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Perceived Risks, Travel Constraints, and Destination Perception: A Study on Sub-Saharan African Medical Travellers


  • Mohammad Jamal Khan

    (College of Health Sciences, Saudi Electronic University, Riyadh 4249, Saudi Arabia)

  • Firoz Khan

    (College of Health Sciences, Saudi Electronic University, Riyadh 4249, Saudi Arabia)

  • Saba Amin

    (College of Health Sciences, Saudi Electronic University, Riyadh 4249, Saudi Arabia)

  • Shankar Chelliah

    (School of Management, Universiti Sains Malaysia, Penang 11800, Malaysia)


In medical travel, previous studies have investigated the factors that influence medical travellers to receive treatment outside the country. However, most of these studies are limited to travel motivations and perceptions of medical services at destinations. The main objective of this study was to investigate the relationship between medical travellers’ perceived risks, travel constraints, and destination image based on medical and non-medical attributes. This is a quantitative study whereby the data was collected from 306 sub-Saharan African medical travellers, who visited India for the treatment. The study found that physical-health risk has a significant negative influence on destination image based on medical attributes. The service quality risk has a negative effect on destination image based on both medical and non-medical attributes, and destination risk has a negative effect on destination image based on medical attributes. The study also found that travel constraints have a negative influence on both medical and non-medical destination image.

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  • Mohammad Jamal Khan & Firoz Khan & Saba Amin & Shankar Chelliah, 2020. "Perceived Risks, Travel Constraints, and Destination Perception: A Study on Sub-Saharan African Medical Travellers," Sustainability, MDPI, vol. 12(7), pages 1-16, April.
  • Handle: RePEc:gam:jsusta:v:12:y:2020:i:7:p:2807-:d:340285

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    References listed on IDEAS

    1. Chen, Huei-Ju & Chen, Po-Ju & Okumus, Fevzi, 2013. "The relationship between travel constraints and destination image: A case study of Brunei," Tourism Management, Elsevier, vol. 35(C), pages 198-208.
    2. Moghavvemi, Sedigheh & Ormond, Meghann & Musa, Ghazali & Mohamed Isa, Che Ruhana & Thirumoorthi, Thinaranjeney & Bin Mustapha, Mohd Zulkhairi & Kanapathy, Kanagi A./P. & Chiremel Chandy, Jacob John, 2017. "Connecting with prospective medical tourists online: A cross-sectional analysis of private hospital websites promoting medical tourism in India, Malaysia and Thailand," Tourism Management, Elsevier, vol. 58(C), pages 154-163.
    3. Chew, Elaine Yin Teng & Jahari, Siti Aqilah, 2014. "Destination image as a mediator between perceived risks and revisit intention: A case of post-disaster Japan," Tourism Management, Elsevier, vol. 40(C), pages 382-393.
    4. Lepp, Andrew & Gibson, Heather & Lane, Charles, 2011. "Image and perceived risk: A study of Uganda and its official tourism website," Tourism Management, Elsevier, vol. 32(3), pages 675-684.
    5. Crush, Jonathan & Chikanda, Abel, 2015. "South–South medical tourism and the quest for health in Southern Africa," Social Science & Medicine, Elsevier, vol. 124(C), pages 313-320.
    6. Sarstedt, Marko & Ringle, Christian M. & Smith, Donna & Reams, Russell & Hair, Joseph F., 2014. "Partial least squares structural equation modeling (PLS-SEM): A useful tool for family business researchers," Journal of Family Business Strategy, Elsevier, vol. 5(1), pages 105-115.
    7. Moghimehfar, Farhad & Nasr-Esfahani, Mohammad Hossein, 2011. "Decisive factors in medical tourism destination choice: A case study of Isfahan, Iran and fertility treatments," Tourism Management, Elsevier, vol. 32(6), pages 1431-1434.
    8. Milica Z. Bookman & Karla R. Bookman, 2007. "Medical Tourism in Developing Countries," Palgrave Macmillan Books, Palgrave Macmillan, number 978-0-230-60565-7, September.
    9. Connell, John, 2013. "Contemporary medical tourism: Conceptualisation, culture and commodification," Tourism Management, Elsevier, vol. 34(C), pages 1-13.
    10. Hanefeld, J. & Lunt, N. & Smith, R. & Horsfall, D., 2015. "Why do medical tourists travel to where they do? The role of networks in determining medical travel," Social Science & Medicine, Elsevier, vol. 124(C), pages 356-363.
    11. Reinartz, Werner & Haenlein, Michael & Henseler, Jörg, 2009. "An empirical comparison of the efficacy of covariance-based and variance-based SEM," International Journal of Research in Marketing, Elsevier, vol. 26(4), pages 332-344.
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    2. Peiman Ghasemi & Amir Mehdiabadi & Cristi Spulbar & Ramona Birau, 2021. "Ranking of Sustainable Medical Tourism Destinations in Iran: An Integrated Approach Using Fuzzy SWARA-PROMETHEE," Sustainability, MDPI, vol. 13(2), pages 1-32, January.

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