Ever since her daughter, aged 12 at the time of the interview, was diagnosed with autism spectrum disorder, and her eight-year-old son with an intellectual disability and cerebral cortical atrophy, Shorouk Hafez has spent years trying to obtain government rehabilitation services for her two children. But the length of the procedures and the waiting lists, according to her account, prevented them from actually benefiting from those services.
This report is based on interviews and testimonies collected before it was submitted in August 2026. The children’s ages, the costs of treatment and the waiting situations are given as the families described them at the time of the interviews, and do not represent a survey of service prices or a confirmation that each case remained in the same situation up to the day of publication.
Over the past ten years, she periodically visited a number of government hospitals, among them Abu El-Reish Hospital and El-Demerdash Hospital, as well as the Hearing and Speech Institute and the Polio Institute, seeking examination and assessment services or the medical reports needed to prove the two children’s disability, but she often faced the absence of doctors or the postponement of appointments, to the point that on one occasion she spent the whole day inside the hospital before obtaining only a new appointment without the examination being carried out.
Shorouk had to leave her home in Shubra El-Kheima, in Qalyubia Governorate, at six in the morning with the two children, and her journey with them to the hospital took about an hour and a half on three different means of transport, at a cost of up to about EGP 200 per visit; there they had to wait for hours to book a turn, then more hours inside the hospital before the doctor arrived, and they might be shocked by the examination being postponed to a later date, which made benefiting from free or low-cost speech therapy sessions impractical for her family.
She tells "Zawia3": "The examination took a few minutes, without any real examination of the children, explanation of the condition or discussion of treatment options; some doctors would write quick prescriptions and then direct us to their private clinics to continue the follow-up".
She adds that the medicines prescribed for her children were not available in the hospital pharmacies, even though they are essential medicines, which forced her to buy them outside, noting that the prices of some medicines range between EGP 600 and EGP 1,500 per pack, which represents a large financial burden on her family.
In 2024, Shorouk was visiting the social rehabilitation office to renew the integrated services card for her two children when the employee told her that there was a comprehensive rehabilitation centre for people with special needs, located in the Ard Nubar area of Shubra El-Kheima, which provides the speech therapy, skills development and occupational therapy sessions they need, free of charge.
When she went to the centre, she was asked to register the two children’s names and her phone number in the waiting-list records, on the understanding that she would be called when they had two vacant places for them, as the centre was at its maximum capacity of children with intellectual disabilities, but her wait stretched to about two years.
Shorouk registered her two children on the waiting list in 2024, and she says her wait stretched to about two years.
In the end, the mother had to rely on private rehabilitation centres, where the price of a single session, according to what she pays, is no less than EGP 100, and she estimates the total cost of the sessions at between EGP 6,000 and EGP 7,000 per month. She mentions that additional burdens amounting to EGP 2,500 increase the pressure on the family budget. The family bears these expenses from a monthly income that does not exceed EGP 12,000, while it lives in an apartment under the new rent system.
A Monthly Bill That Cannot Wait
Five years ago, Donia Mohamed turned to the outpatient clinics of Kasr Al-Ainy Hospital to obtain a medical assessment of the condition of her daughter, who is now nine years old; there she was diagnosed with autism spectrum disorder, and the condition was assessed and the appropriate rehabilitation plan determined, without therapy sessions being provided inside the hospital or medicines being dispensed from the pharmacy, which forced her family to complete speech therapy, skills development and sensory integration services at private centres at its own expense.
She tells "Zawia3": "My daughter goes five days a week to day care at a private rehabilitation centre that provides her with speech therapy, skills development, behaviour modification and occupational therapy sessions for a monthly subscription of EGP 5,000, subject to annual increases, and she also receives three sensory integration sessions a week at EGP 120 per session, in addition to physical activity at a sports training academy twice a week at a cost of EGP 1,500 per month, and we incur about EGP 2,000 for her transport".
The mother explains that her daughter’s condition requires periodic medical follow-up with a neurologist and a clinical nutrition doctor, with the fee for each examination ranging between EGP 600 and EGP 1,000, in addition to the prices of medicines, which are constantly rising, bringing the monthly rehabilitation and treatment bill close to EGP 15,000, borne by the two parents, whose combined monthly salary does not exceed EGP 25,000, from which they pay the instalments on the apartment in which their family lives, living expenses and the education of their younger son.
Under these burdens, in January 2026 Donia went to the centre for persons with disabilities at the integrated services complex in Al-Asmarat in the Mokattam district, seeking speech therapy, skills development, learning difficulties, sensory integration, occupational therapy, psychomotor and family counselling services. She says that the employee merely registered her daughter’s name on a long waiting list, on the understanding that she would call her when her turn came, which had not happened at the time of the interview. The construction of the complex had been announced at a cost of EGP 76 million in July 2020, then the Minister of Social Solidarity, Maya Morsy, inspected it in February 2025; the latest visit was not a new opening of the complex.
As for Hoda Hassan, she had to use three means of transport, at a cost exceeding EGP 100, to travel from her home in the El-Marg district to the Abbasiya Mental Health Hospital, so that her child, who has intellectual delay and brain atrophy, could receive speech therapy, skills development and behaviour modification sessions at nominal prices and have his medicines dispensed from the hospital pharmacy.
But her ten-year-old son was soon deprived of the sessions because he had exceeded the age permitted for the programme, so she took him to El-Demerdash Hospital, where he received a speech therapy session for EGP 25 and a skills development session for EGP 75, but the cost of transport and travel raised total daily expenses to about EGP 250, which led her to stop the rehabilitation there after four months, she tells "Zawia3".
When Hoda learned of the announcement of the services of the Riyada Egyptian International Center for the Empowerment of People with Special Needs, under the supervision of the Ministry of Education, she planned to move her home so that her son could join the centre in 10th of Ramadan City in Sharqia Governorate, where her family comes from. In an official presentation of its services in April 2025, the Minister of Education described it as one of the largest centres concerned with rehabilitation in the Arab world and Africa. Its announced facilities include eight audiology clinics and four speech therapy rooms, and rooms for family counselling, skills development, play, occupational therapy, sensory integration, behaviour modification and cognitive therapy, as well as physiotherapy, hydrotherapy, artistic and sports activities and vocational training, and about 25 rooms for residence or hosting.
For months, she kept waiting for a phone call informing her that her son had been accepted, ever since his name was placed on the waiting lists, but that did not happen, and she found no option but to turn to a private centre near her home, where a session costs EGP 120; and although the child needs, according to her estimate, 60 rehabilitation sessions a month, among speech therapy, skills development, sensory integration, occupational therapy, behaviour modification and physical rehabilitation, she cannot afford the cost of more than 12 speech therapy sessions because of her financial circumstances, as she is a mother supporting three children on her own, with an income not exceeding EGP 4,000, which has had a negative effect on his condition.
Disability and Education Figures: What Do They Measure?
The figures reveal the breadth of the need for disability services, but they require distinguishing between categories and years of measurement. The 2017 census data recorded difficulties ranging from mild to absolute among 10.67% of the population aged five and over, compared with 2.61% for severe to absolute difficulties. As for the circulating estimates of total numbers, which range between ten million and 12 million people, they are not to be combined with the 15% figure as the results of a single count or as a measure of the need for rehabilitation. At a workshop of the National Council for Persons with Disabilities in May 2026, a figure of 3.1% for children with disabilities was presented, based on data from the Central Agency for Public Mobilisation and Statistics. Compared with an estimate of about 39.7 million children in Egypt, this percentage is arithmetically equivalent to about 1.23 million children. This estimate does not represent the number of those registered on waiting lists or the number of those needing the same type of rehabilitation.
According to Ministry of Education data published in November 2024, the number of inclusion pupils in Egypt reached 159,825 male and female students, enrolled in the various stages and levels of education in general and technical education schools; Ministerial Decision No. 252 of 2017 stipulated that their proportion should not exceed 10% of the total number of students in the class, with a maximum of 4 students per class, and it was applied to cases of mild or moderate disability in general education schools, including (mild intellectual disability, slow learning –autism spectrum disorder, Down syndrome, physical disability, cerebral palsy, hearing impairment, visual impairment, blindness, Irlen syndrome – learning difficulties, attention deficit hyperactivity disorder).
As for cases of severe and moderate disability (intellectual, visual, hearing), they can turn to special education schools and classes, which include schools for intellectual disability and associated syndromes such as: ( Down syndrome- autism spectrum disorder, cerebral palsy, slow learning), schools for hearing disability dedicated to the deaf and hard of hearing, schools for visual disability dedicated to the blind and visually impaired, and classes for those with dual disabilities, and the education data referred to indicate about 46,994 male and female students; these are numbers of those enrolled in education, and they do not measure the number of those receiving rehabilitation sessions or the number of those waiting for them.
Waiting Lists and a Shortage of Specialists
Many families face great difficulties in accessing government rehabilitation services because of long waiting lists, limited operation or changes in the mechanisms for providing the service, according to Sonia Ahmed, one of the founders of the "Support Autistic Children" campaign, who stresses that the campaign has received complaints from parents who reported that they have been on waiting lists since 2020 at the Riyada Egyptian International Center for the Empowerment of People with Special Needs, even though a delay in starting rehabilitation interventions costs the child decisive years of development opportunities, and she stresses the importance of early intervention in supporting the acquisition of skills, while needs and outcomes vary from one child to another.
She explains that the campaign has recorded, through testimonies from people dealing with some rehabilitation centres, complaints that the Comprehensive Rehabilitation Center for People with Disabilities in Borg El-Arab in Alexandria, which opened in September 2025 as part of the presidential initiative "Haya Karima", which the Shabab 2030 Foundation manages under a ministerial decision, and which was supposed to provide medical and rehabilitation services free of charge or for nominal fees, has come to focus more on services of an investment nature, considering that this contradicts the purpose for which it was established. These complaints are attributed to the campaign, and the material does not include a direct response from the operating foundation to this description.
She stresses that the financial cost represents the greatest burden on families, explaining that providing an integrated rehabilitation programme that includes speech therapy sessions, academic rehabilitation, sensory therapy, social skills training and sports activities requires, according to her estimate of the prices she follows, between EGP 35,000 and EGP 50,000 per month, a sum that exceeds the capacity of most Egyptian families, forcing them to choose between services and give up some of them, and academic support is often the first thing abandoned because of its high cost.
She tells "Zawia3": "The continued failure to operate the Riyada Egyptian International Center for the Empowerment of People with Special Needs in 10th of Ramadan City, which belongs to the Ministry of Education, effectively represents a waste of great potential, and we demand a review of the mechanisms for its management and operation, and that the management of such facilities be entrusted to cadres with specialised expertise in special education and the rehabilitation of children with autism spectrum disorder, who have practical and academic experience in the field".
According to a medical source, the rehabilitation centre for people with special needs in 10th of Ramadan City had written to the Ministry of Health in 2023 requesting physiotherapy doctors to work there, and on that basis the Ministry of Health included the centre among the placement destinations and preferences for mandatory assignment; however, after the assignment results were announced, the doctors who had been nominated to work at the centre were surprised to be redistributed to other bodies and did not take up work at the centre.
The source explains to "Zawia3" that this happened despite the centre’s need for this specialty in light of the services that the Ministry of Education announced it would provide when the centre opened, which include physiotherapy, occupational therapy, sensory integration and hydrotherapy, as well as other rehabilitation services, which means that the cases attending the centre may not benefit from its therapeutic services as required, while testimonies from parents of children with intellectual disabilities confirm that the centre suffers from an acute shortage of specialists and specialised therapists.
Sonia, for her part, recalls her personal experience with one of the government services at the beginning of the treatment journey of her 16-year-old son, who is diagnosed with autism, during which the low cost of the sessions was not enough to guarantee the quality of the service, as the family would go to the hospital more than once only to be surprised by the specialist excusing himself from attending without prior notice, which led her to stop using the service after a short period.
She adds that some government centres provide good services in terms of the level of their specialists, but they set a time limit not exceeding three months for benefiting from the sessions before ending the service to give other families a chance, which does not suit the nature of rehabilitation, because a child usually needs longer periods before the results of interventions begin to appear.
Sonia says that some centres end the sessions after three months to make way for other families, even though children need continuity of rehabilitation.
She also criticises some centres’ requirement that children be admitted after the age of six or after joining the education system, considering that these conditions deprive a large number of children of benefiting from the years of early intervention, and also exclude children who have been unable to join inclusive education or who have multiple disabilities.
The Ministry of Social Solidarity’s published conditions for comprehensive rehabilitation centres stipulate that the accepted age varies according to the type of service requested, and they do not set the age of six as a uniform limit for all services. The above complaints remain related to families’ experiences with specific centres and programmes.
She believes that the system of rehabilitation services needs a comprehensive restructuring that guarantees that services are made available fairly and effectively to all children, instead of being limited to small numbers or subject to conditions that restrict access to them, and she believes that the priority should be to provide efficient government rehabilitation centres that offer integrated services on a continuous basis, to enable the person with an intellectual disability to acquire the greatest possible degree of independence and self-reliance, and the highest possible level of productivity within society.
Dr Mohamed Mohsen says that the crisis over the assignment of the 2022 physiotherapy graduating class, and the accompanying official assurances that assignment had become linked to actual need and the absence of vacant places, raises questions in light of incidents of staff shortages that call for clarification and review. This question highlights the difference between the existence of doctors looking for a placement and the ability of rehabilitation facilities to attract the specialties they need and to employ them on a continuous basis.
According to the statement of the official source at the Ministry of Social Solidarity, the number of government comprehensive rehabilitation centres affiliated to it, which provide care and rehabilitation services for persons with disabilities, is about 27 centres nationwide, and the services they provide include physiotherapy, sensory integration and the development of skills and abilities, as well as early intervention programmes and nurseries, academic and educational rehabilitation services, and cultural, recreational and sports activities.
The service network includes care and rehabilitation institutions and social rehabilitation offices, as well as centres established or upgraded under the “Haya Karima” initiative, among them the Borg El-Arab centre in Alexandria. Egypt’s periodic report published in September 2025 before the African Committee on the Rights of the Child records 78 residential institutions, 72 outpatient care and rehabilitation institutions, 225 rehabilitation offices and 25 integrated rehabilitation centres, within a network that includes other services. These figures represent a count that appeared in that report, while the official source speaks of 27 centres at the time of the interview. The functions of the institutions, centres and offices also differ, so adding up their numbers does not mean that they all provide therapy or speech therapy sessions. Support services include assessing cases, preparing reports and referral to the appropriate bodies, and help in obtaining some assistive devices, vocational rehabilitation and training in crafts.
Management and Operation: What Does the Ministry of Social Solidarity Say?
In the same context, an official source at the Central Administration for the Affairs of Persons with Disabilities at the Ministry of Social Solidarity tells "Zawia3" that the ministry supervises 27 rehabilitation centres nationwide, which vary in their capabilities according to the date of their establishment and the upgrading projects that have covered them, explaining that the services complex for persons with disabilities in Al-Asmarat has advanced equipment, while other centres have been established in various governorates, among them Borg El-Arab in Alexandria, as well as centres upgraded within the framework of the presidential initiative that include sensory rooms, psychomotor rooms, learning resources and specialised equipment.
Regarding the specialised centre in 10th of Ramadan City, the source stresses that it does not belong to the Ministry of Social Solidarity, but falls under the Ministry of Education, noting that the building was constructed with great capabilities and includes advanced equipment, but has not yet reached the level of full operation, which has been reflected in the extent to which its services are used, pointing out that the success of rehabilitation centres is not linked to the physical infrastructure alone, but depends to a large degree on the management style, explaining that in a number of centres the ministry is moving towards entrusting operation to specialised associations or civil society foundations, giving them greater flexibility in attracting technical staff, obtaining grants and donations, and developing services on a continuous basis, which is difficult for government bodies to do by virtue of the nature of administrative procedures.
He shows that there is a fundamental difference between the ministry’s rehabilitation offices and its comprehensive rehabilitation centres, pointing out that the role of rehabilitation offices is limited to registering disability cases and issuing rehabilitation certificates and integrated services cards through the electronic system, while rehabilitation centres are integrated service facilities that include rehabilitation, treatment, vocational training and language rehabilitation services, as well as nurseries, and some of them provide residential accommodation for cases that need it.
He stresses that many associations and civil society foundations provide rehabilitation services of a good standard, pointing out that some foundations have qualified staff and suitable equipment, and provide specialised services even though families bear the cost of those services, considering that the main goal of rehabilitation programmes is not to "cure" the child of the disability, but to improve his functional and life abilities and develop self-reliance skills to the greatest possible degree.
On the other hand, he criticises what he described as the spread of some inaccurate diagnoses in a number of private rehabilitation centres, such as attributing the symptoms of developmental disorders to "environmental deprivation" or excessive screen use, stressing that such explanations may lead to delaying the correct diagnosis, and consequently to wasting the golden period of early intervention, which is the most important in improving rehabilitation outcomes, noting that a wrong diagnosis may also affect the stability of the family, if one of the parents is held responsible for the child’s condition without scientific basis.
Funding Social Protection Does Not Equal Funding Rehabilitation
International cooperation projects related to disability in Egypt have included support for establishing and upgrading rehabilitation centres, prosthetic limb units and adapted means of transport, as well as capacity building and improving inclusion. Among the partnerships reviewed by the report are projects with Japanese support and others with Emirati support, but the objectives of the projects differ between providing a direct service and developing policies and institutions, and not every funding for social protection can be treated as allocated to rehabilitation.
With the launch of the “Takaful and Karama” programme in 2015, international funding for social protection expanded. The World Bank explains that its support included $900 million for the Strengthening Social Safety Nets project, then another loan worth $500 million, for a total of $1.4 billion. The work included developing cash transfers, beneficiary databases and targeting mechanisms, along with supporting disability assessment tools and economic inclusion programmes. But this sum concerns a social protection programme that also benefits the poor, the elderly, orphans and families with children, and does not represent funding allocated entirely to disability or to children’s rehabilitation centres.
The issuance of the Law on the Rights of Persons with Disabilities No. 10 of 2018 was an important legislative milestone. On a separate track, partnerships with the European Union and the Italian Agency for Development Cooperation supported institutional capacity building and the strengthening of rights and access to services and information. The announced agreements include, for example, an Italian grant worth EUR 1.8 million to promote the rights and inclusion of persons with disabilities, which appeared in the 2024 cooperation round-up. The coincidence of these projects with the issuance of the law is not enough to prove that the law alone was the reason for the funding, nor does the value of the agreement mean that the whole sum was spent on rehabilitation sessions.
The memorandum on Egypt issued by the Global Disability Summit in June 2025, based on data from the Development Assistance Committee of the Organisation for Economic Co-operation and Development for 2023, shows that 3% of activities funded by official development assistance in Egypt recorded the inclusion of persons with disabilities as a principal or significant objective, compared with 29% classified as not targeting this objective, while no classification data were available for 68% of activities. These percentages are measured by the number of activities, not by the value of the money. The Amman-Berlin Declaration aims for the proportion of programmes that adopt disability inclusion to reach at least 15% by 2028.
This reporting gap illustrates the difficulty of assessing the extent to which international funding takes into account the rights of persons with disabilities. Unclassified activities do not necessarily exclude them; rather, it means that the data do not allow a definitive conclusion. At the level of local services, 1.5 million integrated services cards were issued during 2024, but the number of cards does not equal the number of beneficiaries of rehabilitation sessions, nor does it alone prove a decline in waiting lists. It is therefore necessary to distinguish between cash transfers, proof of disability and receiving a regular rehabilitation service when assessing the impact of spending.
Regular Service Is the Test
Between the mothers’ stories, the specialists’ testimonies and the statement of the official source, the obstacles of waiting, expenses and lack of continuity of service recur. These interviews offer examples of the problems of access to rehabilitation, and do not represent a statistical survey of all centres or a national measurement of the length of waiting lists. Children’s needs also differ, and the number of sessions that a family mentions cannot be turned into a general therapeutic recommendation for all children.
While the state has expanded the establishment of new centres, and local and international support and funding programmes have increased, the gap remains between the announced capabilities and the actual service that reaches families.
Given the growing number of children with disabilities, which the arithmetic estimates given here indicate exceeds 1.2 million children, the challenge remains to make the appropriate service available for each case. An equipped building, a services card or the announcement of a new centre: none of these is a substitute for providing qualified specialists, individual assessment, clear appointments and continuous services that the family can access and afford. This is the difference that the mothers sum up, between waiting for a call from a government centre and paying a monthly bill that may swallow up the greater part of the family’s income.
