--- type: "Case Study" title: "Multi-Market Ad Architecture: Istanbul Care Case Study" description: "How we set up Google Ads and Meta Ads separately across 11 country and language splits for Istanbul Care, a health tourism brand with six source countries." url: "https://www.roicool.com/en/case-studies/multi-market-ad-architecture" lang: "en" dateModified: "2026-08-16" expert: "Mahmud Filoğlu" resource: "https://www.roicool.com/en/case-studies/multi-market-ad-architecture" alternates: tr: "https://www.roicool.com/vaka-calismalari/11-ulke-dil-reklam-mimarisi.md" generated: { by: "process:roicool-cms", at: "2026-08-16T21:00:02.527Z" } related: - { title: "Performance marketing", resource: "https://www.roicool.com/en/services/performance-marketing-agency.md" } - { title: "Google Ads", resource: "https://www.roicool.com/en/services/google-ads-agency.md" } - { title: "Meta ads", resource: "https://www.roicool.com/en/services/meta-ads-agency.md" } - { title: "International SEO", resource: "https://www.roicool.com/en/services/international-seo.md" } - { title: "İstanbul Care", resource: "https://www.roicool.com/en/projects/istanbul-care.md" } - { title: "Medical tourism marketing agency", resource: "https://www.roicool.com/en/industries/health-tourism-marketing-agency.md" } - { title: "Royal Hair", resource: "https://www.roicool.com/en/case-studies/google-meta-multi-stage-funnel.md" } - { title: "Serkan Hezar", resource: "https://www.roicool.com/en/case-studies/healthcare-appointment-optimization.md" } - { title: "EsteMoon Clinic", resource: "https://www.roicool.com/en/case-studies/service-line-campaign-split.md" } - { title: "Albania Hair Clinic", resource: "https://www.roicool.com/en/case-studies/location-advantage-meta-ads.md" } - { title: "Royal Hair", resource: "https://www.roicool.com/en/case-studies/patient-flow-gain-in-2-months-in-health-tourism.md" } - { title: "SESTEK", resource: "https://www.roicool.com/en/case-studies/sestek-webflow-cloud-dynamics-365-integration.md" } - { title: "Case studies", resource: "https://www.roicool.com/en/case-studies.md" } --- # How we built the ad architecture for a multi-market health tourism brand Istanbul Care's ads are not pooled into one campaign set. Google Ads and Meta Ads are set up separately for each of 11 country and language splits, and each platform applies that breakdown on its own. CAPI feeds the conversion signal back without loss. The $120,000 monthly budget follows the architecture rather than a market list. ## Measured results - **12x** average ROI (Published on the project record: the average of the work so far · 3 months (ongoing)). - **$14** cost per lead (Published on the project record; it varies by period · 3 months (ongoing)). ## Fact sheet | | | | --- | --- | | Client | İstanbul Care | | Industry | Health tourism | | Country | Global | | Industry | Health Tourism | | Country | Global | | Service | Google Ads Management | ## Case analysis: how one ad architecture covers 11 country and language splits A single campaign structure will not carry a brand that runs branches across multiple continents and takes patients from six countries and counting1. At Istanbul Care the work started with the account map, not the ad copy. Ad architecture means settling the account, campaign and language layers before a single ad goes live. In health tourism the language of first contact and the local rules change market by market; a [health tourism advertising agency](https://www.roicool.com/en/industries/health-tourism-marketing-agency) writes those differences into the account map rather than the ad copy. The number that drives the build is the split count, not the market count. Google Ads and Meta Ads are set up separately for each of 11 country/language combinations 1 — one country can be targeted in more than one language, and one language crosses borders. ## The challenge: six source countries, two platforms, one account map Complexity here comes from the splits, not from the size of the account. One map holds different countries, different languages and two ad platforms at once. Pooled together, the market that performs disappears into the average. ### Patient intent is not the same in every market Requests from different source countries do not behave alike: decision time, the language of the exchange and the proof a patient wants before booking all shift. One ad text across every market averages them away. ### A language split is really a campaign split Six source countries 1 and 11 splits 1 are not the same number: a country can be targeted in more than one language, and a language crosses borders. Each split carries its own ad text, its own targeting and its own compliance question — [health advertising regulation](https://www.roicool.com/en/blog/health-advertising-regulation-2026) in Türkiye draws one frame, target markets another. Single campaign structure versus country/language split architecture ## The strategy: building campaign architecture around country and language splits Three decisions carry the architecture: platforms built independently, budget following that build, conversion signal fed back without loss. How the multi-market ad architecture was built ### 1. Building Google Ads and Meta Ads separately Google Ads and Meta Ads were set up separately for each of the 11 country/language combinations1. The two platforms meet the same patient at different moments: on the [Google Ads management](https://www.roicool.com/en/services/google-ads-agency) side demand is already expressed as a search, on the [Meta Ads platform](https://www.roicool.com/en/glossary/meta-ads) it still has to be created. On Meta the split follows the audience profile of the 11 countries and languages1. ### 2. Distributing the budget by architecture, not by market The $120,000 monthly ad budget is allocated across this multi-market setup1. The line item is not the achievement; what matters is seeing how much reaches which split. Divided by combination, every line carries its own budget, conversions and report; Looker Studio sits in the technology set1. ### 3. Feeding the conversion signal back without loss through CAPI Conversion API (CAPI) takes the conversion event off the browser and sends it to the platform from the server. Here it captures conversion data without loss 1 and keeps that data consistent across platforms1. In a multi-market build every split then produces its own conversion signal. ## Results: published performance indicators and the client's own comment Every figure below is already public on the [Istanbul Care project page](https://www.roicool.com/en/case-studies/multi-market-ad-architecture) . The project duration is published as 3 Months and the work is ongoing1. The indicators: an average 12x ROI1, a 6% conversion rate reaching up to 8% depending on the campaign1, and a $14 lead cost that can vary seasonally1. Published indicators on the Istanbul Care project "After we started working with Roicool, our patient application process became far more organized and trackable. With strategic campaign management, CRM integration, and transparent reporting, we run the process with confidence." — Istanbul Care Team, Verified Comment These are a published snapshot, not a fixed promise: the conversion rate moves with the campaign, the lead cost with the season. No before-and-after comparison is drawn, because no starting value has been published. The average makes sense only next to the architecture: each of the 11 combinations produces its own conversions1. ## The lesson: multi-market complexity is handled by architecture, not by budget What grows with the number of markets is not cost but the number of decisions. Every added country and language brings its own ad text, targeting and conversion measurement. If the architecture cannot hold those splits, a larger budget will not rescue the outcome: spend rises, learning does not. Three questions transfer to any multi-market account: how many country and language splits do you have, which platform breaks along which split, and does the conversion data come back intact? At Istanbul Care those answers sit in the account structure, so each of the 11 combinations is managed on its own1. Order matters: inventory first, platform separation next, budget last. Put budget first and the architecture forms around it; the splits never get built. ## Source - [Istanbul Care — Google Ads and Meta Ads campaign management project page](https://www.roicool.com/en/case-studies/multi-market-ad-architecture) ## Services used in this case ### Performance marketing [Performance marketing](https://www.roicool.com/en/services/performance-marketing-agency) ### Google Ads Performance marketing [Google Ads](https://www.roicool.com/en/services/google-ads-agency) ### Meta ads Performance marketing [Meta ads](https://www.roicool.com/en/services/meta-ads-agency) ### International SEO SEO [International SEO](https://www.roicool.com/en/services/international-seo) ## The work itself: the project page ### İstanbul Care İstanbul Care is an established brand with 3 branches worldwide, drawing patients from Italy, Germany, Albania, Spain, the US, and France. We run its Google Ads and Meta Ads across 11 country/language combinations, with CAPI tracking every conversion. [İstanbul Care](https://www.roicool.com/en/projects/istanbul-care) ## Expert Mahmud Filoğlu, Managing Partner ## Industry - [Medical tourism marketing agency](https://www.roicool.com/en/industries/health-tourism-marketing-agency) ## Similar cases ### Royal Hair: how did we split a $60,000 budget between two different jobs? Royal Hair [Royal Hair](https://www.roicool.com/en/case-studies/google-meta-multi-stage-funnel) ### Performance marketing optimization: 150% increase in appointments Serkan Hezar [Serkan Hezar](https://www.roicool.com/en/case-studies/healthcare-appointment-optimization) ### How did we split campaigns in a clinic with a broad service range? EsteMoon Clinic [EsteMoon Clinic](https://www.roicool.com/en/case-studies/service-line-campaign-split) ### How did we turn a Tirana clinic's location into a Meta Ads strategy? Albania Hair Clinic [Albania Hair Clinic](https://www.roicool.com/en/case-studies/location-advantage-meta-ads) ### How to generate patient flow from scratch in 2 months for medical tourism Royal Hair [Royal Hair](https://www.roicool.com/en/case-studies/patient-flow-gain-in-2-months-in-health-tourism) ### SESTEK: how we connected Webflow forms to Dynamics 365 SESTEK [SESTEK](https://www.roicool.com/en/case-studies/sestek-webflow-cloud-dynamics-365-integration) Breadcrumb: [Home](https://www.roicool.com/en) › [Real Success Stories of Brands](https://www.roicool.com/en/case-studies) › How we built the ad architecture for a multi-market health tourism brand Related pages: - [Case studies](https://www.roicool.com/en/case-studies) **Let’s talk about a similar result.** A 30-minute intro call about your goal and your measurement, and a clear plan out of it. [Get a proposal](https://www.roicool.com/en/get-a-proposal) Source: https://www.roicool.com/en/case-studies/multi-market-ad-architecture · Last updated: 2026-08-16