Introduction

Background

Medical Tourism takes place when a person travels across the border and outside their usual
environment to seek medical treatment is called as ‘medical travel’, upon arrival such person is
called a ‘medical tourist’, and the activities such as utilization of medical services by the medical
tourist is called as ‘medical tourism’ (Jagyasi, 2008). There are many benefits of the medical
tourism like cost savings, high quality care, specialty treatments, minimum waiting periods, new
countries to visit and a totally new experience. With such benefits, there are also few risks
involved in medical tourism such as the quality of postoperative procedure is very much
important as patients travel to a foreign country for better treatment in treatments like surgery,
bypass, organ transplantation etc. After the treatment when medical tourists come back to their
home country, postsurgical care and precautions are very important which depend on the
hospitals in home country. It could be different and not up to the expected standards. The long
distance travelled soon after the surgery may lead to few complications such as
thromboembolism (blood clot formation), also known as economy class syndrome.

Medical tourism provides a unique opportunity to contribute to growth while ensuring that the
ultimate goal of the Ethiopian HSTP-II is providing affordable, easily accessible and better
quality of healthcare that will result in improving health outcomes of the population. Different
studies indicated, the medical tourism market is estimated to be growing at a rate of 10-20% per
annum globally and the overall market could be somewhere between $24-100 billion for about
eight million cross-border patients clinically served worldwide. Globally, the average amount of
money spent by a single patient under medical tourism market estimated to be between $3,500
and $5,800 per visit. Medical tourism has great economic benefits for a number of countries such
as in India, medical tourism industry was able to generate around $2.6 billion in 2012 (7-9% of
their GDP), whereas in Tunisia the industry generated close to $254 million in 2007, and in
South Africa around $184 million was harvested from the medical tourism by end of 2010.

According to major findings from the research & analysis done in Rwanda, East African region
where Ethiopia is located, indicated an addressable market size of more than $175 million could
generate through the provision of Rwanda’s specialty services including consultations with
international experts and Rwandan stakeholders. The same study has also revealed that
diagnostics, cardiology, oncology and nephrology are the highest in demand specialty care in the
region where, if done properly, the medical tourism could potentially generate around $46 M
additional revenues by end of 2023. Ethiopia has great competitive advantages to practically
become one of the most preferred and leading medical tourism destination in Africa within the
next 5-8 years, if the county is just able to implement the various high impact national strategies
designed for its health sector as well as economic growth. Unquestionably, the country is
required to go much further than the expected outcomes under universal health coverage, while
improving the national efforts to avail world-class specialty medical services through
encouraging investors for specialized service provisions and production of highly preferred and
skilled human power in the country.

Currently, in Ethiopia there are three major national issues related to the needs to strategically
invest on medical tourism which includes opportunities, potentials and natural factors:

• Ethiopian Airlines is the leading airline and aviation industry in Africa with

internationally known capacities of transporting millions of passengers within African

countries and connecting with 5 continents. The country has also the leading cargo carrier

airlines in Africa capable of carrying million tons of cargo within African countries and

across many other worldwide destinations.

• In Ethiopia, each year, in average around 100,000 patients seek abroad referrals to get

medical care they need across the world which has been demanding the country to avail

(lose, if everted) close to 700 Million USD annually.

• The newly elected government of Ethiopia has prioritized and massively invested to

significantly expand tourist destinations with the hope to maximized national financial

gains from tourism sector.

• The country tremendously found to be owner of so many natural destinations, cultures

and so much more for local and international tourists to experience through physically

visiting the sites.

Rationales

The three-tier health system—having 353 functional hospitals categorized in to primary,

secondary and tertiary—continues to be the backbone of health service delivery. The primary
health care coverage reached more than 90% in 2019. In the second- and third-tier facilities,
implementation of strategic initiatives and reforms has strengthened pre-hospital and hospital
clinical care. Overall, outpatient attendance rate increased from 0.27 to 0.9 per capita per year
between 2000 and 2019. Similarly, between 2000 and 2017, Ethiopia’s Human Development
Index value increased between 2000 and 2017 from 0.283 to 0.463, an increase of 63.5% and
0.485 in 2020. However, it remains below the average of 0.504.

Despite encouraging improvements in life expectancy at birth, premature death and suboptimal
quality of life still constitute major health and development challenges in Ethiopia. In addition
currently the country is facing triple burden of diseases (communicable and non-communicable
diseases or NCDs, mental health, and injuries) that affects all age groups, with a
disproportionately higher burden among children and women in their reproductive age.
According to the 2019 global burden of disease (GBD) report estimate, the number of all deaths
in Ethiopia annually is 559,997. Of these 39% were attributable to non-communicable diseases
(NCD) and 8% due to injuries. Most of deaths from NCD are due to cardiovascular diseases
(30%), cancer (15%), digestive diseases (13.5%) and diabetes and kidney disease (8.7%) which
are expected to be provided at the tertiary level of care.

Nevertheless, according to the National Specialty and sub-specialty roadmap (202-2029) a

growing number of Ethiopians are traveling abroad seeking tertiary health care services that are
not available in the country. For example, from those 1102 patients seen at government
institutions (from July 2004 E.C.to June 2010 E.C.) who are referred overseas the major reason
for referrals includes cardiac conditions, orthopedics, cancer, and renal diseases. Similarly, Rak
Hospital in Dubai, U.A.E. treats up to 240 people from Ethiopia every year for different cases;
Bangkok Hospital in Thailand treated more than 6,000 Ethiopians in 2011 alone. Consequently,
such travel involved an estimated average cost of about US $20,000 per trip.

Major pushing factors;

• Increasing number of Ethiopian citizens travelling abroad due to different reasons

• Absence of policy or strategy that defines the multi-sectoral coordination and leadership
mechanism on medical and wellness tourism investment

• Lack of improved enabling environment of foreign investment that attracts internationally

accredited investors in the medical care industry

• Increasing out-of-pocket expenditure (in USD) by citizens for medical care, air ticket and
 related hospitality service

• Poor access to comprehensive and advanced tertiary level of care through

• Underutilized existing opportunities that can support medical tourism; such as African
leading Airlines, natural beauty and pleasant weather, natural and man-made tourist sites,
the existence of many diplomatic offices and center in the nation capitol
• Very low and fragmented contribution of the medical care investment on the national
foreign currency stock
Therefore, the above mentioned pushing factors urged the development of this medical and
wellness tourism strategy

Scope
This National Medical Tourism Strategy is designed jointly by Ministry of Health to be
implemented in the next 10 years both at national and regional levels. The strategy provides
comprehensive and specific guidance for governmental, private and none-governmental
implementers on priority investment areas and expected tourism products within known
frameworks of leadership, coordination and accountability mechanisms at all levels.

Situational Analysis
S.W.O.T
Strength
Build on (Competitive advantages)
• Specialty and subspecialty strategy and roadmap
that guides development of tertiary care service
• Lower labor cost, transport and hospitality costs
(competitive service price)
• Increasing investment in health care service
expansion
• Increased medical training institutions and
increased specialty and subspecialty training
programs.
• Increased(ing) specialty and subspecialty services
• Social Health Insurance proclamation/ CBHI legal
frame work in place
• Diversified tourist destinations- The presence
unique cultural, natural and historical tourist
Opportunity
(Invest growth goals)
• Tourism sector obtained priority in the
homegrown economic reform and
government’s high interest in medical tourism
• Rapid economic growth /Growing middle
income population, increased demand for high
quality health care
• The presence of world class airline and
aviation hub.
• Strategic geographic location and favorable
climatic/ Weather condition
• The presence of highly qualified and
experienced medical professionals in the
diaspora community. (can serve as
professionals and potential investors)
 destinations in the country. • High potential market in the neighboring
• Development of new tourist destinations sites countries, high cross border population
(Koisha, Gorgora and Wonchi) • Head Quarter to African Union and UN
• Developing hospitality sector -SPA /Hotels and regional agencies, large expatriate and
resorts and parks diplomatic community
• High cost of healthcare service in developed
countries and popular medical tourism
destinations (UAE, India, Turkey and Thailand
Weakness Threat
Shore up (Goals, Initiatives, Operations) Monitor
• Lack of national medical tourism policy or • The current conflict and security situation in
initiatives that guides local or international the country
investment in medical industry • Regional political instability
• Lack of the service quality assurance system (e.g • Economic slowdown due to the COVID 19
accreditation) for facilities and certification pandemic , conflict, drought, locust
system for professionals infestation
• Inadequate pharmaceutical supply chain • Shortage of foreign currency hindering
management system timely procurement of equipment, supplies
• Lack of incentives and regulations for quality of and pharmaceuticals
care, absence of internationally accredited medical • Increased market competition from existing
centers medical tourism destinations,
• Inadequate number of highly trained
professionals (both clinical and non-clinical)
required for the highly competitive medical
tourism market
• Lack of marketing and promotion to attract
medical tourists (to retain local patients and attract
international health tourists)
• Bureaucratic hurdle (Low rated ease of doing
business)
• Poor customer handling
• Inadequate number of specialized and super
speciality medical centers and suboptimal service.
• Weak implementation of SHI,
• Lack of payment modality (medical insurance
system )
Abroad Referral and Service Availability Analysis
Every decade since the 1940s, health policymakers, professionals, and health care providers have
launched new global and national initiatives to address the health challenges and needs of
populations living in sub-Saharan Africa. However, few reforms have been successful. Recent
debates have emphasized how to make progress in strengthening the health systems, achieving
universal health coverage, and making progress towards meeting the Sustainable Development
Goals.

Mortality and morbidity from common conditions needing specialty and sub specialty care
services have grown in the world’s poorest regions and incidence of cancer, road traffic injuries,
and cardiovascular and metabolic diseases will continue to rise substantially. However, in sub-
Saharan countries like Ethiopia, policies related to primary care and communicable diseases still
drive many discussions with little attention to specialized care.

As a result there is still dissatisfaction amongst the public resulting from inadequate access to
specialty/subspecialty care services, inadequate clinical care standards affecting the quality of
health services, shortage of healthcare professionals in specialty and subspecialty services, weak
hospital management capacity resulting in inefficient management of scarce resources, a
fragmented health care system with weak referral services and limited financial support to ensure
optimal coverage of services. The above-mentioned problems are attested by the increasing
number of patients going abroad to access tertiary care. Therefore it is sensible to improve access
to specialty/subspecialty services by setting up a medical tourism site; considering the economic,
social, and epidemiological realities which face Africa today and, in the coming 10 years.

Preliminary Medical Specialty Service Selection

Selection criteria: 1. Disease burden in sub-Saharan Africa countries: 2. Cost Implication 3.

National abroad referral rates and 4. Existing infrastructure

List of Selected Description

services

1 Definitive Mgmt. of 2° causes of Hypertension, Perform

advanced Mgmt. of acute coronary syndrome, Perform FFR,
IVUS, OCT, Utilize Intra-Aortic Balloon Pump, utilize ECMO,
perform implantable cardioverter defibrillator (ICD), perform left
ventricular assist device implantation, Advanced evaluation and
Cardiac Service Mgmt. of peripheral arterial disease (PAD), catheter-based
intervention, vascular surgery, Percutaneous mitral balloon
 commissurotomy (PMBC), transcatheter aortic valve
implantation (TAVI), Cardiac electrophysiology, Advanced
Mgmt. of cardiogenic heart failure and shock, cardiac
resynchronization therapy with defibrillator (CRT-D),
valvuloplasty, Pacemaker insertion and interrogation, myocardial
biopsy, open heart surgery diagnostic and ablation
2 Oncology Service Training Oncologists MP RTT oncology nurses , Advanced
diagnosis of malignancies, Advanced Treatment (chemo, surgery
and radiation therapy) , Radio-surgery, Palliative care , research,
radiobiology lab, physics lab, Bone marrow & stem cell transplant
3 Kidney transplant/dialysis service
Transplant Service +haemodialysis,
Radionuclide scan for functional and structural evaluation of the
urinary system
Management guideline development for common paediatrics renal
diseases
IPD: + renal transplant
- immediate post transplant care
- advanced urologic intervention, plasma phareses, plasma
exchange, permanent vascular access for haemodialysis (AV
fistula/graft/ permcut placement,
Chronic ambulatory peritoneal dialysis, catheter placement and
initiation of dialysis
-conducting clinical trials, HLA matching,
Liver care and transplantation centre:
Liver cancer (hepatoma): CT, dynamic MRI, liver remaining
volume assessment, Fibroscan and proper staging.Biopsy and
hepato-pathology service.

Liver cancer (hepatoma): treatment: Resection, liver

transplantation, ablation chemotherapy.
Liver cancer (hepatoma): Treat late stage liver cancer- extended
palliative care.
Management of decompensated cirrhosis of any cause
including LT, MARS
 Management of schistosoma hepathopathy: end stage liver
disease management

4 Microvascular surgeries, Limb replantation, Surgical treatment of

pediatric injuries, open or closed fractures, Operative and non-
operative treatment of acute or chronic osteomyelitis, Diagnosis
and treatment of congenital problems of hand and upper extremity,
Orthopedic Service
Advanced treatment of brachial plexus injuries, Operative and
nonoperative treatment of any type of DDH , Pelvic osteotomies
for DDH and related problems, Super Hip/super knee/ super ankle
procedures, Advanced limb lengthening and limb reconstruction
surgeries for varieties of deformities, Arthroscopic fixation of
subacromiale, Tendon transfer procedures for RC problems,
Arthroscopic or open biceps tenotomy or tenodosis, Prosthetic or
biologic resurfacing of the shoulder joint, Shoulder arthrodesis ,
Ligament reconstructions for elbow instability, , Arthroscopic
ACL/PCL /PLC reconstruction or repair, Open ACL reconstruction,
Arthroscopic assisted ligament reconstruction of multiligament
knee injuries, Open surgical and arthroscopic assisted
patellofemoral disorders of the knee etc

5 Cryopreservation ,Advanced fertilityenhancing/reproductive

surgeries - Female genital reconstructive suGenetic counselling and
Infertility Service genetic screening - Embryologist - Laparoscope - High-resolution
Doppler US - High fidelity training simulators and manikins,
Audio-visual aids - Invitro fertilization (IVF)/IUI/fertility units -
Andrology lab units - Hysteroscope - Reproductive endocrinologic
assessment & care Infertility - Laparoscopic and hysteroscopic Dx
&Tx surgical procedures - Micro-invasive surgical procedures,
assisted reproductionrgeries, non-invasive and invasive
Hysterosalpingography, Ultrasonography guided procedures -
Permanent contraception and reversal surgeries

6 Neurology Service Acute ischemic stroke care (rTPA,CEA, Embolectomy),

Subarachnoid haemorrhage aneurysm clip/coil application, ICP
monitoring device, Epilepsy monitoring unit (EMU) for epilepsy
surgery localization & RSE, Perform Wada test and intracerebral
grid electrode monitoring for epilepsy surgery, Advanced headache
medicine service (BOTOX injection, VNS, TCMS), CNS tumors:
diagnoses with biopsy, molecular and genetic test including Neuro-
pathology with curative and palliative care, Molecular test,
biomarker study and functional imaging study for advanced
dementia and overlap syndromes, Molecular test, biomarker study
and functional imaging study for refractory cases

Level 4 ICU
Cro ICU management of major burn and electrical injuries,
ss traumatic spine injury, ICU Dialysis for AKI, Pleurodesis,
Cut Advanced Critical Elective pericardiocentesis, Critical care telemedicine
ting Care Service consultation services, Deceased organ donation
Ser
Advanced Diagnostic Advanced laboratory services
vice
Service Sub specialty radiology and pathology service
s
Pathology and radiology telemedicine consultation services
Nuclear Medicine services
Advanced Physiotherapy, speech-language therapy, and occupational
Rehabilitation therapy interventions, Prescribe prosthetics and orthotics
Service

Cardiac Center
Estimated Investment cost: 30.4 million birrs
Burden in sub-Sahara: 1st CVD is one of the leading causes of mortality in Africa.
Modern device, drug and surgical advances in cardiac care have dramatically improved
patient survival after cardiac injury so is essential to establish centers that provides
advanced cardiac care
Rank for Ethiopian abroad referral: 2nd
Current infrastructure status: There are 2 sub specialty cardiac centers in Addis Ababa
that provide advanced cardiac surgeries.3 public hospitals provide Cat lab services. A
state-of-the-Art Cardiac Center in progress at St. Paul’s Hospital.

Oncology center
Estimated Investment cost: 36.5 million birrs
Burden in sub-Sahara: 2nd Cancer is the second leading cause of death
Rank for Ethiopian abroad referral: 1st
Current infrastructure status: Oncology and Radiotherapy service ppp feasibility study
initiated (st. pauls) . We currently have 3 functional and 3 on progress radiotherapy
centers. And 3 new private centers on progress

Transplant center
Estimated Investment cost: 33.3 million birrs
Burden in sub-Sahara: Globally, 139 024 organ and tissue transplants were carried out in
2017 which represents only 10% of the need for transplants. Kidney and liver transplants
were the most frequent procedures (65% and 23% respectively). The true scale of the
unmet need for organ transplantation is unknown in the African Region.
 Rank for Ethiopian abroad referral: 4th
Current infrastructure status: Only one kidney transplant center with huge waiting list

Orthopedic center
Estimated Investment cost: no data
Burden in sub-Sahara: Approximately two thirds of the world’s population lack adequate
orthopedic care. The aging of the populations of developing countries and the increase in
trauma-related injury will add to the already substantial burden of musculoskeletal
disease
Rank for Ethiopian abroad referral: 3rd
Current infrastructure status: There is a huge waiting list backlog nationally. Hip and
knee joint replacement available in 3 facilities only.

Infertility center
Estimated Investment cost: 15.23 million birrs
Burden in sub-Sahara: It is estimated that more than 180 million couples in developing
countries suffer from primary or secondary infertility. (The African population is actually
estimated to be 1.2 billion; therefore 1.8 million IVF cycles should be done to meet its
current population demand.)
Rank for Ethiopian abroad referral: 5th
Current infrastructure status: Only one center. particularly in sub-Saharan Africa
infection-related tubal damage is the commonest resulting in infertility

Neurology center
Estimated Investment cost: no data
Burden in sub-Sahara: In Africa there is 1.9 million case volume of neurological
procedures but only 108,000 case capacity resulting in a huge case deficit.
Rank for Ethiopian abroad referral: No data
Current infrastructure status: Black lion on process to establish advanced neurology
center

Rehabilitation center
Estimated Investment cost: 40.2 million birrs
Burden in sub-Sahara: Rehabilitation is an increasingly important health service in light
of ageing populations and the rising prevalence of NCDIs. However, the need for
 rehabilitation greatly exceeds its availability. It is estimated that 17% of the population
has some form of disability. Substantial unmet need for rehabilitation compromises the
social and economic outcomes of health care and hinders realization of the SDG
Rank for Ethiopian abroad referral: No data
Current infrastructure status: there is no comprehensive center

Critical care center

Estimated Investment cost: No data
Burden in sub-Sahara: No data
Rank for Ethiopian abroad referral: No data
Current infrastructure status: there is no level-4 center

Diagnostic care center

Estimated Investment cost: No data
Burden in sub-Sahara: As an integral part of patient care even though expensive
diagnostic services are curial. Advanced laboratory, radiology and pathology services.
Rank for Ethiopian abroad referral: No data
Current infrastructure status: One accredited laboratory.
Tele medicine consultation service is an option. Nuclear medicine is one of the safe,
painless, and cost-effective way diagnosis.

Stakeholder Analysis
r What is important to How could the How could the Strategy for Impact
the stakeholder? stakeholder contribute to stakeholder block engaging the
the strategy? the strategy? stakeholder How much
does the
strategic t
document
impact them?

(Low, Medium, (
High)
• Establishing specialty • Preparation of the Medical • Not implementing • Preparing Medical
and subspecialty centers tourism strategic the strategy properly tourism and
• Introduction and document and not engaging wellness strategic
establishment of • Taking the initiative to the right document
medical tourism centers coordinate all stakeholders stakeholders. •Preparing a joint
• Decrease abroad in the realization of the •Not preparing the frame work for High
referrals and improve document required standards medical tourism and
the quality of •Informing all agencies and and legislations well services.
care/service institutions under its related to the
•Improving the quality of administration to work medical tourism.
service in the country. towards achieving the
goals of the strategy
• Improving the market • Participating in the • By not participating • Engaging in the
and income generation preparation of the in the strategic document
of the sector. document document preparation
• Aligning the selected preparation •Forming a joint
activities by the MoH to • Not properly team in monitoring
have a continuum of implementing the the progress and
service (both medical and prepared document implementation of
wellness service) • Poor preparation of the document High
•Informing all agencies and the hostel and other
institutions under its natural tourist
administration to work destinations.
towards achieving the •Not preparing the
goals of the strategy required standards
and legislations
related to the
wellness tourism
• Strengthening the • Based on the prioritized • Not engaging in the • Continuous High
country economy by service areas avail the preparation of engagement during
decreasing the hard required budget to realize strategic document the preparation of
currency loss the strategic document • Not availing the the document and to
• Generation income to • Modifying the respective required budget also be part of the
the country from Ministry policies in •Not creating a SC.
medical tourism and creating favourable favourable • Including their role
wellness centers. environment environment to and responsibilities
• Creating incentive investment by in the strategy.
packages for investment in foreigners •
medical and wellness
tourism.
• Advocate the strategy
document to their
respective organization,
organizations under their
 administration and
following closely with the
implementation of the
strategy.
•Informing all agencies and
institutions under its
administration to work
towards achieving the
goals of the strategy
• Identifying key areas • Promoting the country as
for investment and one of the medical tourism
promote the country as and wellness service
one of investment investment
destinations • Lobbying potential
• Generation income to investors in the area
the country from • Working closely with
medical tourism and MoH and MoT in the
wellness centers TWG.
•Informing all agencies and
institutions under its
administration to work
towards achieving the
goals of the strategy
• The country becomes a • By creating an easy
destination for medical system for travellers for
and wellness services accessing their VISA.
• Will strengthen the • Advocating medical and
diplomacy and wellness tourism in every
economic ties of consolettes around the
Ethiopia with other world.
sovereign countries in • Providing information and
s
Africa linking different investors
with the responsible body.
•Informing all agencies and
institutions under its
administration to work
towards achieving the
goals of the strategy
• Will create job • Advocating the medical
s opportunity for few and wellness centers built
professionals in the country for both
• Will have access to local and international
skill improvement and colleagues and community
transfer • Assisting MoH in
• Not endorsing the • Continuous
strategy and engagement during
incorporating it to the preparation of
their plans. the document and to
• Not considering also be part of the
medical tourism and TWG.
wellness service as •Including their role High
one of the and responsibilities
investment areas in the strategy.
•Not allowing
potential investors
to invest in the
country due to the
country policy.
• Not providing VISA • Continuous
for clients in a engagement during
timely manner the preparation of
the document and to
also be part of the
TWG.
•Including their role
and responsibilities Low
in the strategy.
• Not advocating and • Continuous High
promoting of engagement during
medical tourism. the preparation of
•Not engaging and the document and to
supporting the MoH also be part of the
in the preparation of TWG.
• Will acquire new soft prioritization and selection
skills from other of the services that will be
professionals provided in those centers
• Advocating •Assisting MoH in
professionals found in preparing different
the country to have manuals, standards and
international certified. directives.
• Advocating the health
facilities to have
international
certifications.
• Will strengthen the • Increasing the number of
attitude and acceptance peoples enlisted in health
of health insurance insurance system to use
• Will strengthen the services in those centers.
agency financially. • Creating an affordable cost
agreement with those
centers.
• Engaging different
international
organizations, embassies,
tour agents, banks to use
the agency to prior to
linking with the centers.
• Advocating for strategy to
all levels of the
government, non-
governmental
organizations and
countries.
•Informing all agencies and
institutions under its
administration to work
towards achieving the
goals of the strategy
• Will enable them to • Strengthen the
build digital system and digitalization of work
sell their service to the processes.
sector and earn a source • Advocacy and promotion
of income. service to medical and
• Producing innovative wellness tourism using
ideas and locally the internet.
production of medical • Testing and licensing
devices for generating different applications for
the different • Including their role
documents. and responsibilities
in the strategy.
•Ensuring the skill
transfer and possible
engagement of local
health care
professionals
• Continuous
• Not advocating and engagement during
promoting of the preparation of
medical tourism. the document and to
• Not engaging and also be part of the
supporting the MoH SC.
in the preparation of •Including their role
the different and responsibilities
documents. in the strategy.
• Not having the
capacity to
incorporate and
High
manage the
insurance system for
costly services.
• Not reaching to all
community level of
the country.
•Not endorsing the
strategy.
• Not endorsing the • Including their role Low
strategy. and responsibilities
• Not participating in in the strategy.
the digitalization of •Ensuring the skill
the medical service transfer and possible
and wellness engagement of local
service. experts
• Not advocating and
promoting of
 incomes for the their safety before
country. implementing them in the
medical and wellness
centers.
• Informing all agencies
and institutions under its
administration to work
towards achieving the
goals of the strategy
• Will benefit from the • Strive in availing selected
incentive packages set specialty and sub-
by the government. specialty services to the
• Generate income for local community.
their company and the • Establishing medical and
country. wellness centers in the
• Create job identified services and
opportunities for the locations.
h community. • Creating an international
competitive quality
service center.
• Strive for making
Ethiopia a destination of
medical and wellness
tourism.
• Make medical and
wellness service a strong
economic back bone to
the country.
• Deceasing the foreign • Incorporating the selected
currency loss due to the service areas into
abroad referrals. prioritized areas for
• Increasing the accessing foreign
countries’ GDP. currency.
• Participating in costing
k High
exercise of this strategy to
have aligned goals.
• Informing all agencies
and institutions under its
administration to work
towards achieving the
goals of the strategy
• Creating more job • Prepare loans for the such
t
opportunities for the type of investment
population. • Advocating for medical
medical tourism in
different web sites.
• Not advocating and • Including their role
promoting of and responsibilities
medical tourism. in the strategy.
• Not engaging and • Incorporating
supporting MoH in prioritized service
the realization of the areas and the
strategy. locations in the
• Not having the strategy.
capacity to establish • Preparing attractive High
and manage the for incentive packages
such type of for the investors.
services requiring
very huge
investments.
• Not endorsing the
strategy.
• Decreasing or • Continuous
halting hard engagement during
currency access to the preparation of
potential investors. the document and to
• Not endorsing the also be part of the
strategy. SC.
• Not promoting for •Including their role
medical and and responsibilities
wellness tourism in the strategy.
for investors.
• Not preparing the • Continuous Medium
required loans for engagement during
potential investors. the preparation of
 • Strengthening the and wellness service of • Not endorsing the the document and to
medical and wellness the country. strategy. also be part of the
tourism industry • Informing all agencies • Not promoting for TWG.
and institutions under its medical and • Including their role
administration to work wellness tourism and responsibilities
towards achieving the for investors. in the strategy.
goals of the strategy
• Job opportunities for • Availing the required land • Not preparing the • Continuous
the local community. for both the medical and required lands. engagement during
• Address the health wellness services. • Not creating the preparation and
concern of the • Assessing and identifying community informing them in
community tourist attraction sites. awareness of the the progress of the
• Increasing the local • Advocating the medical benefits of such strategy.
investments in those and wellness services investments. •Including their role
selected regions provided in their • Not endorsing the and responsibilities
on • Increase income respective regions for strategy. in the strategy. High
s generation of money in both the local and • Not promoting for
that region. international community medical and
(especially for diasporas). wellness tourism.
• Creating and sensitizing
the community on how to
create a welcoming
environment for medical
and wellness tourists.
• Increased income from • Striving for international • Continuous
the service. accreditation of their • Not advocating and engagement during
• Increased number of teaching institutions promoting of the preparation of
internationally found in the country. medical tourism. the document and to
accredited institutions • Advocating for • Not engaging and also be part of the
• Improved quality of accreditation of supporting MoH in SC.
care. professionals graduating the realization of the • Including their role
• Increased number of from those institutions. strategy. and responsibilities
specialty and sub- • Advocating work for • Not enforcing in the strategy.
specialty services. medical and wellness universities to •Working closely High
• Increased community tourism centers. apply for along with MoH in
trust on their • Capacitating and international fulfilling the
institutions. establishing new specialty accreditation. requests by the
and subspecialty services. • Not preparing the institutions.
• Informing all agencies required
and institutions under its investments to
administration to work strengthen the
towards achieving the institutions.
goals of the strategy
• Help in identifying • Preparing different • Continuous Low
• Not advocating and
 additional sectors for schemes of investment.
investments • Lobbying potential
• Will use this in lenders and investors for
identifying new realizing the strategy.
partners • Advocating medical
tourism along with the
wellness service.
• Promoting medical
tourism and wellness
tourism for local investors
with the incentive
package the government
prepared
• Using the prepared • Preparing ideal locations
d
lands for their planned for medical and wellness
service. centers
• Achieving their plans • Informing all agencies
• Assisting different and institutions under its
federal organizations administration to work
towards achieving the
goals of the strategy
• Generate income by • Promoting medical and
building the required wellness tourism for the
infrastructures (like local and international
road, availing vehicles, community
airplanes) • Building additional
• Increasing the number infrastructures required to
of flight destinations in get to the centers.
Ethiopia (constructing • Working collaboratively
airports) with the medical and
d
tourism sectors to create a
continuum of service for
the clients.
• Informing all agencies
and institutions under its
administration to work
towards achieving the
goals of the strategy
• Improved quality of • Prepare minimum
service standards for both
medical and wellness
tourism service
• Regulating the application
of the standards.
engagement during
promoting of the preparation of
medical tourism. the document and to
• Not engaging and also be part of the
supporting in the TWG.
realization of the
strategy. • Including their role
and responsibilities
in the strategy.
• Not providing lands • Keep informed
for investors during the
preparation of the
strategy Low
•Including their role
and responsibilities
in the strategy.
• Not working • Continuous
closely with the engagement during
medical and the preparation of
tourism sectors. the document and to
• Not availing a also be part of the
standardized means TWG.
of transportation •Including their role
• Not increasing the and responsibilities
number of airports in the strategy Low
and planes.
• Not promoting and
advocating for
medical and
wellness tourism
• Not preparing the • Keep informed Medium
required minimum during the
standards preparation of the
• Not regulating the strategy
implementation of •Including their role
the minimum and responsibilities

• Increase their revenue • Increasing the quality of
• Increase their number connectivity in the
of subscribers of their country
service • Increasing the access rate
to connectivity.
• Advocating and
promoting of medical and
wellness tourism.
• Give stories for • Advocating and
ia
reporters to work on promoting of medical and
wellness tourism
• Will be provided with • Advocating and • Not advocating and
the chance to the promoting of medical and
support their country wellness tourism
• Will be the beneficiary • Investing in medical and
for investment wellness tourism • Not investing in
• Will be given a chance • Using their country health
cy to have access to insurance systems.
quality medical and • Supporting the • Not supporting the
wellness service in government for increasing
their country the access to foreign
• Will be saved from currency.
very expensive health
insurance costs.
• Will open for them a
big opportunity for • Advocating and
selling their goods. promoting of medical and
wellness tourism
ce
• Investing in medical and
wellness tourism
• Providing or availing
quality medical devices to
those centers.
standards in the strategy.
• Not promoting and
advocating for
medical and
wellness tourism
• Not working to • Keep informed
improve the access during the
to connectivity in preparation of the
the country. strategy Low
• Not improving the •Including their role
quality of and responsibilities
connectivity in the in the strategy.
country
• Not advocating and • Keep informed
promoting of during the
medical and preparation of the
wellness tourism strategy Low
•Including their role
and responsibilities
in the strategy.
• Keep informed
promoting of during the
medical and preparation of the
wellness tourism strategy
•Including their role
medical and and responsibilities
wellness tourism in the strategy. Medium
government for
increasing the
access to foreign
currency.
• Not advocating and • Keep informed
promoting of during the
medical and preparation of the
wellness tourism strategy
• Not availing quality •Including their role High
medical devices. and responsibilities
in the strategy.
Vision: To be one of the best and most preferred medical and wellness tourism destinations in
Lower- and Middle-income countries by the end of 2032.

Goal: - To avail safe, affordable and high-quality medical care services that meet the needs
of both domestic and international medical tourists

Strategic Objectives:

• To establish better medical and wellness tourism leadership, coordination, and partnership
mechanisms at all levels

• To create incentive and enabling mechanisms for better investments on medical and wellness
tourism destinations

• To improve the numbers, capacities and standards of medical and wellness tourism facilities

• To create marketing and promotion management system on medical and wellness tourism
products

Priority Service Areas

• Improve Quality and Availability of Cardiac Care

• Improve Quality and Availability of Oncology Care

• Improve Quality and Availability of Transplant Service

• Improve Quality and Availability of Orthopedic Service

• Improve Quality and Availability of Infertility Service

• Improve Quality and Availability of Neurology Service

• Improve Quality and Availability of Rehabilitation Service

 • Improve Quality and Availability of Critical Care Service

• Improve Quality and Availability of Diagnostic Service

Strategic Themes
• Improve Leadership and coordination

• Strengthen Healthcare Quality and Accreditation

• Improve Promotion and marketing

• Improve Human Resource Development and management

• Improve Health Insurance schemes and payment system

Strategic Interventions and Major Actions

Strategic Themes Strategic Interventions Major Action

Establish Medical and Wellness Tourism support

Improve leadership,
coordination and governance
system for Medical and
Wellness Tourism
Improve leadership
and coordination
Increase Investment in
Medical and Wellness
Tourism
coordinating desk/unit/focal at relevant government b
(PMO, MoH, MoT, MoFA … Regional President Office)
Establish National Medical and Wellness Tourism Adv
Council
Revise the existing policies and incentives for pot
investors (land, loan, tax exemption, access to hard cur
and health facility standards)
Establish a strong and effective cooperation between inve
for the realization of bigger entities /hospital groups/
Strengthen the national public private partnership modali
Establish ties with international medical educational
institutions for training, technology application, and
knowledge transfer

Standardize affiliation and twining for outsourcing medic

services

Improve pre-departure
screening and institutional
readiness
Improve institutional client
communication and
technology based service
delivery system
Strengthen
Improve Health Facilities
Healthcare Quality
Readiness for Medical
and Accreditation
Tourism
Improve institutional service
quality and safety
performance monitoring and
learning mechanism
Enhance standardization and
expansion of promotional
Improve medical and
and marketing activities
wellness tourism
promotion and
marketing
Improve technology based
promotion and marketing
mechanism
Improve quality of medical
Organize forums, expos, workshops and experience shari
tours for investors and managers in medical tourism indu
area to promote investment in medical and wellness touri
Develop standard pre-departure client needs and expectat
assessment system (virtual and web based triaging)
Develop pre-departure client needs and expectations mat
and institutional readiness tracking mechanism
Establish institutional risk mitigation mechanisms for
medical tourists
Develop standard client communication and information
management system (institutional protocol, language
translation, cultural sensitivity)
Develop standard web-based e-MR, patient referral, and
health management system
Develop institutional capacity building and preparation
strategy for international service based accreditation
Develop mandatory quality and safety competency assess
and qualification certificating program for clinical
practitioners
Develop mandatory service provision licensing and regu
standards for institutions treating medical tourists
Develop standard incident reporting, auditing and learnin
mechanism
Introduce national service quality and patient safety best
performing award system
Organize national service quality and patient safety lea
forum (summits, expo, conference)
Develop National Medical and Wellness Tourism promot
and marketing strategy
Implement diversified electronic promotion and marketin
(Local & International Medias, Ethiopian Airlines …etc)
Establish diversified free offers corners (gifts, medical
checkup …etc) at airports and major public events
(exhibitions, international conferences, religious gatherin
sport festivals)
Support participation local institutions at international ma
events (expo, conference …etc)
Integrate with government websites and social m
platforms (Embassies, Ministries …etc)
Establish virtual information and support provision cente
Provide technological and technical supports on standard
website development for institutions treating medical tou
Upgrade and Standardize teaching curricula and tra
materials on priority service areas (CPDs)
 education and training Upgrade and standardize academic institutions on comp
programs on priority service priority health professionals production
areas Design financial and administrative support mechanism
Improve Human abroad education on priority health professionals
Resource Design national protocol for local and international acad
Development and institutions joint education program
Management Design mechanisms for provision of better salary
incentive packages for competent local health profession

Design support mechanisms for international h

Improve availability of professionals to work in domestic institutions
competent and productive Design strict professional code of conduct and medico
health professionals cases management system
Design national recognition and award program for best
performing and innovative health professionals (local &
international)

Implementation Arrangement and Performance Management

Introduction

In order to ensure Multisectoral coordination and collaboration for effective implementation of

medical tourism strategy requires appropriate platform to represent all the categories of
stakeholders in medical tourism in the country. This can be achieved by establishing national
medical truism coordination council and technical coordination team. Similarly this coordination
platform will be replicated at regional level. The council provides policy/strategic decisions
related to medical tourism, allocate and approve budget for the implementation of the national
tourism strategy and track the progress periodically with key indicators and provide guidance.
The technical coordination committee comprises the technical personnel from the relevant
stakeholders and mainly responsible for handling of overall technical work related to medical
tourism.

Robust monitoring, support and evaluation framework is of paramount importance for ensuring
accountability for implementing the national medical tourism strategy. This can be accomplished
by establishing regular follow-up mechanisms in place. Implementation of monitoring support
and evaluation helps to assess the implementation status of the project by measuring its output,
outcome and impact. Selected performance measure will be used to track the progress of the
National Medical Tourism strategy. Furthermore, mid-term and end-term evaluations of the
strategic plan will be used as performance measure. The mid-term review will be done every two
year. The end-term evaluation in turn will inform whether the targets are met or not.

Purpose

• To ensure effective coordination and collaboration

• To ensure greater accountability and transparency

• To enhance performance improvement

• To facilitate effective resource allocation and support mechanism

• To promote learning and data driven decision making

• To enhance systematic management

Performance Monitoring and Accountability Mechanism

National
National medical tourism coordination council
Chair
Secretary
Members
Mandates (R/R)
National medical tourism technical support committee
Chair
Secretary
Members
Mandates (R/R)
Regional
Regional medical tourism coordination council
Chair
Secretary
Members
Mandates (R/R)
Regional medical tourism technical support committee
Chair
Secretary
Members
Mandates (R/R)

Performance Measurement

Goal/ Strategic objectives Indicator Type of Data Source Frequency of Resp

indicator data b
collection

Total amount of revenue in USD Outcome MoF, NBE Yearly MoF ,

• Goal generated reports

Total number of international Outcome MoH report Yearly MoH

To avail safe, affordable medical tourists received medical
and high-quality medical care
 Total number of patients received Outcome Report from Yearly INVE
care services that meet the abroad medical care immigration
needs of both domestic and office
international medical
tourists

Presence of National Input Admin. Quarterly Nation

• Establish better level functional report
medical tourism Council
medical and
coordinating structure
wellness TC Input Admin. Quarterly Nation
based on National
tourism report
MTS
leadership, Focals Input Admin. Quarterly Line
coordination, report Minis
releva
and partnership
stakeh
mechanisms at
all levels Presence of Regional Input Admin Quarterly
level functional report
medical tourism Council Regio
coordinating structure
TC Input Admin. Quarterly Regio
based on National
report
MTS
Focals Input Admin. Quarterly Relev
report Burea

Total number of medical institutes Input Admin Yearly MoE

twinned with international report
medical educational institutions

Total number of PPP projects Process Report from Yearly MoF,

approved & implemented based MoF
on priority service area

Total number of expected national

• Create incentive policies/Directives/Guidelines
revised and approved, Input Admin Quarterly
and enabling
report
mechanisms for
better Total number of investors who
received relevant supports per
investments on incentive packages on priority Input Admin Quarterly
medical and service areas report
wellness
Total number of local forums,
tourism expos, and workshops
destinations organized for investors Input Admin Annually
 report

Total number of international

forums, expos, and workshops
attended by local investors Input Admin Annually
report

Total number of health facilities process Admin Annual

• improve the accredited by credible report
numbers, international accreditation bodies
capacities and Total number of health facilities process Admin Annually
standards of accredited by a national report
medical and accreditation agency
wellness Total number of trained and input HRIS Annually MoH
tourism actively working physicians based
on priority service areas
facilities
mortality rate Outcome HMIS Quarterly MoH

Percentage of Medical tourists' Process Survey Annually

experiences of care

Presence of National Medical Input Admin Quarterly

• Create Tourism promotion and report
marketing and marketing strategy
promotion
Presence of standard client input Admin Quarterly
management communication and information report
system on management systems
medical and Presence of client-compliant input Admin Quarterly MoH,
wellness handling systems report
tourism
products

Success factors
Implementation Plan

Time line
Strategic Year Year Year Year Year
Theme Major Actions 2 4 6 8 10

Strategic Intervention 1. Improve leadership, coordination and governance system for Med
Establish Medical and Wellness Tourism support and M
coordinating desk/unit/focal at relevant government bodies E
(PMO, MoH, MoT, MoFA … Regional President Office) N

Establish National Medical and Wellness Tourism Advisory M

Council M

Revise the existing policies and incentives for potential M

investors (land, loan, tax exemption, access to hard E
currency and health facility standards) E
D
Strategic Intervention 2. Increase Investment in Medical and Wellness Tourism
Establish a strong and effective cooperation between E
Improve investors for the realization of bigger entities /hospital D
leadership groups/ F
and N
coordination Strengthen the national public private partnership modality M
M
Establish ties with international medical educational
institutions for training, technology application, and
knowledge transfer M
M
Standardize affiliation and twining for outsourcing medical
services
M
Organize forums, expos, workshops and experience sharing
tours for investors and managers in medical tourism M
industry area to promote investment in medical and M
wellness tourism
 Strategic intervention 1: Improve pre-departure screening and institutional readiness
Develop standard pre-departure client needs and
expectations assessment system (virtual and web based M
triaging) f
Develop pre-departure client needs and expectations
matching and institutional readiness tracking mechanism M
f
Establish institutional risk mitigation mechanisms for each
medical tourists M
f

Strategic intervention 2: Improve institutional client communication and technology based

Develop standard client communication and information
management system (institutional protocol, language
translation, cultural sensitivity) M
f
Develop standard web-based e-MR, patient referral, and
tele-health management system M
f
Strategic intervention 3: Improve Health Facilities Readiness for Medical Tourism
Develop institutional capacity building and preparation
strategy for international service based accreditation E
h
Develop mandatory quality and safety competency
assessment and qualification certificating program for
clinical practitioners M
f
Develop mandatory service provision licensing and
regulatory standards for institutions treating medical
tourists M
h
Strategic intervention 4: Improve institutional service quality and safety performance mon
Develop standard incident reporting, auditing and learning
mechanism P
Introduce national service quality and patient safety best M
Strengthen performing award system f
Healthcare u
Quality and s
Accreditation Organize national service quality and patient safety learning M
forum (summits, expo, conference) f
s

Improve
marketing Strategic Intervention 1: Enhance standardization and expansion of promotional and mar
and
promotion Develop National Medical and Wellness Tourism
for medical promotion and marketing strategy
M
and wellness Implement diversified electronic promotion and marketing M
tourism (Local & International Medias, Ethiopian Airlines …etc) a
products
 Establish diversified marketing and promotion corner (free
offers corners, gifts, medical checkup …etc) at airports and M
major public events (exhibitions, religious gatherings, sport p
festivals) t
Support participation local institutions at international M
major events (expo, conference etc h
f
Strategic intervention 2: Improve technology based promotion and marketing mechanism
Integrate with government websites and social media
platforms (Embassies, Ministries …etc) M
a
Establish virtual information and support provision center
M
Provide technological and technical supports on standard
website development for institutions treating medical
tourist
M

Strategic Intervention 1: Improve quality of medical education and training programs on p

Upgrade and Standardize teaching curricula and training M
materials on priority service areas (CPDs) u
s
Upgrade and standardize academic institutions on M
competent priority health professionals production u
s
Design financial and administrative support mechanism for
abroad education on priority health professionals M
u
Design national protocol for local and international
academic institutions joint education program M
u
Strategic intervention 2: Improve availability of competent and productive health professio
Design mechanisms for provision of better salary and
incentive packages for competent local health
professionals M
f
Design support mechanisms for international health
professionals to work in domestic institutions M
f
Design strict professional code of conduct and medico-legal
cases management system M
f
Improve Design national recognition and award program for best
Human performing and innovative health professionals (local &
Resource international) M
Development f
and u
Management s