Building a Resilient and Valued Care Workforce: Lessons from UK Research for the Middle East

Across the world, the long-term care sector faces a shared and urgent challenge: how to build, support, and retain a capable, confident, and motivated care workforce. While the structures of care systems vary significantly from country to country, the human dynamics at the heart of care work, such as motivation, wellbeing, recognition, and inclusion, are remarkably universal.

Our newly published study in the Journal of Long-Term Care, co-authored with my colleague Eirini-Christina Saloniki, examines the intentions of UK social care workers to leave their employer or the sector during the COVID-19 pandemic. Using longitudinal data from nearly 1,800 workers, the research provides a unique window into what drives staff to stay or leave during an extraordinary period of strain.

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The study forms part of the wider RESSCW (Rapid Evidence Synthesis of the Social Care Workforce) programme and was funded by The Health Foundation, support that allowed us to dig deeper into workforce dynamics across time, not just at a single snapshot.

While this research focuses on the UK context, the implications speak directly to countries across the Middle East and North Africa (MENA) region as they seek to strengthen and professionalise long-term care provision in the face of demographic change, evolving family structures, and the rising need for trained care workers.

What the UK evidence reveals

Our findings highlight several key influences on workers’ intention to leave:

1. Job satisfaction, wellbeing, and organisational commitment matter more than crisis-specific pressures.

Even at the height of the pandemic, core workplace conditions, such as how valued workers feel, how manageable the workload is, and whether they see a career path, shaped retention more strongly than COVID-related factors.

2. Poor pay, limited progression, and work-life imbalance fuel turnover.

These factors remain persistent pain points in the UK, and they are well-documented issues in many MENA countries as well, where care work is often unregulated, undervalued and financially precarious.

3. Racialised-minority workers faced a significantly higher risk of intending to leave.

This finding speaks to the importance of belonging, fairness, and inclusive organisational cultures. For MENA countries, where migrant labour plays a substantial role in care provision, this insight is particularly relevant.

4. Workers on temporary or insecure contracts were more likely to want to leave.

Stability and predictability are fundamental to building a committed workforce.

5. Abuse and mistreatment are crucial red flags.

While COVID-19 itself had a modest overall effect, experiences of abuse dramatically increased intention to leave. This observation reinforces the importance of safeguarding, respect, and protective working environments.

Why this matters for Middle Eastern long-term care systems

Across the Middle East, governments, providers, and communities are grappling with how to build sustainable care ecosystems that can keep pace with demographic and social change. Several countries are exploring national long-term care strategies, workforce training pathways, and new models of financing and regulation.

The UK research offers five cross-border lessons highly relevant to the region.

Lesson 1: Workforce planning must be long-term and system-wide

MENA countries are at a critical stage: ageing populations are rising, families are undergoing structural shifts, and demand for care is growing faster than the formal care workforce has been developed. The UK’s experience shows that piecemeal or reactive measures are insufficient. What is needed is:

• National workforce strategies with clear targets
• Defined competencies and training standards across care roles
• Investment in leadership development for care managers
• Recognition of care work as a professional field, not auxiliary labour

Lesson 2: Pay and career progression underpin retention

Low pay and limited advancement opportunities are universal drivers of turnover. In many MENA countries, care workers, especially migrant workers, face wage suppression and extremely limited opportunities to build a career.

A well-equipped cadre of care professionals requires:

• Competitive, fair pay structures
• Progression pathways—from entry-level roles to specialist and supervisory positions
• Formal accreditation and certification systems that signal professional value

Lesson 3: Inclusion, representation, and fairness matter especially in diverse workforces

Care work in the Middle East often relies on multinational and multi-ethnic workforces, including large numbers of women from Asia and Africa. The UK evidence shows that inequity and exclusion dramatically weaken retention. For MENA care systems, this highlights the need to promote:

• Equitable treatment regardless of nationality or ethnicity
• Mechanisms to address discrimination or abuse
• Stronger regulatory safeguards for migrant workers
• Organisational cultures where all staff feel valued and supported

Lesson 4: Worker wellbeing is a strategic asset

Psychological wellbeing emerged as a strong predictor of intention to stay in our study. Stress, burnout, and emotional strain are common globally in care work, but they are often neglected. Middle Eastern systems can benefit from embedding:

• Staff wellbeing initiatives
• Mental health support
• Reasonable workloads and protected rest time
• Training in emotional resilience and self-care

The wellbeing of care workers directly affects the wellbeing of those they support.

Lesson 5: Abuse and unsafe environments must be addressed head-on

The UK findings show that mistreatment is one of the strongest indicators of a worker’s intent to leave. For MENA countries where domestic care work is common and oversight can be limited, ensuring safety, dignity, and accountability is fundamental.

Ensuring safe work environments for care workers requires:

• Stronger enforcement of labour protections
• Clear rights for paid caregivers working in homes
• Accessible reporting systems
• Support for employers and families to understand their responsibilities

Looking ahead: A shared agenda for the region

As MENA countries continue developing long-term care infrastructure, the foundation of success will be a robust, skilled, and respected care workforce. The lessons from international research, including our own UK study, reinforce a core truth: Care systems cannot thrive unless care workers do.

Developing such an agenda means shifting the narrative from viewing care work as low-skilled, replaceable labour to recognising it as a vital, knowledge-based, emotionally skilled profession requiring investment, respect, and strategic planning.

MENARAH, with its regional expertise and commitment to evidence-based development, is ideally positioned to champion this transformation by:

• Connecting global research to local policy
• Promoting culturally appropriate models of workforce development
• Supporting collaboration among governments, academics, and providers
• Advancing a regional vision for dignified, high-quality long-term care

The UK experience offers important lessons. But ultimately, the Middle East is building opportunities to design care systems that are forward-looking, culturally grounded, and resilient.

A well-equipped care workforce is not just a labour force: it is an enabler of dignity, family wellbeing, social cohesion, and healthy ageing.