Impact of the Role of Health Educators During Pilgrimages in Nigeria
Chapter One
Objective Of The Study
The main objective of this study was to assess the short-term effect on health knowledge among pilgrims after they had been given specific health education messages. Specifically, this study aims:
- To determine the source of health information for the pilgrims.
- To apply health education program, to increase the level of health knowledge to improve some practice, and asses the pilgrims general health status.
- To increase the level health knowledge to improve some practice.
CHAPTER TWO
LITERATURE REVIEW
The tourism literature contains a number of studies that examine individuals who travel for spiritual purposes (Cohen, 1996; Gladstone, 2005; Nyaupane, Timothy, & Poudel, 2015; Timothy & Iverson, 2006). In the academic study of tourism, this study of pilgrimage and spiritual tourism is relatively recent (Haq & Jackson, 2009; Jutla, 2002; Phukan, Rahman, & Devdutt, 2012). One reason may be that many pilgrims do not consider themselves to be involved in tourism. However, other researchers claim that pilgrims behave similarly to tourists when the destinations are far from their home (Cohen, 1992; Santos, 2002), and consider that pilgrimage is “leisure with meaning” (Frey, 1998, p. 254). Today, religious tourism researchers recognise that Hajj can be considered the largest gathering of tourists in the world (Ahmed, 1992; Nyaupane et al., 2015; Raj & Morpeth, 2007; Shinde, 2008).
Hajj has been categorised by other researchers as spiritual tourism including pilgrimage, religious, cultural or experiential travel (Zhang et al., 2007). Certainly the study of pilgrimage is an interdisciplinary field and has been examined by diverse researchers leading to an unconsolidated literature (Collins-Kreiner, Kliot, Mansfield, & Sagi, 2006).
In tourism literature, Hajj, has been studied as an important tourism activity and Mecca as a popular destination (Ahmed, 1992; Ascoura, 2013; Aziz, 2001; Burns, 2007; Eid, 2012; Henderson, 2011; Jafari & Scott, 2014). The Kingdom of Saudi Arabia has been improving and modernising its infrastructure in order to better accommodate 3-4 million pilgrims from all over the world during the Hajj season (Ascoura, 2013; Henderson, 2011; Johnson, 2010). Public facilities include transportation infrastructure and toilets have been built to serve pilgrims. Additionally, airports, seaports and road networks modernised (Henderson, 2011). A range of apartments and hotels have been built from the modest to the luxurious.
In the business and tourism literature Hajj has been primarily examined in terms of service quality and customer satisfaction (Eid, 2012; Haq & Jackson, 2009; Jabnoun, 2003; Othman, 2003). Previous research has examined on how purchase of Hajj and Umrah packages relates to satisfaction, commitment and trust in Hajj and Umrah travel agencies (Oktora & Achyar, 2014). This research suggests that customer satisfaction will impact trust in the travel agents and therefore creates repeat businesses. Another study examines improving Hajj service quality and has developed a scale called HAJQUAL based on SERVQUAL (Jabnoun, 2003; Parasuraman, Zeithaml, & Berry, 1988). This research examines the importance of providing the best service quality for pilgrims. Service quality instruments for Hajj were developed and these instruments are helping Hajj agents to evaluate the service they provide and enabling future improvements (Eid, 2012; Jabnoun, 2003). These service quality instruments measure a variety of factors including human services, Makkah accommodation, Mina-Arafah accessibility, bathroom accessibility, bathroom cleanliness and accommodation outside Makkah (Jabnoun, 2003). From a marketing strategy perspective, Hajj may be considered as a product/service. One paper examines Pakistani pilgrims’ experience comparing those who live in Pakistan and Australia in terms of their expectations and their actual experience of Hajj (Haq & Jackson, 2009). This found significant demographic differences. Pakistani Muslims who live in Pakistan, were found to be more serious and think that Hajj is the most important event in their life (Haq & Jackson, 2009). They think that this spiritual journey is to fulfil the Islamic religious obligation. On the other hand, pilgrims who live in Australia are more open-minded and educated and more critical, they do not think that Hajj is only to fulfil their religious obligation but they are more likely to think that Hajj is a spiritual adventure and achievement. They are concerned more about “value for money” on the funds they have spent for undertaking Hajj (Haq & Jackson, 2009). Some were not happy with their Hajj experience because of the lack of services provided by the Saudi Arabian Ministry of Hajj. The paper reported that “today’s practice of Hajj is more money-making exercise for the Saudi Government and various international business operators involved, such as the airlines, hotels and fast food chains” (Haq & Jackson, 2009, p. 148). The different types of Hajj lead to a lack of equality since wealthy people can stay in five star hotels while others sleep on the ground. One respondent reported “I could not believe that the Hilton Hotel had its accommodation included in the vicinity of the Ka’ba, and people could join the prayers from the luxury of their five star rooms” (Haq & Jackson, 2009, p. 153).
In health literature most studies examine the large scale gathering in Mecca as a site for infectious diseases, injuries or even death (Abdalla, Al-Hamdan, Al-Hoqail, Bahnassy, & Saeed, 2010; Grist, 2008; Khan & McLeod, 2012; Memish, Stephens, Steffen, & Ahmed, 2012; Pane et al., 2013). Preparations are needed to prevent these problems and, for example, all pilgrims must be vaccinated against meningococcal disease before the visa can be issued in order to avoid an outbreak (Gatrad & Sheikh, 2005; Grist, 2008).
CHAPTER THREE
MATERIALS AND METHODS
Study Design
A cross-sectional study was conducted among muslims and Hajj pilgrims attending weekly Hajj and muslims orientation course organized by private Hajj/muslims faithfuls between July and November 2018. Participating in the research was voluntary and anonymous. Hajj/muslims pilgrims from Nigeria, 18 years old and above, with the ability to read and write were considered eligible for the study. The sample size was determined using a margin of error of 5%, a confidence interval (CI) of 95%, and an expected response rate of 70% to most of the main questions. The minimum sample size estimated for the study was 188. We enrolled a larger sample size of 225 pilgrims in accounting for errors and non-respondents.
.Sampling Method
The sampling method used was cluster sampling, which was done in two stages. The first stage was a purposive selection of Hajj and muslims companies as clusters. The second stage was by applying a convenience sampling method. The pilgrims who attended the orientation course were selected as the study participants. An honorarium was given to the respondents for participating in the study. All participants involved in the study were briefed about the study at the beginning of orientation. Verbal consent was obtained from the participants, followed by the administration of the KAP questionnaire. Only those who fulfilled the inclusion and exclusion criteria and consented were included in this study.
Study Population
Hajj/muslims travel pilgrims were eligible if the management was willing to participate actively in the study and to collaborate with the researchers. Nine eligible Hajj/muslims pilgrims were identified in Oyo. All nine companies were contacted and informed about the project, and they agreed to participate. From the two companies, the majority of the participants are muslims pilgrims 89.7% (202/225) and only 10.3% (23/225) are Hajj pilgrims.
CHAPTER FOUR
RESULT AND ANALYSIS
Socio-Demographic Data
The ages of the respondents ranged from 18 to 74 years, with a mean (SD) age of 46.74 (13.38) years. The majority of the respondents were of Malay ethnicity 223 (99.1) and there were 151 (67.1) females. Most of the respondents 169 (75.1%) were married at the time of the research, while single and divorced/widowed accounted for 46 (20.4%) and 10 (4.4%), respectively. The education level of the respondents was secondary school level 80 (35.6%) followed by bachelor’s degree holders 78 (34.7%). Occupation status of the respondents revealed that civil servant accounted for 95 (42.2%), pensioners 41 (18.2%), and 31 (13.8%) housewives. The summary of the characteristics is shown in Table 1.
CHAPTER FIVE
CONCLUSIONS AND RECOMMENDATION
Conclusion
Health educational strategy to pilgrims is effective in increasing the level of knowledge to improve the practice to decreases the prevalence of health disorders among haji pilgrims across years.
Recommendations
Considerable effort on the part of governmental and private health organizations requires continuous training to face both current and future challenges, tailoring health education programs (messages ,tools ) to overcome the gaps and facing the challenges to manage hajj health hazards.
- The HEA programme should continue in the coming Hajj seasons with the inclusion of pilgrims at other portals of entry.
- A study of wider scope should be planned for the next Hajj season.
- An additional study would be worth- while to determine whether or not the intervention actually resulted in any change in health among pilgrims during the Hajj and in the following weeks, compared with those who did not participate in the intervention, along with the specifics of any diagnosis.
- Methods to provide standardized, predeparture, health education to pilgrims scheduled to participate in the Hajj should be explored. Health education materials should be prepared in concert with the Ministry of Health. This could include information provided to foreign travel agencies, additional links to health education posts already provided within Saudi Arabia, and shared through working with air carriers and charter companies serving Hajj ports of entry to provide in-flight health education videos.
- Consideration should be given to investigating methods of educating those who enter the country using other means of transportation, including ships.
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