School of Tourism & Hospitality Management, Director Girne American University, Cyprus


MSc in Tourism &Hospitality Management, GAU




The tourism industry is one of the world's largest and most efficient economic activity that creates the highest level of added value and directly and indirectly influences other economic & cultural activities . Tourism is one of the major sources of employment & income generation in the world such that many refer to it as the world's first industry. Health tourism plays an important role in national revenue of many countries; This industry earns about 100 billion dollars for the governments each year. However, Tourism is not developed in Iran and it is in its initial paces. As a matter of fact, the Ministry of Health recognized tourism-therapy in 2003. In addition, by doing this, rather than supporting tourism-therapy, the ministry mainly tried to create new jobs for the graduates of medical sciences. However, tourism-therapy was introduced as an independent industry in 2004 by the merger The Cultural Heritage Organization to The Iran and World Tourism. According to the planning, the Iranian government has devised plans to cover 30% of medical and health needs of the country, by the end of 4th national development program, through exporting medical products and services. Therefore, determining the obstacles in the way of optimum development of tourism-therapy industry is of great help to the country.

This paper sets out to determine the effective factors for attracting health tourism to Iran & examined the actual potential that foreign patients represent based on costs, quality & recognizing other aspects of marketing mix & investigated the role of the government & related organizations in this market. Iranian health facilities according to the special situation of Iran can provide a massive & potential for medical & health tourism & Iran can become a hub of medical tourism in the region in future.

Keywords: Tourism industry, Health Tourism, Iran, Attracting, Effective, SWOT


1. Introduction

Nowadays , health tourism is one of the fastest growing type of tourism, & there are number of reasons of travel and tourists motivation in this area such as improvement in health of body & mind (weight loss programs, greater physical health and stress management), rest and relaxation, use of medical services & facilities (as surgical specialty) & use of climate and natural features of an area to relax body and mind.

The market of health tourism is introduced as one of lucrative and competitive industries in the world and is one of modern realms in advanced tourism. In national level, governments are interested in taking advantage of financial rewards stemmed from this industry. Increasing competition among different countries, in particular Asian developing countries has begun to attract health tourists [1].

Today, the relationship between economic growth and health development is bright well. In the new approaches it is not only the health sector that has been enjoying benefits of economic growth, but also it could bring many business advantages for countries and beside providing new financial resources for infrastructure and technology development, undertake important role in cross-section plans sustainable development. Health Tourism is an organized travel outside the usual realm of health care and is done to maintain and improve one's physical and mental health of the restoration [2]. Tourism industry in developing countries has turned into a productive and income-generating industry, and competing in attracting international tourists have resulted in making easier political relations between countries and adjusting process of travel and tourism. Foreign exchange or foreign money is a decent commodity that always developing economies in the world have competed with each other in an effort to generate more amounts. Tourism industry is recognized by a currency messenger operation. So tourism development is considered by governments willing to attract more currency sources to their countries (Ranjbarian and Zahedi, 2005). At present, with respect to the low cost and high income of this industry, many countries interested in tourism development, have focused their attention on this section of tourism industry and are planning in this regard (Kazemi, 2008). Iran has potential abilities in tourism industry development. But it is facing the challenges that could note the comprehensive sanctions.


2.Research Background

World Tourism Organization (WTO), in particular, defines health tourism as follows:

Use of services which increase or improve the health or enhance mood of the person (mental/physical by using mineral waters, climate or medical intervention) in a place outside the residence of the person & lasts more than 24 hours or less in a year [3].

Health tourism world's slogan is about facilities and services at same level as those in the first world or advanced countries & prices and costs at same level as those in the third World or developing countries .

Fields of activities in the world health tourism , includes hot water treatment, weight management programs, cosmetic and plastic surgery, joint replacement surgery, coronary artery bypass surgery, organ transplants, ophthalmology (LASIK ) , dentistry and dental implants, rehabilitation and etc. [4].

The special position of Iran’s geographical location, its history of medical science and existence of expert medical and paramedical workforce, low costs and high quality of its health services, all could increase the importance of medical tourism in economic and medical fields in this country [5]. Legal essentials such as achievement of the goals defined in the “Forth Development Planning” and “Vision Document” reveal another aspect of medical tourism necessity [3].

Now the country's reliance on oil revenue is more than 50 percent. Iran economy is based on oil revenue therefore exchange revenue earned by oil export constitute the main part of Iran economy & in the long run this might expose the country to some economic problems . Therefore, measures should be considered in this regard ; & opportunities for exchange revenues & economic prosperity should be identified in order to change the oil-based economy to non-oil based economy so that to be able to compete internationally & get active presence in all industries. Here is a program that can be used for manufacturing and exporting of goods and services which can be obtained for gaining exchange revenue. The tourism industry in all its branches is a perfect source of employment & exchange revenue. [6]

Sadrmomtaz and Agharahimi (2010) studied health tourism in Iran; they believe that the most important factors in developing the health tourism industry in order to develop a strategy for public infrastructure are as follows: human resources development strategy, strategy of development in information systems and marketing, and product development strategy. They suggest that for development of medical tourism, the government should take all factors into consideration and develop a comprehensive and coordinated program to develop its medical tourism industry [7].

Ghezelbash and Abdollahi (2013) in their research concluded that Iran free trade zones because many incentives of investing, is a safe place of economic sanctions for developing medical tourism and strategy of health tourism development is need of using investment opportunities and incentives of free trade zones in medical tourism development [8]. The result of Izadi et al (2012) showed that Iran has many strength points, including expert physicians, up-to-date medical technology and natural healing regions to attract health tourists; however, weaknesses and challenges such as poor coordination among the organizations responsible for medical tourism and inappropriate planning [9].

Haghighi and his colleagues (2005) prioritized the factors on development of health tourism in Iran .Based on the result of their research on the Business practitioners in the health tourism there are three factors for branding the development of health tourism in Iran which are prioritized as health area ,true coordination among the institutions related to the health tourism & intersectoral institution of investment [10].

Nature therapy is a branch of health tourism, that focuses on the region natural and climatic characteristics and this potential is also seen in Iran such as hot water springs in Alborz mountains range, sludge treatment in areas like Lake Orumieh and Taftan mountains range in Balochistan ,hospice summer such as kelardasht and Javaherdeh in Mazandaran, Deylaman in Gilan , Shandiz in Mashhad and Sardasht ,international hubs like hot water springs in Sarein due to its water quality and also natural geography & surrounding landscape &spa in Geno in Hormozgan province .Also hot water baths which usually by use of hot water springs provide services to tourists , are one of the special ways to attract targeted visitors in Iran such as daily hot water bath for providing specialized services in one day, destination hot water bath which besides hot water bath provides services like health food menu planning & programs and strategies to improve life and health , hotel hot tubs which provides hotel hot tub services & offers health plans & warm bath therapy which is founded by one or more physicians and specialists and their main goal is to provide convalescence & complete medical services in an environment comprising a hot water bath. In such an environment, both traditional and complementary therapies are offered. Loyal customers in Iran primarily include increased number of tourists from Persian Gulf countries in Iran in recent years & secondary include tourists from Europe, Japan and Korea due to the history of their presence in Iran .Also special surgeries are cosmetic procedures & special surgeries are attractive for many tourists around the world. The boom in cosmetic surgeries in Iran has increased the quality of these types of surgeries . Surgical hospitals in Shiraz, Qeshm, Kish and Tehran can host foreign tourists, especially from the countries of the Persian Gulf.

But also Iran is facing the challenges that could note the comprehensive sanctions. Review of world health tourism condition shows that many of regional countries are using their health abilities including high quality and low cost health services to overcome on foreign threats such as economic sanctions. The main challenges of health tourism in Iran are as follows;


a. Economic

Oil-dependent economy and no need for tourism income, reluctance of private sector to invest in tourism industry and low income margin are some of the factors that negatively influence Iran’s tour-ism development [11]. Private section of medical industry has simply low activity in this section [9].


b. Social

Lack of public knowledge as for tourism and national tourism attractions, enough welfare, health, and medical facilities, legal problems (customs regulations, visa issuance) are among the social challenges ahead of tourism industry [12] & also an ineffective airline service in Iran is a great challenge ahead of Iran’s tourism industry [13,14].


c. Administrative and organizational

Tourism programming was first started in Iran in 1962), however, after more than 40 years, Iran’s tourism is not in acceptable position [15].

Lack of well-trained workforce in tourism industry, lack of knowledge among the staff of tourism institutes (hotel servants, tourism agency staff) are along with some of administrative and organizational problems of Iran’s wellness tourism [16].

Service sector comprises 46% of Iran’ GNP, still the sector suffers lack of supportive programs and health tourism constitutes a small portion of the market [17].

Mehrabi studied the challenges ahead of development of Iran’s tourism industry and found a significant relation between administrative problems and development of the industry [18].


d. Research and education

In view of the fact that the industry is a newly emerged market in many developing countries, most of them suffer lack of expert work force and even training facilities are not fully developed yet [19]. Lack of permanent education for training technical, executive, and training staff, and lack of effective and efficient research system to recognize the strategic needs of the industry are of the main research and educational obstacles [20]. An international study also emphasized poor English language skills among the work force of Iran’s hospitals [21].


e. Welfare facilities and services

1. Lack of welfare and accommodation services in the tourism industry.

2. Lack of supervision and controls on improvement, repair and maintenance.

Poor transportation system, lack of standard hotels and other services were mentioned in another study as infrastructural problems of Iran’s tourism industry [22]. Furthermore, lack of treatment VISA makes it impossible for these tourists to use medical insurances.


f. Cultural and advertisement

1. Attitudes, negative mental image and wrong perception regarding tourists;

2. Irrational and different methods in dealing with tourists;

3. Structural drawbacks in advertisement and public information; and

4. Failure to used proper methods in dealing with tourists; [23,24]


3: Methods

3.1. Research Method

This article is part of a qualitative study of descriptive, comparative and applied research in the field of health services.


3.2. Research Society

According to a study by Jabbari et al (2013) to identify the beneficiaries in health tourism, health tourism stakeholders in province of Isfahan includes these group: Governor, Office of Cultural Heritage, Handicrafts and Tourism, University of Medical Sciences, medical & health care service providers, tourism service providers, export development bank, private sector investors , Chamber of Commerce, Industry, Mines and Agriculture. Therefore, these groups constitute the statistical community & a sample will be selected among them.


3.3. Statistical Sampling

Most researchers don't have enough power and time to run the study on the whole society so they limit it to a small sample. In this study the snowball sampling method has been used. Snowball or chain or network sampling is frequently used in qualitative research. In this sampling, you choose participants then by their contribution depending on your desired features you will get to the next participants . Patton says, "by questioning number of people about those who you can talk about, the snowball will get bigger and bigger as far as you accumulate items which are rich in information ."In this study, 110 questionnaires were distributed which out of them 104 questionnaires were collected.


3.4. Measuring Tools

In order to identify challenges and opportunities in health tourism , questionnaire was used. Questionnaire is filled by the considered sample and comments will be collected and analyzed. Due to the qualitative nature of the subject and in order to better exchange ideas and information , researcher will do face to face interviewing of respondents .


3.5. Methods of Data Collection

In this research which includes descriptive, scientific, correlation, experimental ,etc , the researcher should study the literature and history of the problem and research subject & hence for the formulation of the research literature, researcher used library methods and scientific internet search engines and upon which the theoretical foundations of this study was prepared. Also in the field part of the research in order to develop and design measurement tools, the method of interviews with number of respondents will be used .


3.6. Stages of Research