A Longitudinal Study of Egypt Healthy Aging Initiative AL-SEHA

AL-SEHA is an Egyptian initiative aiming at contributing to the global knowledge on the aging population by establishing an Egyptian health and retirement study modeled after the US Health and Retirement Surveys (HRS) and its sister Survey of Health, Aging and Retirement in Europe (SHARE). It aims to support responsive healthy aging policies by conducting a longitudinal study of older persons in Egypt that monitors the life journey of adult persons with its various dimensions, including health, access to health services, income, occupation, environment, and socioeconomic changes over a long period of time.

Preparatory Activities

This preparatory stage encompassed three important pilot studies. The main aim of these pilot studies is to explore the feasibility and applicability of applying the SHARE and related aging field studies within the Egyptian context.

Pilot I: The Regional Initiative Eastern Mediterranean Aging (EMage) 2021 -2022

The EMage aims to successfully strengthen capacity in survey methodology and data collection activities, including fieldwork. This activity was the Egyptian component of the EMage initiative. The activity was implemented by the Social Research Center and the Institute of Global Health and Human Ecology of the American University in Cairo and was supported by the German Academic Exchange Services (DAAD) through the Hochschuldialog mit der islamischen Welt program and the Munich Center for the Economics of Aging (MEA) at the Max-Planck-Institute for Social Law and Social Policy, Survey of Health Ageing and Retirement in Europe: (SHARE). ). The activity incorporated capacity building and networking activities, a translation of the SHARE questionnaires to Arabic, and a pilot fielding of the survey (N=300) to test the survey instrument and its suitability for an Arab population (Pilot-I).

The main objectives of this initiative are:

Enhancing the capacity for research and policy development concerning population aging in Egypt.
Encouraging Egypt to implement the SHARE Survey, which is an internationally well-acknowledged household survey for evidence-based advocacy and actions.
Developing a network of scholars engaged in aging-related research and actions.

These objectives were met through:

Request Questionnaires

Team members of AL-SEHA study

Analytical output and publications

Moustafa, S.A., Boersch-Supan, A. & Salama, M. Aging in an Arab country: knowledge gaps in Egypt. Nat Aging 3, 1042–1044 (2023).
El Sayed AEHI, Said MT, Mohsen O, Abozied AM, Salama M. Falls and associated risk factors in a sample of old age population in the Egyptian community. Front Public Health. 2023 Jan 26;11:1068314. doi: 10.3389/fpubh.2023.1068314. PMID: 36778572; PMCID: PMC9909230.

Pilot II: Applying the SHARE in two Governorates in Egypt 2023

The main goal of the pilot study is to test and document the logistics of the fieldwork and data management activities. This activity is implemented within the memorandum of understanding (MOU) with the project partners and is supported by The National Institute of Health through funding from the Institute of Social Research, the University of Michigan; the activities under the pilot study include:

Selecting the two governorates for the pilot study and developing the sample design
Developing the training manuals for interviewers and fieldwork staff
Developing quality control manuals
Fielding the survey in the two governorates
Building data management plan and code book for open-ended questions
Preliminary results from the pilot survey

For more information; check out the Validation of the Egyptian Harmonized Cognitive Assessment Protocol (HCAP) document.

Pilot III: Applying the Harmonized Cognitive Assessment Protocol (HCAP)

This study aimed to validate the Egyptian version of the Harmonized Cognitive Assessment Protocol (HCAP) through a pilot test. Subjects were recruited from three distinct sites, representing key regions in Egypt: Ain Shams Geriatric Hospital in Cairo, Outpatient Clinics in Mansoura University Teaching Hospital in Mansoura, and outpatient clinics in Beni Suef University Teaching Hospital in Beni Suef.

For more information; check out the Design of HCAP Instrument document.

Other Relevant Contributions and Networking Activities on Healthy Aging in Egypt

A literature review of national, regional and international literature on Aging

This literature aims to shed light on Egypt ‘s aging experience through exploring population projections and situating Egypt on the aging dynamics. It also includes a comprehensive literature review of previous Egyptian and regional studies on the aging population to provide the needed base for contextualizing the SHARE questionnaire for the context of the Arab and Egyptian contexts. It further offers a review of the international literature on new aging dimensions to be incorporated into the AL-SEHA, namely health equity and climate change and other relevant issues.

Gaining Regional and National endorsements for health aging studies

This activity incorporated an international and regional expert meeting that aimed to investigate the regional demands to launch an initiative for an aging study modeled on the international and well-acclaimed SHARE experience. Such an experience provided a rich evidence base that successfully contributed to knowledge and influenced policies and actions such as health care, health insurance, pension and social protection in more than fifty countries in Europe, Asia, and the American continent.

On February 6-7, 2022, under the auspices of the Egyptian Ministry of Health and Population (MOHP) and Ministry Of Planning and Economic Development (MPED), the meeting was organized, by the Institute of Global Health and Human Ecology(IGHHE) and the Social Research Center (SRC) of American University in Cairo, in collaboration and with support from the World Health Organization Eastern Mediterranean Regional Office (WHO/EMRO), the National Institute of Aging (NIA), the International Health and Retirement Study (HRS), the Harmonized Cognitive Assessment Protocol study (HCAP), the Survey of Health and Retirement in Europe (SHARE), and Global brain Health Institute (GBHI).

Aging International Agenda
Aging International Concept Notes

The Egyptian Minister of Health participated in the international and regional meetings
The President of the Institute of National Planning participates in the international and regional meeting
Signing a Memorandum of Agreement (in process) between The American University in Cairo, the Ministry of Health and Population (MOHP), the Ministry Of Planning and Economic Development (MPED) and the Institute of National Planning (INA) to collaborate in supporting national efforts in securing the welfare of Egypt’s older population and their families.

Engaging with the regional and international aging community

Hoda Rashad is a Member of the Advisory Board for a Multi-stakeholder network on Aging in the Arab Region established by ESCWA (2022)
Mohamed Salama is enrolling AL-SEHA in the African Population Cohorts Consortium: CE-APCC
AUC submitted an application to The Doha International Family Institute (DIFI) and the Qatar National Research Fund (QNRF) under the OSRA research grant to support the production of an authored volume titled The Welfare of Older Persons in Egypt: People’s Voice and Responsive policy implications. The abstract of this volume was shared with Spring Nature editors, who expressed interest in it

Other Relevant Activities on Healthy Aging Activities in Egypt

Study of Aging Population (Egyptian SAGE-1994)

This study was one of the earliest studies on older persons in Egypt. It was implemented by the Social Research Center of the American University in Cairo with support from the WHO office in Vienna. (for more details on the study, refer to Khadr 1997)

Khadr, Zeinab 1997. Living arrangements and social support systems of the older population in Egypt.” Doctoral Dissertation. The Population Studies Center, The University of Michigan
Khadr Z. Differences in levels of social integration among older women and men in Egypt. J Cross Cult Gerontol. 2011 Jun;26(2):137-56. doi: 10.1007/s10823-011-9140-3. PMID: 21340707

Validation of Gender Differences in Disability, Health Status, and Care

This study aimed to address the important methodological questions regarding the usefulness of health interview surveys to gather information on the elderly in developing country settings. In particular, this study attempted to answer questions about the applicability of health instruments that were designed in developed countries' settings to measure health status among older populations in developing countries.

The study was supported by the National Institute of Aging (NIH R03 AG21707-01 2003)

Addressing Population-Ageing in the Middle East and Sub-Saharan Africa. Cairo, April 9-10, 2019. Read the Concept Note and Cairo Workshop Agenda.
Caring for our older population in the Arab countries: Policies and actions perspectives. Cairo, 29 June 2021.
Aging in the Arab region: Realizing the potentials of the second demographic dividend. Cairo, November 22, 2021.
Strengthening the Evidence Base to Support Healthy Aging in the Arab region: An International Policy and Experts Meeting. Cairo, February 6-7, 2023. Read the Concept Note.