ربط التواصل: نظام جديد لرسم خرائط تدخلات التواصل الاجتماعي

The call to connect 

Social wellbeing has always been enshrined in the World Health Organization’s (WHO) definition of health – “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” – yet for decades it remained as the overlooked third pillar. The growing evidence linking social disconnection to serious physical and mental harm, including cardiovascular disease, stroke, dementia, depression, and premature mortality, has galvanised research, policy, and practical action across the world. MENARAH has explored these themes in more depth in their recent podcast conversation; you can watch it هنا.

The COVID-19 pandemic made this starkly evident. As governments scrambled to respond to what many were calling a “loneliness epidemic”, the WHO responded by establishing the Commission on Social Connection – a landmark recognition of social connection as a genuine public health priority, on par with physical and mental health and wellbeing. The Commission’s flagship report, published in 2025, makes a compelling case for action, identifying five strategic areas to strengthen social connection globally, including measurement, funding, and scaling proven and potential interventions.

Our team’s recent paper in Population Health Metrics builds on this growing momentum, contributing a foundational tool that has been missing from the field: a standardised, evidence-based classification system for social isolation and loneliness (SIL) interventions.

Innovation without consistency

As awareness of social disconnection has grown, so too has the range of interventions designed to address it. These span from psychological and behavioural therapies, relationship-focused programs, digital services, and changes to the physical and social environments and systems in which people live. 

When considering social disconnection, different facets such as social isolation and loneliness, although often conflated, operate using different mechanisms of action. Social isolation is an objective measure of how much contact an individual actually has; loneliness is a subjective felt experience of that contact or connections failing to meet individual expectations. These different mechanisms call for different interventions. However, without a shared language for describing and categorising such interventions, the practical consequences of these inconsistencies are significant:

• approaches cannot be meaningfully compared for relevance or effectiveness,
• evidence is duplicated rather than accumulated,
• policy and resource priorities are harder to justify,
• gaps in the evidence base remain invisible.

Such issues have resulted in a rapidly growing but disconnected body of evidence, contributing to system and resource ineffectiveness and inefficiencies, which will be disproportionately experienced by communities that already face greater resource limitations.

Currently, no universal classification system exists for social connection interventions. Ad hoc systems are employed when presenting information, with the most commonly used groupings being intervention mechanism, mode of delivery, and target population. However, the lack of an established system will continue to exacerbate efficiency and effectiveness issues, necessitating the implementation of standardised policy and practice guidelines.

To address this, the ASSeTS Classification System for Social Connection Interventions has been developed.

Making use of your ASSeTS

To address this gap, our paper develops and empirically tests the ASSeTS Classification System – the first WHO-aligned, evidence-informed framework specifically designed to categorise interventions addressing social isolation and loneliness. Developed through a rigorous systematic review of existing classification systems across 17 international databases, and refined through iterative expert consultation with members of the WHO Commission on Social Connection Technical Advisory Group, ASSeTS outlines five main categories of interventions, including:

1. Access – providing opportunities for social interaction (e.g. accessible transport, community gardens, social prescribing)
2. Skills – building skills for relationship building and maintenance (e.g. social skills training, digital literacy programmes)
3. Social engagement – providing consistent or regular interactions (e.g. peer support groups, befriending, animal-assisted therapy)
4. Therapeutic and psychological – addressing cognitive and emotional barriers (e.g. cognitive behavioural therapy, mindfulness)
5. Systemic – interventions that influence upstream, societal-level determinants of social disconnection (e.g. national policies, public awareness campaigns, research funding)

Each intervention type is used alongside socioecological levels of delivery (self-delivery, interpersonal, community-based, or societal), to capture the full diversity of how interventions operate in practice. For example, a social access (self-delivery) intervention, such as video calling platforms, vs a social access (community-based delivery) intervention, such as provision of communal spaces in a local neighbourhood. The inclusion of both intervention type and socioecological level of delivery further highlights the diversity in social connection interventions, prompting the need for a more unified approach to categorisation.

As social connection continues to shape health policy and practice agendas worldwide, ASSeTS establishes a foundational piece of infrastructure for the field. By providing a standardised and unifying framework, it offers researchers, clinicians, and policymakers a tool for clearer decision-making to address a modern, evolving global health challenge. Although future work is required in refining the framework as the field develops, ASSeTS represents a strategic step towards better global coordination and more effective action to strengthen social connection.

What does this mean for the MENA region?

In the Middle East and North Africa, the importance of social connection is both significant and often underestimated, and ASSeTS provides tools for which there is a major need.

The WHO Commission’s report presents sobering data. The Eastern Mediterranean Region (EMR), which includes much of the MENA region, has the second-highest estimated prevalence of loneliness worldwide at 21.0%, surpassed only by Sub-Saharan Africa (24.3%). For older adults, the situation is even more striking: available data suggest that social isolation among older individuals in the EMR may be the highest of any region, with estimates reaching as high as 46.1%, although the evidence base remains limited and is mainly from Lebanon. Throughout the region, an estimated 76,500 deaths were attributable to loneliness between 2014 and 2019, a figure likely underestimated due to the scarcity of data.

The picture is complicated by culture. The WHO report notes that collectivist societies, a category that includes much of the Arab world, often have lower reported rates of loneliness than individualist ones. However, this is not because the experience is less common, but rather because it is more stigmatised. In contexts where family cohesion and communal bonds are deeply valued social norms, admitting to feeling lonely or isolated can carry particular shame. This means that self-reported loneliness data in the MENA region is likely to underestimate the true extent of the problem, and that interventions framed around individual psychological deficits may be poorly received or culturally misaligned.

These challenges are converging with rapid demographic change. The MENA region is ageing faster than almost any other part of the world, as MENARAH has explored in our recent BSPS keynote. The pace of demographic change in MENA is unprecedented. With urbanisation, migration, shifting family structures, and the spread of digital technologies reshaping social life, the protective traditional networks that once buffered against social disconnection can no longer be taken for granted. Older women are particularly exposed to this erosion of protective networks, as MENARAH’s عمل on elder abuse in the Arab region has shown. Isolation, dependency, and loss of social agency compound significantly for women who have outlived spouses or whose mobility is constrained.

Countries such as Egypt, Morocco, Jordan, Kuwait, and Lebanon show broadly stable loneliness trends in the available data, while the UAE shows a declining trend. However, these patterns must be interpreted with caution, given severe limitations in data quality and coverage. As MENARAH’s own WHO report on unmet needs in the region found, the data picture is deeply incomplete.

This is precisely where the ASSeTS tool becomes relevant. The MENA region has a wide range of social connection interventions in operation – from community-based religious and neighbourhood networks to digital platforms for diaspora connection, to government social protection programmes – but very little systematic research that maps, compares, or evaluates them. The absence of a shared classification framework is one reason why evidence has not yet accumulated, and why investment decisions are often made without a clear evidence base.

By adopting ASSeTS, researchers and policymakers across the region would be better placed to:

• identify which intervention types are present, absent, or underinvested in MENA contexts,
• build a cumulative, comparable body of evidence on what works across different settings,
• design culturally grounded adaptations, particularly in the Systemic and Social Engagement categories, where community and societal-level mechanisms are most relevant to the region’s social fabric, and
• engage with global policy frameworks on social connection from a position of regional visibility and data-informed advocacy.

The WHO Commission explicitly highlights the need for better regional data, cross-cultural validation of measurement tools, and the development of interventions grounded in diverse cultural contexts. The MENARAH Network is well placed to take up this challenge, contributing MENA-specific research that feeds into the global evidence base, while ensuring that interventions developed and tested in the region reflect its social realities – including the central role of family, faith, community, and intergenerational ties in people’s experience of connection and belonging.

Looking ahead

ASSeTS is a first step, not a final answer. The system requires ongoing refinement, particularly in the Social Access and Systemic categories where inter-rater reliability was lower, and broader cross-cultural validation as the field matures. The literature search underpinning the systematic review ends in September 2023, meaning the system will need updating as new evidence emerges.

Nevertheless, the direction is clear. Social connection is now firmly on the global public health agenda, with the World Health Assembly adopting its first ever resolution on the issue in May 2025. The tools to build a more coordinated, evidence-based, and equitable response are beginning to form. For the MENA region, where the need is high, the data are scarce, and the cultural context demands thoughtful adaptation, the moment to engage is now.

This builds on MENARAH’s existing programme of research that has been steadily building the regional evidence base on ageing and wellbeing – from our World Bank demographic analysis, to our WHO report on unmet health and social care needs in the Eastern Mediterranean, and to our ongoing work on the complex realities of ageing in the MENA region. ASSeTS provides this body of work a new tool: a shared framework for asking not just “how many people are ageing?” but “which interventions are reaching them, how, and with what evidence behind them?”

Cite the paper:

Surkalim DL, Farzana A, Choo WY, Hussein S, Hébert PC, Welch V, Tanjong Ghogomu E & Mikton C (2026). ASSeTS: a systematic review and development of the World Health Organization’s classification system for social isolation and loneliness interventions. Population Health Metrics. https://doi.org/10.1186/s12963-026-00472-7