictors phase-specific: age/transport outbound; border, duration, experience on return
  • Fitness and general-health scores not predictive of utilization

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