For the purposes of this entry, North Africa and the Middle East comprise 21 different countries, Palestinian Territories included, ranging in population and geographic size. The population of the entire region is around 385 million. The five most populous countries constitute 64% of the entire regional population: Egypt (74 million), the Islamic Republic of Iran (69.5 million), Sudan (36.2 million), Algeria (32.9 million), and Morocco (31.5 million) (United Nations Children's Fund UNICEF, 2007).

The Gulf States (Bahrain, Kuwait, Qatar, and United Arab Emirates) are primarily urban, while the population in Yemen and Sudan are primarily agrarian and rural; overall, throughout the region urbanization is increasing (Barakat, 1993). The predominant religion in the region is Islam, although there are significant Christian and other smaller minority religions in many countries. In most of these countries, the majority speaks a dialect of Arabic. Two exceptions are Israel, which has an 80% Jewish population with Hebrew as the official language, and the Islamic Republic of Iran in which Persian (or Farsi) is the official state language.

Economic, Social, and Political Features

Economic stratification is one of the region's hallmarks. During the 1990s the region's average economic growth was 3.6%, and in 2003 and 2004 it was 5.6% (North Africa and Middle East Region, Office of the Chief Economist, 2005). Oil and natural gas extraction and sales are major sources of wealth, accounting for 97% of all new economic growth. The Gulf States, Israel, and Iran contain the majority of the wealth in the entire region; other countries are poorer; and extreme inequalities in wealth exist within and between the region's countries. Many states do not generate or distribute reliable poverty and health data, and so generalizations are tentative. A World Bank report indicated that the region's Gini Coefficient fluctuated between 0.32 and 0.44 for most countries, that 20–25% of the region was poor, and that absolute numbers of poor had increased to more than 52 million people in 2001. The region's unemployment rates are estimated to average to 13%. More hopefully, by 2000 literacy had spread to 69% of the population, average years of schooling among adults reached 5.2 years, child mortality rates fell to 46 deaths per thousand children in the first five years of life, women's educational achievement had increased, and average life expectancy increased to 68 (Iqbal, 2006, p. xix). But these are regional generalizations, and do not account for national variance. For example, Egypt and Palestine have poverty rates higher than 40%, compared with Jordan and Iran, which have below 10%. Other regional social issues reported include the increased incidence of HIV and AIDS (World Bank [WB], 2005) and the lesser social, political, and economic status of women (United Nations Development Programme [UNDP], 2005).

Throughout the region there are monarchical and republican regimes but democracy is elusive, with the exception of Israel—rigged elections, one-candidate elections, arbitrary arrest and detention, and an unfree press are widespread (UNDP, 2005). (But in Israel, some commentators criticize the state for being an “ethnocracy,” privileging majority Jewish citizens over non-Jews [Yiftachel, 2006]). Many Middle East countries have not experienced armed conflict and insurgencies for extended periods, but others such as Sudan, Lebanon, Israel, Iraq, and Palestine are in interethnic violence, civil war, and other armed struggles (UNDP, 2004). Secular regimes in postcolonial Arab and Persian states are best described as modestly successful, and the rise of political Islam has been a powerful form of anti-imperialist sentiment. The region continues to reel from centuries of foreign control, and for the past century Arab regimes loyal to the West have been sustained, to the detriment of strong internal social capital for economic and political growth. A recent UN report points out: “In Arab countries…. the pursuit of personal gain, the preference for the private over the public good…. were all related in one way or another to a skewed distribution of power and the resulting social disparities” (UNDP, 2003, pp. 9–10).

Social Policy and Welfare Services

Social policy and welfare services in the Middle East and North Africa region necessarily reflect and are impacted by internal and external political and economic conditions. For one, they are often controlled by large state-run government branches. The Egyptian Ministry of Social Affairs and Insurance, as an example, targets means tested cash payouts to specific populations: people with disabilities, orphans, widows, divorced women and their children, and families of prisoners. Other programs throughout the region provide monetary assistance to senior citizens and needy families (Iqbal, 2006). Most such government ministries were founded during the last half-century, and focused on health and education, consumption subsidies for food and fuel, and public employment (Ragab, 1995); by the 1960s, similarly, most countries had established government departments for social services and assistance.

Social assistance remains the region's primary income security approach. Pension and employment insurance programs are not widely instituted for the region's majority, although there are employment insurance programs in Algeria, Egypt and Iran. Historically, Israel has had a full range of government-run social assistance and services offered to underprivileged population. However, for over 20 years, neoliberal government policies have shifted Israeli social welfare to privatization and reduced benefits (Reiss, 2005). In most countries in the region, the sustainability of these programs is weak, as many of the insurance benefits' reserves are low in comparison to the population base (WB, 2002). The World Bank pessimistically concludes that “opportunities to make social safety nets more efficient instruments for poverty reduction and human development have largely been missed” (Iqbal, 2006).

Most of the region's countries have international and national nongovernmental organizations (NGOs). But many are constrained by national governments, and in Egypt, to cite one example, the state is criticized for defining the roles and scopes of NGOs only to reflect positively on the national government, rather than on social justice and change (Abdelrahman, 2004). Through micro financing—and in countries such as Israel, out-sourcing to private companies—the private sector is enjoying an increased role in social welfare domains. In 2003, there were about 710,000 borrowers of microcredit within eight countries in the region (Brandsma & Burjorjee, 2004). In the tradition of the Bangladesh-based Grameen Bank collateral-free loan system, most borrowers were women. Social movements have been constrained because of a weak history of collective action, few workers in most countries have union representation, and public protest may precipitate large-scale crack-downs. Yet quiet encroachment has had modest success for excluded people: “quiet, largely atomized, and prolonged mobilization with episodic collective action-open and fleeting struggles without clear leadership, ideology, or structured organization” (Bayet, 2002, p. 19).

The Role of Social Work

The region's first social work training school was established in 1936 in Cairo, and social work education here and elsewhere remained strongly indebted to west European and North American approaches. Training usually occurred at junior college and all female educational institutions, and then in 1975 social work education became a mainstream faculty within the Egyptian universities, offering both undergraduate and graduate programs. Libya's system developed in the 1960s, and in the 1990s offered seven diploma programs and one bachelor's degree program. During the late 1970s and the 1980s, governments within Arab countries in the Middle East began hiring large numbers of Egyptian trained social workers and making them the primary employees in government departments responsible for social affairs throughout the entire region (Ragab, 1995). In Israel, social work education began in the 1950s and now includes five university programs at the undergraduate and graduate levels, and four college programs.

Throughout the region the level of training offered varies. Egyptian schools, such as Assiut University, offer programs at the diploma level up to and including the Ph.D. schools in other countries, such as the University of Jordan, offer master's programs, and some countries, such as Algeria, have no formal training in social work. There is no regional accreditation body. The International Federation of Social Workers Web site reveals some national associations, such as L'Association Marocaine des Assistants et Assistantes Sociales, Bahrain Society of Sociologists, Kuwait Association of Social Workers, Palestinian Union of Social Workers and Psychologists, and L'Association des Assistants Sociales du Liban. The Israel Association of Social Workers functions as both a national union and a trade association.

Much of social work practice within the region has its roots in the transference of social technologies from colonizing countries. Hence, North American and West European approaches are still strong. But on the ground, social work intersects with community values, and in this process creates a continuously new, emergent, social work responding to myriad social needs. Of particular importance is crisis intervention; in Palestine or in Israel, for example, social workers frequently encounter war-related posttraumatic stress disorder and other trauma-related problems among children, youth, and adults (Al-Krenawi, Graham, & Sehwail, 2004). Crisis intervention, discharge planning in hospitals, and the provision of income security entitlements are common functions. In Israel, social work is particularly well developed and is prominent among the helping professions in providing psychotherapy, family therapy, and other forms of advanced treatment. Also in Israel the development of social work has been strongly referenced to American clinical traditions, shaped within a distinct, Zionist, Socialist, and Jewish context (Guttmann & Cohen, 1995). Throughout the rest of the region the prevalence of Islam and the “localization” of social work have helped to create an emergent, distinct social work among the communities in which it occurs (Al-Krenawi & Graham, 2007). An increasing amount of scholarly research, for example, examines indigenous healing in the Arab Middle East (among Dervish, Koranic healers, and others) in relation to professional disciplines such as social work; Islam as a force in social work writ-large, and case studies regarding blood vengeance, polygamous family formation, and cultural mediation. Similarly, increasing scholarship considers differential help seeking among Arab communities in Palestine, Jordan, Egypt, the United Arab Emirates, and other parts of the Muslim Arab world (Al-Krenawi & Graham, 2003, 2006).

Trends and Challenges

The future of social work in the region is inextricably linked to each country's domestic economic and social conditions and to the larger geopolitics of the region. Ongoing conflicts in the region have a strong impact on the parameters of practice.

The Development and Practice of Social Work

In the interwar period, new training programs in social work gained quick and widespread acceptance, and Egyptian graduates (where social work had a particularly strong presence) were soon in high demands all over the Middle East. During the early 1960s, other countries felt the need to create local training programs, based on the U.S.-influenced Egyptian model. A new trend emerged in the Gulf region in the early 1980s, calling for the application of Islamic principles in social work education and practice. Followers of this trend claim that some of the basic principles behind the Western model of social work are incompatible with the basic tenets of Islam, and that a model more suitable to the population's special needs is required.

Being Culturally Competent and Respecting Human Rights

Many considerations are to be taken when practicing social work with Arab clients (Al-Krenawi & Graham, 2000, 2003). Limits of space allow us to identify only a few. One must often appreciate the individual's place in their extended families and communities, and realize that unlike Western clients, many interventions with Arab clients are to be especially couched in the context of the family, community, or tribal background. Another important issue to consider is the different approaches to gender relations amongst Arab clients. An opposite-gender client relationship can sometimes be impractical altogether, and at any rate, one must protect the client–therapist relationship by maintaining professional standards. When dealing with Arab clients in the West, one must consider their level of acculturation (Al-Krenawi & Graham, 2005).

Challenges such as Dealing With Disparities Among and Within Ethnic, Religious, Racial, and Cultural Minorities Within Each Country

Two significant examples of Christian minorities in Middle Eastern countries are the Egyptian Coptic community (about 9% of the general population) and the Lebanese, mostly Maronite Christian community, once a majority of the Lebanese population and now constituting about 39% of that country's domestic population (Central Intelligence Agency [CIA], 2007; Yapp, 1996). Another significant minority group in the Middle East are the Kurds, residing in parts of Iraq, Turkey, Syria, and Iran. The Kurds in Iraq, for example, between 15% and 20% of the population, have been engaged in rebellions intended to assure their right to an autonomous regime. During these rebellions, the Kurdish community suffered severe attacks committed by the Iraqi government, which caused a tremendous amount of casualties.

Issues of Refugees and Displaced Persons

The severe insurgencies that took place in Iraq since the American-led invasion of this decade have not only caused an immense number of casualties, but also provoked a massive migration of more than 2 million displaced Iraqis, who found their way to the neighboring countries, notably Syria (Amnesty International, 2007) and Jordan. Life for refugees is profoundly difficult. For example, though the Syrian border has been kept open for Iraqi refugees, their legal status in Syria has remained questionable, and they are forced to go out of the country and re-enter it every few months, a journey that is often both expensive and dangerous.

Perhaps the most well-known issue of refugees in the Middle East is the vast Palestinian migration during and after the 1948 war (Yapp, 1995). A combination of several factors, including the fear of the Zionist forces and several incidents of intended deportation, have caused between 500,000 and 900,000 Arabs to leave their homes in territories captured by the Jewish forces, and seek shelter in Jordan (particularly the West Bank), the Gaza Strip, Syria, and Lebanon. While Israel refuses to allow the refugees to return, and hopes that they will eventually assimilate in other Arab countries, the only country that granted the refugees citizenship was Jordan. This massive migration contributed to the formation of the Palestinian identity, and 1948 is known amongst followers of the Palestinian narrative as Al-Nakba—The Disaster.