From Research to Action: WHO Caregiver Training Expands Autism Support in Egypt

A new study by global and Egyptian partners piloted the WHO Caregiver Skills Training program in Egypt, training public health workers to support families of autistic children. The project showed strong motivation among professionals but highlighted the need for sustained supervision, resources, and cultural adaptation to scale autism services nationally.

A groundbreaking study led by the University of Maryland, McGill University’s Montreal Neurological Institute-Hospital, the Egyptian Ministry of Health and Population, the American University in Cairo, Autism Speaks, and the World Health Organization (WHO) has placed the spotlight on Egypt’s autism care crisis. The research details how the WHO’s Caregiver Skills Training (CST) program, a parent-focused, low-cost intervention already rolled out in more than forty countries, was piloted for the first time in the Eastern Mediterranean Region. By bringing together international expertise and local knowledge, the project set out to address one of Egypt’s most pressing health inequities: the lack of accessible, evidence-based support for families raising autistic children.

Autism Care in Egypt: A System Under Strain

Globally, autism awareness has surged, but the benefits have not been evenly shared. Services and studies remain dominated by North America and Europe, leaving much of the world underserved. Egypt, a lower-middle-income country of more than 112 million people, offers a stark example of the gap. A nationwide screening revealed that 3.3 percent of children may be at a heightened likelihood for autism, yet resources are concentrated almost exclusively in major urban centers like Cairo and Alexandria. Public funding for autism support is scarce, pushing costs onto families and straining caregivers, often mothers, who face stigma, social isolation, and barriers to education for their children. Against this backdrop, CST presents an opportunity to directly empower caregivers. The program consists of nine group sessions and three individual sessions, equipping parents with strategies to enhance children’s communication, engagement, and adaptive behavior, while strengthening caregiver resilience.

Training Egypt’s First Master Trainers

The project’s first milestone was the recruitment of 16 public health employees from Cairo, Alexandria, Port Said, and Asyut to serve as “Master Trainers.” These professionals, predominantly women with backgrounds in child and adolescent psychiatry, were carefully selected for their experience, supervisory roles, and ability to communicate in English during training. Over five intensive days, with Autism Speaks coordinating the program, they were guided through interactive workshops that blended theory with practice. Role plays, live demonstrations with families, and bilingual materials ensured they grasped CST concepts. The training’s collaborative atmosphere, enriched by the contribution of an Egyptian-Canadian instructor who provided Arabic support, prepared the participants to lead and eventually supervise non-specialists.

Then came the pandemic. With in-person activities disrupted, the program shifted gears to a remote “booster” course delivered over three months on Zoom. Far from a mere stopgap, the digital training allowed for deeper dives into autism screening and intervention, alongside structured assignments in which trainers recorded themselves explaining CST concepts and received expert feedback. This flexibility not only kept the initiative alive but also expanded its educational scope.

Testing Confidence, Climate, and Delivery

Before embarking on real-world implementation, the Master Trainers were surveyed about their confidence and perceptions of the health system’s readiness. Their responses painted a mixed picture. Motivation was high: on a five-point scale, intentions to integrate CST into practice scored 4.44. Yet confidence in explaining CST concepts was more modest at 3.75. When assessing organizational climate, implementation prospects looked encouraging, but stress and limited resources emerged as notable obstacles.

Despite these challenges, the trainers delivered CST to 37 caregivers across Cairo, Alexandria, and Asyut. Sessions ran in small groups of five to eight parents, sometimes in person, sometimes online. Trainers described feeling well-prepared, crediting the intensive practice built into their own training. One noted that role plays, once intimidating, became second nature after repeated rehearsal. Another highlighted the reassurance of working alongside colleagues in supportive pairs. Still, doubts lingered about scaling the model through non-specialist facilitators. Trainers feared that without similarly rigorous preparation, facilitators might struggle. As a workaround, they suggested supervision-based models where Master Trainers observe sessions and provide real-time feedback, an approach consistent with WHO’s cascading system of capacity building.

A Path Toward Sustainable Solutions

The Egyptian pilot demonstrates both the promise and the hurdles of embedding caregiver-led autism interventions in resource-limited settings. Strong partnerships between international researchers, local universities, and government bodies were indispensable, ensuring credibility and cultural adaptation. Flexibility proved equally vital, as pandemic-era shifts to online formats showed that CST can be delivered remotely, though limited internet access remains a barrier in many parts of the country.

Perhaps the most important lesson lies in scalability. By equipping non-specialists and strengthening supervisory structures, CST offers a pathway to expanding services without relying solely on a scarce pool of experts. Yet sustainability will demand more than training. Trainers’ moderate confidence scores and the evident strain within Egypt’s health institutions signal the need for long-term mentorship, resources, and systemic support.

The study is among the first to examine autism intervention implementation in Egypt, making it a milestone in the country’s journey toward more equitable health care. The authors stress that future research must move beyond preliminary training data to assess real outcomes for children and caregivers, as well as long-term sustainability. They call for co-designed approaches with local partners, ongoing adaptation to emerging needs, and embedding programs like CST firmly within public health systems.

In a nation where families have long shouldered the burden of autism care with limited assistance, this project points to a more hopeful future. By demonstrating that evidence-based, culturally relevant, and affordable interventions can be introduced and scaled, the Egyptian CST pilot signals a new possibility: that caregiver empowerment and public health systems, working in tandem, can transform autism support from a private struggle into a collective responsibility.