BACKGROUND: Children with disabilities face heightened violence risks, particularly in resource-limited settings. Despite global evidence, data on violence against children with disabilities in rural Upper Egypt remain scarce. This study aimed to determine the prevalence, types, and family-related risk factors of violence against children with disabilities in this region. METHODS: A community-based cross-sectional study was conducted (December 2023-March 2024) in two rural Upper Egypt villages. Using a multistage random sampling, 213 young adults (aged 18-24 years) with disabilities were included. Data were collected using validated structured interviews (ISPCAN tool) and focus group discussions. RESULTS: The sample comprised 54% males and 46% females. Around 50% primarily had intellectual, and 33.8% had physical disabilities. Emotional violence was nearly universal (93.1 in males, 100% in females), followed by physical (73.6-78.6%) and sexual violence (21.1-26.4%). Females experienced higher violence rates (50% vs. 9.6% males, p < 0.001). Parental drug abuse (22.6% males vs. 10.2% females, p = 0.02) and low socioeconomic status (59.1% vs. 43.9%, p = 0.03) were significant risk factors. Intellectual disabilities correlated with elevated sexual violence Perpetrators included parents (35.4-41.8%) and unrelated individuals (44.3-60%). CONCLUSIONS: Systemic violence against children with disabilities in rural Upper Egypt was pervasive, driven by poverty, low parental education, and gender disparities. Interventions must address familial and community-level factors, including economic support, parental education, and stricter enforcement of child protection laws.
Wafaa Abdel-Ghaffar Ali, Ahmed M. Gad-Allah, Seham Abokresha et al.
OBJECTIVES: Teenage pregnancy and motherhood is a crucial problem in countries of the World Health Organisation Eastern Mediterranean Region (WHO-EMR). The aim of this paper is to describe and analyse the phenomenon of adolescent childbearing in ten countries according to social determinants like milieu (rural-urban), education level, wealth quintiles, territoriality (countries, regions) and nationality. METHODS: Inequity in terms of adolescent childbearing was analysed using disaggregated data given by Demographic Health Surveys (DHS), UNICEF Multiple Indicator Cluster Surveys (MICS) and the Pan Arab Project for Family Health (PAPFAM) surveys. Beside the absolute differences (gaps) and relative differences (ratios), the index of dissimilarity (ID) was used to compare the distributions of adolescent pregnancy and motherhood by social determinants in each country. RESULTS: Data analysis indicates that the average percentage of adolescent women aged 15-19 years who have begun childbearing shows a large difference between countries, varying from 0.4% in Tunisia to 15.1% in Sudan, combined with huge gaps within each country as indicated by the values of the index of dissimilarity. Poor, rural and non-educated adolescent girls are more exposed to teenage childbearing than their counterparts-rich, urban and educated girls. CONCLUSION: According to different social determinants, sensible variations are seen in terms of adolescent pregnancy and motherhood within the ten countries considered in this study. This is a clear appeal to decision makers to reduce child marriage and pregnancy by acting on social determinants of health, targeting disadvantaged girls coming mainly from marginalised groups and poor families living in remote rural zones.
Background: Phenylketonuria is a genetic disorder resulting from lack or inadequacyof phenylalanine hydroxylase enzyme activity. Caring for and making nutritionaldecisions for a child with phenylketonuria puts a great deal of stress on the parents.Moreover, the financial and psychological burden of the disease as well as its chronicnature could affect the psychological well-being of both parents and their childrenwith phenylketonuria. Aim: to assess the struggles and psychological well-being ofparents and their children with phenylketonuria. Subjects & Method: a correlationaldescriptive study design was conducted on of 145 parents and their children withphenylketonuria. Tools: three tools were used to collect the necessary data for thecurrent study, tool (I): Self-administered questionnaire to collect bio-socio-demographic data, tool (II): Depression, Anxiety, and Stress Scale, tool (III) TheStrengths and Difficulties Questionnaire. Results: it was found that 17.9%, 29%, and15.9% of the participant parents have extremely severe levels of depression, anxiety,and stress respectively. The results also reveal that 64.8%, 59.3%, 53.1%, and 58.6%of the studied children have emotional, conduct, hyperactivity, and peer problemsrespectively. Moreover, 62.8% of the studied children have a negative impact ondifferent areas of their everyday life related to the difficulties they have. Conclusion:the studied parents struggle to provide care and special foods for their children withphenylketonuria. Behavioral and psychological difficulties facing children withphenylketonuria affect the psychological well-being of their parents.Recommendations: further qualitative studies are needed to provide deep insightsinto challenges perceived by parents of Phenylketonuria children. Designing andimplementing training programs for parents to improve their coping strategies andpsychological well-being is mandatory
Eman Mahmoud Aboelela, Miada Mohamed Ali Hanfy, Khadiga Z.Moustafa
Nefissa Naguib’s Nurturing Masculinities is built around such conversations with working- and middle-class Egyptian men, this one with Moody, a shopkeeper from the working-class Cairo neighborhood of Bulaq. Moody and his family had recently moved to a larger apartment in one of Cairo’s new suburbs, reflecting a rise in their socioeconomic status. Nevertheless, he remained deeply conflicted about severing ties with his old neighborhood and moving to an area that “had no soul or ambience” (113). Moody shared these concerns and memories of Bulaq with Naguib over a “tin plate of ful [fava beans]” and tea in a café. Naguib argues that food is central to masculinity in Egypt and offers understudied insights into men’s vulnerabilities, affective ties, and gendered constructions of self, family, and community.Naguib’s study, based on ethnographic fieldwork in Cairo between 2011 and 2013, builds on an exciting body of anthropological literature that explores “lived masculinities.” She completed interviews with fifty men of various ages and socioeconomic backgrounds whom she had previously met during trips to Egypt in the 1980s and the early 2000s. The men were similar in being emotional, caring, generous, and protective, standing in stark contrast, Naguib argues, to the stern authoritarian Egyptian man often seen in literature. Nurturing Masculinities, which challenges the efficacy of studying masculinity in urban centers through the lens of patriarchy, is composed of an introduction and four thematically organized chapters.The first two chapters discuss the concept of “nurturing masculinities,” which Naguib defines as “men’s food talk and their efforts to care for loved ones” (33). She argues that an anthropological investigation of nurturing masculinities “problematizes the hitherto exclusive link between femininity and food in Egypt” (33) by revealing the centrality of food to men’s fluid identities as husbands, fathers, and sons. Her interlocutors, inspired by duty as well as by affection, regularly and proudly shop for fresh vegetables, fruits, and meat for their families. The work argues that the intersection of “affection and authority” undergirds a wide range of men’s activities in daily life.Chapter 2, focused on “food activism,” is based on interviews with members of the youth branch of the Muslim Brotherhood, who distribute food to the less fortunate and are highly critical of the organization’s old guard. “Islamic activism,” according to Naguib’s interlocutor Sherif Hassan, a member of the brotherhood who studied economics at the American University in Cairo, “is about telling everybody that a Muslim’s wealth is governed by communal obligations that stress the rights of the needy, poor, orphaned, and drifters” (62). In other words, food distribution is central to these young male pious activists’ identities and ideal vision of society. Naguib shows how the intersection of age and gender among these activists fractures the category of even that Egyptian masculinity. She stops short, however, of investigating how food activism relates to the identity of these activists as sons, brothers, husbands, and fathers.In chapter 3 Naguib discusses the centrality of food to men’s recollections. One of her main interlocutors, the taxi driver Mustafa Hashim, describes the importance of “samna baladi” (clarified butter): “It’s the flavor of Egyptian cooking. An ingredient an Egyptian man cannot live without” (76). Hashim explains how he lost his temper with his wife when he noticed that she was cooking rice with olive oil, not his preferred samna baladi, which is inextricably connected to his childhood and his mother. In addition to illustrating the relationship between food and memory, the anecdote demonstrates the link between consuming authentic samna baladi and being a real Egyptian man.The final chapter examines the defining characteristics of ibn al-balad in the eyes of Naguib’s interlocutors. A “real ibn al-balad,” according to Farouk Mansour, a coffeehouse owner, is “very gallant, convivial, good-humored” (98). He is playful, witty, funny, even flirtatious (108). In addition to being lighthearted or “light-blooded” (dammu khafif), a “real ibn al-balad” is generous. He provides food for less fortunate neighbors and friends. The multiple characteristics that Naguib’s interlocutors use to describe themselves convincingly problematize reducing masculinity in Egypt to one element.Naguib offers a textured and compelling examination of the centrality of food to the obligations, responsibilities, and characteristics of many Egyptian men without flattening the differences among her interlocutors. The men in Nurturing Masculinities are bakers, butchers, grocers, florists, and taxi drivers as well as college-educated social activists. Their commitments, concerns, emotions, and responsibilities are inextricably connected to and shaped by their particular experiences, revealing the plurality of Cairo’s lived masculinities. Naguib’s extensive and illuminating engagement with the secondary anthropological and historical literature at times inhibits the development of her own narrative. Nevertheless, Nurturing Masculinities is an exciting study of the masculinities of a diverse set of men in coffee shops, bakeries, and butcher shops and around the dinner table. This work is important for students and scholars of the modern Middle East, the Arab world, anthropology, and gender studies.
By the time children in low- and middle-income countries start primary school, large socioeconomic disparities are evident in children’s learning and development. Both pre-primary and home environments can play important roles in influencing school readiness and can contribute to disparities in early childhood development, but there is limited evidence on their relative roles in low- and middle-income countries. This paper examines how pre-primary quality, stimulation at home, and early childhood development vary by socioeconomic status for pre-primary students in the Arab Republic of Egypt. The results demonstrate substantial socioeconomic inequality in stimulation at home, more so than in pre-primary quality and inputs, although there is variation in the degree of inequality across different dimensions of pre-primary quality. “Double inequality” is observed, where students with less stimulating home environments experience slightly lower quality pre-primary inputs. There are particularly large pre-primary inequities in structural quality (physical environment) and less inequity in process quality (pedagogy). These results suggest that targeted investments in pre-primary education in Egypt are necessary to reduce inequality in school readiness but are likely insufficient to close the socioeconomic status gap in children’s development. Investing in interventions to improve vulnerable children’s home learning environments, as well as investing in quality pre-primary, is critical to address disparities in children’s development.
Caroline Krafft, Abbie Raikes, Samira Nikaein Towfighian et al.
BACKGROUND: Female genital mutilation and cutting (FGM/C, herein FGM) is a widespread and harmful practice. The Government developed a national campaign in Sudan, called Saleema, to change social norms discouraging FGM. Saleema translates to being "whole", healthy in body and mind, unharmed, intact, pristine, and untouched, in a God-given condition. An interim evaluation was conducted using focus groups among Sudanese adults. The primary aim was to explore perceptions of the Saleema poster exemplars and to assess if the desired themes were being communicated. Secondary aims were to understand more about participants' information sources, values, and suggestions for the campaign broadly. METHODS: The Saleema campaign evaluation included four focus groups from each of the 18 states in Sudan (72 total). Participants were presented with three poster stimuli from the Saleema campaign and asked about the content and their reactions. Themes were coded inductively by concepts that arose through content in the transcripts. Codes were also reviewed in conjunction with themes from the broader Saleema evaluation framework. RESULTS: Participants reported the most common source of information or admiration was from local leaders who are responsive to a community, media-based outlets, and discussions among community members. Participants held high value for education, community solidarity, and/or religious devotion. Participants had positive opinions of Saleema and responded positively to the branding elements in the posters and the campaign as a whole. The most common suggestion was continued awareness. Advocacy, training, and posters were suggested to highlight the harms of FGM through leaders or in community settings. Individuals suggested that these activities target older women and individuals in rural villages. There was also a burgeoning theme of targeting youth for support of the campaign. DISCUSSION: The results of this focus group analysis demonstrate support for future Saleema campaign efforts promoting awareness and community engagement. The campaign could capitalize on partnerships with young people and those who are respected in the community (e.g., religious leaders) or continue promoting common values aligning with the support of education and community solidarity. Continuing campaign efforts have promise to decrease the harms of FGM in Sudan.
Andrea C. Johnson, William Douglas Evans, Nicole D. Barrett et al.
BACKGROUND: Female genital mutilation or cutting (FGM/C) is a form of violence against women and girls that is widely performed in about 30 countries in Africa, Middle East and Asia. In Sudan, the prevalence of FGM/C among women aged 15-49 years was 87% in 2014. Little is known about household decision-making as it relates to FGM/C. This study aimed to understand the key people involved in FGM/C-related decisions, and to assess predictors of households' decision to cut or not cut the youngest daughter and the reasons for these decisions. METHODS: We drew on household survey data collected as part of a larger cross-sectional, mixed methods study in Sudan. The analytical sample comprised of data from 403 households that both reported that they had discussion around whether to cut the youngest daughter aged 19 years or younger and arrived at a decision to either cut or leave her uncut. Descriptive statistics summarizing the people involved in FGM/C-related decisions and the reasons for decisions are presented. We also present logistic regression analyses results summarizing predictors of households' decision to leave the youngest daughter uncut. RESULTS: Household decision-making on FGM/C involved discussions among the nuclear and extended family, and non-family members. Mothers and fathers were found to be the key decision makers. A greater proportion of fathers were involved in instances where the final decision was to leave the daughter uncut. Thirty-six percent of households decided to leave the youngest daughter uncut. State of residence, mothers' level of education and FGM/C status and exposure to FGM/C-related information or campaigns were associated with households' decision to leave the daughter uncut. Health concerns were the most commonly cited reason for deciding not to cut their daughters (57%), while custom or culture was the most commonly cited reason for households deciding to cut their daughter (52%). CONCLUSION: FGM/C-related decisions result from deliberations that involve many people. Our findings underscore the important role that fathers play in decision-making and highlight the need to involve men in FGM/C programs. Findings also stress the need to understand and address the drivers of FGM/C.
Majdi M. Sabahelzain, Ahmed Gamal Eldin, Suad M Babiker et al.
Female genital mutilation (FGM) is a human rights violation that continues to affect over 86% of women and girls in Egypt. While it has declined, the practice is increasingly medicalized posing a significant challenge to abandonment efforts. This study aims to examine FGM medicalization in Egypt by exploring temporal trends, subnational patterns, underlying drivers, and the legal and policy context. We employed a mixed-methods approach, including a quantitative analysis of data from the 1995-2014 Egypt Demographic Health Surveys and the 2021 Egypt Family Health Survey, complemented by existing qualitative data among parents, healthcare providers, NGO program staff, and other stakeholders. Our findings demonstrate a marked decline in FGM prevalence over time and among younger cohorts. However, medicalization has risen sharply, reaching 83% in 2021. We identified three distinct typologies of subnational patterns in FGM prevalence and medicalization: (1) governorates with high FGM prevalence and high medicalization; (2) governorates where FGM persists but medicalization remains lower, and traditional practitioners like dayas - traditional cutters - are still commonly used; and (3) governorates with lower FGM prevalence but high rates of medicalization among those still undergoing the practice. Factors driving the medicalization of FGM in Egypt include persistent cultural beliefs that frame medicalized FGM as a safer option and means of beautification, parental deference to medical providers and a reliance on their "expertise" to determine the necessity for the procedure, limited awareness of FGM health consequences and legal prohibitions, and weak enforcement of penalties. To advance concrete action on medicalized FGM, a multi-level approach is essential-one that strengthens the enforcement of legal bans, integrates FGM into medical curricula and in-service training, and tailors interventions to subnational contexts based on the distinct patterns of FGM prevalence and medicalization across governorates.
Shatha Elnakib, May Sallab, Amira F. A. Hussein et al.
Aim: The aim of this study was to detect the most common causative organism causing neonatal sepsis in women suffered preterm prelabour rupture of membranes and if it is different from that of the maternal genital swab.Materials and Methods: This study was carried out on 200 pregnant women with PPROM at gestational age between 23 weeks plus 6 days to 28 weeks. Genital swabs were taken for microbiological study and all women were managed conservatively. After delivery, buccal and nasal swab were taken from the neonates and the detected organism(s) were correlated with those detected from the mothers' swabs. Also, neonatal outcome was studied regarding incidence of neonatal sepsis, Neonatal Intensive Care Unit) admission and neonatal mortality.Results: From the 200 enrolled cases and their neonates, there were thirty-three neonates (16.5%) that were admitted to the NICU with twenty-one neonates (67.8%) of them suffering neonatal sepsis. Only thirteen neonates (61.9%) of those who had suffered sepsis shared the same organisms with their mothers. The other eight cases (38.1%) had different organisms. The most frequent organism regarding maternal vaginal swabs was Escherichia coli followed by Group B Streptococci sharing the same frequency with non-hemolytic Streptococci, Staphylococcus aureus and Group A streptococci sharing the same frequency with Klebsiella species.Conclusion: E-coli is the most common causative organism for neonatal sepsis in PPROM before 28 weeks of gestation.
BACKGROUND: The incidence of child labour, especially across developing nations, is of global concern. The use of children in employment in developing economies constitutes a major threat to the societies, and concerted efforts are made by the relevant stakeholders towards addressing some of the factors and issues responsible. Significant risk factors include socio-demographic and economic factors such as poverty, neglect, lack of adequate care, exposure of children to various grades of violence, parental education status, gender, place of residence, household size, residence type or size, wealth index, parental survivorship and household size. Egypt is the largest country in Africa by population. Although UNCIF 2017 reported that the worst forms of child labour in Egypt are concentrated in domestic work, forced begging and commercial sexual exploitation, the situation has received little attention. There are still very few studies initiated specifically to look at child labour in domestic service in Egypt and those that exist have been limited in the scope of their methodology. Geographical coverage and research for child labour in Egypt is also limited, as are accurate statistics and data. There was, therefore, a strong case for looking again at the domestic child labour phenomenon in Egypt, especially after the Demographic Health Survey (DHS) released the first data about child labour in Egypt in 2014. This study builds on the few findings of earlier work, and broadens coverage by including advanced methods and geographical effects of this problem. OBJECTIVES: This study focuses on identifying socio-demographic, economic and geospatial factors associated with child labour participation. METHODS: We used the 2014 Egypt Demographic and Health Survey (EDHS) from the Ministry of Health and Population in Egypt, with the record of 20,560 never-married children aged 5-17 years engaging in economic activities, in and out of their home. The data focused on demographic and socio-economic characteristics of household members. Multivariate Bayesian geo-additive models were employed to examine the demographical and socio-economic factors for children working less than 16 hrs; between 16 and less 45 hrs; and over 45 hrs weekly. RESULTS: The results showed that at least 31.6% of the children in the age group from 5-10 were working, 68.5% of children aged 11-17 years were engaged in child labour for a wage, and 44.7% of the children in the age group from 5-10 were engaged in hazardous work. From the multivariate Bayesian geo-additive models, female children (with male children as reference category) working at least 16 hrs (OR: 1.3; with 95% CI: 1.2-1.5) were more likely to be engaged in child labour than girls working 16 to 45 hrs (OR: 1; 95% CI: 0.3-1.5). Children born to women without formal education, in non-hazardous jobs, irrespective of the hours spent at work, were more likely to be involved in child labour (52.9%, 56.8%, 62.4%) compared to children of mothers with some level of education. Finally, children who have experienced psychological aggression and physical punishment are more likely to be used as child labour than those without such experience across the job types and hours spent. North-eastern Egypt has a higher likelihood of child labour than most other regions, while children who live in the Delta are more engaged in hazardous work. CONCLUSION: This study revealed a significant influence of socio-demographic and economic factors on child labour and violence against children in Egypt. Poverty, neglect, lack of adequate care and exposure of children to various grades of violence are major drivers of child labour across the country. The spatial effect suggests the need to give more attention to some areas that have high rates of child labour, such as the Nile Delta, Upper Egypt, and North-eastern Egypt.
Khaled Khatab, Maruf Ariyo Raheem, Benn K. D. Sartorius et al.
