Promoting Health Communication in Religious Gatherings: A Hajj Case Study

There are health challenges at large pilgrimage sites where crowd members congregate in unfamiliar settings from various countries with different socio-demographic characteristics. Hajj pilgrimage is one of these major events that has more than 2 million Muslims attending annually. Pilgrims’ congestion in Hajj holy shrines is a main cause of many health issues, including the spread of infectious diseases. Hajj authorities encounter these challenges by allocating a large amount of expenditure in different health promoting materials. They want to educate lay-people about unhealthy behaviors and demonstrate ways to prevent the spread of diseases. However, there is no available evidence about the benefits of different health media channels in engaging crowd members. Therefore, this study aims at filling this gap by answering the following research questions: (1) which socio-economic groups benefited from health awareness in crowded events? and (2) what can be done to enhance health communication during crowded events? The study uses the Health Belief Model (HBM) to collect empirical data from 245 pilgrims in Makkah, Saudi Arabia, between September 9^th to September 19^th of 2017. Two major nationalities in the three largest Muslim’s areas were approached, which were (38) Indonesians and (18) Malaysians from Southeast Asia, (27) Indians and (43) Pakistanis from South Asia, and (52) Egyptians and (33) Algerians from North Africa. There were also (34) participants from Europe and the Americas. Participants provided information on threats perceived, health media channels used, challenge in access, and external and internal factors affecting health behaviors. The study concludes with recommendations for Hajj crowd managers and international governments on which channels are most effective in providing health information and what can be done by Hajj authorities and other country governments to improve proactive health protective behaviors. Such transboundary cooperation is essential to help reduce emerging health threats in crowded religious venues.