استعرض مصدر Population Ageing - Egypt Report

== Health care services==
Population aging is a great challenge for the health care systems. Although the health status of older people is improving over time now and the life expectancy is increasing, still, with aging, the prevalence of disability, frailty, cancer, and chronic diseases (Alzheimer's disease, cardiovascular and cerebrovascular diseases, etc.) is expected to increase, especially with the large growth in the oldest old group (+70yrs old) that constitutes 31.73% of the Egyptian elderly and 2.5% of the Egyptian population. The older the person is, the more likely they are to face a compounding of multiple health, psychological and social problems that make accurate medical diagnosis and proper medical management difficult.

Elderly people have high risk for functional impairments with inability to perform ordinary activities of daily living (ADL) and activities related to household management termed instrumental activities of daily living (IADL). 

Therefore, a country in which there are increases in the older population has to be prepared for the epidemiologic transition from infectious diseases of the young population to the chronic diseases of the old population. In such conditions health services and resources have to be directed to medical care as well as home and institutional care.

Various services for elderly are provided through governmental, private, and non- governmental sectors. The government also provides some medical services through the medical insurance scheme. It has been estimated that 6% of the total population have been covered by the Health Insurance Organization (HIO).

The Egyptian national medical security covers all pensioners with subscription of 1% from monthly pension salary (2% for widows). The medical services are distributed all over the governorates.

In addition to the general health services, whether governmental or private, available for the use by the elderly, there are other special services for the older people that have developed in Egypt.
Since 2007, 11 geriatric healthcare centers (offering health care services to elderly people through specialists from different branches) have been set up by the Ministry of Health distributed all over the governorates. 

Ministry of Health has also established Clinical Diagnostic Service to the dementia patients (Memory clinic in hospitals) since January 2000. The service included assessment service, counseling and family support.

Outside the ministry of health, academic units provide a very satisfactory unique model of care including; 
• Geriatrics and Gerontology Department - Ain Shams University
The Geriatrics and Gerontology Department at Faculty of Medicine- Ain Shams University started in 1982, as a day care unit providing services to the elderly patients of the medical and psychiatry department, then development and growth went on where an outpatient clinic was established and the department was developed in 1994, and over time more services were developed in the department including geriatric intensive care unit in 2000, and an osteoporosis unit in 2002.

The department involved 23 inpatient, plus 9 ICU beds, an osteoporosis Unit which offers diagnostic and therapeutic services, and daily outpatient clinic. Comprehensive geriatric assessment is being carried out through a multidisciplinary team including geriatricians, nurses, social workers, physiotherapists, psychologists, dieticians, and speech therapists. In addition to the care offered to the patient, family and caregiver education and psychological support is offered by the team. 

Currently the department is being renovated; the 3 floor building was put down and in its place a 7 floor building is being established with a capacity of 109 beds including 36 ICU beds. The new hospital will be offering several levels of care including acute and subacute care, long term care and day care services.


===Center of elderly care, Helwan University (CEC)===
The center of elderly care - Helwan University was established in 1996, as a self-financed unit under the umbrella of the center for community development in Helwan University. Services offered include; 10 inpatient beds, day care services and out-patients clinic. 

A Long term unit is also available in the CEC mainly for frail older people who are functionally dependent on others for their ADLs and IADLs. 

Examples of other unique centers include; center of geriatric service, Nasr city, and geriatric department in Palestine Hospital.

Military hospitals also provide elderly care services, and NGOs and the private sector also play a role. 

In addition, population aging implied new services that meet the specific needs of the elderly including homes for the aged and geriatric clubs. 

As for the Egyptians themselves, the family has been and still is the main social institution, which offers support and services to the aged. According to a report from Cairo Demographic Center most elderly people (66.8%) live with sons and daughters and (13%) live with spouse. A small percentage (9.1%) of elderly people live with relatives other than mentioned above and the same percentage live alone due to different reasons.

However, social changes e.g. rural-urban migration with older people left behind, Egyptian women increasingly being employed outside homes, changing in housing stock (nuclear instead of extended family) and decreasing family size with fewer people in the 'young generation' available to take care of larger numbers of people in the 'old generation', have created some demands for extra-familial services.

All these factors caused changes in living arrangements resulting in an increasing number of older people living alone especially females, raising the need for institutions for the aged. 
 The beginning of the twentieth century witnessed a great concern of the Egyptians about institutions. The establishment of the first ministry of social affairs in 1939 represented a milestone in social work. Since then, official policy s encouraged and supported social work through numerous associations. One of these is the General Association for the Care of the Aged established in 1981 to offer social, cultural, and religious services to the aged with branches in different governorates. The association has given the priority to two services: setting up homes and clubs for the aged and training staff for this purpose. By the financial support of the Ministry of Social Affairs, several ssociations have set up homes in different parts of the country.

The participation of NGOs in care of elderly started before 1939. Many houses for the elderly had been established by local and foreign social organizations before that date; many of these houses are still operating in the present and such services were sometimes offered on a religious basis. 

The first home for aged in Egypt was established in 1900. In 1980, the total number of geriatric homes in Egypt was 63, increasing to 94 in 1990, 103 in 2000, 161 in 2011and currently reaching to 170 in 2015 with a capacity of more than 4,800 elderly. All of the registered geriatric homes are supervised by the ministry of social affairs.

These homes provide medical, social and recreational services and allow the elderly to live with dignity.

Several elderly clubs have been established all over the country with different activities practiced under the supervision of the organizing committees and the ministry of social affairs. The number of these clubs was 50 clubs in 1990, and increased to be 110 in 1999 with a ratio of increase 120%. The numbers of elderly who benefited from this service were 8,538 in 1990 which increased in 1996 to be 23,970 with an increase of 181%. In 2011, there was 193 clubs with 40,171 elderly benefiting from them. Currently, the number of these clubs reached 196 all over Egypt.

The day services are offered in the elderly clubs through which medical, social and recreational services are introduced.

Since 2011, 52 physiotherapy units attached to the geriatric homes and clubs are offering rehabilitation for 50,000 elderly.

In 2009, the Ministry of Social Affairs developed offices (most of them were attached to elderly clubs) that provide home care services (as basic activities of daily living) for the elderly especially those living alone. These offices were 30 distributed all over the Egyptian governorates serving 40,000 elderly but unfortunately this service stopped in 2011.

There are 857 NGOS concerned with geriatric care and their branches are distributed all over the Egyptian governorates. In spite of being a large number, this represents only 1.55% of the whole Egyptian NGOS. NGOs play a key role in the field of social work in support of governmental plans. They carry out their plans within the framework of stable regulatory and structural mechanisms, namely the General Union of NGOs, regional unions and specific unions.

Some of them are offering social and medical services e.g. the Egyptian society of geriatric care. Others are scientific e.g. Egyptian Society of Gerontology, Egyptian Alzheimer's Society, and Egyptian Society of Psycho-geriatrics. Some of these NGOS do provide some integrated services in the form of homes for the aged along with hospital and religious services.

Still, there is minimal role of NGOS in policy planning of care of elderly, in research work, and in media to increase the awareness of population by the problem of aging. Every individual organization works separately, with minimal communication between each other.

 Alzheimer Egypt society was started in 1999. It aims at raising awareness among the health and social care providers to persons with dementia and their caregivers. It has many activities such as monthly "Alzheimer café" a meeting to support persons with dementia and their carers; annual celebration of the "Alzheimer day"; non-regular Alzheimer bulletin; and a health education book for caring after persons with dementia at home.

 The Egyptian Society of Geriatrics and Gerontology, an NGO, was founded late in the year 2014. Being founded by geriatric specialists, The Geriatric and Gerontology Department, Ain Shams Faculty of Medicine, it adopted a more specific way to decide on its goals that are to be based more on the needs of the seniors in the Egyptian community goals than most others. In order to attend to actual needs of the senior Egyptian citizens on multiple levels (e.g. medical, social, financial and any other societal services) rather than the expected, the Society started a project of building a database on the needs of the Egyptian seniors. 

 Wikiageing, a knowledge management tool, was established in 2014 by academics from Ain Shams Geriatrics and Gerontology Department. Its mission is to promote and improve the elderly care in MENA. The tool operates by the Wiki technology based on a dynamic website (http://wikiageing.org/). It is a collaborative, voluntary, open access knowledge project aiming at improving the elderly care in the Arab speaking region. Wikiageing as an open access knowledge tool provides a means to pool knowledge, categorizes knowledge, networking, and general knowledge management. 

 Several conferences, symposiums, and workshops concerned with ageing have been held in Egypt over the past years. These were sponsored by either the Ministry of Health, Ministry of social affairs, Universities, and non-governmental organizations. They were aiming to orient the health-professionals and also the general people with aging and the elderly needs.

 Media also made modifications to cope with the graying of the population. The Radio developed a channel specific for old people, and the television developed a program since 1994 called
 'Age Spring'  The national newspaper 'Al-Ahram' developed a page since 2001 named
 'Age Flower'  concerned with older people. There is also a special Radio channel for elderly named 
 "Elderly specialized Radio " broadcasted all through the day.

Large amounts of research in the field of aging was done and still ongoing to develop a data base of the elderly population and their needs.

 Bulletins are published regularly by non-governmental organizations e.g. 'towards healthy aging', 'sound of time'  "the Butterfly  ", and 'for better mental health for the elderly'.

 Social training programs are presented by the Ministry of Insurance and Social Welfare including a program for older people to prepare the population for the changes that occur after retirement.
 The whole health system in Egypt became oriented to the phenomenon of aging. For several years now, the Ministry of Health started to have residents for geriatric medicine with training courses and residency programs offered to them in collaboration with the academic departments. As mentioned above several services were established to cope with the elderly needs and others will be. A large number of Egyptian geriatric specialists and consultants are available nowadays across the country. Health professionals were trained and are being trained for geriatric care.