Specifies the number of studies evaluated orselected
Steps, and targets of constructing a good review article are listed in Table 3 . To write a good review article the items in Table 3 should be implemented step by step. [ 11 – 13 ]
Steps of a systematic review
Formulation of researchable questions | Select answerable questions |
Disclosure of studies | Databases, and key words |
Evaluation of its quality | Quality criteria during selection of studies |
Synthesis | Methods interpretation, and synthesis of outcomes |
It might be helpful to divide the research question into components. The most prevalently used format for questions related to the treatment is PICO (P - Patient, Problem or Population; I-Intervention; C-appropriate Comparisons, and O-Outcome measures) procedure. For example In female patients (P) with stress urinary incontinence, comparisons (C) between transobturator, and retropubic midurethral tension-free band surgery (I) as for patients’ satisfaction (O).
In a systematic review on a focused question, methods of investigation used should be clearly specified.
Ideally, research methods, investigated databases, and key words should be described in the final report. Different databases are used dependent on the topic analyzed. In most of the clinical topics, Medline should be surveyed. However searching through Embase and CINAHL can be also appropriate.
While determining appropriate terms for surveying, PICO elements of the issue to be sought may guide the process. Since in general we are interested in more than one outcome, P, and I can be key elements. In this case we should think about synonyms of P, and I elements, and combine them with a conjunction AND.
One method which might alleviate the workload of surveying process is “methodological filter” which aims to find the best investigation method for each research question. A good example of this method can be found in PubMed interface of Medline. The Clinical Queries tool offers empirically developed filters for five different inquiries as guidelines for etiology, diagnosis, treatment, prognosis or clinical prediction.
As an indispensable component of the review process is to discriminate good, and bad quality researches from each other, and the outcomes should be based on better qualified researches, as far as possible. To achieve this goal you should know the best possible evidence for each type of question The first component of the quality is its general planning/design of the study. General planning/design of a cohort study, a case series or normal study demonstrates variations.
A hierarchy of evidence for different research questions is presented in Table 4 . However this hierarchy is only a first step. After you find good quality research articles, you won’t need to read all the rest of other articles which saves you tons of time. [ 14 ]
Determination of levels of evidence based on the type of the research question
I | Systematic review of Level II studies | Systematic review of Level II studies | Systematic review of Level II studies | Systematic review of Level II studies |
II | Randomized controlled study | Crross-sectional study in consecutive patients | Initial cohort study | Prospective cohort study |
III | One of the following: Non-randomized experimental study (ie. controlled pre-, and post-test intervention study) Comparative studies with concurrent control groups (observational study) (ie. cohort study, case-control study) | One of the following: Cross-sectional study in non-consecutive case series; diagnostic case-control study | One of the following: Untreated control group patients in a randomized controlled study, integrated cohort study | One of the following: Retrospective cohort study, case-control study (Note: these are most prevalently used types of etiological studies; for other alternatives, and interventional studies see Level III |
IV | Case series | Case series | Case series or cohort studies with patients at different stages of their disease states |
Rarely all researches arrive at the same conclusion. In this case a solution should be found. However it is risky to make a decision based on the votes of absolute majority. Indeed, a well-performed large scale study, and a weakly designed one are weighed on the same scale. Therefore, ideally a meta-analysis should be performed to solve apparent differences. Ideally, first of all, one should be focused on the largest, and higher quality study, then other studies should be compared with this basic study.
In conclusion, during writing process of a review article, the procedures to be achieved can be indicated as follows: 1) Get rid of fixed ideas, and obsessions from your head, and view the subject from a large perspective. 2) Research articles in the literature should be approached with a methodological, and critical attitude and 3) finally data should be explained in an attractive way.
How to write a research proposal.
For many subjects, writing a research proposal is a key part of your postgraduate research degree application. This is your opportunity to demonstrate your knowledge and how you want to contribute to the subject.
We use the proposal to match your interest with an appropriate supervisor to make sure you have the best support during your degree. We are looking for originality and relevance when assessing the overall quality of your application, including your suitability for this level of study.
We highly recommend that you explore which academic researchers are working in your subject area and contact them first with any questions, this is a good opportunity to firm up your ideas, further explore the topic and talk with others in your field.
A research proposal is a concise and coherent document, usually between 1500 – 2000 words, maximum 4 x A4 pages. You should outline your proposed research project, why it is of relevance (rationale), what research questions are you going to ask, what you hope to achieve (aims and objectives) and how you plan to carry out your research (methodology).
This page is your comprehensive guide to writing a research proposal and will cover seven key elements of a proposal:
You should include a title for your thesis in the proposal.
Your title may change as you further your research, but at this stage it's important to state succinctly what your research will cover.
Briefly identify your idea, what is your ‘research question’?
It could be the theory you want to test, or a more open question. It would be useful to give examples, 3-5 research questions from recently completed PhDs in a relevant field. You should discuss the context around your research topic, such as current debates and issues. The important thing here is that you introduce your research project with clarity and in a way that stimulates your reader’s interest.
Demonstrate the significance of your research project.
To do this, explain why your research is important, what makes it original and how it will contribute to existing knowledge within its field.
What are you hoping to achieve with your research?
Try and produce four or five bullet points of objectives for each aim, which demonstrate your understanding of how to meet your research aims. You can use the SMART acronym to support you in creating objectives, which involves making your objectives: specific, measurable, achievable, realistic and time specific.
Demonstrate your knowledge and awareness of relevant literature
A literature review is a discussion and evaluation of academic literature or a relevant body of knowledge (for practice-based research). You should use this section of your proposal to show that you are familiar with work in your chosen topic area and that your research will contribute something new and/or meaningful to it.
Explain how you plan to carry out your research
The methodology section of your research proposal is where you explain how you plan to carry out your research. This should include the research techniques and methods you will use, why these are most appropriate and how you will implement them. You should also include a discussion of the research strategy (general approach) you will adopt, with appropriate justification, including the analytical approach. The section should also contain the range of research findings that will be gathered from the research and how you will analyse or evaluate this. For practice based research, include how will your portfolio of artefacts, code, software, compositions, computer games etc. articulate the originality of your research?
Reference all the materials you used in the preparation your proposal
You may also list references that you didn't directly draw upon, to demonstrate awareness of literature relating to your proposed material.
Your research proposal will be read by academics with an interest in your field of research. You are therefore encouraged to contact members of academic staff informally prior to submitting your application to discuss to your research proposal. This can often speed up the applications process, as you can identify the member(s) of staff you have spoken to on your research degree application form.
Use the Huddersfield Research Portal to browse academic staff profiles and search using key words to find staff members who share your research interests.
Your research proposal is your starting point, and we understand that as your idea develop s , your proposed research is likely to change. As such, you will not be obliged to adhere to the specifics of your proposal if you are offered a place as a research degree candidate at Huddersfield. However, as the proposal is the foundation of your working relationship with your supervisor(s), you will need to discuss any changes with them first.
Once you have written your research proposal you will need to complete an application form. Look at our how to apply webpage for more information.
Our step-by-step guide will help you to make the most out of your application for a research degree
Explore our funding options, including scholarships and Doctoral Loans.
Implementation Science volume 19 , Article number: 63 ( 2024 ) Cite this article
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Co-design with consumers and healthcare professionals is widely used in applied health research. While this approach appears to be ethically the right thing to do, a rigorous evaluation of its process and impact is frequently missing. Evaluation of research co-design is important to identify areas of improvement in the methods and processes, as well as to determine whether research co-design leads to better outcomes. We aimed to build on current literature to develop a framework to assist researchers with the evaluation of co-design processes and impacts.
A multifaceted, iterative approach, including three steps, was undertaken to develop a Co-design Evaluation Framework: 1) A systematic overview of reviews; 2) Stakeholder panel meetings to discuss and debate findings from the overview of reviews and 3) Consensus meeting with stakeholder panel. The systematic overview of reviews included relevant papers published between 2000 and 2022. OVID (Medline, Embase, PsycINFO), EBSCOhost (Cinahl) and the Cochrane Database of Systematic reviews were searched for papers that reported co-design evaluation or outcomes in health research. Extracted data was inductively analysed and evaluation themes were identified. Review findings were presented to a stakeholder panel, including consumers, healthcare professionals and researchers, to interpret and critique. A consensus meeting, including a nominal group technique, was applied to agree upon the Co-design Evaluation Framework.
A total of 51 reviews were included in the systematic overview of reviews. Fifteen evaluation themes were identified and grouped into the following seven clusters: People (within co-design group), group processes, research processes, co-design context, people (outside co-design group), system and sustainment. If evaluation methods were mentioned, they mainly included qualitative data, informal consumer feedback and researchers’ reflections. The Co-Design Evaluation Framework used a tree metaphor to represent the processes and people in the co-design group (below-ground), underpinning system- and people-level outcomes beyond the co-design group (above-ground). To evaluate research co-design, researchers may wish to consider any or all components in the tree.
The Co-Design Evaluation Framework has been collaboratively developed with various stakeholders to be used prospectively (planning for evaluation), concurrently (making adjustments during the co-design process) and retrospectively (reviewing past co-design efforts to inform future activities).
Peer Review reports
While stakeholder engagement in research seems ethically the right thing to do, a rigorous evaluation of its process and outcomes is frequently missing.
Fifteen evaluation themes were identified in the literature, of which research process , cognitive and emotional factors were the most frequently reported.
The Co-design Evaluation Framework can assist researchers with research co-design evaluation and provide guidance regarding what and when to evaluate.
The framework can be used prospectively, concurrently, and retrospectively to make improvements to existing and future research co-design projects.
Lots of money is wasted in health research that does not lead to meaningful benefits for end-users, such as healthcare professionals and consumers [ 1 , 2 , 3 ]. One contributor to this waste is that research often focusses on questions and outcomes that are of limited importance to end-users [ 4 , 5 ]. Engaging relevant people in research co-design has increased in order to respond to this issue. There is a lack of consensus in the literature on the definition and processes involved in undertaking a co-design approach. For the purposes of this review, we define research co-design as meaningful end-user engagement that occurs across any stage of the research process , from the research planning phase to dissemination of research findings [ 6 ]. Meaningful end-user engagement refers to an explicit and measurable responsibility, such as contributing to writing a study proposal [ 6 ]. The variety of research co-design methods can be seen as a continuum ranging from limited involvement, such as consulting with end-users, to the much higher effort research approaches in which end-users and researchers aim for equal decision-making power and responsibility across the entire research process [ 6 ]. Irrespective of the intensity of involvement, it is generally recommended that a co-design approach should be based on several important principles such as equity, inclusion and shared ownership [ 7 ].
Over time, increasing attention has been given to research co-design [ 6 , 8 ]. Funding bodies encourage its use and it is recommended in the updated UK MRC framework on developing and evaluating complex interventions [ 9 ]. End-user engagement has an Equator reporting checklist [ 10 ] and related work has been reported by key organisations, such as the James Lind Alliance in the UK ( www.jla.nihr.ac.uk ), Patient Centered Outcomes Research Institute in the US ( www.pcori.org ) and Canadian Institutes of Health Research ( https://cihrirsc.gc.ca/e/41592.html ). In addition, peer reviewed publications involving co-design have risen from 173 per year in 2000 to 2617 in 2022 (PubMed), suggesting a growing importance in research activities.
Engaging end-users in the health research process is arguably the right thing to do, but the processes and outcomes of co-design have rarely been evaluated in a rigorous way [ 6 ]. Existing anecdotal evidence suggests that research co-design can benefit researchers, end-users and lead to more robust research processes [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. Both researchers and end-users have reported positive experiences of engaging in the co-design process. Potential benefits include a better understanding of community needs, more applicable research questions, designs and materials and improved trust between the researchers and end-users. Several reviews on conducting research co-design have concluded that co-design can be feasible, though predominantly used in the early phases of research, for example formulating research questions and developing a study protocol [ 6 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. However, these reviews highlighted that engagement of end-users in the research process required extra time and funding and had the risk of becoming tokenistic [ 6 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ].
The use of resources in co-design studies might need to be justified to the funder as well as its impacts. A rigorous evaluation of research co-design processes and outcomes is needed to identify areas of potential improvement and to determine the impact of research co-design. Several overviews of reviews on research co-design have been published but with no or limited focus on evaluation [ 20 , 21 , 22 , 23 ]. Moreover, current literature provides little guidance around how and what to evaluate, and which outcomes are key.
This study thus had two aims:
To conduct a systematic overview of reviews to identify evaluation methods and process and outcome variables reported in the published health research co-design literature.
To develop a framework to assist researchers with the evaluation of co-design processes and impacts.
This project used a multifaceted, iterative approach to develop a Co-design Evaluation Framework. It consisted of the following steps: 1) A systematic overview of reviews; 2) Stakeholder panel meetings to discuss and debate findings from the overview of reviews and 3) Consensus meeting with stakeholder panel. The reporting checklist for overviews of reviews was applied in Additional file 1 [ 24 ].
We conducted a systematic overview of reviews [ 25 ], reviewing literature reviews rather than primary studies, to investigate the following question: What is known in the published literature about the evaluation of research co-design in health research? The protocol of our systematic overview of reviews was published in the PROSPERO database (CRD42022355338).
Sub questions:
What has been co-designed and what were the objectives of the co-design process?
Who was involved and what was the level of involvement?
What methods were used to evaluate the co-design processes and outcomes?
What was evaluated (outcome and process measures) and at what timepoint (for example concurrently, or after, the co-design process)?
Was a co-design evaluation framework used to guide evaluation?
We searched OVID (Medline, Embase, PsycINFO), EBSCOhost (Cinahl) and the Cochrane Database of Systematic reviews on the 11th of October 2022 for literature reviews that reported co-design evaluation or outcomes in health research. The search strategy was based on previous reviews on co-design [ 6 , 14 , 26 ] and refined with the assistance of a research librarian and the research team (search terms in Additional file 2). Papers published from January 2000 to September 2022 were identified and retrieved by one author (SP).
Database records were imported into EndNote X9 (The EndNote Team, Philadelphia, 2013) and duplicates removed. We managed the study selection process in the software program Covidence (Veritas Health Innovation, Melbourne, Australia). Two independent reviewers (SP, MK or LG) screened the titles and abstracts of all studies against the eligibility criteria (Table 1 ). Discrepancies were resolved through discussion or with a third reviewer (either SP, MK or LG, depending on which 2 reviewers disagreed). If there was insufficient information in the abstract to decide about eligibility, the paper was retained to the full-text screening phase. Full-text versions of studies not excluded at the title and abstract screening phase were retrieved and independently screened by two reviewers (SP, MK or LG) against eligibility criteria. Disagreements were resolved through discussion, or with a third reviewer, and recorded in Covidence.
Data extraction of included papers was conducted by one of three reviewers (SP, MK or LG). A second reviewer checked a random sample of 20% of all extracted data (LG or SP). Disagreements were resolved through regular discussion. Data were extracted using an excel spreadsheet developed by the research team and included review characteristics (such as references, type of review, number of included studies, review aim), details about the co-design process (such as who was involved in the co-design, which topics the co-design focused on, what research phase(s) the co-design covered, in which research phase the co-design took place and what the end-users’ level of involvement was) and details about the co-design evaluation (what outcomes were reported, methods of data collection, who the participants of the evaluation were, the timepoint of evaluation, whether an evaluation framework was used or developed and conclusions about co-design evaluation).
Types of end-users’ involvement were categorised into four groups based on the categories proposed by Hughes et al. (2018): 1. Targeted consultation; 2. Embedded consultation; 3. Collaboration and co-production and 4. User-led research, see Table 2 .
Data extraction and analysis took place in three iterative phases (Fig. 1 ), with each phase containing one third of the included studies. Each phase of data extraction and analysis was followed by stakeholder panel meetings (see step 2 below). This stepwise approach enabled a form of triangulation wherein themes that emerged through each phase were discussed with the stakeholder panel and incorporated both retrospectively (re-coding data in the prior phase) and prospectively (coding new data in the next phase).
Iterative phases in the process of the Co-design evaluation framework development
All reported outcomes of research co-design in the first phase (one third of all data) were inductively coded into themes, according to the principles of thematic analysis [ 28 ]. Two researchers (SP and MK) double coded 10% of all data and reached consensus through discussion. Given that consensus was high, one researcher (SP) continued the coding while having frequent discussions and reviews within the research team. In phase 2 (also one third of all data), deductive coding was based on the themes identified in the first round. Data of the first phase were re-coded, if new codes emerged during the stakeholder panel meeting. The same process took place for the third phase.
Results from step 1 were presented to the stakeholder panel to interpret and critique the review findings. The panel consisted of ten people, including a mix of consumers, healthcare professionals and researchers. Stakeholders were selected for their experience or expertise in research co-design. The number of meetings was not pre-determined, rather, it was informed by the outcomes from step 1. The number of stakeholders in each meeting ranged from six to ten.
A core group from the broader stakeholder panel (SP, MK, LG, JF) with a breadth of research experience and methodological expertise discussed the themes arising from both steps 1 and 2 and considered various ways of presenting them. Multiple design options were considered and preliminary frameworks were developed. Following discussion with the stakeholder panel, it was agreed that the evaluation themes could be grouped into several clusters to make the framework more comprehensible. The grouping of evaluation themes into clusters was informed by reported proposed associations between evaluation themes in the literature as well as the stakeholder panel’s co-design experience and expertise. Evaluation themes as well as clusters were agreed upon during the stakeholder panel meetings.
The consensus meeting included the same stakeholder panel as in step 2. The meeting was informed by a modified Nominal Group Technique (NGT). The NGT is a structured process for obtaining information and reaching consensus with a target group who have some association or experience with the topic [ 29 ]. Various adaptations of the NGT have been used and additional pre-meeting information has been suggested to enable more time for participants to consider their contribution to the topic [ 30 ]. The modified NGT utilised in this study contained the following: (i) identification of group members to include experts with depth and diverse experiences. They were purposively identified at the start of this study for their expertise or experience in research co-design and included: a patient consumer, a clinician, three clinician researchers and six researchers with backgrounds in behavioural sciences, psychology, education, applied ethics and participatory design. All authors on this paper were invited by e-mail to attend an online meeting; (ii) provision of information prior to the group meeting included findings of the overview of reviews, a draft framework and objectives of the meeting. Five authors with extensive research co-design experience were asked to prepare a case example of one of their co-design projects for sharing at the group meeting. The intention of this exercise was to discuss the fit between a real-world example and the proposed framework; (iii) hybrid meeting facilitated by two researchers (SP & JF) who have experience in facilitating consensus meetings. Following presentation of the meeting materials, including the preliminary framework, group members were invited to silently consider the preliminary framework and generate ideas and critiques; iv) participants sharing their ideas and critiques; v) clarification process where group members shared their co-design example project and discussed the fit with components of the initial framework, and vi) silent voting and/or agreement on the framework via a personal email to one of the researchers (SP).
The database searches identified a total of 8912 papers. After removing 3016 duplicates and screening 5896 titles and abstracts, 148 full texts were sought for retrieval. Sixteen were not retrieved as they were not available in English ( n = 2) or full-text was not available ( n = 14). Of the remaining 132 papers assessed for eligibility, 81 were excluded. The final number of papers included in this overview of reviews was 51 (See Fig. 2 ).
PRISMA flow chart (based on [ 31 ]) of overview of reviews
Of the 51 included reviews [ 11 , 12 , 14 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 ], 17 were systematic reviews, 12 were scoping reviews, 14 did not report the type or method of review, three were narrative reviews, two were qualitative evidence synthesis, another two were a structured literature search and one was a realist review. The number of studies included in the reviews ranged from 7 to 260. Nineteen reviews focused on co-design with specific populations, for example older people, people with intellectual disabilities, people living with dementia and 32 reviews included co-design with a range of end-users. The co-design focused in most cases on a mix of topics ( n = 31). Some reviews were specifically about one clinical topic, for example critical care or dementia. In ten cases, the clinical topics were not reported. Co-design took place during multiple research phases. Thirty-six reviews covered co-design in agenda/priority setting, 36 in study design, 30 in data collection, 25 in data analysis and 27 in dissemination. With regards to the research translation continuum, most of the co-design was reported in practice and community-based research ( n = 32), three reviews were conducted in basic research and 11 in human research. The types of end-users’ involvement in co-design ranged from targeted consultation ( n = 14) to embedded consultation ( n = 20), collaboration and co-production ( n = 14) to end-user- led research ( n = 6), including papers covering multiple types of involvement. Seventeen papers did not report the types of involvement. The reported co-design included a variety of time commitments, from a minimum of a one-off 60-min meeting to multiple meetings over multiple years. Twenty-seven reviews did not report details about the end-users’ types of involvement.
Fifteen evaluation themes were identified and were arranged into two higher level groups: 1. within the co-design team and 2. broader than co-design team (Table 3 ). The themes related to the first group (within the co-design team) included: Structure and composition of the co-design group, contextual enablers/barriers, interrelationships between group members, decision making process, emotional factors, cognitive factors, value proposition, level/ quality of engagement, research process, health outcomes for co-design group and sustainment of the co-design team or activities. The themes within the second group (broader than co-design team) included: Healthcare professional-level outcomes, healthcare system level outcomes, organisational level outcomes and patient and community outcomes.
The research process was the most frequently reported evaluation theme in the reviews ( n = 44, 86% of reviews), followed by cognitive factors ( n = 35, 69%) and emotional factors ( n = 34, 67%) (Table 4 ). Due to variability in reporting practices, it was not possible to specify the number of primary studies that reported specific evaluation themes. Evaluation methods for the themes were not reported in the majority of reviews ( n = 43, 84%). If evaluation methods were mentioned, they were mainly based on qualitative data, including interviews, focus groups, field notes, document reviews and observations (see overview with references in Additional file 3). Survey data was mentioned in three reviews. Many reviews reported informal evaluation based on participant experiences (e.g. informal feedback), reflection meetings, narrative reflections and authors’ hypotheses (Additional file 3). The timing of the evaluation was only mentioned in two papers: 1. Before and after the co-design activities and 2. Post co-design activities. One paper suggested that continuous evaluation might be helpful to improve the co-design process (Additional file 3).
The systematic overview of reviews found that some authors reported proposed positive associations between evaluation themes (Table 5 ). The most frequently reported proposed association was between level/quality of engagement and emotional factors ( n = 5, 10%). However, these proposed associations did not seem to have any empirical evidence and evaluation methods were not reported.
All evaluation themes were grouped into the following clusters (Table 6 ): People (within co-design group), group processes, research processes, co-design context, people (outside co-design group), system and sustainment.
Only one paper reported the evaluation in connection to the research phases (Agenda/priority setting, study design, data collection, data analysis and dissemination). This paper reported the following outcomes for the following research phases [ 58 ]:
Agenda/priority setting: Research process; Level/quality of engagement; Cognitive factors; Attributes of the co-design group; Interrelationships between group members; Sustainment of the co-design team or activities; Patient and community outcomes.
Study design: Attributes of the co-design group; Interrelationships between group members; Level/quality of engagement; Cognitive factors; Emotional factors; Research process.
The various research phases in which consumers could be involved, as well as the clusters of evaluation themes, informed the design of the co-design evaluation framework.
Two main options were voted on and discussed within the stakeholder panel. The two main options can be found in Additional file 4. Draft 2 was the prefered option as it was perceived as more dynamic than draft 1, representing a clearer interplay between the two contexts. The stakeholder panel suggested a few edits to the draft, such as the inclusion of bi-directional arrows in the tree trunk and a vertical arrow from underground to above ground with the label ‘impact’.
The final version of the Co-design Evaluation framework is presented in Fig. 3 .
Research Co-design evaluation framework
Figure 3 presents co-design evaluation as the below-ground and above-ground structures of a tree. The tree metaphor presents the processes and people in the co-design group (below-ground) as the basis for system- and people-level outcomes beyond the co-design group (above-ground). To evaluate research co-design, researchers may wish to consider any or all components in this Figure. These evaluation components relate to the methods, processes, and outcomes of consumer involvement in research.
The context within the co-design group (the roots of the tree) consists of the people, group processes and research processes, with various evaluation themes (dot points) related to them, as well as contextual barriers and enablers that relate to situational aspects that might enable or hinder consumer engagement. The context outside the co-design group, i.e., the wider community (the branches and leaves of the tree), comprises people who were not involved in the research co-design process, the system-level and sustainment-related outcomes. These above ground groups are potential beneficiaries or targets of the co-design activities.
The arrows in the middle of the trunk represent the potential mutual influence of the two contexts, suggesting that an iterative approach to evaluation might be beneficial. For example, when deciding the composition of the co-design group, it may be important to have an appropriate representation of the people most impacted by the problem issue or topic at hand. Or, if a co-designed healthcare intervention does not achieve the desired outcomes in the wider context, the co-design group might consider potential ways to improve the intervention or how it was delivered. Evaluation of a research co-design process might start with the foundations (the roots of the tree) and progress to above ground (the tree grows and might develop fruit). Yet, depending on the aim of the evaluation, a focus on one of the two contexts, either below or above ground, might be appropriate.
Which, and how many, components are appropriate to evaluate depends on the nature of the co-design approach and the key questions of the evaluation. For example, if a co-design approach is used in the very early stages of a research program, perhaps to identify priorities or to articulate a research question, then 'below' the ground components are key. While a randomised study comparing the effects of a co-designed intervention versus a researcher-designed intervention might only consider 'above' the ground components.
The white boxes on the right-hand side of Fig. 3 indicate the research phases, from agenda/priority setting to dissemination, in which consumers can and should be involved. This co-design evaluation framework may be applied at any phase of the research process or applied iteratively with a view to improving future co-design activities.
This systematic overview of reviews aimed to build on current literature and develop a framework to assist researchers with the evaluation of research co-design. Fifty-one included reviews reported on fifteen evaluation themes, which were grouped into the following clusters: People (within co-design group), group processes, research processes, co-design context, people (outside co-design group), system and sustainment. Most reviews did not report measurement methods for the evaluation themes. If methods were mentioned, they mostly included qualitative data, informal consumer feedback and researchers’ reflections. This finding strengthens our argument that a framework may be helpful in supporting methodologically robust studies to assess co-design processes and impacts. The Co-Design Evaluation Framework has adopted a tree metaphor. It presents the processes and people in the co-design group (below-ground) as the underpinning system- and people-level outcomes beyond the co-design group (above-ground). To evaluate stakeholder involvement in research, researchers may wish to consider any or all components in the tree. Which, and how many, components are appropriate to evaluate depends on the nature of the co-design approach and the key questions that stakeholders aim to address. Nonetheless, it will be important that evaluations delineate what parts of the research project have incorporated a co-design approach.
The Equator reporting checklist for Research Co-Design, GRIPP2, provides researchers with a series of concepts that should be considered and reported on when incorporating patient and public involvement in research [ 10 ]. These concepts include, but are not limited to, methods of involving patients and the public in research and intensity of engagement. The Co-Design Evaluation Framework is not intended as a replacement for the GRIPP2, rather, it can be used prospectively to inform development of the co-design project or retropsectively to inform completion of the GRIPP2. Table 7 provides hypothetical examples of research questions that co-design evaluation projects might address. The framework could be used at multiple points within co-design projects, including prospectively (planning for evaluation before the co-design process has started), concurrently ( incorporating improvements during the co-design process) and retrospectively (reviewing past co-design efforts to inform future projects).
Our systematic overview of reviews identified multiple evaluation themes. Some of these overlapped with reported values associated with public involvement in research [ 80 ], community engagement measures [ 15 ] and reported impacts of patient and public involvement in research, as described by others [ 16 , 81 , 82 ]. The added value of our systematic overview of reviews is that we went beyond a list of items and took it one step further by looking at evaluation themes, potential associations between evaluation themes, clusters of evaluation themes and ultimately developed a framework to assist others with research co-design evaluation.
Some reviews in our overview of reviews proposed potential associations between evaluation themes. Yet, these proposed associations were not empirically tested. One of the included studies [ 58 ] proposed conditions and mechanisms involved in co-design processes and outcomes related to diabetes research. Although it is a promising starting point, this should be further explored. A realist evaluation including other research topics and other approaches, such as the use of logic models, which was also recognised in the updated MRC framework [ 9 ], might help to build on explorations of included mechanisms of action [ 83 ] and give insight into how core ingredients contribute to certain co-design processes and outcomes. As recognised by others [ 6 , 84 ], the reporting practice of research co-design in the literature could be improved as details about context, mechanisms and expected outcomes are frequently missing. This will also help us to gain a better understanding of what works for whom, why, how and in which circumstances.
The lack of a consistent definition of co-design makes it challenging to identify and synthesise the literature, as recognised by others [ 6 ]. Given that there are so many different terms used in the literature, there is a risk that we might have missed some relevant papers in our overview of reviews. Nevertheless, we tried to capture as many as possible synonyms of co-design in our search terms. The absence of quality assessment of included studies in our overview of reviews can be seen as a limitation. However, our overview of reviews did not aim to assess existing literature on the co-design process, but rather focused on what to evaluate, how and when. We did note whether the reported evaluation themes were based on empirical evidence or authors’ opinions. Primary studies reported in the included reviews were not individually reviewed as this was outside the scope of this paper. A strength in our methods was the cyclical process undertaken between steps 1 and 2. Analysis of the data extracted from the overview was refined over three phases following rigorous discussions with a diverse and experienced stakeholder panel. It was a strength of our project that a mix of stakeholders were involved, including consumers, healthcare professionals and researchers.
Stakeholders are frequently engaged in research but if research co-design processes and outcomes are not evaluated, there will be limited learning from past experiences. Evaluation is essential to make refinements during existing projects and improve future co-design activities. It is also critical for ensuring commitments to the underpinning values of c-odesign are embedded within activities.
A systematic review of all primary studies within the included reviews of this overview of reviews, would allow greater depth relating to the practicalities of how to evaluate certain themes. It would lead to a better understanding of existing measures and methods and which evaluation areas need further development. Future research should also focus on whether co-design leads to better outcomes than no co-design (only researcher-driven research). To our knowledge, this has not been explored yet. Moreover, future research could gain better insight into the mechanisms of change within co-design and explore potential associations between evaluation themes for example, those proposed in the included reviews between level/quality of engagement and emotional factors.
We followed a systematic, iterative approach to develop a Co-Design Evaluation Framework that can be applied to various phases of the research co-design process. Testing of the utility of the framework is an important next step. We propose that the framework could be used at multiple points within co-design projects, including prospectively (planning for evaluation before the co-design process has started), concurrently (to incorporate improvements during the co-design process) and retrospectively (reviewing past co-design efforts to inform future projects).
All data generated during this study are included either within the text or as a supplementary file.
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Over the last two decades, the phenomenon of “slum tourism” and its academic exploration have seen considerable growth. This study presents a systematic literature review of 122 peer-reviewed journal articles, employing a combined approach of bibliometric and content analysis. Our review highlights prominent authors and journals in this domain, revealing that the most cited journals usually focus on tourism studies or geography/urban studies. This reflects a confluence of travel motivations and urban complexities within slum tourism. Through keyword co-occurrence analysis, we identified three primary research areas: the touristic transformation of urban informal settlements, the depiction and valorization of urban poverty, and the socio-economic impacts of slum tourism. This study not only maps the current landscape of research in this area but also identifies existing gaps. It suggests that the economic, social, and cultural effects of slum tourism are areas that require more in-depth investigation in future research endeavors.
Introduction.
“Slums” are defined by UN-Habitat ( 2006 ) as underdeveloped urban areas lacking in a durable housing, adequate living space, safe water access, sanitation, and tenure security. Emerging from urban growth disparities, these informal settlements have proliferated since the latter half of the 20th century, especially in the Global South’s cities. Despite progress in urban planning and poverty reduction, UN-Habitat ( 2020 ) reports that over a billion people, with 80% in developing regions, still live in such conditions.
Slums undeniably “represent one of the most enduring faces of poverty, inequality, exclusion and deprivation” (UN-Habitat, 2020 , p. 25), necessitating policy intervention. However, the term “slum” is controversial among scholars as it often carries negative connotations, conflating poor housing conditions with the identities of residents (Gilbert, 2007 ). Beyond poverty and disease, it suggests crime and immorality, contributing to a narrative of fear and fascination (Davis, 2006 ; Mayne, 2017 ).
Recent decades have seen a surge in “slum tours” in the Global South, attracting tourists from the affluent North. Driven by complex motives that “consist of a mix of adventurous inquiry and humanitarian ambitions” (Dürr, 2012b , p. 707), tourists from the affluent North desire to glimpse “the other side of the world” (Steinbrink, 2012 , p. 232). This trend has turned guided tours in informal settlements into a booming business in cities like Mumbai, Rio de Janeiro, Cape Town, and Nairobi, drawing approximately one million tourists annually (Frenzel, 2016 ).
Modern slum tourism has deep historical roots, originating as “slumming” in Victorian England and early 20th-century America. Rapid urbanization in cities like London and New York created neglected areas, which, to middle and upper-class observers, represented a mysterious and chaotic “other world” (Steinbrink, 2012 ). This perception of danger and uncivilization paradoxically attracted bourgeois curiosity (Frenzel et al. 2015 ).
By the late 1970s, with the surge in international tourism, this localized “slumming” transformed into a global phenomenon. Affluent residents from the Global North began exploring underprivileged urban pockets in the Global South, making these areas tourism hotspots (Freire-Medeiros, 2009 ; Iqani, 2016 ). This trend marked the beginning of modern slum tourism, a practice that took a significant turn in the 1990s in South Africa. Initially focusing on anti-apartheid landmarks in townships like Soweto, Johannesburg (Steinbrink, 2012 ), these tours diversified to other cities, including Rio de Janeiro, Mumbai, and Manila (Frenzel et al. 2015 ). The once sporadic visits to informal settlements have now metamorphosed into well-orchestrated tours, often recommended by travel guidebooks. Today’s travelers can dine at local eateries, visit schools, interact with residents, or even step inside their homes (Frenzel, 2017 ; Frenzel and Blakeman, 2015 ). The industry has professionalized, with cities in the Global South attracting tourists mainly from the United Kingdom, United States, Germany, and Scandinavia (Frenzel, 2012 ; Frenzel and Blakeman, 2015 ; Steinbrink, 2012 ).
The burgeoning interest in slum tourism has sparked significant scholarly discourse, particularly in the new millennium. Research in this realm predominantly orbits around the ethical implications of such tourism, its role in mitigating poverty, and the duties of governing bodies in these scenarios. Slum tourism research encompasses various disciplines, including urban studies, tourism and hospitality, and human geography, with a significant proliferation of publications in recent years.
The surge in research has also led to several evaluative studies scrutinizing the breadth and depth of the subject. Frenzel’s ( 2013 ) thematic review, for instance, probed the nexus between slum tourism and poverty alleviation. Given that most slum tours proclaim poverty alleviation as their core intent, Frenzel’s inquiry into the intersection of this mission with tourism was insightful. He also championed the need for a rigorous exploration of the multifaceted valorization of poverty within tourism dynamics. A more expansive review by Frenzel et al. ( 2015 ) delved into various research focuses like the evolution of slum tourism, tourist experiences, operational aspects, economic implications, and so on. Their assessment underscored existing research voids, emphasizing the necessity for more nuanced, comparative studies. Tzanelli ( 2018 ) examined the socio-cultural and political drivers behind tourists’ inclinations towards informal settlements, critically analyzing the epistemological frameworks employed by scholars.
While these reviews have significantly sketched the contours of the discipline, many leaned heavily on conventional literature review techniques—predicated on selected, and at times, circumscribed resources (Petticrew and Roberts, 2008 ). Such manual methodologies, albeit insightful, are prone to biases “during the identification, selection, and synthesis of included studies” (Haddaway et al. 2015 , p. 1956). A systematic literature review, which adheres to rigorous protocols and curtails subjective inclinations, would be more enriching. Such a methodological shift not only offers a panoramic view of pivotal research arguments and deliberations but also illuminates evolving trends and perspectives. The surge in slum tourism literature recently underscores its dynamic nature, necessitating a renewed scrutiny of nascent discussions eluding preceding reviews.
Addressing this research exigency, our current endeavor undertakes a comprehensive examination of a gamut of articles illuminating diverse research angles on slum tourism. Employing both bibliometric and qualitative content analysis techniques, our study dissects 122 journal articles published over the past twenty years. We endeavor to spotlight seminal authors and journals, delineate prevailing themes in slum tourism studies, and carve out prospective trajectories for forthcoming research endeavors.
Search process and sample selection.
A systematic review requires researchers to thoroughly examine all existing studies in a certain research area. This ensures a replicable, scientific, and transparent approach with minimal bias (Denyer and Tranfield, 2009 ). We adopt the “Preferred Reporting Items for Systematic Reviews and Meta-Analysis” (PRISMA) guideline (Moher et al. 2009 ) to identify eligible articles. The screening process is presented in Fig. 1 . We consulted an advanced keyword search on Google Scholar to retrieve literature on slum tourism. We chose Google Scholar because it provides broader access to a diverse range of scholarly articles, including those from various regions and disciplines that may not be indexed in databases like Web of Science or Scopus. Furthermore, since this study aims to review research articles on slum tourism, which is pertinent in the Global South, many journals or articles published or authored in the Global South are not indexed in Web of Science or Scopus but can be found on Google Scholar. This accessibility is vital for ensuring the inclusion of relevant studies that reflect the diverse contexts of slum tourism.
The systematic workflow and results.
For our subject search, we used the keywords “slum tourism.” We consciously omitted country-specific terms like barrios, township, and favela to prevent a regional bias (Baffoe and Kintrea, 2023 ). Google Scholar Advanced Search provides the choice to locate keywords either “in the title of the article” or “anywhere in the article.” We chose the latter, ensuring the inclusion of articles that might employ regional terms synonymous with “slum” in their titles. This approach also considered the potential cross-referencing of slum tourism literature in these articles. Conducted in August 2023 without time constraints, our search yielded 2690 materials.
To uphold the literature’s quality, only peer-reviewed scientific articles were chosen, excluding “grey literatures” such as reports, theses, conference proceedings, and other similar outputs. Books and book chapters were not incorporated into our review because our focus extended to trends in slum tourism research. The accelerated pace of academic publishing in journals, as compared to the longer timelines associated with books, means they often house the most current findings and trends. Utilizing a bibliometric analysis approach, we found the standardized structure of journal articles particularly beneficial, allowing for a more straightforward process in extracting, comparing, and synthesizing data. Books and their chapters, given their varied formats, might not always provide this level of consistency. Recognizing that a systematic review cannot encompass all languages, we confined our study to English-written articles.
After the initial screening, 148 articles closely related to slum tourism were identified. Our perspective on slum tourism aligns with Frenzel’s ( 2018 , p. 51) definition, describing it as “tourism where poverty and associated signifiers become central themes and (part of the) attraction of the visited destination.” Upon a thorough review of the full texts, it became apparent that some articles, while mentioning “slum tourism,” did not primarily focus on it. For instance, the work of Jones and Sanyal ( 2015 ) discusses the portrayal of Dharavi—India and Asia’s largest informal settlement—in slum tours, arts, and documentaries. Although their article addresses how Dharavi is represented in slum tours, its primary focus is on the depiction of informal settlements and urban poverty across various media, not slum tourism per se. Consequently, this article was excluded from our dataset. We also eliminated editorials, short commentaries, research notes, and prior literature reviews. This filtering narrowed our selection to 107 peer-reviewed articles. An exhaustive examination of their references added another 15 articles, giving a total of 122 articles. Figure 1 visualizes the selection process.
This study utilized both bibliometric and qualitative content analyses. Bibliometric analysis is crucial for identifying both established and emerging research themes as well as influential authors, key studies, and prominent journals (Hajek et al. 2022 ). We employed VOSviewer, a leading bibliometric analysis software, to undertake co-citation and keyword co-occurrence analyses, examining slum tourism research. Co-citation analysis pinpoints influential authors, studies, and journals, leveraging citations as pivotal indicators of scientific impact (De Bellis, 2009 ). Meanwhile, keyword co-occurrence analysis highlights prominent keywords and their relationships, signposting research field hotspots (Wang and Yang, 2019 ).
Augmenting the bibliometric approach, our qualitative content analysis delved deeper into the primary themes of slum tourism research. The keyword co-occurrence analysis supplied a broad view of research themes and trending topics. Emerging nodes and clusters helped pinpoint dominant research themes. By meticulously analyzing each article’s content, we executed a critical review of every theme. We also broached prospective research trajectories in the article’s conclusion.
Figure 2 illustrates the evolving research landscape of slum tourism. The journey began in 2004 with two seminal papers by Kaplan ( 2004 ) and Rogerson ( 2004 ). Both delved into Johannesburg’s township tourism, emphasizing tourism’s potential in poverty mitigation and the region’s economic upliftment. Post-2004, the domain attracted escalating scholarly interest, evidenced by a notable publication upswing from 2012 onward.
Publishing trends of slum tourism research.
Two pivotal discursive events in Bristol (2010) and Potsdam (2014) further catalyzed the field’s evolution. Gathering global experts on slum tourism, these events spurred foundational texts that have since informed the discipline. The post-Bristol momentum produced a special Tourism Geographies issue in 2012, curated by Frenzel and Koens. Successive publications, like the “Slum Tourism” special issue of Die Erde 144 (2) in 2013, and the themed “Slum Tourism” issue of Tourism Review International in 2015, further cemented the field’s prominence. Undoubtedly, these seminal conferences and publications have been instrumental in surging scholarly endeavors in slum tourism research.
We conducted a co-citation analysis to pinpoint the leading authors and journals in the realm of slum tourism research. A co-citation refers to the simultaneous citation of two documents (Small, 1973 ). Such analysis aids scholars in organizing scientific literature and grasping the evolution of specific research domains (Surwase et al. 2011 ).
Figure 3 illustrates the outcomes of our author co-citation analysis. We established a threshold of 40 citations to identify the most influential authors within our dataset of 4229 authors. Only 11 authors met this threshold, allowing for a focused examination of the core contributors in the field. Their significant scholarly impact is reflected by their extensive citations, with node size in the visualization representing co-citation strength. Rogerson, Frenzel, and Steinbrink emerged as the most frequently cited authors, with the highest link strengths of 3978, 3173, and 2734, respectively. Rogerson’s work delved into the economic ramifications of tourism in South African townships, highlighting the part slum tourism plays in poverty reduction and sustainable community economic growth (Booyens and Rogerson, 2019 a, 2019b ; Rogerson, 2014 ). He also discussed urban tourism’s influence on small and medium-sized enterprises (Rogerson, 2004 , 2008 ). In contrast, Frenzel and Steinbrink examined the commercialization of urban informal settlements and the portrayal and appreciation of poverty (Frenzel, 2017 ; Frenzel and Blakeman, 2015 ; Steinbrink, 2012 , 2013 ).
Author co-citation network.
Other notable authors in this field include Freire-Medeiros, who discussed the transformation of Brazilian favelas into tourist attractions (Freire-Medeiros et al. 2013 ; Freire-Medeiros, 2007 , 2009 , 2011 ), Koens, who probed the growth of small and medium-sized businesses in South African townships (Koens and Thomas, 2015 , 2016 ) and local perceptions of slum tourism in India (Slikker and Koens, 2015 ), and Booyens, who primarily focused on responsible tourism in South African townships (Booyens, 2010 ; Booyens and Rogerson, 2019b , 2018). Rolfes also made a significant contribution by studying the ethical aspects of slum tourism (Burgold and Rolfes, 2013 ; Rolfes, 2010 ).
Intriguingly, although not a slum tourism specialist, Urry stands among the eleven most-cited authors. He is renowned for introducing “the tourist gaze” concept (Urry, 1990 ), suggesting that tourist experiences and choices are more influenced by the tourism industry, societal norms, and cultural factors than by personal autonomy. This theory offers a crucial framework for understanding how poverty is portrayed in slum tourism and the dynamics between tourists and local residents.
Figure 4 presents the map of journal co-citations, illuminating the academic areas focused on the topic of “slum tourism.” A journal co-citation analysis, conducted with a threshold of 40 citations, identified 11 key journals from a pool of 3013 in our dataset, underscoring their central roles in the discourse of the field. Notably, the Annals of Tourism Research occupies a central position on the map with the highest link strength of 2608, highlighting its prominence as the most-cited journal in slum tourism research. These journals are categorized into two primary clusters: tourism studies and geography/urban studies. This categorization reflects the dual scholarly interest in slum tourism, which intertwines travel motivations with the complexities of urban environments. On one hand, tourism researchers probe the allure of these regions, the ensuing cultural interactions, and the ethical debates surrounding poverty as an attraction. Conversely, geography and urban studies scholars explore the spatial structures of informal settlements, underlying socio-economic drivers, and the reciprocal impact between tourism and urban evolution. Collectively, these disciplines provide a nuanced view of slum tourism’s multifaceted nature. Notably, Development Southern Africa does not align strictly with these categories, but as a multidisciplinary journal emphasizing policy and practice in Southern Africa—a hub for modern slum tourism—it garners frequent citations.
Journal co-citation network.
After meticulously reviewing the 122 publications, we pinpointed the locations that are focal points for slum tourism research. As presented in Table 1 , South Africa, India, and Brazil emerge as the most extensively researched countries in this domain. They are closely followed by Kenya, Mexico, Colombia, Egypt, and Indonesia.
Township tourism in South Africa, deeply rooted in the country’s complex history, is a significant topic in slum tourism research. This form of tourism, which emerged in post-apartheid South Africa (Steinbrink, 2012 ), focuses on areas historically designated as “black only” zones, where disparities still exist (Iqani, 2016 ). Originating in Soweto, Johannesburg, it has since spread to other major cities. The 2010 FIFA World Cup, hosted by South Africa, notably boosted its popularity (Marschall, 2013 ). Today, Cape Town is a key destination for township tourism, with townships like Langa and Khayelitsha attracting tourists due to their historical significance (Rolfes, 2010 ).
Similar to South Africa, favela tourism in Brazil has political roots. These favelas, initially informal settlements for the formerly enslaved (Iqani, 2016 ), gained international attention after the 1992 Earth Summit, when delegates visited Rio de Janeiro’s favelas (Frenzel, 2012 ). Their prominence increased further during the 2014 FIFA World Cup and the 2016 Olympics (Steinbrink, 2013 ). Despite their cultural richness, favelas face challenges like crime and drug trafficking (Freire-Medeiros, 2009 ). Rio’s favelas, especially Rocinha and Santa Marta, attract numerous tourists each year (Frenzel and Blakeman, 2015 ).
In India, the scenario of slum tourism is notably different, with Mumbai’s Dharavi, one of the world’s largest informal settlement, being a key focus of India-specific studies. Other informal settlements in cities like Kolkata and Delhi have also attracted scholarly attention (Holst, 2015 ; Sen, 2008 ). These informal settlements are characterized by their micro-industries and recycling efforts, showcasing the resilience and entrepreneurial spirit of the residents (Gupta, 2016 ). Although a relatively new trend compared to its counterparts, India’s slum tourism industry has burgeoned, spawning numerous tour operators (Frenzel and Blakeman, 2015 ).
Over time, slum tourism has gained traction, spreading to nations across the Global South, including Kenya, Colombia, Mexico, Egypt, and the Philippines. In our study, while most articles were location-specific, ten adopted a holistic approach, discussing the overarching theme of slum tourism.
We conducted a keyword co-occurrence analysis on our slum tourism research dataset to identify and visualize the most significant themes by examining the frequency and relationships of keywords. This method facilitated the identification of central research clusters and thematic hotspots within the topic. Figure 5 illustrates the network of keywords that frequently co-occur in slum tourism studies. To refine our data, we consolidated similar keywords, for example, pairing “township” with “townships” and “developing countries” with “developing world.” For this analysis, we set a threshold to include keywords that appeared at least three times, leading to the selection of 44 out of 322 keywords, thereby emphasizing their significance within the field. In the network, each node represents a keyword; larger nodes indicate higher frequencies of occurrence. Our analysis revealed six distinct clusters, each differentiated by a unique color.
Network visualization of the keywords co-occurrence.
The red cluster focuses on “slum tourism,” examining the development of tourism in informal settlements and its wide-ranging socio-economic impacts. This cluster covers aspects such as “branding” and the role of “tour guides,” and emphasizes key socio-economic factors including “residents’ perceptions” and “poverty alleviation.” Simultaneously, the green cluster, highlighting terms such as “township tourism” and “economic development,” shifts focus to the growth of local, often small-to-medium-sized, tourism businesses, particularly spotlighting township tourism in South Africa. Meanwhile, the light blue cluster examines the impact of slum tourism on local communities, with a special focus on “community-based tourism” and favela tourism in Brazil. The yellow cluster delves into the portrayal of poverty as a key draw in slum tourism, questioning its classification as “poverty tourism” and exploring the shift towards more ethical, “pro-poor,” and responsible tourism practices. Concurrently, the purple cluster critically examines the portrayal and perception of poverty in slum tourism, focusing on tourist perspectives influenced by the “tourist gaze” and social media. Lastly, the dark blue cluster analyzes how globalization and rising consumer culture have spurred the growth of slum tourism, integrating themes like “globalization,” “space,” and “consumption,” and underscoring poverty’s central role in this phenomenon.
In our thematic analysis of publications, we integrated clusters with similar themes. The red, green, yellow, and light blue clusters, which focus on the socio-economic impacts of slum tourism on local communities, were merged. The red and dark blue clusters, addressing the transformation of urban informal settlements into tourist destinations and their driving factors, were also combined into a single theme. Furthermore, the purple and yellow clusters, centered on the portrayal and perception of poverty in slum tourism, were grouped together. Our review systematically examines these unified themes, as illustrated in Table 2 .
The transformation of urban informal settlements into tourist destinations has been extensively discussed in earlier literature on slum tourism. This transformation hinges significantly on cultural and historical heritage. As previously mentioned, Brazil’s favelas and South Africa’s townships attracted visitors with political and cultural interests (Frenzel, 2012 ; Steinbrink, 2012 ). Gradually, with the globalization that stimulated global mobility and the rise of consumer culture, these locales became spaces of interaction, juxtaposing mobility and immobility on a global scale (Dürr, 2012a ). As many informal settlements in the Global South were represented in global media, they gained increasing touristic attention. For instance, after the success of the film “The City of God” in 2003, the number of foreign visitors to favelas in Rio grew significantly (Freire-Medeiros, 2011 ). As Freire-Medeiros ( 2009 , p. 582) mentioned in another article that tours in these informal settlements “are equally indebted to the phenomenon of circulation and consumption, at a global level, of the favela as a trademark.”
In the touristic transformation of informal settlements, policy plays a pivotal role. For instance, local governments in South Africa actively encouraged township tourism by creating museums, developing historical and political heritage sites, and promoting township upgrading programs (Booyens, 2010 ; Booyens and Rogerson, 2019b ; Marschall, 2013 ). In Brazil, favela tourism served as a means to enhance its image in the context of preparations for mega-events in Rio, a strategy dubbed “Festifavelasation” (Steinbrink, 2013 ). South Africa pursued a similar path after securing the 2010 FIFA World Cup (Marschall, 2013 ). In Colombia, a policy known as “social urbanism” led Medellin, previously known for its drug barons and criminal activities, to undergo social and economic transformation, attracting both interest and tourists (Hernandez‐Garcia, 2013 ).
In analyzing our dataset’s articles, it is evident that slum tours primarily occur in well-known informal settlements of the Global South, such as Mumbai’s Dharavi, Rio de Janeiro’s Rocinha, and Johannesburg’s Soweto. These locations are preferred due to the factors previously mentioned. However, this growing industry often overlooks numerous lesser-known and more impoverished communities (Koens, 2012 ). Issues such as insufficient infrastructure, the absence of tourist attractions, and poor security hinder the growth of tourism in informal urban settlements. This situation is clearly seen in areas like Harare, Zimbabwe (Mukoroverwa and Chiutsi, 2018 ), and certain townships in Durban, South Africa (Chili, 2015 ).
A significant barrier is also the lack of awareness of pro-poor tourism in these lesser-known areas. Munyanyiwa et al.’s ( 2014 ) research in Harare’s townships revealed that many residents were unaware of township tourism, compounded by insufficient infrastructure and community involvement to support it. Moreover, residents were unsure of how to benefit from such initiatives, with historical tourism activities largely unknown to them. Similarly, Attaalla’s ( 2016 ) study in Egypt highlighted the minimal awareness of pro-poor tourism, the absence of a comprehensive government policy to develop this tourism type, and the scarcity of specialized Egyptian tour operators and travel agencies in the pro-poor tourism market. For successful tourism in these areas, it’s vital to enhance infrastructure, safety, and offer innovative tourism experiences (Mukoroverwa and Chiutsi, 2018 ). Additionally, improved information dissemination and increased stakeholder engagement are essential (Munyanyiwa et al. 2014 ).
The transition of informal settlements into tourist destinations brings several challenges. Notably, the commercialization of these marginalized areas can aestheticize deprivation and social inequality, turning them into themed spaces that reinforce stereotypes and maintain informal settlements as attractions shaped by tourist expectations (e.g. Altamirano, 2022b ; Dürr, 2012a ). Building on this point, Dürr et al. ( 2020 ) highlighted that marketing urban poverty and violence as a city brand could exacerbate existing inequalities. Research also shows that in many touristic informal settlements, local residents often do not fully engage with or benefit from tourism (Koens and Thomas, 2015 ; Marschall, 2013 ). Furthermore, public policies aimed at transforming these settlements sometimes lack consistency, creating insecurity among locals (Altamirano, 2022b ). Addressing these issues requires enhanced policies and increased community involvement in tourism, posing significant challenges for local governments.
In 2010, the term “poverty tourism” was recognized in slum tourism research, casting a spotlight on the intricate connection between poverty and this type of tourism (Rolfes, 2010 ). This tourism variant is not without controversy, interrogating the confluence of poverty, power, and ethical dilemmas (see Chhabra and Chowdhury, 2012 ; Korstanje, 2016 ; Outterson et al. 2011 ). This dynamic between the commodification of impoverished settlements and their portrayal within the tourism spectrum has ignited fervent academic debate.
Frenzel ( 2014 ) critically observed that within the paradigm of slum tourism, poverty transcends its role as a mere backdrop, ascending to the primary spectacle. Consequently, this leads to the commodification of urban impoverishment, turning it into a tourism commodity with tangible monetary value (Rolfes, 2010 ). Scholars have extensively dissected this juxtaposition. While some examine the framing, representation, and marketing dimensions (Dürr et al. 2020 ; Meschkank, 2011 ; Rolfes, 2010 ), others argued that poverty becomes romanticized, perceived more as a cultural artifact rather than an urgent societal issue (Crossley, 2012 ; Huysamen et al. 2020 ; Nisbett, 2017 ).
In this tapestry, both tourists and tour operators play pivotal roles in framing the narrative. Operators, tapping into the tourists’ quest for the “authenticity” embedded in the narratives of global urbanization, exert significant influence in shaping perceptions (Meschkank, 2012 ; Rolfes, 2010 ). Studies have observed that in an attempt to counteract the inherently negative perceptions surrounding informal settlements (Dyson, 2012 ), operators often position these spaces as beacons of hope, underlining the tenacity, optimism, and aspirations of the residents (Crossley, 2012 ; Dürr et al. 2020 ; Huysamen et al. 2020 ; Meschkank, 2011 ). Moreover, to navigate the moral complexities that tourists might grapple with, operators design their offerings as ethical enterprises, promising both enlightenment for the tourists and tangible economic upliftment for the communities (Muldoon and Mair, 2016 ; Nisbett, 2017 ).
However, such strategies face intellectual scrutiny for their potential to obfuscate the palpable suffering that underpins these urban landscapes. Several studies affirm that poverty dominates the observational narratives across tours in global cities from Mumbai to Rio de Janeiro (Crossley, 2012 ; Dürr et al. 2020 ; Meschkank, 2012 ). As Clini and Valančiūnas ( 2023 ) observed, such sanitized representations, while better than negative stereotypes, could unintentionally normalize the systemic inequalities associated with poverty. This approach not only risks reducing the perceived need for urgent poverty alleviation efforts but also may leave existing societal inequalities unchallenged. This has prompted critiques that label the phenomenon as commercial “voyeurism, and exploitation for commercial ends” (Burgold and Rolfes, 2013 , p. 162).
For tourists, their motivation often orbits around the pursuit of “authenticity” when they consider visiting informal settlements (see Clini and Valančiūnas, 2023 ; Crossley, 2012 ; Gupta, 2016 ; Meschkank, 2011 ; Steinbrink, 2012 ). Marketed as unvarnished encounters with reality, informal settlements are often depicted as bastions of culture, diversity, and authenticity (Frenzel et al. 2015 ). This category of slum tourism is, thus, situated within the broader realm of “reality tourism,” promising participatory experiences in socio-economically challenged urban landscapes (Wise et al. 2019 ). However, this approach, despite aligning with general tourism patterns, is not devoid of problems. The very essence of this touristic venture, which is to experience urban impoverishment, inherently establishes an imbalanced dynamic between tourists and inhabitants, leading to its characterization as a form of voyeurism. (Dürr et al. 2020 ; Meschkank, 2011 ).
In the last decade, slum tourism has diversified with new tours offered by locals and NGOs, aiming to challenge stereotypes and present a more complex picture of informal settlements. Frenzel ( 2014 ) noted that guides can empower communities by focusing on often-ignored aspects of these areas. While motivations vary, with some guides driven by profit and others by community welfare and resisting gentrification effects, the role of guides is crucial. Angelini’s ( 2020 ) examination of favela tours accentuated the nuanced challenges faced by these guides, as they attempt to strike a balance between authentic representation and the commodification of their environments. Further, Dürr et al. ( 2021 ) in their ethnographic study in Mexico City’s Tepito, showed how guides can positively portray deprived areas without depoliticizing them, contextualizing local achievements within city politics and using historical narratives to emphasize the area’s significance.
In the digital era, social media significantly influences the slum tourism narrative (Sarrica et al. 2021 ). The Internet is vital for operators to market and sell tours and provide information to potential travelers (Privitera, 2015 ). Many studies have analyzed slum tourism portrayals in online reviews and media, exploring how these areas and experiences are represented (Huysamen et al. 2020 ; Nisbett, 2017 ; Sarrica et al. 2021 ; Shang et al. 2022 ; Wise et al. 2019 ). For instance, Nisbett ( 2017 ) highlighted concerns about reviews that often gloss over poverty’s complexities, focusing instead on the tours’ economic aspects. Similarly, Huysamen et al. ( 2020 ) observed that tourist narratives tend to paint these areas as “slums of hope,” ignoring the disparity between wealthy tourists and impoverished locals. Ekdale and Tuwei ( 2016 ) studied texts from Kibera visitors, noting that while tourists claim to gain authentic understanding of global inequality, their privileged perspective remains unexamined. These “ironic encounters” often reinforce global inequalities, serving more as self-validation for tourists than a true engagement with local challenges.
On the flip side, social media’s role in depicting informal settlements is not always reductive. Some academics posit that these platforms can provide a counter-narrative to skewed representations by offering avenues to disseminate a diverse array of authentic stories and perspectives (Sarrica et al. 2021 ). Crucially, social media can amplify local residents’ voices, allowing them to share concerns about slum tourism, including privacy, potential exploitation, and daily life disruptions (Crapolicchio et al. 2022 ). The digital era thus presents both opportunities and challenges for slum tourism, underscoring the need for ethical and respectful interactions that honor and authentically represent these communities’ narratives.
The economic and social impacts of tourism in these informal settlements are prominent themes in slum tourism research. Across various countries, including Egypt, South Africa, Brazil, and Indonesia, tourism has spurred urban development and improved living conditions in informal settlements (Anyumba, 2017 ; Booyens and Rogerson, 2019a ; Mekawy, 2012 ; Sulistyaningsih et al. 2022 ; Torres, 2012 ). Developments like aerial cable cars in Brazil’s favelas and minibus-taxis in South African townships have evolved local transportation systems (Freire-Medeiros and Name, 2017 ; Rietjens et al. 2006 ). These advancements facilitate social transformation, such as increased security investments in Brazilian favelas (Freire-Medeiros et al. 2013 ) and “social urbanism” in Colombian barrios, integrating marginalized communities and improving education and security (Hernandez‐Garcia, 2013 ). A comparative study of the touristification of Gamcheon Culture Village (Busan, South Korea) and Comuna 13 (Medellin, Colombia) highlighted that effective governance can create community networks and stakeholder partnerships, fostering entrepreneurial opportunities (Escalona and Oh, 2022 ).
Tourism holds potential as a means to reduce poverty by creating employment opportunities in impoverished urban areas (Aseye and Opoku, 2015 ; Cardoso et al. 2022 ; Paul, 2016 ). Slum tourism, in particular, fosters entrepreneurship, allowing residents to start their own tour companies or bed and breakfasts. However, challenges for local entrepreneurs include limited market access, stiff competition, low marketing budgets, poor business locations, and lack of support from established firms, often leading to the marginalization of smaller operators in a market dominated by larger companies (see Chili, 2018 ; Hikido, 2018 ; Mokoena and Liambo, 2023 ; Mtshali et al. 2017 ; Nemasetoni and Rogerson, 2005 ). Further, small business owners frequently lack essential education and marketing skills (see Leonard and Dladla, 2020 ; Letuka and Lebambo, 2022 ; Rogerson, 2004 ). Mokoena and Liambo ( 2023 ) observed that only a minority of entrepreneurs adopt competitive strategies in their businesses.
Scholars have also observed that the profits from slum tourism are insufficient for significant poverty alleviation (Freire-Medeiros, 2009 , 2012 ). Koen and Thomas’ study of South Africa townships ( 2015 ) highlighted the challenge to the idea that small business owners reinvest their profits locally for economic development. Successful entrepreneurs often leave their townships due to a lack of local ties, leading to economic benefits being concentrated among a small, predominantly male, privileged group, while marginalized groups’ businesses yield lower gains. Moreover, most slum tour companies depend heavily on foreign support, resulting in substantial economic leakage (Frenzel and Blakeman, 2015 ; Meschkank, 2012 ; Rolfes, 2010 ).
The social implications of slum tourism form a major focus in recent academic studies, particularly regarding how local residents perceive this tourism form. Surveys and interviews with inhabitants of informal settlements have uncovered a range of reactions, including positive, negative, skeptical, and indifferent attitudes toward slum tourism (Amo et al. 2019 ; Auala et al. 2019 ; Freire-Medeiros, 2012 ; Marschall, 2013 ; Slikker and Koens, 2015 ).
In Rio, Mumbai, and Nairobi, some studies reveal that residents feel embarrassed by slum tourism, as certain operators emphasize negative community aspects to cater to tourists seeking “real” poverty experiences, leading to privacy issues (Freire-Medeiros, 2012 ; Kieti and Magio, 2013 ; Slikker and Koens, 2015 ). Conversely, slum tourism is also viewed positively in many areas. Slikker and Koens’ ( 2015 ) study in Mumbai and Amo et al. ( 2019 ) research in Medellin found residents believe it counters negative stereotypes and raises community visibility. In Nairobi and Cape Town, locals welcome it as a source of income and jobs (Chege and Mwisukha, 2013 ; Potgieter et al. 2019 ). Additionally, Muldoon et al.’s South African studies suggest slum tourism empowers residents by bringing international attention to townships, giving them more control over their narratives and a sense of importance (Muldoon, 2020 ; Muldoon and Mair, 2022 ).
Indeed, the social impact of tourism is dualistic. As Altamirano ( 2022a ) pointed out, while tourism can establish new material and symbolic frameworks, providing residents with chances for counter-hegemonic actions, it does not uniformly support the cultural empowerment of impoverished communities. Instead, it can result in neoliberal development and increased surveillance. This underscores the necessity for thoughtful policymaking in slum tourism, advocating for policies that prioritize the well-being and cultural richness of communities over mere profit generation, particularly in environments marked by urban disparities and complex power dynamics.
Booyens and Rogerson ( 2019 b) suggested that slum tourism ought to function as a type of “creative tourism,” fostering solidarity and mutual understanding between tourists and local residents, stimulating economic growth in communities, and increasing awareness of the North-South disparity in the postcolonial context. The transition to pro-poor tourism heavily relies on effective policy implementation. Therefore, numerous scholars have advocated for policy instruments to enhance safety and infrastructure, and to facilitate effective coordination among various stakeholders, alongside strengthening institutional frameworks (e.g. Aseye and Opoku, 2015 ; Booyens, 2010 ; Chege and Mwisukha, 2013 ; Rusata et al. 2023 ).
Furthermore, the success of slum tourism largely depends on local community engagement (Duarte and Peters, 2012 ). Yet, in many cases, such as in India (Slikker and Koens, 2015 ), Kenya (Kieti and Magio, 2013 ), Brazil (Freire-Medeiros, 2012 ), and elsewhere, local residents’ participation is limited. Various factors contribute to this, including inadequate business knowledge and skills, and social and financial barriers (Dzikiti and Leonard, 2016 ; Hammad, 2021 ; Leonard and Dladla, 2020 ). Addressing this, researchers emphasize the need for tourism-specific training and resources for local entrepreneurs, particularly focusing on youth (Dzikiti and Leonard, 2016 ; Mbane and Ezeuduji, 2022 ; Nkemngu, 2014 ). To leverage slum tourism for community development, equipping locals with the skills and tools for effective tourism participation is crucial, though it remains a challenging goal.
Over the past two decades, “slum tourism” and its academic study have expanded significantly. Our systematic review of 122 peer-reviewed journal articles sheds light on key authors and journals in this field. The most cited journals typically specialize in tourism studies or geography/urban studies, underscoring the blend of travel motivations and urban complexities in slum tourism. Our findings show that South Africa, India, and Brazil are the most researched countries, with others like Kenya, Mexico, Colombia, Egypt, and Indonesia also being significant. The keyword co-occurrence analysis identified three primary research areas: the touristic transformation of urban informal settlements, the portrayal and valorization of urban poverty, and the socio-economic impacts of slum tourism. This study not only outlines the scope of current research but also points out gaps, suggesting that the economic, social, and cultural effects of slum tourism warrant further exploration in future studies.
The economic aspects of slum tourism, widely debated in academic circles, pose unanswered questions about the actual financial benefits for local residents and communities. Frenzel and Koens ( 2012 ) noted a lack of quantitative evaluations, leaving the impact of slum tours on poverty reduction and urban development uncertain. Existing research, primarily qualitative involving interviews, ethnography, media content analysis, and stakeholder surveys, fails to adequately measure the economic impact on informal settlements. Although studies like those by Chege and Mwisukha ( 2013 ) and Potgieter et al. ( 2019 ) indicated resident perceptions of slum tourism as a source of income and employment, these lack concrete statistical backing. The financial dynamics of slum tourism, including the economic leakage stemming from reliance on external and foreign support (Frenzel and Blakeman, 2015 ; Meschkank, 2012 ; Rolfes, 2010 ), warrant more in-depth investigation. Future research should focus on tracing profit distribution in slum tourism and assessing its real effects on the communities, considering the prominent role of local guides and their relationships with tour operators.
The intangible impacts of slum tourism, including social, political, and cultural aspects, are a fertile area for future research. Shifting focus to local residents’ views, recent studies have shown slum tourism’s broad influence beyond just economic factors, notably in changing perceptions of poverty. However, as Koens ( 2012 ) pointed out, evaluating these impacts is complex due to the deep social and historical contexts within these communities. Advocates for authentic local engagement, like Slikker and Koens ( 2015 ) and Freire-Medeiros ( 2012 ), emphasized the importance of giving local residents a voice. Muldoon’s research ( 2020 ; Muldoon and Mair, 2022 ) in South Africa demonstrates how township tourism allows locals to redefine their identities and interactions with tourists. On the other hand, Freire-Medeiros ( 2012 ) noted in Brazil’s Rocinha the possibility of residents altering narratives for tourist appeal. This highlights the need to integrate the genuine experiences of locals into slum tourism research to fully grasp its diverse impacts.
The potential for slum tourism to either reinforce or challenge existing power dynamics and stereotypes represents a dynamic area of ongoing debate, ripe for further theoretical exploration. Slum tourism is emblematic of neoliberal capitalist practices, where the lived experiences of marginalized communities are commodified and consumed predominantly by Western tourists. This pattern aligns with David Harvey’s concept of “accumulation by dispossession,” where the exploitation and aestheticization of poverty serve to reinforce global economic disparities (Harvey, 2003 ). By transforming informal settlements into tourist attractions, slum tourism becomes a mechanism of cultural commodification, packaging poverty-stricken environments for sale and perpetuating a global hierarchy that privileges affluent tourists while marginalizing local residents.
The representation of informal settlements within this tourism framework often involves selective storytelling, echoing Edward Said’s notion of “Orientalism.” This process portrays the “Other” in ways that reinforce Western superiority and exoticize non-Western realities, contributing to the perpetuation of stereotypes and obscuring the systemic causes of poverty (Said, 2003 ). Such portrayals often sanitize the harsh realities of poverty, presenting informal settlements as exotic and intriguing destinations, thus skewing the understanding of global inequalities and framing poverty more as a cultural artifact than an urgent social issue.
Conversely, slum tourism holds potential to challenge and subvert these entrenched power dynamics and stereotypes. When approached through the lens of ethical representation, it becomes a platform that amplifies marginalized voices and promotes more equitable narratives. This approach is deeply rooted in theories of participatory development and empowerment, which argue that local communities should be active agents in shaping their own narratives, rather than passive subjects (Dürr et al. 2021 ; Frenzel, 2014 ). Employing local guides and focusing on authentic narratives that highlight both the challenges and resilience of informal settlement residents can provide a counter-narrative to dominant discourses, promoting a more nuanced and respectful understanding of these communities.
The role of social media in slum tourism highlights the significance of digital globalization in shaping narratives. Social media platforms provide avenues for local residents to share their perspectives, thereby democratizing the discourse and challenging stereotypical representations (Sarrica et al. 2021 ). This aligns with the ethics of representation, advocating for portrayals that respect the dignity and agency of marginalized communities (Crapolicchio et al. 2022 ). By enabling a more participatory and inclusive approach, social media can help mitigate the voyeuristic tendencies of slum tourism and foster a more ethical engagement with these communities.
Another prominent takeaway from this systematic literature review is the observation that the practice, perception, and success of slum tourism vary significantly across different cultural and geographical contexts. In Brazil, for instance, the favelas of Rio de Janeiro have been transformed into tourist destinations, influenced not only by their portrayal in internationally acclaimed films but also by the mega-events hosted in the city. This phenomenon has led to a form of tourism that often celebrates the cultural vibrancy of these areas, despite underlying issues of poverty and inequality. Conversely, in India, Mumbai’s Dharavi is marketed as a hub of entrepreneurship and industry, attracting tourists more interested in the economic dynamics of informal settlement life than in cultural spectacle alone. These differences illustrate how local contexts shape the thematic emphasis of slum tours.
However, the ability to develop slum or pro-poor tourism is not uniformly distributed. Many areas lack the necessary infrastructure, adequate security, or appealing tourist attractions, which impedes their ability to attract and sustain tourism. For instance, some townships in Durban, South Africa, and informal settlements in Harare, Zimbabwe, contend with issues such as poor security and insufficient infrastructure, making them less appealing to tourists and challenging to market as destinations (Chili, 2015 ; Mukoroverwa and Chiutsi, 2018 ). This disparity highlights the uneven impacts of global tourism trends on local communities and points to the necessity for ethical and sustainable tourism practices in urban settings marked by significant socio-economic divides.
To enhance our understanding of slum tourism dynamics and to devise more effective interventions, it is crucial to undertake further comparative studies. These studies should delve into why certain areas are successful in developing tourism that benefits local communities while others falter, considering both global influences and local conditions. Such research is imperative for uncovering the potential of tourism as a tool for social and economic improvement in marginalized urban areas and contributes significantly to the broader discourse on globalization, urban inequality, and sustainable development.
In this vein, a pivotal area for future research is transforming “slum tourism” into a form of responsible tourism that transcends the poverty-centric narrative often associated with terms like “slum,” “township,” and “favela” (Burgold and Rolfes, 2013 ; Rolfes, 2010 ; Steinbrink et al. 2012 ). While it is valuable to highlight the cultural and historical aspects of these communities, such portrayals frequently overlook the entrenched structural inequality and violence that pervade these areas. Furthermore, tourism often concentrates only on well-known locations, ignoring the most impoverished and lesser-known settlements, thus raising questions about the applicability of sustainable development strategies in these marginalized areas (Frenzel, 2013 ). It is essential that future research explores how slum tourism can truly benefit residents and address broader socio-economic challenges, ensuring it evolves into a form of responsible tourism.
This shift towards responsible slum tourism necessitates a comprehensive emphasis on ethical considerations, community involvement, and sustainable economic benefits for local residents. Ethical considerations must encompass respect for the dignity and agency of the communities involved, eschewing exploitative practices that commodify poverty for tourist consumption. Community involvement is imperative, as it enables residents to influence how their neighborhoods are portrayed and ensure their central participation in both managing and benefiting from tourism initiatives. This might include training local guides, engaging residents in creating tour content, and allocating a substantial share of tourism revenues back into the community.
Furthermore, ensuring sustainable economic benefits for residents is fundamental to responsible slum tourism. This involves fostering tourism that generates reliable income opportunities for locals, such as through establishing small businesses or cooperative ventures tailored to the tourism industry. Potential enterprises could include local eateries, souvenir shops, and accommodation services, all managed and operated by community members. Investment in infrastructure improvements that support tourism activities and simultaneously enhance resident quality of life is also crucial. Additionally, it is essential to implement mechanisms to track the flow of financial benefits to ensure that the revenue generated by tourism is indeed benefiting the local communities as intended.
The data collection for this study, completed in August 2023, revealed a notable gap: the lack of research on the impact of the COVID pandemic on slum tourism, despite the pandemic lasting three years. The pandemic has disproportionately affected informal settlement dwellers, as evidenced by Seddiky et al. ( 2023 ). For instance, Bangkok’s informal settlement residents have suffered significant economic hardships (Pongutta et al. 2021 ), and containment measures have led to widespread business closures, impacting low-income, daily wage earners in impoverished communities (Solymári et al. 2022 ). This absence of academic focus on COVID’s specific impact on slum tourism marks a limitation in current literature. The pandemic’s disruption of travel presents an opportunity to reassess and develop more sustainable tourism practices that could benefit residents in impoverished areas.
Additionally, this study’s focus on slum tourism in the Global South overlooks the re-emerging field of slum or poverty tourism in the Global North. For instance, Burgold ( 2014 ) explored guided walking tours in Berlin-Neukölln, an area known for poverty and social issues, contrasting them with traditional tourism and highlighting their role in changing perceptions and aiding local residents’ societal integration. Similarly, “homeless experience” tours in cities like Toronto, London, Amsterdam, and Seattle offer insights into the lives of homeless individuals (Haven Toronto, 2018 ; Kassam, 2013 ). These tours, as controversial in the Global North as in the South, raise ethical concerns about commodifying poverty. Proponents see them as empathy-building, while critics view them as exploitative. The dynamics of poverty tours vary between developed and less developed countries, presenting a potential area for future comparative research.
“Slum tourism,” a relatively new research field, reflects the complexities of rapid urbanization and the North-South power dynamics in a globalized era. The current study offers a comprehensive, longitudinal perspective on slum tourism research, charting future directions for scholarly inquiry. It also provides valuable insights for practitioners to reassess the role of tourism in poverty alleviation within urban informal settlements in the Global South. For public policy, this research is instrumental in shaping strategies for urban development, poverty alleviation, and sustainable tourism, advocating for the integration of informal settlements into wider economic frameworks. Academically, it enriches the existing body of knowledge, spurring interdisciplinary research and delving into lesser-explored aspects of slum tourism. Additionally, by shedding light on the effects of tourism in these communities, the study promotes more informed, respectful, and responsible tourist behavior, encouraging travelers to adopt a more empathetic and culturally sensitive approach.
The data supporting the findings of this study are available in an uploaded CSV file.
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Disasters can cause casualties and significant financial loss. In accordance with the Sendai Framework for Disaster Risk Reduction, areas affected by disasters must be built back better. Accurate post-disaster damage and loss assessments are critical for the success of recovery programs. This scoping review aimed to identify the components and entities of the healthcare sector’s post-disaster damage and loss assessment program.
An comprehensive search for relevant literature was performed using several databases, including the Web of Science, PubMed, Scopus, ProQuest, and Magiran. The search was limited to papers published between 2010 and 2022. In addition, we searched the grey literature for resources related to post-disaster damage and loss assessments. Study selection and data extraction were evaluated by a third reviewer. The main themes were determined through a consensus process and agreement among team members.
A total of 845 papers were identified, 41 of which were included in the review. The grey literature search yielded 1015 documents, 23 of which were associated with the study’s purpose. The findings were classified into five main themes, 20 subthemes, and 876 codes. The main-themes include the following: Concepts and Definitions; Post-Disaster Damage and Loss Assessment Procedures; Healthcare sector procedures; Assessments Tools, and Methods; Intra-sectoral, Inter-sectoral, and cross-cutting issues.
The existing corpus of literature on post-disaster damage and loss assessment programs within the healthcare sector offers only limited insights into the entities and components involved. It is of great importance that stakeholders have an extensive grasp of these pivotal concepts and principles, as they are fundamental in enabling effective responses to disasters, informed decision-making, and facilitating rehabilitation and reconstruction efforts. Consequently, there is a considerable scope for further investigation in this area.
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The most significant consequences of disasters are health impacts that occur in the aftermath [ 1 ]. Natural disasters such as earthquakes and floods not only have a detrimental impact on an individual’s health but also result in significant damage to the healthcare sector, reducing its capacity to respond and recover effectively. This, in turn, leads to a rise in mortality and morbidity rates [ 2 , 3 ]. Disasters directly damage the physical structure of hospitals, clinics, and healthcare centers and indirectly affect the health sector by destroying community infrastructure, such as water, electricity, fuel, transportation, and communication systems. Additionally, disasters can impact healthcare providers and their families [ 4 , 5 ].
Providing essential health services is challenging during disasters because of infrastructure failure and the inefficiency of healthcare centres [ 6 ]. It is evident that the health centres play a pivotal role in alleviating the negative consequences that arise in the aftermath of disasters. Therefore, it is of paramount importance to ensure the uninterrupted functioning of this vital infrastructures [ 7 , 8 , 9 ]. Comprehending the health consequences of disasters provides the basis for identifying demands, improving capacity, and providing opportunities for reconstruction and future disaster risk reduction [ 10 ].
The convergence of four seminal accords on disaster risk reduction, development finance, sustainable development, and climate change at the end of 2015 presented a singularly promising opportunity to achieve coherence across related policy domains. The Sendai Framework for Disaster Risk Reduction represents the global policy framework of the United Nations from 2015 to 2030. This represents a significant advance in global policy coherence concerning health, development, and climate change [ 11 , 12 , 13 ]. One of the principal objectives of the Sendai Framework is to enhance disaster preparedness for an effective response and “build back better“(BBB) in recovery [ 14 ].
The scope of disaster recovery is broader than that of response. In the context of the health system, recovery is defined as the reconstruction, restoration, and upgrading of the components of a country’s health sector and the main functions of public health, in accordance with the BBB principle and the goals of sustainable development [ 15 ]. For an optimal reconstruction, it is necessary to develop a legal, technical, and comprehensive framework. The success of a reconstruction program depends on an accurate assessment of the damage, loss, and needs of the post-disaster area to determine the approaches, goals, priorities, and measures required for reconstruction [ 2 ].
The post-disaster reconstruction of the health system in developing countries is hindered by some factors, including a lack of knowledge and expertise, limited budget and planning, political competition, fraud, and embezzlement or misuse of social benefits [ 3 , 16 ]. Considering the argument of ‘humanitarian ignorance’, In light of the argument put forth by scholars who refer to this phenomenon as “humanitarian ignorance,“ [ 17 ], it can be argued that this “knowledge” does exist and that it is purposeful ignorance of said knowledge.
In 2008, the European Union, World Bank, and United Nations Development Group implemented a standard post-disaster assessment approach and developed a comprehensive and collaborative post-disaster assessment program [ 18 ]. In damage and loss assessments, experts in each sector calculate post-disaster damage and loss, which are essential in reconstruction programs [ 19 , 20 ].
Chapin et al. (2009) studied the impact of the 2007 Ica earthquake on healthcare facilities in southern Peru. They reported that after an earthquake of magnitude 7.9 in Peru, 60% of the health centers in the region were affected to the degree that they were unable to provide client services. This study revealed that reports of damage assessments in a single disaster were sometimes not the same [ 21 ]. Achour et al. (2020) evaluated hospital performance after the 2016 Kumamoto Earthquake in Japan. Data analysis revealed that the impaired function of some healthcare centers in the affected areas significantly affected the health needs of the local communities [ 22 ].
Similar to other social sectors, the disaster impacts on the healthcare sector is considerable and is one of the concerns of managers and experts in the healthcare sector. In light of the pivotal role of the health sector in post-disaster response and recovery, as well as in the development of a post-disaster reconstruction program, it is crucial to conduct a thorough assessment of damage and losses incurred following a disaster. A post-disaster damage and loss assessment in the health sector can serve as a foundation for the creation of a coherent and integrated framework for health reconstruction. The absence of a post-disaster damage and loss assessment program may result in certain requirements being overlooked, the results of which are not deemed acceptable, facilities being allocated on a non-prioritized basis, and there being no basis for monitoring the implementation of plans and activities. Assessment is a demanding and decisive management task that is effective in decision-making, planning, monitoring, handling a program, and taking coherent actions. Post-disaster damage and loss assessment has a direct impact on decision-making, planning, monitoring of responses, and the implementation of recovery operations. Consequently, these assessments must be purposeful and scheduled.
This scoping review was conducted to identify the entities and components of post-disaster damage and loss assessment programs in the healthcare sector. The PCC framework, which includes the participants, concepts, and context recommended by the Joanna Briggs Institute, was used to develop the research question [ 23 ]. The research question for this scoping review is as follows: what information is available about the entities and components of the healthcare sector’s post-disaster damage and loss assessment program?
A knowledge gap exists in the field of post-disaster damage and loss assessment in the healthcare sector. To address this issue, the most appropriate methodology for achieving the study’s objective was identified as a scoping review. This systematic scoping review was conducted under the proposed Joanna Briggs Institute method [ 24 ]. The study included the following steps: defining and aligning the research objectives and questions, developing the inclusion and exclusion criteria, describing the planned approach to the evidence search, study selection, data extraction, presentation of the evidence, searching for evidence, selecting the evidence, extracting the evidence, analyzing the evidence, presenting the results, and summarizing the evidence [ 23 ]. The study protocol was registered in the Open Science Framework on 4 June 2022 [ 25 ] and was published in BMJ Open [ 26 ]. The Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews (PRISMA-ScR Checklist 1) [ 27 ] checklist was used to report the results of this scoping review.
In keeping with the scoping review methodology, our inclusion criteria (Table 1 ) were broad, and our search was comprehensive in capturing the entities and components of the healthcare sector’s post-disaster damage and loss assessment program. We included literature reviews, primary empirical articles, case studies, opinion pieces, and editorials published in English or Persian “due to geographical focus, and researcher language skills”. In addition, grey literature related to the study objective, including dissertations, organizational documents, post-disaster assessment reports, and guidelines, was searched and reviewed. Table 2 presents a distribution of studies by location, organization, and document type.
The search strategy was drafted with the help of an experienced informaticist librarian and was further refined through team discussion. Initially, a primary search was conducted on the Google Scholar, PubMed, World Bank, and PreventionWeb websites. The following concepts were extracted from the documents: post-conflict consequences in health systems, disaster impacts on the healthcare sector, post-disaster damage and loss assessment, post-earthquake hospital functionality, post-disaster damage and loss assessment, disaster damage, operational status of healthcare facilities during a hurricane, and the impacts of extreme events. An appropriate search strategy was used for each database (Table 3 ).
We searched all English and Persian articles published from 2010 to 2022 on the Web of Science, PubMed, Scopus, ProQuest, Google Scholar, and Magiran databases. Our search started on 20 January 2022. The search results were imported into Endnote X9 software. After removing the duplicates, J. Miri checked all the remaining titles to remove unrelated documents. The titles and abstracts of the remaining articles were independently examined by two authors (J. Miri and A.R. Raeisi) to reach a common understanding of the selection criteria, discussion of disagreements, and definition of the inclusion and exclusion criteria. The remaining articles were uploaded to Rayyan software to facilitate record screening. The full texts of articles whose abstracts did not meet the exclusion criteria or were ambiguous were reviewed. Discrepancies in inclusion or exclusion decisions were resolved through discussion (G. Atighechian). Finally, the reference lists were checked to identify relevant studies. In the grey literature search, researchers also investigated organizations’ websites related to disaster management, such as the UNDP, World Bank, UNDRR, International Recovery Platform, PreventionWeb, WHO, and FEMA. (Fig. 1 )
Adapted from the PRISMA 2020 flow diagram from Page et al. [ 47 ].
PRISMA flow diagram of the scoping review process.
Supplementary Tables 1 and 2 show the characteristics of the articles and grey literature discussed in this study. General information (title, authors, publication year, study location, and key findings) regarding the questions addressed in this scoping review was extracted from the selected studies. Two independent reviewers extracted all relevant information and any discrepancies were resolved through discussion.
The documents were organized and analyzed by the researchers using the MAXQDA 2020 software. The data analysis strategy employed at this juncture was a thematic analysis approach. Thematic analysis is a valuable approach for elucidating experiences, thoughts, or behaviors within a data set. Additionally, researchers have proposed that thematic analysis is an optimal analytical method for novice qualitative researchers due to its transparent and straightforward procedures [ 28 , 29 ].
The search of the related electronic databases led to the identification of 845 articles. After removing the duplicates, 826 studies remained. The titles were screened, and 102 potentially eligible articles were selected. The simultaneous title and abstract review by two independent reviewers led to the selection of 80 articles that were uploaded to Rayyan software. Finally, 41 articles were selected for full-text review. The grey literature search identified 1015 documents, reports, manuals, and guidelines based on the inclusion and exclusion criteria and the study objectives, and 23 documents were selected for review.
Researchers have classified resources into five categories: articles, books, dissertations, policy documents, and reports. Studies have been conducted in different countries, half of which have been published in the last five years. The findings were categorized into five main themes, 20 subthemes, and 876 codes according to the research objectives and questions. The main themes, subthemes, and some related codes are presented in (Table 4 ).
This study provides a comprehensive perspective on post-disaster damage and loss assessment in the healthcare sector. To achieve a common understanding of post-disaster damage and loss assessment in the healthcare sector, the researchers first collected definitions and related concepts. Then, organized concepts related to damage and loss assessment teams, damage and loss assessment stages, data collection elements, assessment tools, and programs. The paper concludes with a discussion of the linkages between the healthcare sector and other sectors affected by disasters.
The health system comprises a wide range of organizations, institutions, groups, and individuals in governmental and nongovernmental sectors that policy, produce resources, finance, and provide health services to restore, promote, and maintain public health [ 30 ]. According to the WHO framework, the health system comprises six building blocks; service delivery, health workforce, information, medical products, vaccines and technologies, financing, leadership, and governance [ 31 , 32 ]. The realization and promotion of community health and fair cooperation in providing resources are crucial goals of the health system and are considered fundamental in most countries [ 33 ].
The continuity of services is critical in some businesses, such as those in the healthcare sector. However, these trends can be disrupted by disasters [ 34 ]. Achour et al. (2020) evaluated hospital performance after the 2016 Kumamoto Earthquake in Japan. The occurrence of this event resulted in a disruption to the continuity of healthcare services. The investigation revealed that the primary causes of the disruption were damage to the infrastructure, including buildings, critical systems, and medical equipment. The results of the study indicated a 15% reduction in healthcare functionality in the affected regions [ 22 ]. In the study by Gufue et al. (2024), the direct economic loss to the health system caused by war-related looting or vandalism in the Tigray region of Northern Ethiopia was quantified in excess of $511 million. The assessment revealed that 80.6% of health posts, 73.6% of health centres, 80% of primary hospitals, 83.3% of general hospitals and two specialized hospitals were damaged and/or vandalized either fully or in part due to the war [ 35 ]. Therefore, a disaster recovery plan in the healthcare sector is essential for providing necessary measures and minimizing disaster consequences, And international frameworks such as Sendai play an important role in this regard and emphasize the need to develop and implement measures for disaster risk reduction and vulnerability [ 36 , 37 ].
For reconstruction, a reliable post-disaster damage and loss assessment method is required. The diversity of approaches and assessment-related outputs have led to various challenges. A significant obstacle to post-disaster damage and loss assessment is access to consistent, dependable, and detailed data on the impact of disasters. Establishing guidelines for reporting post-disaster damage and loss assessments is necessary to help national and regional institutions collect information in a structured manner [ 38 ]. Accurate data on disaster damage and losses are crucial for effective risk management, including loss accounting, disaster forensics, and risk analysis [ 39 ]. Assessment information is pivotal for effective policy development, resource allocation, and disaster preparedness [ 40 ]. We can improve disaster management and link disaster management science to disaster risk reduction policymaking by using these data [ 38 ].
In the Kermanshah Earthquake Lessons Learned study conducted by Khankeh et al. (2018) in Iran, it was recommended that a standard protocol be established for the receipt of reports from disaster locations in the initial days and weeks following an earthquake. Moreover, the establishment of rapid assessment teams at the local, regional, and national levels, with specific guidelines, was considered a crucial step [ 41 ]. The composition of the assessment team depends on the sector to be assessed. Healthcare sector assessment teams from different disciplines, including public health experts, physicians, epidemiologists, architects, civil engineers, and health economists, can estimate the value of production losses [ 18 , 31 , 42 ].
The post-disaster damage and loss assessment methodology includes pre-disaster baseline data collection, disaster effects, impact analysis, recovery needs estimation, and strategies that recommend appropriate interventions, implementation arrangements, and policies [ 43 ]. Documentation of damage and loss assessments should begin as soon as possible after a disaster [ 44 ]. A post-disaster damage and loss assessment report is a live document that is revised as better data become available [ 45 ]. Post-disaster damage and loss assessment reports should differ according to the assessment stage and type of disaster [ 46 ].
There is the fact that all societies and countries are susceptible to disasters. The primary responsibility for disaster and emergency management is affected by local communities and countries. After a disaster, the healthcare sector faces multiple hazards, limited resources for dealing with them, and high expectations regarding their performance. Multiple stakeholders engage in post-disaster damage and loss assessments and their interventions are guided by various damage and loss assessment methods. Such variations in techniques and related assessment outputs challenge the comparability across assessments and often present conflicting images. Despite the long history of reconstruction in Iran, there are numerous challenges in assessing post-disaster damage and loss. Therefore, there is a need to develop a set of post-disaster damage and loss assessment frameworks, including methodologies and guidelines, for the healthcare sector.
Limited scientific resources for disaster damage assessment in the healthcare sector, access to imperative content, and documentation in the country were limitations of this study. As with all scoping reviews, we did not formally evaluate the quality of the evidence, and because of the varying nature of the studies, only a limited synthesis of results was possible.
In light of the pivotal role of the post-disaster healthcare sector, it is of the utmost importance to develop appropriate post-disaster damage and loss assessment programme that can be adapted to different socio-cultural contexts and varying resources. To date, there have been few studies that have discussed the entities and components of disaster damage and loss assessment programme in the healthcare sector. It was, however, determined that identifying the entities and components of the healthcare sector’s post-disaster damage and loss assessment program was a necessary step for advancing the healthcare sector in Iran. This review offers a detailed examination of post-disaster damage and loss assessment programs within the healthcare sector.
All data generated or analysed during this study are included in this published article [and its supplementary information files].
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The authors express their gratitude to the Vice Chancellor for Research and Technology at Isfahan University of Medical Sciences for financial support.
This work was supported by the Vice-Chancellery of Research and Technology at Isfahan University of Medical Sciences, Isfahan, Iran [grant no. 3400686].
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Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Golrokh Atighechian
Department of Health in Disaster and Emergencies, School of Health Management and Information Sciences, University of Medical Sciences, Tehran, Iran
Hesam Seyedin
Health Management and Economics Research Center, Department of Health Services Management, Isfahan University of Medical Sciences, Isfahan, Iran
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J. Miri contributed to study design, title, abstract and full-text screening, data extraction, data analysis, writing the first draft of the manuscript, and subsequent revisions of the manuscript. A.R. Raeisi contributed to study design, literature search and project management. G. Atighechian was also involved in drafting the abstract, full-text screening, data extraction and writing the manuscript at all stages. H. Seyedin contributed to the study design and drafting of the manuscript. All authors critically revised the manuscript and approved the final version for submission.
Correspondence to Ahmad Reza Raeisi .
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This study was approved by the Research Ethics Committee of the Isfahan University of Medical Sciences, Iran (IR.MUI.NUREMA.REC.1400.171).
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Miri, J., Atighechian, G., Seyedin, H. et al. Components and entities of post-disaster damage and loss assessment program in healthcare sector: a scoping review. BMC Public Health 24 , 2417 (2024). https://doi.org/10.1186/s12889-024-19523-5
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DOI : https://doi.org/10.1186/s12889-024-19523-5
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Writing a Literature Review. A literature review is a document or section of a document that collects key sources on a topic and discusses those sources in conversation with each other (also called synthesis). The lit review is an important genre in many disciplines, not just literature (i.e., the study of works of literature such as novels and ...
Examples of literature reviews. Step 1 - Search for relevant literature. Step 2 - Evaluate and select sources. Step 3 - Identify themes, debates, and gaps. Step 4 - Outline your literature review's structure. Step 5 - Write your literature review.
The Research Gap. The third essential ingredient of a high-quality literature review is a discussion of the research gap (or gaps).. But what exactly is a research gap? Simply put, a research gap is any unaddressed or inadequately explored area within the existing body of academic knowledge. In other words, a research gap emerges whenever there's still some uncertainty regarding a certain ...
A literature review is a critical analysis and synthesis of existing research on a particular topic. It provides an overview of the current state of knowledge, identifies gaps, and highlights key findings in the literature. 1 The purpose of a literature review is to situate your own research within the context of existing scholarship ...
Literature Reviews that are organized methodologically consist of paragraphs/sections that are based on the methods used in the literature found.This approach is most appropriate when you are using new methods on a research question that has already been explored.Since literature review structures are not mutually exclusive, you can organize the use of these methods in chronological order.
Compiling and synthesizing literature as a justification for one's own research is a key element of most academic work. Nonetheless, both the strategies and components of literature reviews vary based on the genre, length, and prospective audience of a text. This resource gives advice on how to effectively
The basic components of a literature review include: a description of the publication; a summary of the publication's main points; ... Do Your Research Review a number of texts that most closely pertain to your topic and position, and are written by relevant scholars. Understand who the top voices are in your topic's academic field, and be ...
In a stand-alone literature review, this statement will sum up and evaluate the current state of this field of research; In a review that is an introduction or preparatory to a thesis or research report, it will suggest how the review findings will lead to the research the writer proposes to undertake. Body Purpose:
1. Introduction. Not to be confused with a book review, a literature review surveys scholarly articles, books and other sources (e.g. dissertations, conference proceedings) relevant to a particular issue, area of research, or theory, providing a description, summary, and critical evaluation of each work. The purpose is to offer an overview of significant literature published on a topic.
A literature review is meant to analyze the scholarly literature, make connections across writings and identify strengths, weaknesses, trends, and missing conversations. A literature review should address different aspects of a topic as it relates to your research question. A literature review goes beyond a description or summary of the ...
How To Structure Your Literature Review. Like any other chapter in your thesis or dissertation, your literature review needs to have a clear, logical structure. At a minimum, it should have three essential components - an introduction, a body and a conclusion. Let's take a closer look at each of these. 1: The Introduction Section
In writing the literature review, your purpose is to convey to your reader what knowledge and ideas have been established on a topic, and what their strengths and weaknesses are. As a piece of writing, the literature review must be defined by a guiding concept (e.g., your research objective, the problem or issue you are discussing, or your ...
Examples of a published literature review Literature reviews are often published as scholarly articles, books, and reports. Here is an example of a recent literature review published as a scholarly journal article: Ledesma, M. C., & Calderón, D. (2015). Critical race theory in education: A review of past literature and a look to the future.
A literature review discusses published information in a particular subject area, and sometimes information in a particular subject area within a certain time period. A literature review can be just a simple summary of the sources, but it usually has an organizational pattern and combines both summary and synthesis.
A literature review is a comprehensive summary of previous research on a topic. The literature review surveys scholarly articles, books, and other sources relevant to a particular area of research. The review should enumerate, describe, summarize, objectively evaluate and clarify this previous research. It should give a theoretical base for the ...
A literature review is an integrated analysis-- not just a summary-- of scholarly writings and other relevant evidence related directly to your research question.That is, it represents a synthesis of the evidence that provides background information on your topic and shows a association between the evidence and your research question.
This is why the literature review as a research method is more relevant than ever. Traditional literature reviews often lack thoroughness and rigor and are conducted ad hoc, rather than following a specific methodology. Therefore, questions can be raised about the quality and trustworthiness of these types of reviews.
The literature review is the cornerstone of academic research due to the fact that it offers a thorough overview and critical analysis of the content of previously published scholarly works on a certain subject. As scholars set out on their intellectual journeys, it becomes increasingly important to comprehend the key components that are involved in creating an effective and compelling ...
The review must consist of: An Introduction- here the topic should be specified, overall trends and conflicts in the literature should be outlined and gaps in previous research identified. It is also very important at this point to justify your reasons for writing the review.
A sophisticated literature review (LR) can result in a robust dissertation/thesis by scrutinizing the main problem examined by the academic study; anticipating research hypotheses, methods and results; and maintaining the interest of the audience in how the dissertation/thesis will provide solutions for the current gaps in a particular field.
Purpose and Importance of the Literature Review. An understanding of the current literature is critical for all phases of a research study. Lingard 9 recently invoked the "journal-as-conversation" metaphor as a way of understanding how one's research fits into the larger medical education conversation. As she described it: "Imagine yourself joining a conversation at a social event.
The fundamental rationale of writing a review article is to make a readable synthesis of the best literature sources on an important research inquiry or a topic. This simple definition of a review article contains the following key elements: The question (s) to be dealt with.
A literature review is a discussion and evaluation of academic literature or a relevant body of knowledge (for practice-based research). You should use this section of your proposal to show that you are familiar with work in your chosen topic area and that your research will contribute something new and/or meaningful to it.
Context: In response to the growth of evidence-based practice in social work, systematic literature reviews offer significant value to social work but are often met with concerns of time scarcity. Purpose: Through a case study search strategy addressing the research question "What are practicing frontline social workers' experiences of bureaucracy?," this article seeks to promote ...
Background Co-design with consumers and healthcare professionals is widely used in applied health research. While this approach appears to be ethically the right thing to do, a rigorous evaluation of its process and impact is frequently missing. Evaluation of research co-design is important to identify areas of improvement in the methods and processes, as well as to determine whether research ...
At several points during a hospital stay, a patient may receive a medication review with a pharmacist to reduce the risk of medication errors. This review characterizes themes and components of pharmacist-led medication reviews associated with positive patient outcomes. Patient involvement in goal setting was identified as a successful component that would benefit from additional research.
Over the last two decades, the phenomenon of "slum tourism" and its academic exploration have seen considerable growth. This study presents a systematic literature review of 122 peer-reviewed ...
Disasters can cause casualties and significant financial loss. In accordance with the Sendai Framework for Disaster Risk Reduction, areas affected by disasters must be built back better. Accurate post-disaster damage and loss assessments are critical for the success of recovery programs. This scoping review aimed to identify the components and entities of the healthcare sector's post ...
Our literature review indicates that quantitative theory-testing research is underrepresented. Prior work on DSBMs has focused more on exploring individual components of our framework than on studying the relationships and interdependencies among multiple concepts/constructs of interests.