New study finds Egypt’s paid care workforce has been shrinking since 2015 — the workers left behind are less insured, less protected, and lower paid

💼🧑‍💼 Egypt’s paid care workforce — the teachers, nurses, and domestic workers staffing schools, hospitals, and homes — has shrunk as a share of total employment every year since 2015, driven by a public sector retreat that the private market was set to fill… but isn’t just yet. The workers inside it are less formally employed, less insured, and lower paid than they were a decade ago. Most of them are women. And the same women losing ground as care workers are absorbing more unpaid care work at home as the services they once relied on contract.

That is the central argument of a peer-reviewed paper published in June in the Journal for Labour Market Research by Caroline Krafft of the University of Minnesota (LinkedIn) and Maye Ehab (LinkedIn) of the Institute for Employment Research in Nuremberg. Within that picture, one group sits at the bottom — the only category excluded from Egypt’s most recent labor-law reform.

A shrinking sector

The drop: The care economy, defined by the International Labor Organization (ILO) as employment in education, health and social work, and domestic work, accounted for roughly 20% of Egypt’s total wage employment between 2009 and 2015. By 2019-2021, that share had fallen to 16-17%. As of 2021, 3.4 mn Egyptians worked in care. This was driven almost entirely by the retreat of the public sector, whose share of care employment fell from 17% to 13% of total wage employment over the study period. Private sector care work grew — from 2% to 4% of total wage employment — but not fast enough to compensate.

In Om El Donia, the care sector is the largest employer of women of any sector in the Arab region — around 30% of employed women worked in care between 2009 and 2017, according to Krafft and Ehab, compared to 8-9% of men. A 2018 ILO Care Work and Care Jobs report puts the broader Arab states figure at 53% of women’s employment — the highest share of any region globally.

Why has the public sector retreated? The paper points to the structural reform program Egypt has been running since the ’90s — hiring freezes, early retirement incentives, and declining public expenditure on education, which have been falling since 2015, according to the AUC’s Alternative Policy Solutions Unit.

The price of privatization

As public sector care employment has contracted, the private sector has grown — but not on equivalent terms. According to Krafft and Ehab, the gap in employment conditions between the two sectors is evident. In 2018, 82% of public sector care workers had social ins. coverage. In the private sector, that figure was 22%. Across the full care workforce, social ins. coverage fell from 91% in 2009 to 84% by 2021, a drop driven both by the growth of private sector care employment and by declining coverage within the private sector itself — from 56% in 2009 to 39% by 2021.

The share of care workers without a formal contract nearly doubled between 2012 and 2018, rising from 10% to 21%. More than half of women in care employment — 59% — were classified as working poor in 2018, earning below the low earnings line defined by the national poverty rate adjusted for household dependency, according to the study.

At the bottom: domestic workers

Domestic workers — nannies, housekeepers, and personal carers employed directly in private homes — occupy a category of their own. The paper tracks them separately, and on every measure, they sit furthest from any form of protection. Their social ins. coverage is nearly non-existent. Yet, according to the study, they’re the fastest-growing care occupation.

Left hanging? Egypt’s Labor Law No. 14 of 2025 — the country’s most significant overhaul of employment law since 2003, effective 1 September 2025 — extended new protections to informal workers, seasonal workers, remote workers, and gig economy workers. Domestic workers were excluded from it and will instead be governed by a separate, upcoming law designed specifically for labor in private households, as EnterpriseAM had previously reported. That remains pending. Foreign domestic workers, however, have it somewhat better, with former labor minister Mohamed Gobran announcing last October that foreign domestic workers would require work permits, “ensuring lawful employment practices,” according to Al Ahram.

Un-shrinking care employment?

The study doesn’t reach a conclusive single fix. What Krafft and Ehab argue is that public investment in care services produces better employment outcomes than private provision. Public-sector care jobs carry near-universal social ins. coverage and more permanent contracts than their private-sector equivalents. The retreat of the public sector is the single biggest driver of the conditions the paper documents — and reversing it, or at minimum slowing it down, is the primary lever the authors identify.