When evidence speaks Arabic: Closing Egypt’s health gaps
Author: Eman Ibrahim
Pharmacist Advocate for Health Governance and Clinical Researcher, Egyptian Ministry of Health
Introduction
Working in the healthcare sector, I am surrounded by evidence—clinical studies, national data, global guidelines. Yet, the most critical question persists: why does this knowledge often fail to change practice in our clinics and hospitals? This challenge is at the heart of World EBHC Day 2025’s focus on collaborative knowledge communication.
The problem
Egypt is navigating a complex health landscape, characterized by a rising tide of non-communicable diseases alongside persistent infectious diseases, all during an ambitious national rollout of Universal Health Coverage (UHC). As a pharmacist and health governance advocate, I work at the critical intersection where global research evidence meets the complex reality of public healthcare delivery. Here, the central problem is not a scarcity of science, but a profound systemic failure in implementation.
Globally produced evidence is often locked in international journals, published in English and designed for resource-rich settings. This renders it largely irrelevant to frontline Egyptian workers who grapple with overcrowding, limited resources and specific patient expectations. Consequently, life-saving guidelines are perceived not as practical tools, but as external impositions that ignore local context, stifle professional autonomy and lack the necessary supportive structures. This is the critical implementation gap.
The powerful concept of making ‘Evidence Speak Arabic’ encapsulates the solution. This is not about linguistic translation, but a profound contextual translation systematic process of adapting knowledge into actionable, owned and enabled practice within the unique healthcare ecosystem.1
The search for answers
The solution to bridging the gap between evidence and practice in Egypt lies in a fundamental shift from a top-down directive model to a systematic approach of co-creation. This philosophy proved transformative in our experience, successfully replacing failed mandates with owned initiatives. For instance, we redesigned our Antimicrobial Stewardship Program by identifying and empowering respected clinical leaders within our own settings. These ‘champions’ co-developed streamlined guidelines and used persuasive, peer-to-peer communication, turning initial resistance into active collaboration. Simultaneously, we replaced cumbersome paper reports with intuitive digital dashboards that provided real-time, unit-specific data on key performance indicators. Placing these screens in staff common areas fostered a sense of shared responsibility and healthy competition, making progress visible and driving measurable improvements in protocol adherence. These initiatives succeeded precisely because they were co-designed, building local ownership and practical utility necessary for sustainable change.
Results
The impact of this co-creation model was transformative. The introduction of digital dashboards fostered a culture of transparency and shared learning among providers, while the champion-led Antimicrobial Stewardship Program succeeded where previous top-down directives did not work. This approach created a powerful ‘flywheel effect’ within our healthcare system, where each success generated momentum for the next. Our research—from foundational COVID-19 studies on medication management2 to study analyses on antimicrobial stewardship demonstrating reduced antibiotic misuse3—consistently emerged from real clinical challenges. By generating evidence that directly addressed frontline needs while aligning with international standards, we established a self-reinforcing cycle: research questions arising from practice yielded immediately implementable solutions. This parallel process, where local evidence generation and global guidelines continuously informed each other, built unprecedented trust and engagement among healthcare teams. Each small success built the momentum and trust necessary to systematically accelerate the path from evidence to lasting impact across Egypt's healthcare landscape.
Challenges and lessons learned
We faced significant obstacles: bureaucratic inertia, resistance to new technologies and deep-seated scepticism. The key lessons were clear:
1. Technology is an enabler, but trust is built by people.
2. Evidence must be communicated in the language—both linguistic and cultural—of its end-users.
3. Sustainable change requires co-creation, not just instruction.
Next steps
The journey is far from over. The next goal is to integrate these principles directly into the architecture of Egypt’s UHC system. This means advocating policies that promote creative knowledge translation and scaling the ‘clinical champion’ model nationwide, ensuring the flywheel turns faster and reaches further.
Key take-home messages
- Collaborative communication is a critical health system intervention. A guideline is only as good as its understanding by those who implement it.
- True leadership in healthcare is about building bridges—between data and practice, between policy and people.
- When evidence learns to ‘speak Arabic,’ it stops being a foreign concept and becomes a localised practical tool for saving lives, creating a sustainable cycle of improvement.
References
1. https://www.afro.who.int/sites/default/files/2017-06/Improving_Availability_and_Use_of_IEK2010.pdf.
2. Saleh E, et al. Oxygen saturation in hospitalized COVID-19 patients and its relation to colchicine treatment: A retrospective cohort Study. Medicina. 2023. https://doi.org/10.3390/medicina59050934
3. Saleh E, et al. Impact of an antimicrobial stewardship program on optimizing linezolid consumption and susceptibility in intensive care unit patients. BMC Infectious Diseases. 2025. https://doi.org/10.1186/s12879-025-11510-4
Links to additional resources
To link to this article - DOI: https://doi.org/10.70253/WGPA4995
Disclaimer
The views expressed in this World EBHC Day Blog, as well as any errors or omissions, are the sole responsibility of the author and do not represent the views of the World EBHC Day Steering Committee, Official Partners or Sponsors; nor does it imply endorsement by the aforementioned parties.
