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 both children. Lengthy procedures and waiting lists, she says, have prevented them from benefiting meaningfully from those services.
This report draws on interviews and accounts collected before its submission in August 2026. The children’s ages, treatment costs and waiting-list situations reflect what families reported at the time of those interviews. They are not a survey of service prices or confirmation that every family’s circumstances remain unchanged at publication.
Over the previous ten years, Hafez had repeatedly visited public hospitals, including Abu El-Rish and El-Demerdash, as well as the Hearing and Speech Institute and the Poliomyelitis Institute. She was seeking examinations, assessments and the medical reports needed to establish her children’s disabilities. She frequently encountered absent doctors or postponed appointments. On one occasion, she spent an entire day at a hospital only to receive another appointment rather than an examination.
Hafez would leave her home in Shubra El-Kheima, Qalyubia, at six in the morning with both children. The journey took about an hour and a half, involved three different forms of transport and cost approximately EGP 200 per visit. Once there, they would wait hours to book a place and then wait again for the doctor. Sometimes the consultation was postponed. For her family, this made supposedly free or low-cost speech therapy impractical.
“The consultation would last only a few minutes, without a real examination of the children, an explanation of their condition or a discussion of treatment options,” she tells Zawia3. “Some doctors would quickly write prescriptions and then direct us to their private clinics for follow-up.”
She says the prescribed medicines were not available in hospital pharmacies, even though she considered them essential, forcing her to buy them elsewhere. Some cost between EGP 600 and EGP 1,500 per pack, placing a substantial financial burden on the family.
In 2024, Hafez visited a social rehabilitation office to renew her children’s Integrated Services Cards. An employee told her about a comprehensive rehabilitation centre in Ard Nubar, Shubra El-Kheima, that offered the speech therapy, skills development and occupational therapy they needed free of charge.
When she went to the centre, she was asked to register both children’s names and her telephone number on a waiting list. Staff would contact her when two places became available, as the centre was already operating at its maximum capacity for children with intellectual disabilities. Her wait, however, stretched to approximately two years.
Hafez registered her children on a waiting list in 2024. She says the wait extended to around two years.
Ultimately, she turned to private rehabilitation centres, where she pays at least EGP 100 per session. She puts the total monthly cost of sessions at EGP 6,000 to EGP 7,000 and describes a further EGP 2,500 in expenses adding to the pressure on the household budget. Her family’s monthly income does not exceed EGP 12,000, and they live in an apartment rented under the newer rental system.
A monthly bill that cannot wait
Five years before her interview, Donia Mohamed went to the outpatient clinics at Qasr El-Aini Hospital to have her daughter assessed. The girl, nine at the time of the interview, was diagnosed with autism spectrum disorder. Doctors evaluated her condition and identified a rehabilitation plan, but the family was not provided with therapy sessions at the hospital or medicines from its pharmacy. They therefore paid privately for speech therapy, skills development and sensory integration services.
“My daughter attends day care five days a week at a private rehabilitation centre offering speech therapy, skills development, behavioural support and occupational therapy,” Mohamed tells Zawia3. “The monthly subscription is EGP 5,000 and is subject to annual increases. She also has three sensory integration sessions a week at EGP 120 each, physical activity twice a week at a sports academy costing EGP 1,500 a month, and around EGP 2,000 in transport expenses.”
Her daughter also needs regular appointments with a neurologist and a clinical nutrition specialist. Each consultation costs between EGP 600 and EGP 1,000, in addition to medicines whose prices keep rising. Mohamed estimates the combined monthly rehabilitation and treatment bill at almost EGP 15,000. The parents’ combined monthly salaries do not exceed EGP 25,000, from which they also pay their apartment instalments, living expenses and their younger son’s schooling.
Facing these costs, Mohamed went in January 2026 to the disability centre at the Integrated Services Complex in Asmarat, in Cairo’s Mokattam district. She sought speech therapy, skills development, support for learning difficulties, sensory integration, occupational therapy, psychomotor services and family counselling. She says an employee simply added her daughter’s name to a long waiting list and promised to call when her turn came. That call had not arrived by the time of the interview. The complex’s construction cost had been announced as EGP 76 million in July 2020. Social Solidarity Minister Maya Morsy subsequently visited it in February 2025; that later visit was an inspection, not a new opening of the complex.
Another mother, Hoda Hassan, used to take three forms of transport from her home in El-Marg to Abbasiya Mental Health Hospital, spending more than EGP 100 on the journey. Her son, who has developmental difficulties and brain atrophy, received speech therapy, skills development and behavioural support at nominal prices, as well as medicines from the hospital pharmacy.
Her son, ten at the time of the interview, subsequently lost access to the sessions because he had exceeded the programme’s age limit, she says. Hassan took him to El-Demerdash Hospital instead, where speech therapy cost EGP 25 per session and skills development EGP 75. Transport raised the total daily expense to around EGP 250. After four months, she stopped taking him there.
When Hassan learned of the services advertised at the Egyptian International Riyada Centre for Empowering People with Special Needs, overseen by the Ministry of Education, she considered moving so her son could attend. The centre is in Tenth of Ramadan City, Sharqia, where her family is from. In an official presentation of its services in April 2025, the education minister described it as one of the largest rehabilitation facilities in the Arab world and Africa. Its advertised facilities include eight hearing-treatment clinics, four speech-therapy rooms, and rooms for family counselling, skills development, play, occupational therapy, sensory integration, behavioural support and cognitive therapy. It also offers physiotherapy, hydrotherapy, artistic and sporting activities, vocational training and approximately 25 rooms for accommodation or hosting.
For months, Hassan waited for a call confirming her son’s admission after his name was placed on a waiting list. It never came. She instead found a private centre near her home charging EGP 120 a session. She says her son needs 60 rehabilitation sessions a month across speech therapy, skills development, sensory integration, occupational therapy, behavioural support and physical rehabilitation. But she can afford only 12 speech-therapy sessions. As the sole provider for three children, with an income of no more than EGP 4,000, she says these financial constraints have adversely affected her son’s progress.
What disability and education figures measure
The figures indicate extensive demand for disability services, but they require distinctions between population groups and years of measurement. The 2017 census recorded difficulties ranging from mild to complete among 10.67% of people aged five and above, compared with 2.61% reporting severe to complete difficulties. Circulating estimates of ten million to 12 million people cannot be combined with a figure of 15% as though they came from a single census or measured demand for rehabilitation. At a National Council for Persons with Disabilities workshop in May 2026, a figure of 3.1% of children was presented using data from Egypt’s statistics agency. Applying that proportion to an estimated 39.7 million children produces an approximate figure of 1.23 million. It does not represent the number on waiting lists or the number needing the same type of rehabilitation.
According to Ministry of Education figures published in November 2024, 159,825 students were enrolled in inclusive education across general and technical schools. Ministerial Decision 252 of 2017 set a maximum of 10% of a class, with no more than four included students in one classroom. The arrangements described cover mild or moderate disabilities and conditions including mild intellectual disability, slow learning, autism spectrum disorder, Down syndrome, physical disability, cerebral palsy, hearing and visual impairments, blindness, Irlen syndrome, learning difficulties and attention deficit hyperactivity disorder.
Special education schools and classes provide another route for students with moderate and severe intellectual, visual or hearing disabilities. These include schools serving intellectual disabilities and associated conditions, including Down syndrome, autism, cerebral palsy and slow learning; schools for deaf and hard-of-hearing students; schools for blind and partially sighted students; and classes for students with multiple disabilities. The education figures cited put special education enrolment at approximately 46,994. These are numbers enrolled in education, not a measure of those receiving rehabilitation sessions or waiting for them.
Waiting lists and shortages of specialists
Many families struggle to reach government rehabilitation services because of lengthy waiting lists, limited operations or changes to how services are delivered, says Sonia Ahmed, a co-founder of the Support Children with Autism campaign. She says the campaign has received complaints from parents who have been on waiting lists at the Riyada centre since 2020. Delayed intervention, she argues, costs children important opportunities to develop skills. She stresses the value of early support while recognising that children’s needs and outcomes differ.
Ahmed says the campaign has also collected complaints from users of some rehabilitation centres about the comprehensive rehabilitation centre in Borg El-Arab, Alexandria. Opened in September 2025 as part of the Decent Life initiative, it is operated by the Youth 2030 Foundation under a ministerial decision. According to the complaints the campaign received, a facility expected to provide free or nominally priced medical and rehabilitation services has increasingly focused on commercially oriented services. Ahmed believes this conflicts with its intended purpose. These allegations are attributed to the campaign; the reporting does not include a direct response from the operating foundation to that characterisation.
Cost is the greatest burden, Ahmed says. Based on the prices she follows, she estimates that a comprehensive programme combining speech therapy, academic support, sensory therapy, social-skills training and sporting activities can cost EGP 35,000 to EGP 50,000 a month. Such amounts are beyond the means of most families, forcing them to choose between services and give some up. Academic support, she says, is often the first to be dropped because of its expense.
“The continued failure to operate the Egyptian International Riyada Centre in Tenth of Ramadan City effectively represents a waste of considerable resources,” she tells Zawia3. “We call for its management and operating arrangements to be reconsidered, and for such facilities to be run by people with specialist expertise in special education and rehabilitation for children on the autism spectrum, with practical and academic experience in the field.”
A medical source says the Tenth of Ramadan City centre asked the Ministry of Health in 2023 to provide physiotherapists. The ministry consequently included the centre among the destinations available in its graduate assignment process. Yet, after the results were announced, the source says, doctors selected for the centre were reassigned elsewhere and never took up work there.
The source tells Zawia3 that this happened despite the centre’s need for that specialty, given the services the Ministry of Education had advertised, including physiotherapy, occupational therapy, sensory integration and hydrotherapy. The source argues that this may prevent patients from benefiting fully from the facility’s therapeutic services. Parents of children with intellectual disabilities also describe a serious shortage of specialised therapists and practitioners.
Ahmed recalls her own early experience seeking a government service for her autistic son, who was 16 at the time of her interview. Low session fees did not guarantee a reliable service. Her family went to the hospital several times only to discover that the specialist had cancelled without prior notice. They stopped using the service after a short period.
Some government centres employ good specialists, she adds, but limit access to sessions to three months before discharging a child to make room for another family. In her view, that arrangement conflicts with the continuity rehabilitation requires, as children often need longer before the effects of an intervention become apparent.
Ahmed says some centres end sessions after three months to admit other families, even when children need continuing rehabilitation.
She also criticises centres that accept children only after the age of six or after they enter formal education. Such conditions, she argues, exclude children from early intervention opportunities and can shut out those unable to access inclusive schooling or those with multiple disabilities.
The Social Solidarity Ministry’s published eligibility rules for comprehensive rehabilitation centres say that age requirements vary by service. They do not establish six as a universal minimum age for all services. The preceding complaints concern families’ experiences with particular centres and programmes.
Ahmed calls for a comprehensive restructuring of rehabilitation services so that access is fair and effective, rather than limited to small numbers or constrained by restrictive conditions. Her priority is competent government centres providing integrated, continuous services that help people with intellectual disabilities develop as much independence, self-reliance and participation in society as possible.
Dr Mohamed Mohsen says the difficulties surrounding physiotherapy assignments for the class of 2022, alongside official statements linking assignments to actual demand and the absence of vacancies, raise questions when set against accounts of understaffing that require explanation. The issue exposes the gap between doctors seeking assignment and rehabilitation facilities’ ability to recruit and continuously employ the specialties they need.
According to the official source at the Ministry of Social Solidarity, the ministry oversees approximately 27 comprehensive rehabilitation centres nationwide. Their services include physiotherapy, sensory integration, skills and capacity development, early intervention programmes and nurseries, academic and educational rehabilitation, and cultural, recreational and sporting activities.
The service network also includes residential and non-residential care institutions and social rehabilitation offices, alongside centres built or upgraded through Decent Life, including Borg El-Arab. Egypt’s periodic report published in September 2025 before the African child-rights committee lists 78 residential institutions, 72 non-residential care and rehabilitation institutions, 225 rehabilitation offices and 25 integrated rehabilitation centres, within a wider network. Those figures reflect the inventory presented in that report; the official interviewed for this article referred to 27 centres. The institutions also perform different functions, so adding them together does not mean that all provide therapy or speech sessions. Supporting services include assessments, reports, referrals, assistance in obtaining certain assistive devices, vocational rehabilitation and training in trades.
Management and operations: the ministry’s perspective
A source at the Ministry of Social Solidarity’s Central Administration for Persons with Disabilities tells Zawia3 that the 27 centres vary in their resources, depending on when they were established and which development projects have covered them. The Asmarat complex has advanced equipment, the source says, while centres in other governorates, including Borg El-Arab, and facilities upgraded through the presidential initiative have sensory and psychomotor rooms, learning resources and specialised equipment.
The source emphasises that the Tenth of Ramadan City centre belongs to the Ministry of Education, not the Ministry of Social Solidarity. Although it was built with substantial resources and advanced equipment, the source says it had not reached full operation, reducing the benefit available from its services. Successful rehabilitation centres depend on management as well as buildings. The social solidarity ministry has therefore been assigning operations at some centres to specialised civil society organisations, the source explains, giving them greater flexibility to recruit technical staff, secure grants and donations and develop services than government administrative procedures allow.
The source distinguishes between rehabilitation offices and comprehensive rehabilitation centres. Offices register disability cases and process rehabilitation certificates and Integrated Services Cards through the electronic system. Centres, by contrast, combine rehabilitation, treatment, vocational training, language support and nurseries, with some offering residential care for those who need it.
Many civil society organisations provide good rehabilitation services, the source says. Some have qualified staff and suitable equipment and deliver specialist care, although families must pay for it. The purpose of rehabilitation, the source stresses, is not to “cure” a child’s disability, but to improve functional and daily-living abilities and develop the greatest possible degree of independence.
The source also criticises what they describe as inaccurate diagnoses in some private rehabilitation centres, including attributing developmental symptoms to “environmental deprivation” or excessive screen use. Such explanations can delay an appropriate diagnosis and waste valuable opportunities for early intervention, they say. Incorrect diagnoses can also destabilise a family when a parent is blamed for a child’s condition without a scientific basis.
Social protection funding is not a rehabilitation budget
International cooperation projects connected to disability in Egypt have included support for building and improving rehabilitation centres, prosthetics facilities and accessible transport, alongside capacity building and inclusion. Partnerships reviewed for this report include Japanese and Emirati support. Their objectives differ, however, from direct service provision to the development of institutions and policies. Not all funding for social protection can be treated as money earmarked for rehabilitation.
International funding for social protection expanded after Takaful and Karama was launched in 2015. The World Bank describes support of USD 900 million for the Strengthening Social Safety Nets Project and a further USD 500 million loan, totalling USD 1.4 billion. The work has included cash transfers, beneficiary databases and targeting mechanisms, alongside support for disability assessment tools and economic inclusion. But the programme also serves poor households, older people, orphans and families with children. The total is not a budget devoted entirely to disability or children’s rehabilitation centres.
The enactment of Disability Rights Law 10 of 2018 was an important legislative milestone. Separately, partnerships with the European Union and the Italian Agency for Development Cooperation have supported institutional capacity, rights and access to services and information. Announced agreements include an Italian grant of EUR 1.8 million to promote the rights and inclusion of persons with disabilities, listed in the government’s 2024 cooperation review. The timing of these projects does not establish that the law alone caused the funding, nor does an agreement’s value mean that the full amount was spent on rehabilitation sessions.
The Global Disability Summit’s Egypt briefing note, dated June 2025 and drawing on OECD Development Assistance Committee data for 2023, reports that 3% of official-development-assistance-funded activities in Egypt identified disability inclusion as a significant or principal objective. A further 29% were classified as not targeting that objective, while 68% had no reported disability-marker classification. These percentages refer to numbers of activities, not the monetary value of aid. The Amman-Berlin Declaration aims for at least 15% of programmes to pursue disability inclusion by 2028.
The reporting gap makes it difficult to evaluate how far international funding incorporates disability rights. Unclassified activities are not necessarily exclusionary; the data are insufficient to determine their orientation. Domestically, 1.5 million Integrated Services Cards were issued in 2024. Yet card numbers do not equal the number of children receiving rehabilitation sessions and cannot, by themselves, establish that waiting lists have shortened. Assessing spending therefore requires a distinction between cash transfers, formal recognition of disability and regular access to rehabilitation.
The test is a reliable service
Across mothers’ accounts, specialist testimony and the ministry source’s explanation, the recurring barriers are waiting, expense and interrupted services. The interviews illustrate access problems; they are not a statistical survey of every centre or a national measurement of waiting-list lengths. Children’s needs also differ. A session count reported by one family cannot be treated as a general treatment recommendation for all children.
While the state has expanded the construction of centres and domestic and international support programmes have grown, the accounts show a continuing gap between advertised capacity and the service families actually receive.
With the approximate calculation discussed here indicating more than 1.2 million children with disabilities, the challenge is to make appropriate services available for each child’s needs. A well-equipped building, a services card or the announcement of a new centre cannot substitute for qualified specialists, individual assessment, clear appointments and continuous care that families can reach and afford. For the mothers interviewed, that difference is expressed in the wait for a call from a public centre and the monthly private bill that may consume most of a household’s income.
