The healthcare system in Comoros is structured but severely under-resourced, facing significant challenges characteristic of developing countries. Managed by the Ministry of Health, it operates a tiered system from local health centers to regional and national hospitals. However, many facilities lack reliable electricity, running water, modern equipment, and basic medical supplies. Political instability has historically hampered the development of robust health policies and infrastructure. For expats, this means that local healthcare, both public and private, is generally basic and may not meet international standards. Serious medical conditions or complex procedures almost always necessitate medical evacuation to better-equipped facilities in neighboring countries. Upfront payment for services is a common expectation.

Comoros' public healthcare system is the primary provider for the majority of the population. It is organized from village-level health centers to regional and national hospitals, with El-Maarouf National Hospital in Moroni being the main facility. While Comorians can consult a general practitioner free of charge in the public sector, nothing is free when it comes to medication or surgery. Public facilities are often understocked, understaffed, and in poor condition, lacking modern equipment. For foreigners, direct access to the public system for routine care might be possible, but upfront payment is generally required. There is no formal national health insurance system in place, though the government plans to introduce a generalized health insurance scheme by 2030. Waiting times can be significant due to resource limitations. The quality of care is basic, and specialized services are extremely limited.

Private healthcare options in Comoros are very limited, primarily concentrated in Moroni. Notable private facilities include the International Hospital, Caritas Hospital, Bahani Medical Center, Vouvouni Medical Center, and Ongoni Medical Center, all located in Moroni. While these private clinics may offer slightly shorter waiting times and more personalized attention, they are still constrained by the same resource limitations as the public system and may not offer care comparable to Western standards. They typically provide general consultations, basic diagnostics, and some specialized services like cardiology or gynecology. Expats often prefer private clinics for routine care. Typical consultation costs for a GP visit in a private setting can be around €10 (approximately $11 USD). For more complex procedures, costs can rise significantly, for example, appendicitis surgery costs at least €200 (approximately $215 USD) and a Caesarean delivery up to €600 (approximately $645 USD).

Foreigners and expats in Comoros face a healthcare landscape that necessitates careful planning. There are no reciprocal health agreements, and a formal national health insurance scheme for residents is not yet in place, though one is planned by 2030. Therefore, all care providers, whether public or private, typically require upfront payment in Comorian Francs (KMF) or US Dollars (USD) before treatment. For any serious illness or injury, medical evacuation insurance is considered essential, as local facilities are often inadequate for complex conditions. Expats should carry all necessary prescription medications, along with their doctor's prescription, as pharmacy stock is limited, especially outside Moroni. It is also advisable to have a medical summary available in French.

Given the limitations of the local healthcare system, securing comprehensive health insurance is paramount for expats in Comoros. There is currently no mandatory public health insurance contribution for expats, as a generalized national health insurance scheme is still in development, aiming for full implementation by 2030. Therefore, voluntary private health insurance, particularly international health insurance, is highly recommended. These plans should include robust coverage for medical evacuation, as serious conditions often require transfer to facilities in Mayotte, Reunion, or South Africa. Employer-provided plans may offer some coverage, but expats should verify the extent of local and international coverage, especially for emergency evacuations. Typical monthly premiums for expat health insurance are estimated to range from $90 to $180 USD. It is crucial to confirm with your insurer the extent of their coverage in Comoros and the procedures for claims, as upfront payment is the norm.

Healthcare in Comoros generally requires out-of-pocket payments. A general practitioner (GP) consultation in a public facility might be free for Comorians, but for foreigners, a private GP visit typically costs around $5–15 USD or €10. Specialist consultations are limited, and their costs would vary, but specialist care is largely unavailable for complex conditions. Hospital stays and procedures can be costly, with examples like appendicitis surgery costing at least €200 (approximately $215 USD) and a Caesarean delivery up to €600 (approximately $645 USD). Patients are often required to purchase their own medications, IV fluids, and even basic supplies from private pharmacies before treatment in public hospitals. Prescription medications are often in short supply, and pharmacies are limited, especially outside Moroni. Dental and vision care are also basic and would require direct payment. Medical evacuations for serious cases are a significant expense, estimated between $6,000 and $15,000 USD, underscoring the need for comprehensive insurance.

Emergency medical services in Comoros are limited. The primary emergency number for medical assistance is 112. Other emergency numbers include 17 for Police and 18 for Fire/Gendarmerie. However, ambulance services are not always reliable or readily available, and it is often recommended to call the nearest hospital directly or arrange private transportation. Key hospitals like El-Maarouf National Hospital in Moroni (+269 773 26 04) can be contacted directly for emergencies. In the event of a serious medical emergency, treatment is not free for foreigners, and upfront payment is expected. For critical conditions, particularly those requiring advanced care, medical evacuation via air ambulance to regional hubs like Mayotte, Reunion, or South Africa is frequently necessary. Several private air ambulance services operate to and from Comoros, offering critical care transport.

The quality of healthcare in Comoros is generally considered basic and substandard by international measures. While some sources from 2025 suggest improvements and a growing focus on medical tourism, the consensus among expat and travel advisories remains cautious. The Human Rights Measurement Initiative finds that Comoros is fulfilling 64.2% of what it should for the right to health based on its income level, with reproductive health being particularly low at 21.6%. Strengths, as highlighted by some recent reports, include efforts in maternal and child health through programs like PASCO, which has led to the rehabilitation of facilities and training of professionals. However, weaknesses are profound, including a severe lack of resources, modern equipment, specialized staff, and consistent electricity and water supplies in many facilities. Specialist capabilities are very limited or non-existent, leading to long waiting times for complex care and a high reliance on medical evacuations. Compared to neighboring French overseas territories like Mayotte and Reunion, Comoros's healthcare system is significantly less developed, making these islands common destinations for medical transfers.