Jalil Arab Kheradmand - Department of Neurosurgeon, Defense Health Research Center, Tehran, Iran.
Hamidreza Khankeh - Health in Accidents and Disasters Research Center, University of Social Health and Rehabilitation Sciences, Tehran, Iran.
Seyyed Mohsen Hosseini Borujeni - Department of Nursing, Boroujen School of Nursing, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Ali Nasiri - Department of Health in Disasters and Emergencies, Faculty of Health, Baqiyatullah University of Medical Sciences, Tehran, Iran.
Yousef Akbari Shahrestanki - Department of Emergency Medicine, Faculty of Health and Paramedical, Qazvin University of Medical Sciences, Qazvin, Iran.
Vahid Ghanbari - Department of Emergency and Critical Care Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Jafar Bazyar - School of Allied Medical Sciences, Ilam University of Medical Sciences, Ilam, Iran.
Asghar Tavan - Department of Health in Disasters and Emergencies, Faculty of Management and Medical Informatics, Kerman University of Medical Sciences, Kerman, Iran.
Hamid Safarpour - Department of Health in Disasters and Emergencies, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Saeed Nazari - Department of Health in Disasters and Emergencies, Faculty of Nursing, Army University of Medical Sciences, Tehran, Iran.
Mohammad Muniei - Department of Medical Emergencies, Faculty of Nursing, Tehran University of Medical Sciences, Tehran, Iran.
Seyedah Samaneh Miressmaili - Defense Health Research Center, Tehran, Iran.

Background: The Arbaeen march ritual stands as one of the largest congregations, attended by tens of millions every year. Given the large number of participants in this ritual, it is essential to minimize the health repercussions for pilgrims and ensure their prompt access to medical care. The present study was conducted to analyze the healthcare services during the ۲۰۱۹ Arbaeen march. Materials and Methods: Employing a qualitative approach, this study utilized various data collection methods, including in-depth and semi-structured interviews, field observations, and document review. The target population comprised healthcare decision-makers, managers, and providers of the ۲۰۱۹ Arbaeen march. The interview and data collection guide were developed in accordance with the World Health Organization (WHO) guidelines. Data collection continued until data saturation. Directed content analysis was employed to analyze the data.  Results: Data saturation was achieved after conducting ۳۰ personal interviews. Out of the challenges and significant factors found in healthcare deliveries during the Imam Hussein (AS) Arbaeen march, ۹ main themes and categories were identified: Trauma system, disease surveillance system, health issues, health education and promotion, healthcare coordination and collaboration command in the health system, information and communication management, response planning, support and resource management, and safety and security. Conclusion: This study identified the major healthcare issues in the AS Arbaeen march, serving as an evidence-based guide for policymakers and planners of this famous religious ritual. The results of this study are applicable to similar public gatherings and marches.

Arbaeen march ritual, Healthcare, Qualitative study, Mass gatherings