The Herbal Promise: Service Quality Attributes and Their Impact on Tourist Loyalty in Sri Lanka’s Ayurveda Medical Tourism Sector

Sri Lanka has long been recognized as an island where traditional Ayurvedic wisdom thrives amid a rich abundance of medicinal flora. Within this cultural and ecological heritage, Ayurveda-based medical tourism has emerged as a promising niche capable of revitalizing the national tourism industry. However, despite the rise in international tourist arrivals after 2009, the number of visitors traveling specifically for medical and wellness purposes has declined. This paradox raises an important question regarding whether the service quality offered by Ayurveda resorts aligns with the expectations of modern wellness travelers, who seek an integrated experience of authentic healing and contemporary hospitality standards. In this context, the present study examines the influence of key service quality dimensions on medical tourists’ satisfaction and loyalty toward Sri Lanka’s Ayurveda tourism offerings. Using a quantitative approach grounded in SERVQUAL, survey data were collected from 112 international wellness tourists receiving treatment in 13 Ayurveda resorts along the southern coastal belt. The findings indicate that tangibility, responsiveness, and empathy significantly contribute to tourist satisfaction, while higher satisfaction strongly predicts intentions to revisit and recommend Sri Lanka to others. These results underscore that service quality is not merely an operational component but the central determinant of sustainable growth in the country’s medical tourism sector. Beyond theoretical contributions, the study provides practical implications. Enhancing staff professionalism, improving facilities, offering personalized care, and upholding certified Ayurvedic practices can strengthen credibility and trust. Policymakers are encouraged to integrate Ayurveda into national tourism branding, expand multilingual training, and foster international collaborations.