Demand estimation of mass-gathering healthcare in developing countries: The case of Kumbh Mela in India

A mass-gathering is defined as a congregation of a relatively large number of people in a specific location for a specific purpose over a short duration of time. Managing Mass-Gathering Healthcare (MGH), especially in resource-constrained regions, is a key policy challenge. Planning and preparation for MGH require understanding the sources, and estimation of demand. We propose a spatio-temporal Poisson point process model for MGH demand estimation that considers the associated risk factors. We analyze admissions data from a multi-specialty hospital in Ujjain, India, spanning a period before, during, and after Kumbh Mela, one of the larger religious gatherings globally. The results show that the effect of mass-gathering on hospital admissions is heterogeneous across disease groups. We identify key socio-economic and healthcare infrastructural factors that are associated with MGH demand. We establish the external-validity of the results by demonstrating that mass-gatherings generally increase the spatial dependence across regions, particularly where availability of healthcare infrastructure is relatively low. Finally, we discuss policy insights for managing MGH.