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Background of The Study – Examples and Writing Guide

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Background of The Study

Definition:

Background of the study refers to the context, circumstances, and history that led to the research problem or topic being studied. It provides the reader with a comprehensive understanding of the subject matter and the significance of the study.

The background of the study usually includes a discussion of the relevant literature, the gap in knowledge or understanding, and the research questions or hypotheses to be addressed. It also highlights the importance of the research topic and its potential contributions to the field. A well-written background of the study sets the stage for the research and helps the reader to appreciate the need for the study and its potential significance.

How to Write Background of The Study

Here are some steps to help you write the background of the study:

Identify the Research Problem

Start by identifying the research problem you are trying to address. This problem should be significant and relevant to your field of study.

Provide Context

Once you have identified the research problem, provide some context. This could include the historical, social, or political context of the problem.

Review Literature

Conduct a thorough review of the existing literature on the topic. This will help you understand what has been studied and what gaps exist in the current research.

Identify Research Gap

Based on your literature review, identify the gap in knowledge or understanding that your research aims to address. This gap will be the focus of your research question or hypothesis.

State Objectives

Clearly state the objectives of your research . These should be specific, measurable, achievable, relevant, and time-bound (SMART).

Discuss Significance

Explain the significance of your research. This could include its potential impact on theory , practice, policy, or society.

Finally, summarize the key points of the background of the study. This will help the reader understand the research problem, its context, and its significance.

How to Write Background of The Study in Proposal

The background of the study is an essential part of any proposal as it sets the stage for the research project and provides the context and justification for why the research is needed. Here are the steps to write a compelling background of the study in your proposal:

• Identify the problem: Clearly state the research problem or gap in the current knowledge that you intend to address through your research.
• Provide context: Provide a brief overview of the research area and highlight its significance in the field.
• Review literature: Summarize the relevant literature related to the research problem and provide a critical evaluation of the current state of knowledge.
• Identify gaps : Identify the gaps or limitations in the existing literature and explain how your research will contribute to filling these gaps.
• Justify the study : Explain why your research is important and what practical or theoretical contributions it can make to the field.
• Highlight objectives: Clearly state the objectives of the study and how they relate to the research problem.
• Discuss methodology: Provide an overview of the methodology you will use to collect and analyze data, and explain why it is appropriate for the research problem.
• Conclude : Summarize the key points of the background of the study and explain how they support your research proposal.

How to Write Background of The Study In Thesis

The background of the study is a critical component of a thesis as it provides context for the research problem, rationale for conducting the study, and the significance of the research. Here are some steps to help you write a strong background of the study:

• Identify the research problem : Start by identifying the research problem that your thesis is addressing. What is the issue that you are trying to solve or explore? Be specific and concise in your problem statement.
• Review the literature: Conduct a thorough review of the relevant literature on the topic. This should include scholarly articles, books, and other sources that are directly related to your research question.
• I dentify gaps in the literature: After reviewing the literature, identify any gaps in the existing research. What questions remain unanswered? What areas have not been explored? This will help you to establish the need for your research.
• Establish the significance of the research: Clearly state the significance of your research. Why is it important to address this research problem? What are the potential implications of your research? How will it contribute to the field?
• Provide an overview of the research design: Provide an overview of the research design and methodology that you will be using in your study. This should include a brief explanation of the research approach, data collection methods, and data analysis techniques.
• State the research objectives and research questions: Clearly state the research objectives and research questions that your study aims to answer. These should be specific, measurable, achievable, relevant, and time-bound.
• Summarize the chapter: Summarize the chapter by highlighting the key points and linking them back to the research problem, significance of the study, and research questions.

How to Write Background of The Study in Research Paper

Here are the steps to write the background of the study in a research paper:

• Identify the research problem: Start by identifying the research problem that your study aims to address. This can be a particular issue, a gap in the literature, or a need for further investigation.
• Conduct a literature review: Conduct a thorough literature review to gather information on the topic, identify existing studies, and understand the current state of research. This will help you identify the gap in the literature that your study aims to fill.
• Explain the significance of the study: Explain why your study is important and why it is necessary. This can include the potential impact on the field, the importance to society, or the need to address a particular issue.
• Provide context: Provide context for the research problem by discussing the broader social, economic, or political context that the study is situated in. This can help the reader understand the relevance of the study and its potential implications.
• State the research questions and objectives: State the research questions and objectives that your study aims to address. This will help the reader understand the scope of the study and its purpose.
• Summarize the methodology : Briefly summarize the methodology you used to conduct the study, including the data collection and analysis methods. This can help the reader understand how the study was conducted and its reliability.

Examples of Background of The Study

Here are some examples of the background of the study:

Problem : The prevalence of obesity among children in the United States has reached alarming levels, with nearly one in five children classified as obese.

Significance : Obesity in childhood is associated with numerous negative health outcomes, including increased risk of type 2 diabetes, cardiovascular disease, and certain cancers.

Gap in knowledge : Despite efforts to address the obesity epidemic, rates continue to rise. There is a need for effective interventions that target the unique needs of children and their families.

Problem : The use of antibiotics in agriculture has contributed to the development of antibiotic-resistant bacteria, which poses a significant threat to human health.

Significance : Antibiotic-resistant infections are responsible for thousands of deaths each year and are a major public health concern.

Gap in knowledge: While there is a growing body of research on the use of antibiotics in agriculture, there is still much to be learned about the mechanisms of resistance and the most effective strategies for reducing antibiotic use.

Edxample 3:

Problem : Many low-income communities lack access to healthy food options, leading to high rates of food insecurity and diet-related diseases.

Significance : Poor nutrition is a major contributor to chronic diseases such as obesity, type 2 diabetes, and cardiovascular disease.

Gap in knowledge : While there have been efforts to address food insecurity, there is a need for more research on the barriers to accessing healthy food in low-income communities and effective strategies for increasing access.

Examples of Background of The Study In Research

Here are some real-life examples of how the background of the study can be written in different fields of study:

Example 1 : “There has been a significant increase in the incidence of diabetes in recent years. This has led to an increased demand for effective diabetes management strategies. The purpose of this study is to evaluate the effectiveness of a new diabetes management program in improving patient outcomes.”

Example 2 : “The use of social media has become increasingly prevalent in modern society. Despite its popularity, little is known about the effects of social media use on mental health. This study aims to investigate the relationship between social media use and mental health in young adults.”

Example 3: “Despite significant advancements in cancer treatment, the survival rate for patients with pancreatic cancer remains low. The purpose of this study is to identify potential biomarkers that can be used to improve early detection and treatment of pancreatic cancer.”

Examples of Background of The Study in Proposal

Here are some real-time examples of the background of the study in a proposal:

Example 1 : The prevalence of mental health issues among university students has been increasing over the past decade. This study aims to investigate the causes and impacts of mental health issues on academic performance and wellbeing.

Example 2 : Climate change is a global issue that has significant implications for agriculture in developing countries. This study aims to examine the adaptive capacity of smallholder farmers to climate change and identify effective strategies to enhance their resilience.

Example 3 : The use of social media in political campaigns has become increasingly common in recent years. This study aims to analyze the effectiveness of social media campaigns in mobilizing young voters and influencing their voting behavior.

Example 4 : Employee turnover is a major challenge for organizations, especially in the service sector. This study aims to identify the key factors that influence employee turnover in the hospitality industry and explore effective strategies for reducing turnover rates.

Examples of Background of The Study in Thesis

Here are some real-time examples of the background of the study in the thesis:

Example 1 : “Women’s participation in the workforce has increased significantly over the past few decades. However, women continue to be underrepresented in leadership positions, particularly in male-dominated industries such as technology. This study aims to examine the factors that contribute to the underrepresentation of women in leadership roles in the technology industry, with a focus on organizational culture and gender bias.”

Example 2 : “Mental health is a critical component of overall health and well-being. Despite increased awareness of the importance of mental health, there are still significant gaps in access to mental health services, particularly in low-income and rural communities. This study aims to evaluate the effectiveness of a community-based mental health intervention in improving mental health outcomes in underserved populations.”

Example 3: “The use of technology in education has become increasingly widespread, with many schools adopting online learning platforms and digital resources. However, there is limited research on the impact of technology on student learning outcomes and engagement. This study aims to explore the relationship between technology use and academic achievement among middle school students, as well as the factors that mediate this relationship.”

Examples of Background of The Study in Research Paper

Here are some examples of how the background of the study can be written in various fields:

Example 1: The prevalence of obesity has been on the rise globally, with the World Health Organization reporting that approximately 650 million adults were obese in 2016. Obesity is a major risk factor for several chronic diseases such as diabetes, cardiovascular diseases, and cancer. In recent years, several interventions have been proposed to address this issue, including lifestyle changes, pharmacotherapy, and bariatric surgery. However, there is a lack of consensus on the most effective intervention for obesity management. This study aims to investigate the efficacy of different interventions for obesity management and identify the most effective one.

Example 2: Antibiotic resistance has become a major public health threat worldwide. Infections caused by antibiotic-resistant bacteria are associated with longer hospital stays, higher healthcare costs, and increased mortality. The inappropriate use of antibiotics is one of the main factors contributing to the development of antibiotic resistance. Despite numerous efforts to promote the rational use of antibiotics, studies have shown that many healthcare providers continue to prescribe antibiotics inappropriately. This study aims to explore the factors influencing healthcare providers’ prescribing behavior and identify strategies to improve antibiotic prescribing practices.

Example 3: Social media has become an integral part of modern communication, with millions of people worldwide using platforms such as Facebook, Twitter, and Instagram. Social media has several advantages, including facilitating communication, connecting people, and disseminating information. However, social media use has also been associated with several negative outcomes, including cyberbullying, addiction, and mental health problems. This study aims to investigate the impact of social media use on mental health and identify the factors that mediate this relationship.

Purpose of Background of The Study

The primary purpose of the background of the study is to help the reader understand the rationale for the research by presenting the historical, theoretical, and empirical background of the problem.

More specifically, the background of the study aims to:

• Provide a clear understanding of the research problem and its context.
• Identify the gap in knowledge that the study intends to fill.
• Establish the significance of the research problem and its potential contribution to the field.
• Highlight the key concepts, theories, and research findings related to the problem.
• Provide a rationale for the research questions or hypotheses and the research design.
• Identify the limitations and scope of the study.

When to Write Background of The Study

The background of the study should be written early on in the research process, ideally before the research design is finalized and data collection begins. This allows the researcher to clearly articulate the rationale for the study and establish a strong foundation for the research.

The background of the study typically comes after the introduction but before the literature review section. It should provide an overview of the research problem and its context, and also introduce the key concepts, theories, and research findings related to the problem.

Writing the background of the study early on in the research process also helps to identify potential gaps in knowledge and areas for further investigation, which can guide the development of the research questions or hypotheses and the research design. By establishing the significance of the research problem and its potential contribution to the field, the background of the study can also help to justify the research and secure funding or support from stakeholders.

Advantage of Background of The Study

The background of the study has several advantages, including:

• Provides context: The background of the study provides context for the research problem by highlighting the historical, theoretical, and empirical background of the problem. This allows the reader to understand the research problem in its broader context and appreciate its significance.
• Identifies gaps in knowledge: By reviewing the existing literature related to the research problem, the background of the study can identify gaps in knowledge that the study intends to fill. This helps to establish the novelty and originality of the research and its potential contribution to the field.
• Justifies the research : The background of the study helps to justify the research by demonstrating its significance and potential impact. This can be useful in securing funding or support for the research.
• Guides the research design: The background of the study can guide the development of the research questions or hypotheses and the research design by identifying key concepts, theories, and research findings related to the problem. This ensures that the research is grounded in existing knowledge and is designed to address the research problem effectively.
• Establishes credibility: By demonstrating the researcher’s knowledge of the field and the research problem, the background of the study can establish the researcher’s credibility and expertise, which can enhance the trustworthiness and validity of the research.

Disadvantages of Background of The Study

Some Disadvantages of Background of The Study are as follows:

• Time-consuming : Writing a comprehensive background of the study can be time-consuming, especially if the research problem is complex and multifaceted. This can delay the research process and impact the timeline for completing the study.
• Repetitive: The background of the study can sometimes be repetitive, as it often involves summarizing existing research and theories related to the research problem. This can be tedious for the reader and may make the section less engaging.
• Limitations of existing research: The background of the study can reveal the limitations of existing research related to the problem. This can create challenges for the researcher in developing research questions or hypotheses that address the gaps in knowledge identified in the background of the study.
• Bias : The researcher’s biases and perspectives can influence the content and tone of the background of the study. This can impact the reader’s perception of the research problem and may influence the validity of the research.
• Accessibility: Accessing and reviewing the literature related to the research problem can be challenging, especially if the researcher does not have access to a comprehensive database or if the literature is not available in the researcher’s language. This can limit the depth and scope of the background of the study.

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

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What is the Background of the Study and How to Write It

What is the Background of the Study in Research? 

The background of the study is the first section of a research paper and gives context surrounding the research topic. The background explains to the reader where your research journey started, why you got interested in the topic, and how you developed the research question that you will later specify. That means that you first establish the context of the research you did with a general overview of the field or topic and then present the key issues that drove your decision to study the specific problem you chose.

Once the reader understands where you are coming from and why there was indeed a need for the research you are going to present in the following—because there was a gap in the current research, or because there is an obvious problem with a currently used process or technology—you can proceed with the formulation of your research question and summarize how you are going to address it in the rest of your manuscript.

Why is the Background of the Study Important?

No matter how surprising and important the findings of your study are, if you do not provide the reader with the necessary background information and context, they will not be able to understand your reasons for studying the specific problem you chose and why you think your study is relevant. And more importantly, an editor who does not share your enthusiasm for your work (because you did not fill them in on all the important details) will very probably not even consider your manuscript worthy of their and the reviewers’ time and will immediately send it back to you.

To avoid such desk rejections , you need to make sure you pique the reader’s interest and help them understand the contribution of your work to the specific field you study, the more general research community, or the public. Introducing the study background is crucial to setting the scene for your readers.

Table of Contents:

• What is “Background Information” in a Research Paper?
• What Should the Background of a Research Paper Include?
• Where Does the Background Section Go in Your Paper?

Background of the Study Structure

Before writing your study background, it is essential to understand what to include. The following elements should all be included in the background and are presented in greater detail in the next section:

• A general overview of the topic and why it is important (overlaps with establishing the “importance of the topic” in the Introduction)
• The current state of the research on the topic or on related topics in the field
• Controversies about current knowledge or specific past studies that undergird your research methodology
• Any claims or assumptions that have been made by researchers, institutions, or politicians that might need to be clarified
• Methods and techniques used in the study or from which your study deviated in some way

Presenting the Study Background

As you begin introducing your background, you first need to provide a general overview and include the main issues concerning the topic. Depending on whether you do “basic” (with the aim of providing further knowledge) or “applied” research (to establish new techniques, processes, or products), this is either a literature review that summarizes all relevant earlier studies in the field or a description of the process (e.g., vote counting) or practice (e.g., diagnosis of a specific disease) that you think is problematic or lacking and needs a solution.

Example s of a general overview

If you study the function of a Drosophila gene, for example, you can explain to the reader why and for whom the study of fly genetics is relevant, what is already known and established, and where you see gaps in the existing literature. If you investigated how the way universities have transitioned into online teaching since the beginning of the Covid-19 pandemic has affected students’ learning progress, then you need to present a summary of what changes have happened around the world, what the effects of those changes have been so far, and where you see problems that need to be addressed. Note that you need to provide sources for every statement and every claim you make here, to establish a solid foundation of knowledge for your own study. 

Describing the current state of knowledge

When the reader understands the main issue(s), you need to fill them in more specifically on the current state of the field (in basic research) or the process/practice/product use you describe (in practical/applied research). Cite all relevant studies that have already reported on the Drosophila gene you are interested in, have failed to reveal certain functions of it, or have suggested that it might be involved in more processes than we know so far. Or list the reports from the education ministries of the countries you are interested in and highlight the data that shows the need for research into the effects of the Corona-19 pandemic on teaching and learning.

Discussing controversies, claims, and assumptions

Are there controversies regarding your topic of interest that need to be mentioned and/or addressed? For example, if your research topic involves an issue that is politically hot, you can acknowledge this here. Have any earlier claims or assumptions been made, by other researchers, institutions, or politicians, that you think need to be clarified?

Mentioning methodologies and approaches

While putting together these details, you also need to mention methodologies : What methods/techniques have been used so far to study what you studied and why are you going to either use the same or a different approach? Are any of the methods included in the literature review flawed in such a way that your study takes specific measures to correct or update? While you shouldn’t spend too much time here justifying your methods (this can be summarized briefly in the rationale of the study at the end of the Introduction and later in the Discussion section), you can engage with the crucial methods applied in previous studies here first.

When you have established the background of the study of your research paper in such a logical way, then the reader should have had no problem following you from the more general information you introduced first to the specific details you added later. You can now easily lead over to the relevance of your research, explain how your work fits into the bigger picture, and specify the aims and objectives of your study. This latter part is usually considered the “ statement of the problem ” of your study. Without a solid research paper background, this statement will come out of nowhere for the reader and very probably raise more questions than you were planning to answer.   

Where does the study background section go in a paper?

Unless you write a research proposal or some kind of report that has a specific “Background” chapter, the background of your study is the first part of your introduction section . This is where you put your work in context and provide all the relevant information the reader needs to follow your rationale. Make sure your background has a logical structure and naturally leads into the statement of the problem at the very end of the introduction so that you bring everything together for the reader to judge the relevance of your work and the validity of your approach before they dig deeper into the details of your study in the methods section .

Consider Receiving Professional Editing Services

Now that you know how to write a background section for a research paper, you might be interested in our AI text editor at Wordvice AI. And be sure to receive professional editing services , including academic editing and proofreading , before submitting your manuscript to journals. On the Wordvice academic resources website, you can also find many more articles and other resources that can help you with writing the other parts of your research paper , with making a research paper outline before you put everything together, or with writing an effective cover letter once you are ready to submit.

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Background information identifies and describes the history and nature of a well-defined research problem with reference to contextualizing existing literature. The background information should indicate the root of the problem being studied, appropriate context of the problem in relation to theory, research, and/or practice , its scope, and the extent to which previous studies have successfully investigated the problem, noting, in particular, where gaps exist that your study attempts to address. Background information does not replace the literature review section of a research paper; it is intended to place the research problem within a specific context and an established plan for its solution.

Fitterling, Lori. Researching and Writing an Effective Background Section of a Research Paper. Kansas City University of Medicine & Biosciences; Creating a Research Paper: How to Write the Background to a Study. DurousseauElectricalInstitute.com; Background Information: Definition of Background Information. Literary Devices Definition and Examples of Literary Terms.

Importance of Having Enough Background Information

Background information expands upon the key points stated in the beginning of your introduction but is not intended to be the main focus of the paper. It generally supports the question, what is the most important information the reader needs to understand before continuing to read the paper? Sufficient background information helps the reader determine if you have a basic understanding of the research problem being investigated and promotes confidence in the overall quality of your analysis and findings. This information provides the reader with the essential context needed to conceptualize the research problem and its significance before moving on to a more thorough analysis of prior research.

Forms of contextualization included in background information can include describing one or more of the following:

• Cultural -- placed within the learned behavior of a specific group or groups of people.
• Economic -- of or relating to systems of production and management of material wealth and/or business activities.
• Gender -- located within the behavioral, cultural, or psychological traits typically associated with being self-identified as male, female, or other form of  gender expression.
• Historical -- the time in which something takes place or was created and how the condition of time influences how you interpret it.
• Interdisciplinary -- explanation of theories, concepts, ideas, or methodologies borrowed from other disciplines applied to the research problem rooted in a discipline other than the discipline where your paper resides.
• Philosophical -- clarification of the essential nature of being or of phenomena as it relates to the research problem.
• Physical/Spatial -- reflects the meaning of space around something and how that influences how it is understood.
• Political -- concerns the environment in which something is produced indicating it's public purpose or agenda.
• Social -- the environment of people that surrounds something's creation or intended audience, reflecting how the people associated with something use and interpret it.
• Temporal -- reflects issues or events of, relating to, or limited by time. Concerns past, present, or future contextualization and not just a historical past.

Background information can also include summaries of important research studies . This can be a particularly important element of providing background information if an innovative or groundbreaking study about the research problem laid a foundation for further research or there was a key study that is essential to understanding your arguments. The priority is to summarize for the reader what is known about the research problem before you conduct the analysis of prior research. This is accomplished with a general summary of the foundational research literature [with citations] that document findings that inform your study's overall aims and objectives.

NOTE: Research studies cited as part of the background information of your introduction should not include very specific, lengthy explanations. This should be discussed in greater detail in your literature review section. If you find a study requiring lengthy explanation, consider moving it to the literature review section.

ANOTHER NOTE: In some cases, your paper's introduction only needs to introduce the research problem, explain its significance, and then describe a road map for how you are going to address the problem; the background information basically forms the introduction part of your literature review. That said, while providing background information is not required, including it in the introduction is a way to highlight important contextual information that could otherwise be hidden or overlooked by the reader if placed in the literature review section.

YET ANOTHER NOTE: In some research studies, the background information is described in a separate section after the introduction and before the literature review. This is most often done if the topic is especially complex or requires a lot of context in order to fully grasp the significance of the research problem. Most college-level research papers do not require this unless required by your professor. However, if you find yourself needing to write more than a couple of pages [double-spaced lines] to provide the background information, it can be written as a separate section to ensure the introduction is not too lengthy.

Background of the Problem Section: What do you Need to Consider? Anonymous. Harvard University; Hopkins, Will G. How to Write a Research Paper. SPORTSCIENCE, Perspectives/Research Resources. Department of Physiology and School of Physical Education, University of Otago, 1999; Green, L. H. How to Write the Background/Introduction Section. Physics 499 Powerpoint slides. University of Illinois; Pyrczak, Fred. Writing Empirical Research Reports: A Basic Guide for Students of the Social and Behavioral Sciences . 8th edition. Glendale, CA: Pyrczak Publishing, 2014; Stevens, Kathleen C. “Can We Improve Reading by Teaching Background Information?.” Journal of Reading 25 (January 1982): 326-329; Woodall, W. Gill. Writing the Background and Significance Section. Senior Research Scientist and Professor of Communication. Center on Alcoholism, Substance Abuse, and Addictions. University of New Mexico.

Structure and Writing Style

Providing background information in the introduction of a research paper serves as a bridge that links the reader to the research problem . Precisely how long and in-depth this bridge should be is largely dependent upon how much information you think the reader will need to know in order to fully understand the problem being discussed and to appreciate why the issues you are investigating are important.

From another perspective, the length and detail of background information also depends on the degree to which you need to demonstrate to your professor how much you understand the research problem. Keep this in mind because providing pertinent background information can be an effective way to demonstrate that you have a clear grasp of key issues, debates, and concepts related to your overall study.

The structure and writing style of your background information can vary depending upon the complexity of your research and/or the nature of the assignment. However, in most cases it should be limited to only one to two paragraphs in your introduction.

Given this, here are some questions to consider while writing this part of your introduction :

• Are there concepts, terms, theories, or ideas that may be unfamiliar to the reader and, thus, require additional explanation?
• Are there historical elements that need to be explored in order to provide needed context, to highlight specific people, issues, or events, or to lay a foundation for understanding the emergence of a current issue or event?
• Are there theories, concepts, or ideas borrowed from other disciplines or academic traditions that may be unfamiliar to the reader and therefore require further explanation?
• Is there a key study or small set of studies that set the stage for understanding the topic and frames why it is important to conduct further research on the topic?
• Y our study uses a method of analysis never applied before;
• Your study investigates a very esoteric or complex research problem;
• Your study introduces new or unique variables that need to be taken into account ; or,
• Your study relies upon analyzing unique texts or documents, such as, archival materials or primary documents like diaries or personal letters that do not represent the established body of source literature on the topic?

Almost all introductions to a research problem require some contextualizing, but the scope and breadth of background information varies depending on your assumption about the reader's level of prior knowledge . However, despite this assessment, background information should be brief and succinct and sets the stage for the elaboration of critical points or in-depth discussion of key issues in the literature review section of your paper.

Writing Tip

Background Information vs. the Literature Review

Incorporating background information into the introduction is intended to provide the reader with critical information about the topic being studied, such as, highlighting and expanding upon foundational studies conducted in the past, describing important historical events that inform why and in what ways the research problem exists, defining key components of your study [concepts, people, places, phenomena] and/or placing the research problem within a particular context. Although introductory background information can often blend into the literature review portion of the paper, essential background information should not be considered a substitute for a comprehensive review and synthesis of relevant research literature.

Hart, Cris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage, 1998; Pyrczak, Fred. Writing Empirical Research Reports: A Basic Guide for Students of the Social and Behavioral Sciences . 8th edition. Glendale, CA: Pyrczak Publishing, 2014.

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How to Write the Background of a Study

• Research Process

The background to a study sets the scene . It lays out the “state of the art”. It tells your reader about other research done on the topic in question, via useful review papers and other summaries of the literature.

Updated on May 5, 2023

The background to your study, sometimes called the ‘state of the art’ (especially in grant writing), sets the scene for a paper. This section shows readers why your research is important, relevant, and why they should continue reading. You must hook them in with a great background to your study, which is part of the overall introduction to your research paper.

In higher impact articles, such as those published in Nature or Science (which is what we are all aiming for, after all …), the study background is t he middle section of an essentially three-part introduction . This section is framed by a presentation of ‘the question’ (first part of the introduction) and a quick explanation of ‘what this paper will do’ (the third part of the introduction).

The introduction of a research paper should be “shaped” like an upside down triangle: 

Start broad. Set the scene with a large-scale general research area [e.g., why doing a PhD erases your writing skills (ha ha) or mental health in teenagers and why this is such a widespread global issue] and then focus down to the question your research addresses (e.g., how can writing skills be improved in PhD students, or brain scans and how these can be used in treatment).

Read on to learn more about framing your next research paper with a well-written and researched background section.

What is the background of a study?

The background to a study sets the scene . It lays out the “state of the art”. It tells your reader about other research done on the topic in question, via useful review papers and other summaries of the literature. 

A background is not a literature review: No one wants to read endless citations back-to-back in this section. You don’t need to list all the papers you’ve read, or all the work done in the past on this topic. 

Set the scene and frame your question in the context of the literature. Seek out review articles in particular. The aim of this section is to build on what has come before so your reader will be armed with all the information they need to understand the remainder of your article, and why - in context - the aims of your study are important.

How to write the background to your research paper

Cater to your audience.

It’s important to frame your background to the right audience.

The background of your study needs to be pitched differently depending on your target journal. A more subject-area specific journal (e.g. Journal of Brain Studies ) will be read by specialists in your field. Generally, less information to set up the paper in a wider context and less background information will be required. Your readers are already experts on the topic in question .

However, if you are aiming your paper at a more general audience (a journal like Nature or Science , for example) then you're going to need to explain more in your background. A reader of a specialized journal will know about the neocortex within the brain and where this is located, but a general reader will need you to set things up more.

Readers are always the most important people in research publishing, after all: If you want your work to be read, used, and cited (and therefore drive up your H-index as well as your institution’s ranking) you’ll need a well-pitched background of your study.

What is included in the background of a study?

Remember this section sits in the middle of the introduction. Here’s a handy template for what to include:

• Existing research on the area of study (not everything, but a broad overview. Aim to cite review papers if you can). Start this section with preliminary data and then build it out;
• Mention any controversies around your topic (either that you’ve identified, or that have been picked up by earlier work. Check the discussion sections of recent articles for pointers here);
• Any gaps in existing research?, and;
• How will your study fill these gaps? State your research methodologies. Any further research that needs to be done?

Aim for one paragraph , or a series of short paragraphs within one section. The last two of the topics outlined above can be short, just one or two sentences. These are there to hook the reader in and to frame your background so that the text leads into the final section of the introduction where you explain ‘What your paper is going to do’.

Simple really.

And finally…some thoughts

I used to get really bogged down with article writing, especially the shape of the introduction.

Here’s a trick to keep in mind: Remember that the average length of an academic research paper published in a peer reviewed journal is around 4,000 - 5,000 words - not too long. 

This means that you're likely going to be aiming for an article of about this length the next time you sit down to write: Not too many words for an effective and well-structured introduction. You’ve got about 1,500 - 2,000 words maximum. And aim to keep it short (this will be enforced by word count limits, especially in higher impact journals like Nature and Science ). Editors at these journals are trained to cut down your writing to make sure your research fits in.

Less is more, in other words.

Keeping tight word count limits in mind means you can’t write an expansive, flowing background to your study that goes off in all directions and covers a huge amount of ground. Keep an eye on our tips for what to include, cite review papers, and keep your readers interested in the question your paper seeks to address.

A well written background to your study will ensure your paper gets read all the way through to the end. Can’t ask for more than that!

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What is the Background of a Study and How Should it be Written?

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Table of Contents

The background of a study is one of the most important components of a research paper. The quality of the background determines whether the reader will be interested in the rest of the study. Thus, to ensure that the audience is invested in reading the entire research paper, it is important to write an appealing and effective background. So, what constitutes the background of a study, and how must it be written?

What is the background of a study?

The background of a study is the first section of the paper and establishes the context underlying the research. It contains the rationale, the key problem statement, and a brief overview of research questions that are addressed in the rest of the paper. The background forms the crux of the study because it introduces an unaware audience to the research and its importance in a clear and logical manner. At times, the background may even explore whether the study builds on or refutes findings from previous studies. Any relevant information that the readers need to know before delving into the paper should be made available to them in the background.

How is a background different from the introduction?

The introduction of your research paper is presented before the background. Let’s find out what factors differentiate the background from the introduction.

• The introduction only contains preliminary data about the research topic and does not state the purpose of the study. On the contrary, the background clarifies the importance of the study in detail.
• The introduction provides an overview of the research topic from a broader perspective, while the background provides a detailed understanding of the topic.
• The introduction should end with the mention of the research questions, aims, and objectives of the study. In contrast, the background follows no such format and only provides essential context to the study.

How should one write the background of a research paper?

The length and detail presented in the background varies for different research papers, depending on the complexity and novelty of the research topic. At times, a simple background suffices, even if the study is complex. Before writing and adding details in the background, take a note of these additional points:

• Start with a strong beginning: Begin the background by defining the research topic and then identify the target audience.
• Cover key components: Explain all theories, concepts, terms, and ideas that may feel unfamiliar to the target audience thoroughly.
• Take note of important prerequisites: Go through the relevant literature in detail. Take notes while reading and cite the sources.
• Maintain a balance: Make sure that the background is focused on important details, but also appeals to a broader audience.
• Include historical data: Current issues largely originate from historical events or findings. If the research borrows information from a historical context, add relevant data in the background.
• Explain novelty: If the research study or methodology is unique or novel, provide an explanation that helps to understand the research better.
• Increase engagement: To make the background engaging, build a story around the central theme of the research

Avoid these mistakes while writing the background:

• Ambiguity: Don’t be ambiguous. While writing, assume that the reader does not understand any intricate detail about your research.
• Unrelated themes: Steer clear from topics that are not related to the key aspects of your research topic.
• Poor organization: Do not place information without a structure. Make sure that the background reads in a chronological manner and organize the sub-sections so that it flows well.

Writing the background for a research paper should not be a daunting task. But directions to go about it can always help. At Elsevier Author Services we provide essential insights on how to write a high quality, appealing, and logically structured paper for publication, beginning with a robust background. For further queries, contact our experts now!

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What Is Background in a Research Paper?

So you have carefully written your research paper  and probably ran it through your colleagues ten to fifteen times. While there are many elements to a good research article, one of the most important elements for your readers is the background of your study.

What is Background of the Study in Research

The background of your study will provide context to the information discussed throughout the research paper . Background information may include both important and relevant studies. This is particularly important if a study either supports or refutes your thesis.

Why is Background of the Study Necessary in Research?

The background of the study discusses your problem statement, rationale, and research questions. It links  introduction to your research topic  and ensures a logical flow of ideas.  Thus, it helps readers understand your reasons for conducting the study.

Providing Background Information

The reader should be able to understand your topic and its importance. The length and detail of your background also depend on the degree to which you need to demonstrate your understanding of the topic. Paying close attention to the following questions will help you in writing background information:

• Are there any theories, concepts, terms, and ideas that may be unfamiliar to the target audience and will require you to provide any additional explanation?
• Any historical data that need to be shared in order to provide context on why the current issue emerged?
• Are there any concepts that may have been borrowed from other disciplines that may be unfamiliar to the reader and need an explanation?

Related: Ready with the background and searching for more information on journal ranking? Check this infographic on the SCImago Journal Rank today!

Is the research study unique for which additional explanation is needed? For instance, you may have used a completely new method

How to Write a Background of the Study

The structure of a background study in a research paper generally follows a logical sequence to provide context, justification, and an understanding of the research problem. It includes an introduction, general background, literature review , rationale , objectives, scope and limitations , significance of the study and the research hypothesis . Following the structure can provide a comprehensive and well-organized background for your research.

Here are the steps to effectively write a background of the study.

1. Identify Your Audience:

Determine the level of expertise of your target audience. Tailor the depth and complexity of your background information accordingly.

2. Understand the Research Problem:

Define the research problem or question your study aims to address. Identify the significance of the problem within the broader context of the field.

3. Review Existing Literature:

Conduct a thorough literature review to understand what is already known in the area. Summarize key findings, theories, and concepts relevant to your research.

4. Include Historical Data:

Integrate historical data if relevant to the research, as current issues often trace back to historical events.

5. Identify Controversies and Gaps:

Note any controversies or debates within the existing literature. Identify gaps , limitations, or unanswered questions that your research can address.

6. Select Key Components:

Choose the most critical elements to include in the background based on their relevance to your research problem. Prioritize information that helps build a strong foundation for your study.

7. Craft a Logical Flow:

Organize the background information in a logical sequence. Start with general context, move to specific theories and concepts, and then focus on the specific problem.

8. Highlight the Novelty of Your Research:

Clearly explain the unique aspects or contributions of your study. Emphasize why your research is different from or builds upon existing work.

Here are some extra tips to increase the quality of your research background:

Example of a Research Background

Here is an example of a research background to help you understand better.

The above hypothetical example provides a research background, addresses the gap and highlights the potential outcome of the study; thereby aiding a better understanding of the proposed research.

What Makes the Introduction Different from the Background?

Your introduction is different from your background in a number of ways.

• The introduction contains preliminary data about your topic that  the reader will most likely read , whereas the background clarifies the importance of the paper.
• The background of your study discusses in depth about the topic, whereas the introduction only gives an overview.
• The introduction should end with your research questions, aims, and objectives, whereas your background should not (except in some cases where your background is integrated into your introduction). For instance, the C.A.R.S. ( Creating a Research Space ) model, created by John Swales is based on his analysis of journal articles. This model attempts to explain and describe the organizational pattern of writing the introduction in social sciences.

Points to Note

Your background should begin with defining a topic and audience. It is important that you identify which topic you need to review and what your audience already knows about the topic. You should proceed by searching and researching the relevant literature. In this case, it is advisable to keep track of the search terms you used and the articles that you downloaded. It is helpful to use one of the research paper management systems such as Papers, Mendeley, Evernote, or Sente. Next, it is helpful to take notes while reading. Be careful when copying quotes verbatim and make sure to put them in quotation marks and cite the sources. In addition, you should keep your background focused but balanced enough so that it is relevant to a broader audience. Aside from these, your background should be critical, consistent, and logically structured.

Writing the background of your study should not be an overly daunting task. Many guides that can help you organize your thoughts as you write the background. The background of the study is the key to introduce your audience to your research topic and should be done with strong knowledge and thoughtful writing.

The background of a research paper typically ranges from one to two paragraphs, summarizing the relevant literature and context of the study. It should be concise, providing enough information to contextualize the research problem and justify the need for the study. Journal instructions about any word count limits should be kept in mind while deciding on the length of the final content.

The background of a research paper provides the context and relevant literature to understand the research problem, while the introduction also introduces the specific research topic, states the research objectives, and outlines the scope of the study. The background focuses on the broader context, whereas the introduction focuses on the specific research project and its objectives.

When writing the background for a study, start by providing a brief overview of the research topic and its significance in the field. Then, highlight the gaps in existing knowledge or unresolved issues that the study aims to address. Finally, summarize the key findings from relevant literature to establish the context and rationale for conducting the research, emphasizing the need and importance of the study within the broader academic landscape.

The background in a research paper is crucial as it sets the stage for the study by providing essential context and rationale. It helps readers understand the significance of the research problem and its relevance in the broader field. By presenting relevant literature and highlighting gaps, the background justifies the need for the study, building a strong foundation for the research and enhancing its credibility.

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The background of the study is the key to introduce your audience to YOUR research topic.

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Writing Research Background

Research background is a brief outline of the most important studies that have been conducted so far presented in a chronological order. Research background part in introduction chapter can be also headed ‘Background of the Study.” Research background should also include a brief discussion of major theories and models related to the research problem.

Specifically, when writing research background you can discuss major theories and models related to your research problem in a chronological order to outline historical developments in the research area.  When writing research background, you also need to demonstrate how your research relates to what has been done so far in the research area.

Research background is written after the literature review. Therefore, literature review has to be the first and the longest stage in the research process, even before the formulation of research aims and objectives, right after the selection of the research area. Once the research area is selected, the literature review is commenced in order to identify gaps in the research area.

Research aims and objectives need to be closely associated with the elimination of this gap in the literature. The main difference between background of the study and literature review is that the former only provides general information about what has been done so far in the research area, whereas the latter elaborates and critically reviews previous works.

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• How to Write a Research Proposal | Examples & Templates

How to Write a Research Proposal | Examples & Templates

Published on 30 October 2022 by Shona McCombes and Tegan George. Revised on 13 June 2023.

A research proposal describes what you will investigate, why it’s important, and how you will conduct your research.

The format of a research proposal varies between fields, but most proposals will contain at least these elements:

Introduction

Literature review.

• Research design

Reference list

While the sections may vary, the overall objective is always the same. A research proposal serves as a blueprint and guide for your research plan, helping you get organised and feel confident in the path forward you choose to take.

Table of contents

Research proposal purpose, research proposal examples, research design and methods, contribution to knowledge, research schedule, frequently asked questions.

Academics often have to write research proposals to get funding for their projects. As a student, you might have to write a research proposal as part of a grad school application , or prior to starting your thesis or dissertation .

In addition to helping you figure out what your research can look like, a proposal can also serve to demonstrate why your project is worth pursuing to a funder, educational institution, or supervisor.

Research proposal length

The length of a research proposal can vary quite a bit. A bachelor’s or master’s thesis proposal can be just a few pages, while proposals for PhD dissertations or research funding are usually much longer and more detailed. Your supervisor can help you determine the best length for your work.

One trick to get started is to think of your proposal’s structure as a shorter version of your thesis or dissertation , only without the results , conclusion and discussion sections.

Download our research proposal template

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Writing a research proposal can be quite challenging, but a good starting point could be to look at some examples. We’ve included a few for you below.

• Example research proposal #1: ‘A Conceptual Framework for Scheduling Constraint Management’
• Example research proposal #2: ‘ Medical Students as Mediators of Change in Tobacco Use’

Like your dissertation or thesis, the proposal will usually have a title page that includes:

• The proposed title of your project
• Your supervisor’s name
• Your institution and department

The first part of your proposal is the initial pitch for your project. Make sure it succinctly explains what you want to do and why.

Your introduction should:

• Introduce your topic
• Give necessary background and context
• Outline your  problem statement  and research questions

To guide your introduction , include information about:

• Who could have an interest in the topic (e.g., scientists, policymakers)
• How much is already known about the topic
• What is missing from this current knowledge
• What new insights your research will contribute
• Why you believe this research is worth doing

As you get started, it’s important to demonstrate that you’re familiar with the most important research on your topic. A strong literature review  shows your reader that your project has a solid foundation in existing knowledge or theory. It also shows that you’re not simply repeating what other people have already done or said, but rather using existing research as a jumping-off point for your own.

In this section, share exactly how your project will contribute to ongoing conversations in the field by:

• Comparing and contrasting the main theories, methods, and debates
• Examining the strengths and weaknesses of different approaches
• Explaining how will you build on, challenge, or synthesise prior scholarship

Following the literature review, restate your main  objectives . This brings the focus back to your own project. Next, your research design or methodology section will describe your overall approach, and the practical steps you will take to answer your research questions.

To finish your proposal on a strong note, explore the potential implications of your research for your field. Emphasise again what you aim to contribute and why it matters.

For example, your results might have implications for:

• Improving best practices
• Informing policymaking decisions
• Strengthening a theory or model
• Challenging popular or scientific beliefs
• Creating a basis for future research

Last but not least, your research proposal must include correct citations for every source you have used, compiled in a reference list . To create citations quickly and easily, you can use our free APA citation generator .

Some institutions or funders require a detailed timeline of the project, asking you to forecast what you will do at each stage and how long it may take. While not always required, be sure to check the requirements of your project.

Here’s an example schedule to help you get started. You can also download a template at the button below.

Download our research schedule template

If you are applying for research funding, chances are you will have to include a detailed budget. This shows your estimates of how much each part of your project will cost.

Make sure to check what type of costs the funding body will agree to cover. For each item, include:

• Cost : exactly how much money do you need?
• Justification : why is this cost necessary to complete the research?
• Source : how did you calculate the amount?

To determine your budget, think about:

• Travel costs : do you need to go somewhere to collect your data? How will you get there, and how much time will you need? What will you do there (e.g., interviews, archival research)?
• Materials : do you need access to any tools or technologies?
• Help : do you need to hire any research assistants for the project? What will they do, and how much will you pay them?

Once you’ve decided on your research objectives , you need to explain them in your paper, at the end of your problem statement.

Keep your research objectives clear and concise, and use appropriate verbs to accurately convey the work that you will carry out for each one.

I will compare …

A research aim is a broad statement indicating the general purpose of your research project. It should appear in your introduction at the end of your problem statement , before your research objectives.

Research objectives are more specific than your research aim. They indicate the specific ways you’ll address the overarching aim.

A PhD, which is short for philosophiae doctor (doctor of philosophy in Latin), is the highest university degree that can be obtained. In a PhD, students spend 3–5 years writing a dissertation , which aims to make a significant, original contribution to current knowledge.

A PhD is intended to prepare students for a career as a researcher, whether that be in academia, the public sector, or the private sector.

A master’s is a 1- or 2-year graduate degree that can prepare you for a variety of careers.

All master’s involve graduate-level coursework. Some are research-intensive and intend to prepare students for further study in a PhD; these usually require their students to write a master’s thesis . Others focus on professional training for a specific career.

Critical thinking refers to the ability to evaluate information and to be aware of biases or assumptions, including your own.

Like information literacy , it involves evaluating arguments, identifying and solving problems in an objective and systematic way, and clearly communicating your ideas.

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Background of the Study

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The background of the study provides a comprehensive overview of the research problem, including the context , significance, and gaps in existing knowledge. It sets the stage for the research by outlining the historical, theoretical, and practical aspects that have led to the current investigation, highlighting the importance of addressing the identified issues.

What is the Background of a Study? 

The background of a study provides context by explaining the research problem, highlighting gaps in existing knowledge, and establishing the study’s significance. It sets the stage for the research objective , offering a foundation for understanding the study’s purpose and relevance within the broader academic discourse.

Background of the Study Format

The background of the study is a foundational section in any research paper or thesis . Here is a structured format to follow:

1. Introduction

• Briefly introduce the topic and its relevance.
• Mention the research problem or question.

2. Contextual Framework

• Provide historical background.
• Discuss relevant theories and models.
• Explain the practical context.

3. Literature Review

• Summarize key studies related to the topic.
• Highlight significant findings and their implications.
• Identify gaps in the existing literature.

4. Rationale

• Explain why the study is necessary.
• Discuss the significance and potential impact.
• Justify the research focus and scope.

5. Objectives and Research Questions

• State the primary objective of the study.
• List the specific research questions.

6. Conclusion

• Summarize the importance of the background.
• Emphasize how it sets the stage for the research.

Introduction The increasing incidence of climate change and its effects on global agriculture has raised significant concerns among researchers. This study focuses on the impact of climate change on crop yields. Contextual Framework Historically, agricultural practices have adapted to gradual climate changes. However, recent rapid shifts have outpaced these adaptations, necessitating urgent research. Theoretical models of climate adaptation provide a foundation for understanding these changes. Literature Review Recent studies show mixed results on the extent of climate change impacts on agriculture. While some regions experience reduced yields, others report minimal changes. These discrepancies highlight the need for a focused study on regional impacts. Rationale This research is crucial for developing strategies to mitigate adverse effects on agriculture. Understanding specific regional impacts can help tailor interventions, making this study highly significant for policymakers and farmers. Objectives and Research Questions To assess the impact of climate change on crop yields in the Midwest. What are the main climate factors affecting agriculture in this region? How can farmers adapt to these changes effectively? Conclusion The background of the study underscores its relevance and importance, providing a solid foundation for the research. By addressing identified gaps, this study aims to contribute valuable insights into climate change adaptation strategies in agriculture.

Background of the Study Examples

Impact of social media on academic performance, effects of urbanization on local ecosystems, role of nutrition in early childhood development.

More Background of the Study Examples

• Online Learning and Reading Skills
• Mindfulness at Work
• Parental Role in Preventing Childhood Obesity
• Green Building and Energy Efficiency
• Peer Tutoring in High Schools
• Remote Work and Work-Life Balance
• Technology in Healthcare

Background of the Study in Research Example

Background of the Study in Qualitative Research Example

Importance of Background of the Study

The background of the study is essential for several reasons:

• Context Establishment : It sets the stage for the research by outlining the historical, theoretical, and practical contexts.
• Literature Review : It provides a summary of existing literature, highlighting what is already known and identifying gaps in knowledge.
• Research Justification : It explains why the study is necessary, showcasing its relevance and significance.
• Research Direction : It guides the research questions and objectives, ensuring the study is focused and coherent.
• Foundation for Methodology : It lays the groundwork for the research methodology, explaining the choice of methods and approaches.
• Informing Stakeholders : It helps stakeholders understand the importance and potential impact of the research.

How is the Background of a Study Different From the Introduction?

The background of a study and the introduction serve distinct but complementary purposes in a research paper. Here’s how they differ:

• Provides detailed context for the research problem.
• Explains the historical, theoretical, and practical background of the topic.
• Identifies gaps in existing knowledge that the study aims to fill.
• Includes a comprehensive literature review.
• Discusses relevant theories, models, and previous research findings.
• Sets the stage for the study by explaining why it is important and necessary.
• Typically more detailed and longer than the introduction.
• Provides in-depth information to help readers understand the broader context of the research.

Introduction

• Introduces the topic and the research problem in a concise manner.
• Captures the reader’s interest and sets the stage for the rest of the paper.
• States the research objectives, questions, and sometimes hypotheses.
• Brief overview of the topic and its significance.
• Clear statement of the research problem.
• Outline of the study’s objectives and research questions.
• May include a brief mention of the methodology and scope.
• Typically shorter and more succinct than the background.
• Provides a snapshot of what the study is about without going into detailed literature review or theoretical background.

Example to Illustrate the Difference

Introduction Example : The rapid growth of social media usage among students has raised concerns about its impact on academic performance. This study aims to investigate how social media influences students’ grades and study habits. By examining different platforms and usage patterns, the research seeks to provide insights into whether social media acts as a distraction or a beneficial tool for learning. Background of the Study Example : Social media has transformed communication and information sharing, particularly among young people. Historically, educational environments have seen various technological impacts, from the introduction of computers to the widespread use of the internet. Theories of digital learning suggest both positive and negative effects of technology on education. Previous studies have shown mixed results; some indicate that social media can enhance collaborative learning and resource access, while others point to decreased academic performance due to distraction. Despite these findings, there is limited research on the long-term effects of specific social media platforms on academic outcomes. This study addresses these gaps by exploring how different types of social media usage impact student performance, aiming to provide a nuanced understanding of this contemporary issue.

Where is the Background of a Study Placed in a Research Paper? 

The background of a study is typically placed within the Introduction section of a research paper, but it can also be a separate section immediately following the introduction. Here’s a more detailed breakdown of where the background of the study can be placed:

Within the Introduction

• In many research papers, the background of the study is woven into the introduction. It provides context and justification for the research problem, leading up to the statement of the research objectives and questions.
• Starts with a general introduction to the topic.
• Provides background information and context.
• Reviews relevant literature and identifies gaps.
• States the research problem, objectives, and questions.

As a Separate Section

• In more detailed or longer research papers, the background of the study can be a standalone section that comes immediately after the introduction. This allows for a more comprehensive presentation of the context, literature review, and theoretical framework.
• Introduction : Briefly introduces the topic and states the research problem.
• Background of the Study : Provides detailed context, literature review, theoretical background, and justification for the research.
• Research Objectives and Questions : Clearly states the aims and specific questions the research seeks to answer.

How to Write a Background of the Study

Writing a background of the study involves providing a comprehensive overview of the research problem, context, and significance. Here’s a step-by-step guide on how to write an effective background of the study:

Introduce the Topic

Begin with a General Introduction : Start by introducing the broad topic to give readers an overview of the field. Example : “Social media has revolutionized communication and information sharing in the digital age.”

Provide Context

Historical Background : Explain the historical development of the topic. Example : “Historically, communication technologies have significantly influenced educational practices, from the introduction of the internet to the advent of mobile learning.” Theoretical Framework : Mention relevant theories and models. Example : “Theories such as social constructivism and digital learning provide a basis for understanding how students interact and learn through social media.”

Review Relevant Literature

Summarize Key Studies : Provide a summary of significant studies related to your topic. Example : “Previous research has shown mixed results regarding the impact of social media on academic performance. Some studies suggest that social media can be a distraction, leading to lower grades, while others indicate it can enhance learning through collaboration.” Identify Gaps in Knowledge : Highlight gaps or inconsistencies in the existing literature. Example : “Despite extensive research, there is limited understanding of the long-term effects of specific social media platforms on student performance.”

Explain the Rationale

Justify the Need for the Study : Explain why your study is necessary and important. Example : “Assessing the impact of social media on academic performance is crucial for developing effective educational strategies and policies. This study aims to fill the existing knowledge gaps by providing detailed insights into how different platforms affect student learning outcomes.”

State the Research Objectives and Questions

List the Objectives : Clearly state the main objectives of your study. Example : “The primary objectives of this study are to analyze the relationship between social media usage and academic performance and to identify the most and least beneficial platforms for students.” Pose Research Questions : Include specific research questions that guide your study. Example : “What are the main factors influencing the impact of social media on academic performance? How can students balance social media use and academic responsibilities?”

Conclude with the Importance of the Study

Summarize the Significance : Emphasize how your study will contribute to the field. Example : “This study’s findings will provide valuable insights into the role of social media in education, informing educators and policymakers on how to leverage these tools effectively to enhance student learning outcomes.”

How to avoid mistakes in writing the Background of a Study 

Avoiding mistakes in writing the background of a study involves careful planning, thorough research, and attention to detail. Here are some tips to help you avoid common mistakes:

1. Lack of Clarity and Focus

• Example : If your research is about the impact of social media on student performance, don’t delve into unrelated topics like general internet usage unless directly relevant.

2. Insufficient Literature Review

• Example : Use databases like Google Scholar, PubMed, or your institution’s library to find peer-reviewed articles and credible sources.

3. Overwhelming with Too Much Information

• Example : Summarize key studies and avoid detailed descriptions of every study you come across.

4. Failure to Identify Gaps in Knowledge

• Example : “While several studies have explored social media’s impact on general communication skills, few have examined its specific effects on academic performance among high school students.”

5. Lack of Theoretical Framework

• Example : “The study is grounded in social constructivism, which suggests that learning occurs through social interactions, making it relevant to examine how social media platforms facilitate these interactions.”

6. Inadequate Justification for the Study

• Example : “Understanding the impact of social media on academic performance is crucial for developing effective educational strategies and policies.”

7. Poor Organization and Structure

• Example : Use clear headings like “Introduction,” “Contextual Framework,” “Literature Review,” “Rationale,” and “Research Objectives and Questions.”

8. Using Jargon and Complex Language

• Example : Instead of “The pedagogical implications of digital media necessitate a paradigmatic shift,” say “Digital media impacts teaching methods, requiring changes in how we educate.”

9. Ignoring the Research Objectives and Questions

• Example : “This background review highlights the need to investigate how different social media platforms affect high school students’ study habits, directly addressing the research questions outlined.”

10. Neglecting to Update References

• Example : Instead of relying solely on sources from over a decade ago, incorporate recent studies that reflect current trends and findings.

What is the background of the study?

The background of the study provides context, explains the research problem, reviews relevant literature, and identifies gaps the study aims to fill.

Why is the background of the study important?

It establishes the context and significance of the research, justifies the study, and helps readers understand the broader academic landscape and gaps the research addresses.

How does the background of the study differ from the introduction?

The background provides detailed context and literature review, while the introduction briefly presents the research problem, objectives, and significance.

What should be included in the background of the study?

Include historical context, theoretical framework, literature review, gaps in knowledge, and the rationale for the study.

Where is the background of the study placed in a research paper?

It is typically integrated within the introduction or presented as a separate section following the introduction.

How long should the background of the study be?

The length varies, but it should be detailed enough to provide context and justification, typically a few paragraphs to several pages.

How do you write a strong background of the study?

Conduct thorough research, organize logically, include relevant theories and studies, identify gaps, and justify the research’s importance.

Can the background of the study include preliminary data?

Yes, including preliminary data can strengthen the background by demonstrating initial findings and supporting the research rationale.

How do you identify gaps in the literature?

Conduct a comprehensive literature review, compare findings, and note inconsistencies, unexplored areas, or outdated research that your study will address.

Should the background of the study be written in chronological order?

Not necessarily. Organize logically by themes, concepts, or research gaps rather than strictly chronologically to provide a coherent context for your study.

Text prompt

• Instructive
• Professional

10 Examples of Public speaking

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Research Proposal Example/Sample

Detailed Walkthrough + Free Proposal Template

If you’re getting started crafting your research proposal and are looking for a few examples of research proposals , you’ve come to the right place.

In this video, we walk you through two successful (approved) research proposals , one for a Master’s-level project, and one for a PhD-level dissertation. We also start off by unpacking our free research proposal template and discussing the four core sections of a research proposal, so that you have a clear understanding of the basics before diving into the actual proposals.

• Research proposal example/sample – Master’s-level (PDF/Word)
• Research proposal example/sample – PhD-level (PDF/Word)
• Proposal template (Fully editable) 

If you’re working on a research proposal for a dissertation or thesis, you may also find the following useful:

• Research Proposal Bootcamp : Learn how to write a research proposal as efficiently and effectively as possible
• 1:1 Proposal Coaching : Get hands-on help with your research proposal

PS – If you’re working on a dissertation, be sure to also check out our collection of dissertation and thesis examples here .

FAQ: Research Proposal Example

Research proposal example: frequently asked questions, are the sample proposals real.

Yes. The proposals are real and were approved by the respective universities.

Can I copy one of these proposals for my own research?

As we discuss in the video, every research proposal will be slightly different, depending on the university’s unique requirements, as well as the nature of the research itself. Therefore, you’ll need to tailor your research proposal to suit your specific context.

You can learn more about the basics of writing a research proposal here .

How do I get the research proposal template?

You can access our free proposal template here .

Is the proposal template really free?

Yes. There is no cost for the proposal template and you are free to use it as a foundation for your research proposal.

Where can I learn more about proposal writing?

For self-directed learners, our Research Proposal Bootcamp is a great starting point.

For students that want hands-on guidance, our private coaching service is recommended.

Psst… there’s more!

This post is an extract from our bestselling short course, Research Proposal Bootcamp . If you want to work smart, you don't want to miss this .

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• Open access
• Published: 27 May 2024

Challenges to the implementation of a multi-level intervention to reduce mistreatment of women during childbirth in Iran: a qualitative study using the Consolidated Framework for Implementation Research

• Marjan Mirzania 1 ,
• Elham Shakibazadeh 1 ,
• Meghan A. Bohren 2 ,
• Sedigheh Hantoushzadeh 3 ,
• Abdoljavad Khajavi 4 &
• Abbas Rahimi Foroushani 5  

Reproductive Health volume  21 , Article number:  70 ( 2024 ) Cite this article

Metrics details

Mistreatment during childbirth is a growing concern worldwide, especially in developing countries, such as Iran. In response, we launched a comprehensive implementation research (IR) project to reduce mistreatment during childbirth and enhance positive birth experiences in birth facilities. This study identified the challenges of implementing a multi-level intervention to reduce mistreatment of women during childbirth using the Consolidated Framework for Implementation Research (CFIR).

An exploratory qualitative study, involving 30 in-depth interviews, was conducted between July 2022 and February 2023. Participants included a purposive sample of key stakeholders at different levels of the health system (macro: Ministry of Health and Medical Education; meso: universities of medical sciences and health services; and micro: hospitals) with sufficient knowledge, direct experience, and/or collaboration in the implementation of the studied interventions. Interviews were transcribed verbatim and coded using directed qualitative content analysis (CFIR constructs) in MAXQDA 18.

The identified challenges were: (1) individual level (childbirth preparation classes: e.g., adaptability, design quality and packaging, cosmopolitanism; presence of birth companions: e.g., patient needs and resources, structural characteristics, culture); (2) healthcare provider level (integrating respectful maternity care into in-service training: e.g., relative priority, access to knowledge and information, reflecting and evaluating); (3) hospital level (evaluating the performance of maternity healthcare providers: e.g., executing, external policies and incentives); and (4) national health system level (implementation of pain relief during childbirth guidelines: e.g., networks and communications, patient needs and resources, executing, reflecting and evaluating).

Conclusions

This study provides a clear understanding of the challenges of implementing a multi-level intervention to reduce mistreatment of women during childbirth and highlights potential implications for policy makers and practitioners of maternal health programs. We encourage them to take the lessons learned from this study and revise their current programs and policies regarding the quality of maternity care by focusing on the identified challenges.

Plain English summary

Evidence suggests that mistreatment during childbirth is a growing concern worldwide, especially in developing countries, such as Iran. In this qualitative study, through 30 in-depth interviews with key stakeholders at different levels of the health system (macro: Ministry of Health and Medical Education; meso: universities of medical sciences and health services; and micro: hospitals), we identified the challenges of implementing a multi-level intervention to reduce mistreatment of women during childbirth using the Consolidated Framework for Implementation Research (CFIR). The data were analyzed using directed content analysis and a deductive approach in MAXQDA 18 software. The identified challenges were: (1) individual level (childbirth preparation classes: e.g., adaptability; presence of birth companions: e.g., patient needs and resources); (2) healthcare provider level (integrating respectful maternity care into in-service training: e.g., relative priority); (3) hospital level (evaluating the performance of maternity healthcare providers: e.g., executing, external policies and incentives); and (4) national health system level (implementation of pain relief childbirth guidelines: e.g., networks and communications). This study provides a clear understanding of the challenges of implementing a multi-level intervention to reduce mistreatment of women during childbirth; and highlights potential implications for policy makers and practitioners of maternal health programs.

Peer Review reports

Despite the recognition of every woman's right to enjoy the highest attainable standard of health, including the right to dignified and respectful care [ 1 ], evidence shows that mistreatment during childbirth is a common experience among women worldwide [ 2 , 3 ]. It is increasingly recognized as an urgent public health priority and a poor quality of care index [ 1 , 4 ], and is a critical determinant of women's decisions regarding place of birth, mode of birth, lactation, mother-child bonding, and childbirth experiences [ 5 , 6 ]. The prevalence of mistreatment among women seeking maternity care varies across different settings, from 43% in Latin America and the Caribbean [ 7 ] to 76.3% in Europe (Germany and the Netherlands) [ 8 ]. The prevalence in Iran is likewise high, reported as 75.7% [ 9 ] and 100% [ 10 ]. Women in Iran have experienced verbal abuse, frequent and painful vaginal examinations, lack of continuity of care, empathy, participation in decision-making, choice of preferred birth position, privacy, and birth companions [ 11 , 12 , 13 , 14 ].

In recent years, some interventions have been developed, implemented, and showed promising results on reducing mistreatment and promoting respectful care for all women [ 15 , 16 , 17 , 18 ]. The Heshima project reported reductions in most forms of disrespect and abuse (D&A) in 13 health facilities in Kenya [ 15 ]. A study by Kujawski et al. (2017) in two hospitals in Tanzania (Staha project) showed a 66% reduction in the odds of women experiencing D&A after the intervention [ 17 ]. Asfa et al.'s (2020) study in Ethiopia showed that the intervention led to an 18% reduction in the number of mistreatment components [ 18 ].

In Iran, the Ministry of Health and Medical Education (MOHME) has developed a list of programs and practices to ensure maternal dignity during childbirth, such as the mother's bill of rights, maternal dignity training package, maternal dignity seminars for maternity healthcare providers (MHCPs) [ 19 , 20 ], and emphasis on respectful maternity care (RMC) in the national guidelines for normal childbirth [ 21 ]. However, these actions did not make effective changes in the maternity quality of care. It seems that the programs implemented by the MOHME were not developed using context- and evidence-based approaches. There were also lacks of precise guidance on their effective implementation. Furthermore, the available research evidence on respectful/disrespectful maternity care in Iran has focused on the prevalence [ 9 , 10 ], development and psychometrics of instruments [ 22 , 23 ], and descriptions of women and healthcare providers’ experiences [ 24 , 25 ], and few interventional studies have been conducted to reduce D&A or promote RMC, including workshops for midwives [ 26 , 27 ]. It seems that healthcare providers training alone is not a sufficient solution [ 28 ]. In response, we launched a comprehensive implementation research (IR) project to reduce mistreatment during childbirth and enhance positive birth experiences in health facilities.

Prior to implementing any evidence-based intervention/innovation (EBI), it is important to identify the factors affecting its implementation in “real-world” settings to increase its adoption, scale-up, and sustainability [ 29 ]. It has been shown that many interventions that were effective in “in-vitro” and controlled conditions or small-scale fail in the real world due to contextual factors that acted against the implementation [ 30 , 31 ]. Implementation science (IS) helps to identify factors that can support or inhibit implementation and to optimize intervention implementation. Therefore, although it is necessary to prove the effectiveness of interventions in trials, this is not sufficient to ensure successful implementation at scale. Therefore, it is necessary to understand why intervention works, how, for whom, and in what settings, and what strategies are needed to improve its implementation [ 32 , 33 ].

In recent years, several models, theories, and implementation frameworks have been developed. The Consolidated Framework for Implementation Research (CFIR) [ 31 ] was developed by combining 19 theories on dissemination, innovation, implementation, organizational change, knowledge translation, and research uptake [ 34 ]. The CFIR is a “determinant framework” that consists of five domains, including the intervention characteristics (key features of an intervention), outer setting (features of the external context such as economic, political, and social environments of the intervention), inner setting (features of the organization such as structural, political, and cultural environments), characteristics of individuals involved (features of implementers such as cultural, organizational, and professional norms), and process of implementation (strategies or tactics that might influence the success of implementation) with 39 constructs/sub-constructs [ 34 , 35 ] (Additional file 1 : CFIR).

Despite attention to intervention studies to promote RMC or prevent mistreatment during childbirth, few studies have examined the implementation process of such interventions, and there is little insight into how the contextual conditions surrounding the implementation of these interventions contribute to their success or failure. To address this gap, we chose a qualitative method to obtain the experiences and perspectives of key stakeholders on the challenges of implementing a multi-level intervention to reduce mistreatment of women during childbirth in Iran using CFIR. Qualitative research methods are appropriate when seeking an in-depth understanding of participants' perspectives.

This qualitative study was part of a larger implementation research project focusing on the development and implementation of a context-specific intervention to reduce disrespectful maternity care and evaluation of strategies to improve implementation. The project was initiated in October 2021 in five public teaching hospitals in Tehran, Iran, and consists of five phases: (1) needs assessment (to assess knowledge, attitudes and practices of maternity healthcare providers about mistreatment of women during labour and childbirth, and the manifestations of mistreatment and its influencing factors), (2) identifying interventions to reduce mistreatment of women during childbirth, (3) identifying the implementation challenges of interventions, (4) designing implementation strategies for the intervention, and (5) testing implementation strategies in a real-life setting. The findings of phase 1 of the project are described elsewhere [ 11 , 36 ].

Identifying interventions to reduce mistreatment of women during childbirth

Based on the findings of phase 1 of the project, we created a logical model of the mistreatment problem based on the PRECEDE health-planning model [ 37 ]. According to the determinants of mistreatment based on the model, multi-level intervention was identified to address mistreatment drivers (Fig. 1 ). In this phase 3 of the project, we selected interventions from each level (individual, healthcare provider, hospital, and national health system) that are currently being implemented in Iran's health system to gain in-depth understanding of the challenges that affect proper implementation. Interventions implemented at each level are presented in Table 1 . This study investigated the implementation challenges of these interventions.

Logic model of the study

Study design and participants

We conducted an exploratory qualitative study consisting of individual in-depth interviews between July 2022 and February 2023 in Tehran, Iran. Participants included key stakeholders at different levels of the health system (including healthcare providers, managers, experts, policy makers, and decision makers) with sufficient knowledge, direct experience, and/or collaboration in the implementation of each of the studied interventions. We selected participants using purposive sampling to obtain diverse perspectives and experiences and then used the snowball method to recruit more participants. We aimed for maximum variation among participants according to age, education, organizational role, and work experience. Key stakeholders were selected from three levels: macro (Ministry of Health and Medical Education (MOHME): four participants), meso (universities of medical sciences and health services: 12 participants), and micro (hospitals: 14 participants). These individuals were invited to participate by phone calls and/or in-person. The eligibility criteria for this study were familiarity and/or executive responsibility in any of the studied interventions and having at least five years of work experience.

Data collection

We developed the initial semi-structured interview guide based on sample interviews at http://cfirguide.org [ 42 ]. Damschroder et al. (2009) recommend that researchers try to select constructs from CFIR that are most related to their study setting [ 34 ]. Therefore, the interview guide was revised using study-related constructs (Additional file 2 : interview guide). We then pilot-tested this by conducting two initial interviews, which were not analyzed. Interviews were conducted in Persian by the lead author (M.M.), a female PhD candidate in Health Education and Promotion with previous experience in qualitative studies who had no prior interactions with the participants. To prepare participants for the interview, interview guide questions were sent to them in advance via email. Additionally, at the beginning of the interviews, the purpose of the study, guarantee of confidentiality and anonymity of information, nature of voluntary participation, and the possibility of withdrawing from the study at any time were explained to the participants. All participants provided written informed consent and permission for audio recordings. The interviews were conducted in participants' workplaces (in a private room) and during their preferred accommodation. The duration of the interviews ranged from 40 to 60 min, during which the interviewer made field notes. The demographic characteristics of the participants (including age, gender, education, organizational role, and number of years of work experience) were recorded at the end of each interview. The interviews continued until data saturation was reached. Saturation was obtained after the 28th interview; however, to ensure that no new information emerged, data collection continued until the 30th interview. All the invited individuals participated in the interviews, and no repeat interviews were conducted.

Data analysis

Data analysis was conducted simultaneously with data collection, using directed content analysis [ 43 ] and a deductive approach. After each interview, M.M. listened to the recorded audios several times, transcribed verbatim in Persian, and returned to the participants for comments and/or corrections. E.Sh. (female professor in Health Education and Promotion; an experienced qualitative researcher) checked the transcripts for accuracy and consistency. Prior to coding the data, a categorization matrix was developed based on the interview guide (i.e., CFIR constructs). Next, two authors (M.M. and E.Sh.) independently analyzed the data. We marked and color-coded the significant segments of the text. We put those color-coded text segments together and gave codes. We categorized the codes according to their differences and similarities, and linked them to pre-specified categorizations in sub-themes and themes. If disagreements arose in coding, the authors discussed until consensus was reached. The MAXQDA 18 software was used to manage the data [ 44 ]. We translated selected quotes into English to support the themes developed throughout the analysis.

The trustworthiness of this study was tested based on the four criteria of Lincoln and Guba [ 45 ]. The credibility of the data was ensured through prolonged engagement with the data, applying a sampling technique with maximum variation, multiple data sources (including field notes, audio recordings, and transcripts), and providing initial codes to the three participants for approval. To enhance the transferability of the data, we conducted interviews with participants who had the most experience and knowledge of each of the studied interventions. Furthermore, dependability was obtained by analyzing the data separately by the two members of the research team. To assess confirmability, a qualitative research specialist, who did not participate in this study, confirmed the data analysis process. This paper was reported in accordance with the consolidated criteria for reporting qualitative research (COREQ) checklist [ 46 ] (Additional file 3 : COREQ Checklist).

Characteristics of participants

Thirty in-depth interviews were conducted with the key stakeholders. The mean age of the participants was 49.5 years (range: 35-65 years). Most participants (73.4%) held an MD or PhD degree. Four participants worked in MOHME, 12 in medical universities, and 14 in hospitals; more than half had over 20 years of work experience (Table 2 ).

The identified challenges

The challenges of implementing each intervention (currently implemented in the system) were identified and categorized using the domains and constructs/sub-constructs of the CFIR (Table 3 ).

Individual-level interventions

At the individual level, two interventions were listed according to the determinants of mistreatment based on the model: childbirth preparation classes and the presence of birth companions (Fig.  1 ). Both interventions are implemented in the system; however, there were serious challenges in the settings, as outline below.

Training of pregnant women about the process of labour and childbirth, respectful care and their rights during childbirth

In our study, participants shared opinions about the challenges of implementing childbirth preparation classes in five CFIR domains (intervention characteristics, outer setting, inner setting, characteristics of individuals involved, and process of implementation).

Intervention characteristics

Adaptability.

The level of adaptability of the intervention (childbirth preparation classes) was described as a key barrier to its implementation by most participants. They believed that non-compliance of the conditions and facilities of maternity hospitals with the educational content of the classes, improper timing of the start of classes (from the 20th week of pregnancy), and poor announcements can weaken the implementation of the intervention. The participants suggested that for effective childbirth preparation classes, the situations of facilities of maternity hospitals can be tailored and refined according to the educational content of the classes. Additionally, classes should be held in the early phases of pregnancy and widely announced.

“The training that women receive in classes is different from that implemented in maternity hospitals. For example, we teach that they can move during labour, take their preferred position during childbirth, and have a chosen companion. However, in practice, this has not been implemented in maternity hospitals ...” (Reproductive Health Specialist, University level) “Announcing about childbirth preparation classes in hospitals and health centers is poor. Only 18% of the pregnant women participated in classes. We did not announce them correctly…” (Health Policy Specialist, MOHME level)

Design quality and packaging

Weakness in the design quality and packaging of childbirth preparation classes prevent their successful implementation. Some participants (obstetricians) reported a lack of a multidisciplinary team in holding classes as a barrier to implementation. They believed that classes should be managed by a team and should not be exclusive to midwives. However, the midwives stated that the content of the classes was such that it could be handled by them, but the presence of a psychologist in some sessions could play an important role in the success of the classes.

“We must accept that midwives cannot cover all sessions. Psychologists, nutritionists, and obstetricians can be used in these classes.” (Obstetrician, Hospital level)

Outer setting

Patient needs and resources.

Lack of training about RMC was also considered a fundamental factor. Most participants highlighted that women do not understand respectful care principles and their rights during childbirth, and this should be integrated into the content of childbirth preparation classes.

“… They should be aware of their rights during childbirth. This should be integrated into the content of the childbirth preparation classes.” (Obstetrician, MOHME level)

Cosmopolitanism

A crucial factor affecting childbirth preparation class implementation was the poor collaboration of the private sector to hold classes. Participants reported that since most pregnant women receive their care from the private sector (obstetricians and/or midwives' offices), there is a need to establish efficient mechanisms for more support and collaboration of these sectors in holding classes.

“Participation of the private sector is essential because 70% of pregnant women receive their care from obstetricians and midwives.” (Midwife, University level)

Inner setting

Organizational incentives and rewards.

A few participants expressed concerns about the poor implementation of childbirth preparation classes following the low participation of pregnant women in classes. They believed that setting enough incentives could affect women’s degree of engagement and commitment to participate in classes.

“Between 9-10% of pregnant women attend our classes (health centers), and this rate is very low ... If incentives are provided, they are more motivated to participate.” (Reproductive Health Specialist, University level)

Available resources

Participants reported that poor physical environment and staff shortages were barriers to implementing childbirth preparation classes.

“In some hospitals, there is no standard space to hold classes, especially in private hospitals.” (Midwife, Hospital level) “Dedicated instructors should be considered in these classes. Here, they appoint one person as an instructor, and at the same time, she has to work shifts in the maternity hospital because they do not have staff.” (Midwife, Hospital level)

Characteristics of individuals involved

Other personal attributes.

Instructors’ skill and interest was another challenge that was highlighted by some participants: “Unfortunately, some of our midwives (as instructors of classes) are rarely interested in training or do not have enough skills …” (Reproductive Health Specialist, Hospital level)

Process of implementation

Poor execution of childbirth preparation classes, especially during the COVID-19 pandemic, was an important challenge discussed by participants. They also believed that focusing on quantity and neglecting the quality of the classes made them not have the proper efficiency, and their goal was rarely reached: “The classes are implemented, but they are not implemented according to plan and properly ... Unfortunately, we focused on the quantity of the classes, for example, the forms we have to complete and the statistics we have to give to the MOHME.” (Reproductive Health Specialist, University level)

Reflecting and evaluating

Supervising implementation and continuous evaluation were crucial factors emphasized by the participants. They acknowledged that the MOHME should supervise the implementation of childbirth preparation classes in hospitals and health centers through regular inspections. In addition, evaluate the progress and quality of their implementation through an external evaluation.

“I think the biggest challenge of childbirth preparation classes is that there is no supervision of their implementation … There should be a monitoring and auditing system.” (Reproductive Health Specialist, MOHME level)

Presence of birth companions

In this study, the challenges of implementing birth companions in four CFIR domains (outer setting, inner setting, characteristics of individuals involved, and process of implementation) were discussed by the participants.

According to the participants, the lack of knowledge of companions could be a barrier to their attendance at maternity hospitals. Some participants believed that a person going to be a birth companion should be required to participate in childbirth preparation classes and receive training:

“Companions have limited knowledge. I think birth companions should be required to participate in childbirth preparation classes because those who are trained in these classes are helpful to both labouring women and us providers.” (Reproductive Health Specialist, Hospital level)

Structural characteristics

The lack of physical space in some maternity hospitals was another factor that some participants stated: “Some of our maternity hospitals do not have a standard structure, for example, Hospital X, which is a hall with 12 beds and set up some extra beds because of the high visits, so there will be no place for the presence of a birth companion.” (Health Policy Specialist, MOHME level)

The participants also reported cultural issues as barriers to the implementation of birth companions. They noted that most of the time, if the companion is a partner, due to the feminine environment of maternity hospitals and female providers’ unwillingness to be accompanied by men in the delivery room; they are not allowed to be accompanied.

“The companion is not allowed to enter the maternity hospital; why? Because my colleague (midwife or doctor) does not like a man to be in the labour room, she says, 'No, sir, you go out and let a woman come.” (Reproductive Health Specialist, MOHME level)

Compatibility

One potential barrier to implementation was concern about the compatibility of the presence of birth companions with the existing workflows of maternity staff. The participants agreed that the interference of birth companions in the clinical duties of staff was a major factor for not allowing a companion.

“As a midwife who worked in a maternity hospital for several years and was strongly against the presence of birth companions, I say that our main challenge was the interference of companions. For example, when a labouring woman's serum runs out, the companion comes many times and warns …” (Midwife, University level)

Some participants believed that the unwillingness of staff was an important barrier. They mentioned that staff prevents the presence of birth companions because of the perception that the companion is witnessing their performance as an advocate for the woman, which may cause them to expect more attention to labouring women.

“The companion is like an advocate; it is like a hidden camera. Why do some staff members not like companions to enter maternity hospitals? This is because it controls their performance …” (Obstetrician, Hospital level)

Another factor was related to lack of supervision. The participants highlighted the need for continuous supervision of the implementation of birth companion guidelines in hospitals: “The presence of birth companions has a guideline that has been communicated to all hospitals, but in many hospitals, especially public hospitals, it is not implemented because it is not supervising ...” (Obstetrician, University level)

Healthcare provider-level intervention

At this level, five interventions were listed according to the determinants of mistreatment based on the model (Fig. 1 ). However, one of them (integrating RMC into the in-service training of maternity staff) is implemented in the system. The challenges of this intervention were identified as follows:

Integrating RMC into in-service training of maternity staff

Participants in this study reported intervention implementation challenges in the four CFIR domains (outer setting, inner setting, characteristics of individuals involved, and process of implementation).

External policies and incentives

Regulations and guidelines related to in-service training of staff affect the quality and efficiency of courses. Weakness in some regulations and guidelines has caused staff to be given a quantitative view, which means that many of them participate in the training course to obtain a certificate, rather than improve their knowledge, skills, and behavior, and/or increase the organization's productivity.

“… Unfortunately, our regulations and guidelines are quantitative; that is, they dictate that if a person spends X hours in a year, it will be included in his/her evaluation and career promotion. Therefore, staff members only participate in courses to complete their duty hours and obtain a certificate.” (Midwife, University level)

Relative priority

Obtaining a license to hold an in-service training course was one of the challenges mentioned by some of the participants. They expressed the belief that the necessity of holding a respectful care training course should be clarified in the steering committee of training and empowerment of human resources in such a way that the course is included in the specialized and mandatory training of employees, not general and optional; thus, it is effective in their career development and they have sufficient motivation to participate in the course.

“One of the challenges is to obtain a license to hold the course. You must justify the necessity of holding a respectful care training course in such a way that the course is included in the job description of the maternity staff.” (Public Health- related manager, University level)

Allocation of an insufficient budget for staff training was an important challenge reported by some participants. They found that staff participation in training courses required more financial support: “Unfortunately, the investment in training staff is very low. The per capita education budget for healthcare staff training this year is 800,000 Iranian rials (IRR), is very small.” (Public Health- related manager, MOHME level)

Similarly, the lack of experienced instructors is considered a challenge. When the instructor of an in-service training course does not have specialized knowledge and teaching ability, the course does not have the necessary efficiency and is not welcomed.

Access to knowledge and information

The participants also believed that informing the staff about the value and importance of the training course played an important role in its successful implementation. They highlighted that information and materials about the importance of RMC should already be provided to the maternity staff. A participant said: “First, it clarifies the importance of respectful care training for the maternity staff. They need to know how much their behavior with labouring women can affect their mental health status as well as their decisions for future pregnancies.” (Health Services Management Specialist, University level)

Knowledge and beliefs about the intervention

Managers do not believe in in-service training for staff, and lack of support for them has caused the need for this training to not be included in the organization's plans and priorities.

“Some managers do not support participation in training courses, and they do not believe that these courses have many benefits for the individual and organization.” (Public Health- related manager, University level)

Another major challenge was the weakness of evaluating the effectiveness of the training courses. The participants acknowledged that, although the evaluation of the effectiveness of courses is done using Kirkpatrick's model [ 47 ], it is often incomplete or limited to the first two levels of this model, and the third and fourth levels are not done because of problems and complexity.

“... Our current evaluation method is flawed, and we do not evaluate almost any of our courses at the level of behavior; therefore, we cannot be sure if the person who participated in the course acquired the expected capabilities.” (Reproductive Health Specialist, University level)

Hospital-level intervention

At the hospital level, four interventions were listed based on the model (Fig. 1 ). Of these, the evaluation of the performance of MHCPs is implemented in the system. The identified challenges for this intervention were as follows:

Evaluating the performance of MHCPs about mistreatment and/or RMC

In our study, participants discussed the intervention implementation challenges in two CFIR domains (outer setting and process of implementation).

Some participants complained of weakness in laws and regulations. They stated that to supervise the performance of MHCPs in laws and regulations (including the Support of Family and Youth Population Act), the merit pay of providers dependent on the satisfaction of pregnant women is defined. However, they are not included in the payment systems of all MHCPs. Furthermore, participants expressed concern that these laws (such as reducing merit pay or warnings) were not very effective in supervising the performance of the providers.

“Currently, in the Support of Family and Youth Population Act, merit pay of the providers depends on the satisfaction of pregnant women, but unfortunately not for all providers (including obstetricians or residents). We are pursuing this to be modified.” (Health Policy Specialist, MOHME level)

Poor execution of the intervention (mother’s satisfaction questionnaire) was considered important. Participants stated that, although all hospitals were required to implement and provide feedback to the MOHME, the providers often completed the questionnaire. To solve this problem, an electronic satisfaction questionnaire is currently being designed, whose links will be sent to women, and their satisfaction reports will be registered in the Ministry of Health's portal. However, owing to the poor support of the Information Technology (IT) unit, it has not yet been implemented.

“… Unfortunately, the questionnaires were completed by the providers, without the mother being informed. Currently, an electronic questionnaire is designed, the report of which will be registered in the Ministry of Health's portal, but it has not yet been implemented.” (Reproductive Health Specialist, Hospital level)

National health system-level intervention

At the national health system level, the implementation of pain relief during childbirth guidelines was listed based on the model (Fig. 1 ). This intervention is implemented in the system, and its challenges were as follows:

Implementation of pain relief during childbirth guidelines

In this study, the participants identified implementation challenges in the four CFIR domains (outer setting, inner setting, characteristics of individuals involved, and process of implementation).

Participants mentioned the lack of knowledge of pregnant women as an important challenge in implementing pain relief during childbirth. They believed that most women are unaware of the option of pain relief during childbirth. Pregnancy is an important time to inform and prepare women about pain relief options during childbirth; however, women are unaware of this right and do not demand it.

“… Pregnant women do not have sufficient information regarding pain relief during childbirth … so they do not demand ... Information about this should be provided during pregnancy (for example, in childbirth preparation classes), but when labouring women come to the maternity hospital, we have to go and explain … I think that this is not the right time for training.” (Anesthesiologist, Hospital level)

Some participants also pointed out that a large number of their clients are Afghan women who refuse pain relief, because they do not have insurance coverage and would be required to pay out-of-pocket.

“... Most of our clients are Afghan women. They do not have insurance and have to pay for it. Therefore, they do not do (pain relief during childbirth).” (Obstetrician, Hospital level)

The presence of good networking and relationships with external organizations, such as insurance organizations, to modify pain relief during childbirth tariffs and motivate staff was described by participants as an effective factor in implementation.

“The support of insurance organizations is also crucial for the implementation of pain relief during childbirth; tariffs should be revised, but unfortunately, they do not collaborate.” (Obstetrician, MOHME level)

MOHME policies and support were critical for the successful implementation of pain relief during childbirth. Some participants believed that being free of charge for pain relief during childbirth in public hospitals was one of the factors facilitating its implementation. However, the participants reported that some measures of the MOHME, including the absence of on-call anesthesiologists in hospitals were another challenge for the implementation of the program.

“... The hospital should have an on-call anesthetist, which unfortunately the MOHME took it away ... Therefore; we do not have the possibility of pain relief during childbirth at night because we there is not have an on-call anesthesiologist. There is an aesthesia resident, but it is normal that she/he does not spend X hours on pain relief during childbirth and quickly performs a caesarean section.” (Obstetrician, Hospital level)

Networks and communications

Poor working relationships between obstetricians and anesthesiologists were key barriers. Some participants believed that obstetricians are the primary decision-makers for pain relief during childbirth, and if they approve, labouring woman will be referred to anesthesiologists, but unfortunately, they do not collaborate enough in this regard. A participant stated:

“Obstetricians should select labouring women based on the criteria and then refer to them. Unfortunately, they do not collaborate with us …” (Anesthesiologist, Hospital level)

The availability of resources during the implementation process was critical for success. The participants complained about the low tariff allocated to pain relief during childbirth and considered it a fundamental barrier to non-collaboration of anesthesiologists in the implementation of the program. Furthermore, the lack of staff (anesthesiologists and nurse anesthetists) to offer top-ups and continuous monitoring adds to this factor.

“Pain relief during childbirth is a time-consuming process, but the tariff is so low that the anesthesiologist does not want to perform it. However, there is a shortage of anesthesiologists and nurse anesthetists in most hospitals.” (Anesthesiologist, Hospital level)

Similarly, limited access to knowledge and information about pain relief during childbirth for the provider team was considered another challenge. The participants identified a lack of adequate training for providers prior to implementing the program as a contributing factor.

“Prior to the implementation of this program (pain relief during childbirth), sufficient training should have been provided to all team members (including anesthesiologists, obstetricians, and midwifes), and the purpose and importance of the program were well introduced. We were not justified at all as to why we wanted to do this program ...” (Obstetrician, Hospital level)

Another challenge was the lack of knowledge and misconceptions of providers (obstetricians and midwives) regarding pain relief during childbirth. For example, it is believed that pain relief during childbirth is associated with an increased risk of prolonged labour, poor maternal and infant outcomes, and an increased chance of cesarean section. The participants believed that there was a serious need to spread awareness and cultivate a positive attitude among providers about the benefits of pain relief during childbirth and eliminate misconceptions by holding training courses.

“I think the most important challenge is misconceptions. Still, many obstetricians do not agree with pain relief during childbirth; it is believed that it prolongs the labour process or may have complications for the mother and/or the infant; all this is due to lack of knowledge. This belief needs to be corrected.” (Anesthesiologist, Hospital level)

According to most participants, the lack of expertise and skills of anesthesiologists was another barrier to implementation. They acknowledged that pain relief during childbirth is one of the important abilities that anesthesia residents should acquire, which has not been considered in their educational curriculum. Anesthesiology residents spend a short period of one month in the maternity ward, so they do not acquire enough skills.

“Pain relief during childbirth requires expertise and skill ... However, it has not been considered an important topic in the educational curriculum of anesthesiologists.” (Midwife, University level)

Some participants felt that pain relief during childbirth had not been implemented according to the implementation plan. They emphasized the identification of program problems and the importance of proper planning: “At first, the process of pain relief during childbirth in our hospitals was increasing; for example, in our hospital, we had about 500 pain relief during childbirths per month, but currently we do not have four ... We were weak in execution; we have implemented the program since 2014, but unfortunately, I can say that we have been unsuccessful thus far.” (Anesthesiologist, Hospital level)

In addition, supervising the implementation of pain relief during childbirth in hospitals was another factor mentioned by some participants. They stated that internal and external inspections should be used to supervise the performance of the team in providing pain relief during childbirth.

“There must be supervision ... If it is not done (pain relief during childbirth), it is not supervised that why was it not done? The mother did not request or you (providers) did not?” (Health Education and Promotion Specialist, University level)

In this study, using the CFIR, we identified perspectives of key stakeholders from different levels of the health system regarding the challenges of implementing a multi-level intervention to reduce mistreatment of women during childbirth in Iran. Overall, the findings showed that through the lens of CFIR domains (intervention characteristics, outer setting, inner setting, characteristics of individuals involved, and process of implementation), there are several challenges to successfully implementing current interventions. Documenting the findings of such studies can help formulate appropriate strategies to improve the implementation of interventions to reduce mistreatment during childbirth as well as the development of high-quality maternity care guidelines in similar settings.

In our study, the most identified challenges to successfully implementing the interventions were related to the outer- and inner-setting domains. The key role of the outer setting [ 48 , 49 ] and inner setting [ 50 ], which emphasize the external influences on the intervention and characteristics of the implementing organization, has been highlighted in other studies for successful implementation. Our findings showed that all proposed interventions were influenced by factors from the outer setting. Patients’ needs and resources could challenge the implementation of childbirth preparation classes, birth companionship, and pain relief during childbirth. Participants reported that women were not trained in childbirth preparation classes about respectful care principles and their rights during childbirth, birth companions were not trained, and most women were unaware of pain relief during childbirth. Previous studies are in agreement with our findings and reflect the need for respectful care education for women [ 51 , 52 ], the presence of a trained birth companion [ 25 , 53 ], and training programs to increase women's awareness of pain relief options during childbirth [ 54 ]. In this study, poor collaboration with external organizations was also identified as a barrier to the implementation of childbirth preparation classes and pain relief during childbirth. The Heshima project in Kenya showed that participatory design of interventions at the policy, facility, and community levels played a significant role in the public acceptance of maternity care and health rights; therefore, the successful implementation and sustainability of the RMC intervention requires the formation of partnerships with external organizations [ 55 ]. Furthermore, our findings showed that external policies (including weakness in regulations and guidelines) challenge the implementation of interventions (including integrating RMC into in-service training, evaluating the performance of MHCPs, and pain relief during childbirth). Similar to our findings, Warren et al. (2017) reported that the free maternity care policy in Kenya affected the quality of care by increasing the demand for health facilities, delays in financing, augmented provider workloads and shortages, and posed challenges to the implementation of RMC [ 55 ]. In another study (2021), the existing policy in the West Bank to prevent the presence of birth companions in public facilities was reported by participants as a factor for mistreatment during childbirth [ 56 ].

Inner setting factors that affected the implementation of interventions were structural characteristics, networks and communications, culture, compatibility, relative priority, organizational incentives and rewards, and readiness for implementation (available resources and access to knowledge and information). Participants acknowledged that structural characteristics (including a lack of physical space), cultural issues, and incompatibility can act as barriers to birth companion intervention. Studies support the findings of our study that the limitations of the physical structure of hospitals make it difficult to allow birth companions [ 28 , 57 ]. In addition, in our study, as in some cultures, the presence of male partners was not socially acceptable, especially during childbirth [ 58 ], and there were concerns about the interference of birth companions in healthcare providers’ medical decisions [ 58 ]. Moreover, in this study, participants stressed the importance of holding a respectful care training course for providers. Healthcare providers have been shown to have a negative attitude toward respectful care [ 59 ], which is often less important than other aspects of care [ 60 ]. Poor working relationships between providers were another factor affecting implementation. Similarly, poor teamwork among obstetricians, midwives, and anesthesiologists was highlighted as an important barrier to implementing labour analgesia in Wu et al.'s study [ 61 ]. Moreover, in our study, lack of resources (including physical space, human resources, money, and training) was described as a potential barrier to readiness for implementation. In addition, limited access to knowledge and information about the intervention was another barrier to readiness for implementation. Our findings are consistent with previous studies that have examined how inner setting characteristics such as readiness for implementation [ 55 ] and organizational rewards and incentives [ 62 ] influence implementation.

The intervention characteristics domain, which emphasizes the importance of the need to adapt the intervention to enhance its fit with the context [ 63 ], is a critical determinant of the success of implementation [ 34 , 64 , 65 ]. In our study, adaptability and design quality and packaging were seen as important factors in the implementation of childbirth preparation classes. The findings showed that the situations of facilities of maternity hospitals do not adapt the content of the classes, the timing of the start of the classes are not appropriate, and they are not announced correctly. Previous studies have assessed the factors influencing childbirth preparation classes; for example, a study conducted by Otogara (2017) reported the need for the presence of a psychologist consultant as well as appropriate timing and information for successful implementation of classes [ 66 ].

The domain of the characteristics of individuals involved in the intervention is also crucial to ensure the success of implementation [ 34 ]. Our findings showed that the personal attributes of individuals within the organization (such as interest, skills, and expertise), as well as their knowledge and beliefs about the intervention, are other key factors that can hinder implementation. Other studies have similarly shown that competent, skilled, and motivated service providers are important for RMC provision [ 67 ]. Moreover, providers' knowledge and understanding of RMC are reported to be important in designing interventions to address mistreatment in maternity care [ 68 ]. In Mexico, training and enabling healthcare providers to promote respectful delivery care have been noted [ 69 ].

In our study, the implementation process domain was identified as a key factor in the implementation of all the studied interventions. Participants noted suboptimal execution, lack of supervision, and weakness in evaluating posed challenges for implementing interventions. Previous studies have revealed the key role of monitoring and evaluation interventions in the success of RMC implementation [ 15 , 70 ]. This was implemented in the Hashima project by applying mechanisms to report cases of disrespect, such as customer service desks, suggestion boxes and supervisory visits at the facility level [ 15 ].

Overall, our study has potential implications for practice and research. This study highlights practical benefits for policy makers and practitioners of maternal health programs in Iran and other contexts. We suggest that they consider the findings of this study when implementing their current programs and policies regarding the quality of maternity care. Moreover, intervention studies focusing on RMC and/or mistreatment during childbirth appear to be relatively limited in high-income countries (HICs), and research and implementation efforts in these settings must continue. The implementation process of these interventions has been inadequately explored, thus affecting their comparability. Using the CFIR, this study provides important insights into how the contextual conditions surrounding the implementation of multi-level interventions to reduce mistreatment during childbirth contribute to their success or failure. Therefore, the findings of this study can provide evidence for formulating effective strategies with the potential to increase the positive experiences of childbirth for women.

Strengths and limitations

To the best of our knowledge, this is the first attempt to identify the challenges of implementing a multi-level intervention to reduce mistreatment of women during childbirth in Iran and provides important insights into the contextual conditions around the implementation of each of the interventions. Our findings can be useful for other developing countries (LMICs) in similar contexts, especially those in the Eastern Mediterranean region. Reflecting the perspectives of key stakeholders from the micro- to macro-level of the health system was another strength of our study. Furthermore, the use of CFIR as the most common framework in IS allowed us to comprehensively identify the effective factors in the implementation of each intervention. However, given that the interviews were conducted with key stakeholders involved in the interventions, there is a possibility of a social desirability bias (underreporting of actual experiences and challenges due to their roles). We tried to mitigate this limitation by guaranteeing the confidentiality and anonymity of information as well as, conducting interviews in a private room. Also, this study focused on the interventions that are currently implemented in Iran's health system; and further research is needed to explore the implementation challenges of other interventions intended to reduce mistreatment during childbirth.

Our findings revealed potential challenges for implementing a multi-level intervention to reduce mistreatment of women during childbirth in the domains of intervention characteristics, outer setting, inner setting, characteristics of individuals involved, and process of implementation of the CFIR. Addressing these challenges is necessary to improve the implementation of interventions to reduce mistreatment during childbirth in Iran.

Availability of data and materials

The datasets generated and analyzed during the current study are not publicly available due to privacy restrictions of the participants but are available from the corresponding author on reasonable request.

Abbreviations

Disrespect and Abuse

Respectful Maternity Care

Evidence-Based Intervention/Innovation

Implementation Science

Consolidated Framework for Implementation Research

Ministry of Health and Medical Education

Maternity Healthcare Providers

Consolidated Criteria for Reporting Qualitative Research

Iranian Rials

Information Technology

High-Income Countries

Low and Middle Income Countries

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Acknowledgments

This study was part of a PhD dissertation. We thank the Tehran University of Medical Sciences (TUMS) and the Health Information Management Research Center, TUMS for their financial support. We appreciate the sincere collaboration of all participants who provided valuable information in the interviews.

This study received funding from the Deputy for Education at Tehran University of Medical Sciences (TUMS) (9811108001) and Health Information Management Research Center, TUMS (1401-3-208-62407). The role of the funders is to monitor the corresponding study planning and progression.

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Marjan Mirzania & Elham Shakibazadeh

Gender and Women’s Health Unit, Nossal Institute for Global Health, School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia

Meghan A. Bohren

Department of Obstetrics and Gynecology, School of Medicine, Vali-E-Asr Reproductive Health research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran

Sedigheh Hantoushzadeh

Department of Social Medicine, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran

Abdoljavad Khajavi

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

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Contributions

E.Sh. and M.M. conceived and designed the project with input from all authors. M.M. developed the interview guide, conducted the interviews, coded and analyzed the data, and drafted the manuscript. E.Sh. contributed to the development of the interview guide, coding and analysis the data, and drafting of the manuscript. M.B., S.H., A.Kh., and A.RF. participated in the revision of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Elham Shakibazadeh .

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The study was reviewed and approved by the Ethics Committee of Tehran University of Medical Sciences (code number: IR.TUMS.SPH.REC.1400.169). Written informed consent was obtained from all participants prior to the interviews. This study was performed in accordance with the principles set out in the Declaration of Helsinki.

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Mirzania, M., Shakibazadeh, E., Bohren, M.A. et al. Challenges to the implementation of a multi-level intervention to reduce mistreatment of women during childbirth in Iran: a qualitative study using the Consolidated Framework for Implementation Research. Reprod Health 21 , 70 (2024). https://doi.org/10.1186/s12978-024-01813-1

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Received : 10 May 2023

Accepted : 14 May 2024

Published : 27 May 2024

DOI : https://doi.org/10.1186/s12978-024-01813-1

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