what is a literature synthesis

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• 6. Synthesize
• Literature Reviews: A Recap
• Reading Journal Articles
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• 1. Identify the Question
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• 4. Manage Your References
• 5. Critically Analyze and Evaluate

Synthesis Visualization

Synthesis matrix example.

• 7. Write a Literature Review

• Synthesis Worksheet

About Synthesis

Approaches to Synthesis

You can sort the literature in various ways, for example:

How to Begin?

Read your sources carefully and find the main idea(s) of each source

Look for similarities in your sources – which sources are talking about the same main ideas? (for example, sources that discuss the historical background on your topic)

Use the worksheet (above) or synthesis matrix (below) to get organized

This work can be messy. Don't worry if you have to go through a few iterations of the worksheet or matrix as you work on your lit review!

Four Examples of Student Writing

In the four examples below, only ONE shows a good example of synthesis: the fourth column, or  Student D . For a web accessible version, click the link below the image.

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From Jennifer Lim

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Literature Syntheis 101

How To Synthesise The Existing Research (With Examples)

By: Derek Jansen (MBA) | Expert Reviewer: Eunice Rautenbach (DTech) | August 2023

One of the most common mistakes that students make when writing a literature review is that they err on the side of describing the existing literature rather than providing a critical synthesis of it. In this post, we’ll unpack what exactly synthesis means and show you how to craft a strong literature synthesis using practical examples.

This post is based on our popular online course, Literature Review Bootcamp . In the course, we walk you through the full process of developing a literature review, step by step. If it’s your first time writing a literature review, you definitely want to use this link to get 50% off the course (limited-time offer).

Overview: Literature Synthesis

• What exactly does “synthesis” mean?
• Aspect 1: Agreement
• Aspect 2: Disagreement
• Aspect 3: Key theories
• Aspect 4: Contexts
• Aspect 5: Methodologies
• Bringing it all together

What does “synthesis” actually mean?

As a starting point, let’s quickly define what exactly we mean when we use the term “synthesis” within the context of a literature review.

Simply put, literature synthesis means going beyond just describing what everyone has said and found. Instead, synthesis is about bringing together all the information from various sources to present a cohesive assessment of the current state of knowledge in relation to your study’s research aims and questions .

Put another way, a good synthesis tells the reader exactly where the current research is “at” in terms of the topic you’re interested in – specifically, what’s known , what’s not , and where there’s a need for more research .

So, how do you go about doing this?

Well, there’s no “one right way” when it comes to literature synthesis, but we’ve found that it’s particularly useful to ask yourself five key questions when you’re working on your literature review. Having done so,  you can then address them more articulately within your actual write up. So, let’s take a look at each of these questions.

1. Points Of Agreement

The first question that you need to ask yourself is: “Overall, what things seem to be agreed upon by the vast majority of the literature?”

For example, if your research aim is to identify which factors contribute toward job satisfaction, you’ll need to identify which factors are broadly agreed upon and “settled” within the literature. Naturally, there may at times be some lone contrarian that has a radical viewpoint , but, provided that the vast majority of researchers are in agreement, you can put these random outliers to the side. That is, of course, unless your research aims to explore a contrarian viewpoint and there’s a clear justification for doing so. 

Identifying what’s broadly agreed upon is an essential starting point for synthesising the literature, because you generally don’t want (or need) to reinvent the wheel or run down a road investigating something that is already well established . So, addressing this question first lays a foundation of “settled” knowledge.

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2. Points Of Disagreement

Related to the previous point, but on the other end of the spectrum, is the equally important question: “Where do the disagreements lie?” .

In other words, which things are not well agreed upon by current researchers? It’s important to clarify here that by disagreement, we don’t mean that researchers are (necessarily) fighting over it – just that there are relatively mixed findings within the empirical research , with no firm consensus amongst researchers.

This is a really important question to address as these “disagreements” will often set the stage for the research gap(s). In other words, they provide clues regarding potential opportunities for further research, which your study can then (hopefully) contribute toward filling. If you’re not familiar with the concept of a research gap, be sure to check out our explainer video covering exactly that .

3. Key Theories

The next question you need to ask yourself is: “Which key theories seem to be coming up repeatedly?” .

Within most research spaces, you’ll find that you keep running into a handful of key theories that are referred to over and over again. Apart from identifying these theories, you’ll also need to think about how they’re connected to each other. Specifically, you need to ask yourself:

• Are they all covering the same ground or do they have different focal points  or underlying assumptions ?
• Do some of them feed into each other and if so, is there an opportunity to integrate them into a more cohesive theory?
• Do some of them pull in different directions ? If so, why might this be?
• Do all of the theories define the key concepts and variables in the same way, or is there some disconnect? If so, what’s the impact of this ?

Simply put, you’ll need to pay careful attention to the key theories in your research area, as they will need to feature within your theoretical framework , which will form a critical component within your final literature review. This will set the foundation for your entire study, so it’s essential that you be critical in this area of your literature synthesis.

If this sounds a bit fluffy, don’t worry. We deep dive into the theoretical framework (as well as the conceptual framework) and look at practical examples in Literature Review Bootcamp . If you’d like to learn more, take advantage of our limited-time offer to get 60% off the standard price.

4. Contexts

The next question that you need to address in your literature synthesis is an important one, and that is: “Which contexts have (and have not) been covered by the existing research?” .

For example, sticking with our earlier hypothetical topic (factors that impact job satisfaction), you may find that most of the research has focused on white-collar , management-level staff within a primarily Western context, but little has been done on blue-collar workers in an Eastern context. Given the significant socio-cultural differences between these two groups, this is an important observation, as it could present a contextual research gap .

In practical terms, this means that you’ll need to carefully assess the context of each piece of literature that you’re engaging with, especially the empirical research (i.e., studies that have collected and analysed real-world data). Ideally, you should keep notes regarding the context of each study in some sort of catalogue or sheet, so that you can easily make sense of this before you start the writing phase. If you’d like, our free literature catalogue worksheet is a great tool for this task.

5. Methodological Approaches

Last but certainly not least, you need to ask yourself the question: “What types of research methodologies have (and haven’t) been used?”

For example, you might find that most studies have approached the topic using qualitative methods such as interviews and thematic analysis. Alternatively, you might find that most studies have used quantitative methods such as online surveys and statistical analysis.

But why does this matter?

Well, it can run in one of two potential directions . If you find that the vast majority of studies use a specific methodological approach, this could provide you with a firm foundation on which to base your own study’s methodology . In other words, you can use the methodologies of similar studies to inform (and justify) your own study’s research design .

On the other hand, you might argue that the lack of diverse methodological approaches presents a research gap , and therefore your study could contribute toward filling that gap by taking a different approach. For example, taking a qualitative approach to a research area that is typically approached quantitatively. Of course, if you’re going to go against the methodological grain, you’ll need to provide a strong justification for why your proposed approach makes sense. Nevertheless, it is something worth at least considering.

Regardless of which route you opt for, you need to pay careful attention to the methodologies used in the relevant studies and provide at least some discussion about this in your write-up. Again, it’s useful to keep track of this on some sort of spreadsheet or catalogue as you digest each article, so consider grabbing a copy of our free literature catalogue if you don’t have anything in place.

Bringing It All Together

Alright, so we’ve looked at five important questions that you need to ask (and answer) to help you develop a strong synthesis within your literature review.  To recap, these are:

• Which things are broadly agreed upon within the current research?
• Which things are the subject of disagreement (or at least, present mixed findings)?
• Which theories seem to be central to your research topic and how do they relate or compare to each other?
• Which contexts have (and haven’t) been covered?
• Which methodological approaches are most common?

Importantly, you’re not just asking yourself these questions for the sake of asking them – they’re not just a reflection exercise. You need to weave your answers to them into your actual literature review when you write it up. How exactly you do this will vary from project to project depending on the structure you opt for, but you’ll still need to address them within your literature review, whichever route you go.

The best approach is to spend some time actually writing out your answers to these questions, as opposed to just thinking about them in your head. Putting your thoughts onto paper really helps you flesh out your thinking . As you do this, don’t just write down the answers – instead, think about what they mean in terms of the research gap you’ll present , as well as the methodological approach you’ll take . Your literature synthesis needs to lay the groundwork for these two things, so it’s essential that you link all of it together in your mind, and of course, on paper.

Psst… there’s more!

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

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Get Organized

• Lit Review Prep Use this template to help you evaluate your sources, create article summaries for an annotated bibliography, and a synthesis matrix for your lit review outline.

Synthesize your Information

Synthesize: combine separate elements to form a whole.

Synthesis Matrix

A synthesis matrix helps you record the main points of each source and document how sources relate to each other.

After summarizing and evaluating your sources, arrange them in a matrix or use a citation manager to help you see how they relate to each other and apply to each of your themes or variables.  

By arranging your sources by theme or variable, you can see how your sources relate to each other, and can start thinking about how you weave them together to create a narrative.

• Step-by-Step Approach
• Example Matrix from NSCU
• Matrix Template
• << Previous: Summarize
• Next: Integrate >>
• Last Updated: Jul 30, 2024 1:42 PM
• URL: https://guides.library.jhu.edu/lit-review

How to Synthesize Written Information from Multiple Sources

Shona McCombes

Content Manager

B.A., English Literature, University of Glasgow

Shona McCombes is the content manager at Scribbr, Netherlands.

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Saul McLeod, PhD

Editor-in-Chief for Simply Psychology

BSc (Hons) Psychology, MRes, PhD, University of Manchester

Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.

On This Page:

When you write a literature review or essay, you have to go beyond just summarizing the articles you’ve read – you need to synthesize the literature to show how it all fits together (and how your own research fits in).

Synthesizing simply means combining. Instead of summarizing the main points of each source in turn, you put together the ideas and findings of multiple sources in order to make an overall point.

At the most basic level, this involves looking for similarities and differences between your sources. Your synthesis should show the reader where the sources overlap and where they diverge.

Unsynthesized Example

Franz (2008) studied undergraduate online students. He looked at 17 females and 18 males and found that none of them liked APA. According to Franz, the evidence suggested that all students are reluctant to learn citations style. Perez (2010) also studies undergraduate students. She looked at 42 females and 50 males and found that males were significantly more inclined to use citation software ( p < .05). Findings suggest that females might graduate sooner. Goldstein (2012) looked at British undergraduates. Among a sample of 50, all females, all confident in their abilities to cite and were eager to write their dissertations.

Synthesized Example

Studies of undergraduate students reveal conflicting conclusions regarding relationships between advanced scholarly study and citation efficacy. Although Franz (2008) found that no participants enjoyed learning citation style, Goldstein (2012) determined in a larger study that all participants watched felt comfortable citing sources, suggesting that variables among participant and control group populations must be examined more closely. Although Perez (2010) expanded on Franz’s original study with a larger, more diverse sample…

Step 1: Organize your sources

After collecting the relevant literature, you’ve got a lot of information to work through, and no clear idea of how it all fits together.

Before you can start writing, you need to organize your notes in a way that allows you to see the relationships between sources.

One way to begin synthesizing the literature is to put your notes into a table. Depending on your topic and the type of literature you’re dealing with, there are a couple of different ways you can organize this.

Summary table

A summary table collates the key points of each source under consistent headings. This is a good approach if your sources tend to have a similar structure – for instance, if they’re all empirical papers.

Each row in the table lists one source, and each column identifies a specific part of the source. You can decide which headings to include based on what’s most relevant to the literature you’re dealing with.

For example, you might include columns for things like aims, methods, variables, population, sample size, and conclusion.

For each study, you briefly summarize each of these aspects. You can also include columns for your own evaluation and analysis.

The summary table gives you a quick overview of the key points of each source. This allows you to group sources by relevant similarities, as well as noticing important differences or contradictions in their findings.

Synthesis matrix

A synthesis matrix is useful when your sources are more varied in their purpose and structure – for example, when you’re dealing with books and essays making various different arguments about a topic.

Each column in the table lists one source. Each row is labeled with a specific concept, topic or theme that recurs across all or most of the sources.

Then, for each source, you summarize the main points or arguments related to the theme.

The purposes of the table is to identify the common points that connect the sources, as well as identifying points where they diverge or disagree.

Step 2: Outline your structure

Now you should have a clear overview of the main connections and differences between the sources you’ve read. Next, you need to decide how you’ll group them together and the order in which you’ll discuss them.

For shorter papers, your outline can just identify the focus of each paragraph; for longer papers, you might want to divide it into sections with headings.

There are a few different approaches you can take to help you structure your synthesis.

If your sources cover a broad time period, and you found patterns in how researchers approached the topic over time, you can organize your discussion chronologically .

That doesn’t mean you just summarize each paper in chronological order; instead, you should group articles into time periods and identify what they have in common, as well as signalling important turning points or developments in the literature.

If the literature covers various different topics, you can organize it thematically .

That means that each paragraph or section focuses on a specific theme and explains how that theme is approached in the literature.

Source Used with Permission: The Chicago School

If you’re drawing on literature from various different fields or they use a wide variety of research methods, you can organize your sources methodologically .

That means grouping together studies based on the type of research they did and discussing the findings that emerged from each method.

If your topic involves a debate between different schools of thought, you can organize it theoretically .

That means comparing the different theories that have been developed and grouping together papers based on the position or perspective they take on the topic, as well as evaluating which arguments are most convincing.

Step 3: Write paragraphs with topic sentences

What sets a synthesis apart from a summary is that it combines various sources. The easiest way to think about this is that each paragraph should discuss a few different sources, and you should be able to condense the overall point of the paragraph into one sentence.

This is called a topic sentence , and it usually appears at the start of the paragraph. The topic sentence signals what the whole paragraph is about; every sentence in the paragraph should be clearly related to it.

A topic sentence can be a simple summary of the paragraph’s content:

“Early research on [x] focused heavily on [y].”

For an effective synthesis, you can use topic sentences to link back to the previous paragraph, highlighting a point of debate or critique:

“Several scholars have pointed out the flaws in this approach.” “While recent research has attempted to address the problem, many of these studies have methodological flaws that limit their validity.”

By using topic sentences, you can ensure that your paragraphs are coherent and clearly show the connections between the articles you are discussing.

As you write your paragraphs, avoid quoting directly from sources: use your own words to explain the commonalities and differences that you found in the literature.

Don’t try to cover every single point from every single source – the key to synthesizing is to extract the most important and relevant information and combine it to give your reader an overall picture of the state of knowledge on your topic.

Step 4: Revise, edit and proofread

Like any other piece of academic writing, synthesizing literature doesn’t happen all in one go – it involves redrafting, revising, editing and proofreading your work.

Checklist for Synthesis

•   Do I introduce the paragraph with a clear, focused topic sentence?
•   Do I discuss more than one source in the paragraph?
•   Do I mention only the most relevant findings, rather than describing every part of the studies?
•   Do I discuss the similarities or differences between the sources, rather than summarizing each source in turn?
•   Do I put the findings or arguments of the sources in my own words?
•   Is the paragraph organized around a single idea?
•   Is the paragraph directly relevant to my research question or topic?
•   Is there a logical transition from this paragraph to the next one?

Further Information

How to Synthesise: a Step-by-Step Approach

Help…I”ve Been Asked to Synthesize!

Learn how to Synthesise (combine information from sources)

How to write a Psychology Essay

Literature Synthesis: Guide To Synthesise & Write Literature Review

Literature synthesis is a crucial skill for researchers and scholars, allowing them to integrate findings from multiple sources into a coherent analysis. Mastering literature synthesis will enhance your research and writing skills. 

This guide will walk you through the process of synthesising and writing a literature review, providing practical steps and insider tips. Learn how to:

• organise your sources,
• identify key themes, and
• create a cohesive narrative that highlights both agreements and disagreements within the existing literature.

Literature Synthesis vs Literature Review

You may be familiar with literature review, and the term literature synthesis may throw you off a bit. Are they a similar thing, or something different from each other?

If you are still unsure about how literature synthesis is different from literature review, here are a couple of points to think about: 

Approach To Sources

One difference is the approach to sources. In a literature review, you might describe each source separately, detailing its findings and contributions.

With synthesis, you combine the ideas from multiple sources to highlight relationships and gaps.

One example would be you may find that several studies agree on a particular theme but use different methodologies to reach their conclusions.

Organisation

A second difference is the organization. Literature reviews typically follow a structured format, summarizing each source in a new paragraph.

In contrast, synthesis requires organising sources around key themes or topics. This might involve using a synthesis matrix to align findings and theories from different sources into a cohesive analysis.

How To Evaluate Literature

Evaluating the literature also differs. When you write a literature review, you summarise and describe the existing research. Synthesis goes further by:

• critically evaluating the sources,
• identifying points of agreement and disagreement, and
• assessing the overall state of knowledge.

You need to address the methodological approaches used and how they relate to your research questions.

In terms of purpose, a literature review provides an overview of what’s known about a topic. It sets the stage for your research by summarising existing knowledge.

Synthesis, meanwhile, aims to create new insights by combining and contrasting different sources. This process helps you identify research gaps and questions that need further investigation.

Writing Process

Finally, the writing process differs. A literature review involves compiling summaries, often following a step-by-step guide.

With synthesis, you need to integrate:

• theories, and
• methodologies from various sources.

This involves weaving together different perspectives into a single, cohesive narrative that supports your research aims.

How To Perform Literature Synthesis?

Performing literature synthesis can be daunting, but by breaking it down step by step, you can create a comprehensive and coherent analysis of your topic.

Here’s a guide to help you through the process, with insider details and practical examples that will make your task easier.

Organise Your Sources

First, you need to gather and organise your sources. Start by conducting a thorough search of the existing literature on your topic, using

• research guides,
• library databases, and
• academic journals to find relevant sources.

There are plenty of AI tools that can help with process as well – make sure you check out my guide on best AI tools for literature review.

Record the main points of each source in a summary table. This table should include columns for:

• the author,
• publication year,
• key points,
• methodologies used, and

By organising your sources in this way, you’ll have a clear overview of the existing literature.

Identify Themes

Once you have your sources organised, it’s time to start synthesising the literature. This means combining the ideas and findings from multiple sources to create a cohesive analysis.

Begin by identifying the key themes that emerge from your sources. These themes will form the basis of your synthesis.

Suppose you are you’re researching job satisfaction, In this case, you might find recurring themes such as work-life balance, salary, and workplace environment.

Create A Synthesis Matrix

Next, create a synthesis matrix. This tool helps you organize the key points from each source under the identified themes.

Each row in the matrix represents a source, and each column represents a theme.

By filling in the matrix, you can see how different sources relate to each theme. This will help you identify similarities and differences between the sources.

Write Your Literature Synthesis

With your synthesis matrix in hand, you can start writing your literature synthesis.

Begin each paragraph with a clear topic sentence that identifies the theme you’re discussing. Then, weave together the findings from different sources, highlighting points of agreement and disagreement.

One way you may write this include: “While Franz (2008) found that salary is a major factor in job satisfaction, Goldstein (2012) argued that work-life balance plays a more significant role.”

Critically Evaluate Your Sources

Be sure to critically evaluate the sources as you synthesize the literature. This means assessing the methodologies used in each study and considering their impact on the findings.

Let’s say you found that most studies on job satisfaction used qualitative methods , you might question whether the findings would differ if quantitative methods were used. Addressing these methodological differences can help you identify research gaps and areas for further study.

Don’t Just Summarise

As you write your paragraphs, avoid simply summarising each source. Instead, combine the key points from multiple sources to create a more comprehensive analysis.

If we reuse Franz (2008) as example, rather than describing Franz’s study in one paragraph and Goldstein’s study in another, integrate their findings to show how they relate to each other.

This approach will make your synthesis more cohesive and easier to follow.

Address The Broader Context Of The Topic

To create a strong synthesis, you also need to address the broader context of your research. This means considering the theoretical frameworks and empirical evidence that underpin your topic.

If you’re researching job satisfaction, you might discuss how different theories of motivation relate to your findings. By integrating these broader perspectives, you can provide a more comprehensive overview of the current state of knowledge.

Keep Questioning Yourself

Throughout the writing process, keep the five key questions in mind:

• What’s broadly agreed upon within the current research?
• Where do the disagreements lie?
• Which theories are central to your research topic?
• Which contexts have been covered, and which haven’t?
• What types of research methodologies have been used?

Addressing these questions will help you create a more thorough and insightful synthesis.

Revise & Edit

Finally, revise and edit your work. This means checking for clarity, coherence, and logical flow. Make sure each paragraph has a clear topic sentence and that all sentences within the paragraph relate to that topic.

Remove any unnecessary information and ensure that your synthesis is well-organised and easy to follow.

Your Guide To Synthesise Literature

Performing literature synthesis may seem overwhelming, but by following this step-by-step guide, you can create a comprehensive and cohesive analysis of your topic.

Use tools like summary tables and synthesis matrices to organise your sources, and focus on combining the key points from multiple sources to create a strong synthesis.

With careful planning and critical evaluation, you can produce a literature synthesis that provides valuable insights into your field of study.

Dr Andrew Stapleton has a Masters and PhD in Chemistry from the UK and Australia. He has many years of research experience and has worked as a Postdoctoral Fellow and Associate at a number of Universities. Although having secured funding for his own research, he left academia to help others with his YouTube channel all about the inner workings of academia and how to make it work for you.

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• Synthesizing Sources | Examples & Synthesis Matrix

Synthesizing Sources | Examples & Synthesis Matrix

Published on July 4, 2022 by Eoghan Ryan . Revised on May 31, 2023.

Synthesizing sources involves combining the work of other scholars to provide new insights. It’s a way of integrating sources that helps situate your work in relation to existing research.

Synthesizing sources involves more than just summarizing . You must emphasize how each source contributes to current debates, highlighting points of (dis)agreement and putting the sources in conversation with each other.

You might synthesize sources in your literature review to give an overview of the field or throughout your research paper when you want to position your work in relation to existing research.

Table of contents

Example of synthesizing sources, how to synthesize sources, synthesis matrix, other interesting articles, frequently asked questions about synthesizing sources.

Let’s take a look at an example where sources are not properly synthesized, and then see what can be done to improve it.

This paragraph provides no context for the information and does not explain the relationships between the sources described. It also doesn’t analyze the sources or consider gaps in existing research.

Research on the barriers to second language acquisition has primarily focused on age-related difficulties. Building on Lenneberg’s (1967) theory of a critical period of language acquisition, Johnson and Newport (1988) tested Lenneberg’s idea in the context of second language acquisition. Their research seemed to confirm that young learners acquire a second language more easily than older learners. Recent research has considered other potential barriers to language acquisition. Schepens, van Hout, and van der Slik (2022) have revealed that the difficulties of learning a second language at an older age are compounded by dissimilarity between a learner’s first language and the language they aim to acquire. Further research needs to be carried out to determine whether the difficulty faced by adult monoglot speakers is also faced by adults who acquired a second language during the “critical period.”

Prevent plagiarism. Run a free check.

To synthesize sources, group them around a specific theme or point of contention.

As you read sources, ask:

• What questions or ideas recur? Do the sources focus on the same points, or do they look at the issue from different angles?
• How does each source relate to others? Does it confirm or challenge the findings of past research?
• Where do the sources agree or disagree?

Once you have a clear idea of how each source positions itself, put them in conversation with each other. Analyze and interpret their points of agreement and disagreement. This displays the relationships among sources and creates a sense of coherence.

Consider both implicit and explicit (dis)agreements. Whether one source specifically refutes another or just happens to come to different conclusions without specifically engaging with it, you can mention it in your synthesis either way.

Synthesize your sources using:

• Topic sentences to introduce the relationship between the sources
• Signal phrases to attribute ideas to their authors
• Transition words and phrases to link together different ideas

To more easily determine the similarities and dissimilarities among your sources, you can create a visual representation of their main ideas with a synthesis matrix . This is a tool that you can use when researching and writing your paper, not a part of the final text.

In a synthesis matrix, each column represents one source, and each row represents a common theme or idea among the sources. In the relevant rows, fill in a short summary of how the source treats each theme or topic.

This helps you to clearly see the commonalities or points of divergence among your sources. You can then synthesize these sources in your work by explaining their relationship.

If you want to know more about ChatGPT, AI tools , citation , and plagiarism , make sure to check out some of our other articles with explanations and examples.

• ChatGPT vs human editor
• ChatGPT citations
• Is ChatGPT trustworthy?
• Using ChatGPT for your studies
• What is ChatGPT?
• Chicago style
• Paraphrasing

 Plagiarism

• Types of plagiarism
• Self-plagiarism
• Avoiding plagiarism
• Academic integrity
• Consequences of plagiarism
• Common knowledge

Synthesizing sources means comparing and contrasting the work of other scholars to provide new insights.

It involves analyzing and interpreting the points of agreement and disagreement among sources.

You might synthesize sources in your literature review to give an overview of the field of research or throughout your paper when you want to contribute something new to existing research.

A literature review is a survey of scholarly sources (such as books, journal articles, and theses) related to a specific topic or research question .

It is often written as part of a thesis, dissertation , or research paper , in order to situate your work in relation to existing knowledge.

Topic sentences help keep your writing focused and guide the reader through your argument.

In an essay or paper , each paragraph should focus on a single idea. By stating the main idea in the topic sentence, you clarify what the paragraph is about for both yourself and your reader.

At college level, you must properly cite your sources in all essays , research papers , and other academic texts (except exams and in-class exercises).

Add a citation whenever you quote , paraphrase , or summarize information or ideas from a source. You should also give full source details in a bibliography or reference list at the end of your text.

The exact format of your citations depends on which citation style you are instructed to use. The most common styles are APA , MLA , and Chicago .

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Ryan, E. (2023, May 31). Synthesizing Sources | Examples & Synthesis Matrix. Scribbr. Retrieved August 19, 2024, from https://www.scribbr.com/working-with-sources/synthesizing-sources/

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Literature Review Basics

• What is a Literature Review?
• Synthesizing Research
• Using Research & Synthesis Tables
• Additional Resources

Synthesis: What is it?

First, let's be perfectly clear about what synthesizing your research isn't :

• - It isn't  just summarizing the material you read
• - It isn't  generating a collection of annotations or comments (like an annotated bibliography)
• - It isn't  compiling a report on every single thing ever written in relation to your topic

When you  synthesize  your research, your job is to help your reader understand the current state of the conversation on your topic, relative to your research question.  That may include doing the following:

• - Selecting and using representative work on the topic
• - Identifying and discussing trends in published data or results
• - Identifying and explaining the impact of common features (study populations, interventions, etc.) that appear frequently in the literature
• - Explaining controversies, disputes, or central issues in the literature that are relevant to your research question
• - Identifying gaps in the literature, where more research is needed
• - Establishing the discussion to which your own research contributes and demonstrating the value of your contribution

Essentially, you're telling your reader where they are (and where you are) in the scholarly conversation about your project.

Synthesis: How do I do it?

Synthesis, step by step.

This is what you need to do  before  you write your review.

• Identify and clearly describe your research question (you may find the Formulating PICOT Questions table at  the Additional Resources tab helpful).
• Collect sources relevant to your research question.
• Organize and describe the sources you've found -- your job is to identify what  types  of sources you've collected (reviews, clinical trials, etc.), identify their  purpose  (what are they measuring, testing, or trying to discover?), determine the  level of evidence  they represent (see the Levels of Evidence table at the Additional Resources tab ), and briefly explain their  major findings . Use a Research Table to document this step.
• Study the information you've put in your Research Table and examine your collected sources, looking for  similarities  and  differences . Pay particular attention to  populations ,   methods  (especially relative to levels of evidence), and  findings .
• Analyze what you learn in (4) using a tool like a Synthesis Table. Your goal is to identify relevant themes, trends, gaps, and issues in the research.  Your literature review will collect the results of this analysis and explain them in relation to your research question.

Analysis tips

• - Sometimes, what you  don't  find in the literature is as important as what you do find -- look for questions that the existing research hasn't answered yet.
• - If any of the sources you've collected refer to or respond to each other, keep an eye on how they're related -- it may provide a clue as to whether or not study results have been successfully replicated.
• - Sorting your collected sources by level of evidence can provide valuable insight into how a particular topic has been covered, and it may help you to identify gaps worth addressing in your own work.
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Literature reviews: synthesis.

• Criticality

Synthesise Information

So, how can you create paragraphs within your literature review that demonstrates your knowledge of the scholarship that has been done in your field of study?  

You will need to present a synthesis of the texts you read.  

Doug Specht, Senior Lecturer at the Westminster School of Media and Communication, explains synthesis for us in the following video:  

Synthesising Texts  

What is synthesis? 

Synthesis is an important element of academic writing, demonstrating comprehension, analysis, evaluation and original creation.  

With synthesis you extract content from different sources to create an original text. While paraphrase and summary maintain the structure of the given source(s), with synthesis you create a new structure.  

The sources will provide different perspectives and evidence on a topic. They will be put together when agreeing, contrasted when disagreeing. The sources must be referenced.  

Perfect your synthesis by showing the flow of your reasoning, expressing critical evaluation of the sources and drawing conclusions.  

When you synthesise think of "using strategic thinking to resolve a problem requiring the integration of diverse pieces of information around a structuring theme" (Mateos and Sole 2009, p448). 

Synthesis is a complex activity, which requires a high degree of comprehension and active engagement with the subject. As you progress in higher education, so increase the expectations on your abilities to synthesise. 

How to synthesise in a literature review: 

Identify themes/issues you'd like to discuss in the literature review. Think of an outline.  

Read the literature and identify these themes/issues.  

Critically analyse the texts asking: how does the text I'm reading relate to the other texts I've read on the same topic? Is it in agreement? Does it differ in its perspective? Is it stronger or weaker? How does it differ (could be scope, methods, year of publication etc.). Draw your conclusions on the state of the literature on the topic.  

Start writing your literature review, structuring it according to the outline you planned.  

Put together sources stating the same point; contrast sources presenting counter-arguments or different points.  

Present your critical analysis.  

Always provide the references. 

The best synthesis requires a "recursive process" whereby you read the source texts, identify relevant parts, take notes, produce drafts, re-read the source texts, revise your text, re-write... (Mateos and Sole, 2009). 

What is good synthesis?  

The quality of your synthesis can be assessed considering the following (Mateos and Sole, 2009, p439):  

Integration and connection of the information from the source texts around a structuring theme. 

Selection of ideas necessary for producing the synthesis. 

Appropriateness of the interpretation.  

Elaboration of the content.  

Example of Synthesis

Original texts (fictitious): 

Synthesis: 

Animal experimentation is a subject of heated debate. Some argue that painful experiments should be banned. Indeed it has been demonstrated that such experiments make animals suffer physically and psychologically (Chowdhury 2012; Panatta and Hudson 2016). On the other hand, it has been argued that animal experimentation can save human lives and reduce harm on humans (Smith 2008). This argument is only valid for toxicological testing, not for tests that, for example, merely improve the efficacy of a cosmetic (Turner 2015). It can be suggested that animal experimentation should be regulated to only allow toxicological risk assessment, and the suffering to the animals should be minimised.   

Bibliography

Mateos, M. and Sole, I. (2009). Synthesising Information from various texts: A Study of Procedures and Products at Different Educational Levels. European Journal of Psychology of Education,  24 (4), 435-451. Available from https://doi.org/10.1007/BF03178760 [Accessed 29 June 2021].

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Literature Review How To

• Things To Consider
• Synthesizing Sources
• Video Tutorials
• Books On Literature Reviews

What is Synthesis

What is Synthesis? Synthesis writing is a form of analysis related to comparison and contrast, classification and division. On a basic level, synthesis requires the writer to pull together two or more summaries, looking for themes in each text. In synthesis, you search for the links between various materials in order to make your point. Most advanced academic writing, including literature reviews, relies heavily on synthesis. (Temple University Writing Center)  

How To Synthesize Sources in a Literature Review

Literature reviews synthesize large amounts of information and present it in a coherent, organized fashion. In a literature review you will be combining material from several texts to create a new text – your literature review.

You will use common points among the sources you have gathered to help you synthesize the material. This will help ensure that your literature review is organized by subtopic, not by source. This means various authors' names can appear and reappear throughout the literature review, and each paragraph will mention several different authors. 

When you shift from writing summaries of the content of a source to synthesizing content from sources, there is a number things you must keep in mind: 

• Look for specific connections and or links between your sources and how those relate to your thesis or question.
• When writing and organizing your literature review be aware that your readers need to understand how and why the information from the different sources overlap.
• Organize your literature review by the themes you find within your sources or themes you have identified. 
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• Conducting a Literature Review

Conducting a Literature Review: Synthesize

• What is a Literature Review?
• Research Question
• Information Resources
• Search Strategy
• Cite Resources

• Review the information in the Resources box  to learn about using a synthesis matrix.
• Create your own literature review synthesis matrix using  the Word or Excel files available in the Activity  box.
• Organize and synthesize literature related to your topic using your  synthesis matrix

Synthesize and Apply

When writing a literature review, your objective is to provide an overview of the current state of knowledge about your topic. Throughout the research process, you will identify a variety of resources that reveal what is known, and what is not known, about the issue described in your research question. 

As you complete your reading, you'll come across a number of ideas presented by different authors. You are expected to critically evaluate this information, identify themes and gaps, then synthesize what you have learned to provide your reader with a better understanding of the literature related to your topic.

Because you'll be working with a large number of resources, you may find it challenging to organize the information in a meaningful way. To help with this, you may want to create a synthesis matrix like the one shown below to record the main points of each information resource and document how they relate to each other.

To use the matrix, label each Source column with an author name or brief title. Use the area on the left to note the key points you identify in your reading. As you read each source, make notes in the appropriate Source column whenever you come across additional information that relates to each of the main ideas. When you have completed the chart, review your notes to identify common themes, areas of disagreement, or gaps in the literature.

• Writing a Literature Review and Using a Synthesis Matrix Florida International University
• Synthesis Matrix University of Arizona
• Using a Synthesis Matrix Lumen Learning

Use one of these templates to create your own synthesis matrix as you read and synthesize the literature related to your topic.

• Literature Review Synthesis Matrix
• Synthesis Matrix (.xlsx) From Lumen Learning
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How to Write a Synthesis Essay

Synthesis essays are common assignments in both high school and university, but that doesn’t mean they’re easy or that everyone knows how to write them. In this guide, we discuss everything you need to know in order to write one yourself. We talk about synthesis essay structure and offer some general tips, plus we clarify any confusion between a synthesis essay versus an argumentative essay.

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What is a synthesis essay?

A synthesis essay is a type of essay that combines points, data, and evidence from multiple sources and turns them into one idea that the writing revolves around. In other words, the writer synthesizes their own idea using other sources’ research and points. Usually, synthesis essays are a type of analytical essay , but they have crossover with other types of essays as well, such as argumentative essays .

The central idea in a synthesis essay is represented by the thesis statement , a sentence that succinctly explains the main point of the essay. In a synthesis essay, this “new” idea usually consolidates the main points and/or findings of other sources.

Synthesis essay structure

Creating a solid synthesis essay structure is one of the hardest parts of writing a synthesis essay. Unlike most other essay outlines , an outline for a synthesis essay has to include points from multiple sources, and such combinations don’t always have a logical or chronological sequence. To help you out, here are three strategies for creating a synthesis essay structure and sample outlines that you can use as templates.

Synthesis essay structure 1: By topic

The first kind of synthesis essay structure involves discussing each topic individually, mentioning each source’s perspective on it, and then moving on to the next topic. This approach lets you compare or join together points made by different sources about the same specific topic.

Structuring your synthesis essay by topic works best for more complicated ideas with different aspects that should be explored individually.

Example outline:

I. Introduction A. Thesis statement

II. Topic 1 A. Source A discussing Topic 1 1. A point or piece of evidence/data from Source A about Topic 1 2. Another point or piece of evidence/data from Source A about Topic 1 3. [Etc.]

B. Source B discussing Topic 1 1. A point or piece of evidence/data from Source B about Topic 1 2. [Etc.] 

III. Topic 2 A. Source A discussing Topic 2 B. [Etc.] 

IV. Topic 3 A. [Etc.]

[You can keep going like this with as many topics as you need.]

V. Conclusion A. Revisit thesis statement

Synthesis essay structure 2: By source

Alternatively, you can organize your synthesis essay structure by source: You discuss the main points of one source together and then move on to another source. This approach lets you compartmentalize the main points according to where they come from but ultimately bring together the main points from different sources.

Structuring your synthesis essay by source works best when you want to emphasize the sources themselves over the points they make. For example, if you were using this type of structure for an argumentative essay, you might want to fully discuss the source you’re refuting before making your counterargument.

II. Source 1 A. Source 1 discussing Topic A 1. A point or piece of evidence/data from Source 1 about Topic A 2. Another point or piece of evidence/data from Source 1 about Topic A 3. [Etc.]

B. Source 1 discussing Topic B 1. A point or piece of evidence/data from Source 1 about Topic B 2. [Etc.]

III. Source 2 A. Source 2 discussing Topic A B. Source 2 discussing Topic B C. [Etc.]

IV. Source 3 A. [Etc.]

[You can keep going like this for all your sources.]

V. Conclusion 1. Revisit thesis statement

Synthesis essay structure 3: Combine

The synthesis essay structures above are by no means set in stone. You’re free to adapt or modify them however you need and can even combine them.

For example, what if there’s a special source that stands out from the others? You could begin your synthesis essay by discussing each topic individually so that your reader understands the issue. Then you could switch it up and include a section just for that one special source, explaining that source’s stance on the previously discussed topics.

3 tips for writing a synthesis essay

1 come up with a strong thesis statement.

As mentioned above, a thesis statement is a single sentence that briefly explains the main point of your essay. In a synthesis essay, the thesis statement should effectively bring together the ideas and points from multiple other sources.

Part of writing a strong thesis statement comes from choosing your essay topic . Pick a topic that is broad enough to have sufficient research and enough other sources discussing it but specific enough that you can cover everything.

As for writing the actual thesis statement, a helpful method is to phrase your topic as a question and then answer it. The answer could be a good start to your thesis statement sentence. For example, let’s say your topic is how Denmark came to be first in clean energy. You could phrase the question and answer as:

Q: “Why is Denmark the leading country in renewable energy?”

A: “Denmark is first in clean energy thanks in part to energy conservation from district heating, combined heat-and-power stations, and its use of small, locally based power plants instead of larger ones.”

That answer could double as your thesis statement and mentions some of the other types of sources you use in your essay.

2 Read all the sources carefully

A synthesis essay is only as good as its sources. The nature of a synthesis essay is to build on its sources, so you need to choose the best ones and understand each of them thoroughly.

Make sure you comb through your sources so you don’t miss a good point or piece of evidence you could use in your essay. It helps to come up with your thesis statement early on so you can look for points related to it when you’re reading.

3 Write a gripping introduction

One of the keys to any good essay, synthesis or not, is a strong opening. This is partially determined by your thesis statement, but the other sentences in your introduction also make a big impact.

For starters, you can learn how to write a hook . In writing, a hook is something that grabs the reader’s attention and makes them want to keep reading. Hooks can essentially be anything interesting. Some common strategies for writing hooks include using personal anecdotes to create an emotional connection or providing exciting facts/statistics that the reader might not know.

Additionally, the introduction should also explain the scope of your topic and set the scene for people who aren’t familiar with it. The goal of the introduction is to prepare the reader for what follows so that afterward you can transition straight into making your points.

Synthesis essay vs. argumentative essay

Synthesis essays are often compared to argumentative essays, which attempt to refute, debunk, or criticize existing ideas or other research. The truth is that the two are not mutually exclusive. Although synthesis essays tend to be analytical or expository, they can also be argumentative.

A synthesis essay is any essay that combines ideas from multiple sources to create a new unified idea. If that new idea is a rebuttal to a preexisting idea and the entire essay is written as a critique, then the essay would be both synthesis and argumentative.

Synthesis essay FAQs

A synthesis essay is a type of essay that combines points, data, and evidence from multiple sources and turns them into one unified idea. In other words, the writer synthesizes their own idea using other sources’ research and ideas.

What is a good synthesis essay structure?

Traditionally, the common approaches to creating a synthesis essay structure are organizing by topic or organizing by source. The former means you discuss each source’s perspective on a topic before moving to the next topic; the latter means you discuss one source’s stance on each topic and then move to another source. You can also create a hybrid structure of the two for particular subjects.

What is the difference between a synthesis essay and an argumentative essay?

Synthesis essays are often contrasted with argumentative essays, but the truth is that the two are not mutually exclusive. For example, an argumentative essay can use the format of a synthesis essay—combining points from multiple sources to form a new unified idea—in order to refute a preexisting idea.

Literature Reviews

• Introduction
• Tutorials and resources
• Step 1: Literature search
• Step 2: Analysis, synthesis, critique
• Step 3: Writing the review

If you need any assistance, please contact the library staff at the Georgia Tech Library Help website . 

Analysis, synthesis, critique

Literature reviews build a story. You are telling the story about what you are researching. Therefore, a literature review is a handy way to show that you know what you are talking about. To do this, here are a few important skills you will need.

Skill #1: Analysis

Analysis means that you have carefully read a wide range of the literature on your topic and have understood the main themes, and identified how the literature relates to your own topic. Carefully read and analyze the articles you find in your search, and take notes. Notice the main point of the article, the methodologies used, what conclusions are reached, and what the main themes are. Most bibliographic management tools have capability to keep notes on each article you find, tag them with keywords, and organize into groups.

Skill #2: Synthesis

After you’ve read the literature, you will start to see some themes and categories emerge, some research trends to emerge, to see where scholars agree or disagree, and how works in your chosen field or discipline are related. One way to keep track of this is by using a Synthesis Matrix .

Skill #3: Critique

As you are writing your literature review, you will want to apply a critical eye to the literature you have evaluated and synthesized. Consider the strong arguments you will make contrasted with the potential gaps in previous research. The words that you choose to report your critiques of the literature will be non-neutral. For instance, using a word like “attempted” suggests that a researcher tried something but was not successful. For example: 

There were some attempts by Smith (2012) and Jones (2013) to integrate a new methodology in this process.

On the other hand, using a word like “proved” or a phrase like “produced results” evokes a more positive argument. For example:

The new methodologies employed by Blake (2014) produced results that provided further evidence of X.

In your critique, you can point out where you believe there is room for more coverage in a topic, or further exploration in in a sub-topic.

Need more help?

If you are looking for more detailed guidance about writing your dissertation, please contact the folks in the Georgia Tech Communication Center .

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Chapter 7: Synthesizing Sources

Learning objectives.

At the conclusion of this chapter, you will be able to:

• synthesize key sources connecting them with the research question and topic area.

7.1 Overview of synthesizing

7.1.1 putting the pieces together.

Combining separate elements into a whole is the dictionary definition of synthesis.  It is a way to make connections among and between numerous and varied source materials.  A literature review is not an annotated bibliography, organized by title, author, or date of publication.  Rather, it is grouped by topic to create a whole view of the literature relevant to your research question.

Your synthesis must demonstrate a critical analysis of the papers you collected as well as your ability to integrate the results of your analysis into your own literature review.  Each paper collected should be critically evaluated and weighed for “adequacy, appropriateness, and thoroughness” ( Garrard, 2017 ) before inclusion in your own review.  Papers that do not meet this criteria likely should not be included in your literature review.

Begin the synthesis process by creating a grid, table, or an outline where you will summarize, using common themes you have identified and the sources you have found. The summary grid or outline will help you compare and contrast the themes so you can see the relationships among them as well as areas where you may need to do more searching. Whichever method you choose, this type of organization will help you to both understand the information you find and structure the writing of your review.  Remember, although “the means of summarizing can vary, the key at this point is to make sure you understand what you’ve found and how it relates to your topic and research question” ( Bennard et al., 2014 ).

As you read through the material you gather, look for common themes as they may provide the structure for your literature review.  And, remember, research is an iterative process: it is not unusual to go back and search information sources for more material.

At one extreme, if you are claiming, ‘There are no prior publications on this topic,’ it is more likely that you have not found them yet and may need to broaden your search.  At another extreme, writing a complete literature review can be difficult with a well-trod topic.  Do not cite it all; instead cite what is most relevant.  If that still leaves too much to include, be sure to reference influential sources…as well as high-quality work that clearly connects to the points you make. ( Klingner, Scanlon, & Pressley, 2005 ).

7.2 Creating a summary table

Literature reviews can be organized sequentially or by topic, theme, method, results, theory, or argument.  It’s important to develop categories that are meaningful and relevant to your research question.  Take detailed notes on each article and use a consistent format for capturing all the information each article provides.  These notes and the summary table can be done manually, using note cards.  However, given the amount of information you will be recording, an electronic file created in a word processing or spreadsheet is more manageable. Examples of fields you may want to capture in your notes include:

• Authors’ names
• Article title
• Publication year
• Main purpose of the article
• Methodology or research design
• Participants
• Measurement
• Conclusions

  Other fields that will be useful when you begin to synthesize the sum total of your research:

• Specific details of the article or research that are especially relevant to your study
• Key terms and definitions
• Strengths or weaknesses in research design
• Relationships to other studies
• Possible gaps in the research or literature (for example, many research articles conclude with the statement “more research is needed in this area”)
• Finally, note how closely each article relates to your topic.  You may want to rank these as high, medium, or low relevance.  For papers that you decide not to include, you may want to note your reasoning for exclusion, such as ‘small sample size’, ‘local case study,’ or ‘lacks evidence to support assertion.’

This short video demonstrates how a nursing researcher might create a summary table.

7.2.1 Creating a Summary Table

  Summary tables can be organized by author or by theme, for example:

For a summary table template, see http://blogs.monm.edu/writingatmc/files/2013/04/Synthesis-Matrix-Template.pdf

7.3 Creating a summary outline

An alternate way to organize your articles for synthesis it to create an outline. After you have collected the articles you intend to use (and have put aside the ones you won’t be using), it’s time to identify the conclusions that can be drawn from the articles as a group.

  Based on your review of the collected articles, group them by categories.  You may wish to further organize them by topic and then chronologically or alphabetically by author.  For each topic or subtopic you identified during your critical analysis of the paper, determine what those papers have in common.  Likewise, determine which ones in the group differ.  If there are contradictory findings, you may be able to identify methodological or theoretical differences that could account for the contradiction (for example, differences in population demographics).  Determine what general conclusions you can report about the topic or subtopic as the entire group of studies relate to it.  For example, you may have several studies that agree on outcome, such as ‘hands on learning is best for science in elementary school’ or that ‘continuing education is the best method for updating nursing certification.’ In that case, you may want to organize by methodology used in the studies rather than by outcome.

Organize your outline in a logical order and prepare to write the first draft of your literature review.  That order might be from broad to more specific, or it may be sequential or chronological, going from foundational literature to more current.  Remember, “an effective literature review need not denote the entire historical record, but rather establish the raison d’etre for the current study and in doing so cite that literature distinctly pertinent for theoretical, methodological, or empirical reasons.” ( Milardo, 2015, p. 22 ).

As you organize the summarized documents into a logical structure, you are also appraising and synthesizing complex information from multiple sources.  Your literature review is the result of your research that synthesizes new and old information and creates new knowledge.

7.4 Additional resources:

Literature Reviews: Using a Matrix to Organize Research / Saint Mary’s University of Minnesota

Literature Review: Synthesizing Multiple Sources / Indiana University

Writing a Literature Review and Using a Synthesis Matrix / Florida International University

 Sample Literature Reviews Grid / Complied by Lindsay Roberts

Select three or four articles on a single topic of interest to you. Then enter them into an outline or table in the categories you feel are important to a research question. Try both the grid and the outline if you can to see which suits you better. The attached grid contains the fields suggested in the video .

Literature Review Table  

Test Yourself

• Select two articles from your own summary table or outline and write a paragraph explaining how and why the sources relate to each other and your review of the literature.
• In your literature review, under what topic or subtopic will you place the paragraph you just wrote?

Image attribution

Literature Reviews for Education and Nursing Graduate Students Copyright © by Linda Frederiksen is licensed under a Creative Commons Attribution 4.0 International License , except where otherwise noted.

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Writing the Literature Review

• Getting Started
• Step 1: Choose A Topic
• Step 2: Find Information
• Step 3: Evaluate
• Step 4: Take Notes
• Step 5: Synthesize
• Step 6: Stay Organized
• Write the Review

Synthesizing

What is "Synthesis"?

Synthesis?  

Synthesis refers to combining separate elements to create a whole.  When reading through your sources (peer reviewed journal articles, books, research studies, white papers etc.) you will pay attention to relationships between the studies, between groups in the studies, and look for any pattterns,  similarities or differences.  Pay attention to methodologies, unexplored themes, and things that may represent a "gap" in the literature.  These "gaps" will be things you will want to be sure to identify in your literature review.  

• Using a Synthesis Matrix to Plan a Literature Review Introduction to synthesis matrices, and explanation of the difference between synthesis and analysis. (Geared towards Health Science/ Nursing but applicable for other literature reviews) ***Includes a synthesis matrix example***
• Using a Spider Diagram Organize your thoughts with a spider diagram

Ready, Set...Synthesize

• Create an outline that puts your topics (and subtopics) into a logical order
• Look at each subtopic that you have identified and determine what the articles in that group have in common with each other
• Look at the articles in those subtopics that you have identified and look for areas where they differ.
• If you spot findings that are contradictory, what differences do you think could account for those contradictions?  
• Determine what general conclusions can be reported about that subtopic, and how it relates to the group of studies that you are discussing
• As you write, remember to follow your outline, and use transitions as you move between topics 

Galvan, J. L. (2006). Writing literature reviews (3rd ed.). Glendale, CA: Pyrczak Publishing

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Systematic reviews & evidence synthesis methods.

• Schedule a Consultation / Meet our Team
• What is Evidence Synthesis?
• Types of Evidence Synthesis
• Evidence Synthesis Across Disciplines
• Finding and Appraising Existing Systematic Reviews
• 0. Preliminary Searching
• 1. Develop a Protocol
• 2. Draft your Research Question
• 3. Select Databases
• 4. Select Grey Literature Sources
• 5. Write a Search Strategy
• 6. Register a Protocol
• 7. Translate Search Strategies
• 8. Citation Management
• 9. Article Screening
• 10. Risk of Bias Assessment
• 11. Data Extraction
• 12. Synthesize, Map, or Describe the Results
• Evidence Synthesis Resources & Tools

What are evidence syntheses?

According to the Royal Society, 'evidence synthesis' refers to the process of bringing together information from a range of sources and disciplines to inform debates and decisions on specific issues. They generally include a methodical and comprehensive literature synthesis focused on a well-formulated research question. Their aim is to identify and synthesize all of the scholarly research on a particular topic, including both published and unpublished studies. Evidence syntheses are conducted in an unbiased, reproducible way to provide evidence for practice and policy-making, as well as to identify gaps in the research. Evidence syntheses may also include a meta-analysis, a more quantitative process of synthesizing and visualizing data retrieved from various studies.

Evidence syntheses are much more time-intensive than traditional literature reviews and require a multi-person research team. See this PredicTER tool to get a sense of a systematic review timeline (one type of evidence synthesis). Before embarking on an evidence synthesis, it's important to clearly identify your reasons for conducting one. For a list of types of evidence synthesis projects, see the Types of Evidence Synthesis tab.

How does a traditional literature review differ from evidence synthesis?

One commonly used form of evidence synthesis is a systematic review. This table compares a traditional literature review with a systematic review.

Video: Reproducibility and transparent methods (Video 3:25)

Reporting standards

There are some reporting standards for evidence syntheses. These can serve as guidelines for protocol and manuscript preparation and journals may require that these standards are followed for the review type that is being employed (e.g. systematic review, scoping review, etc).​

• PRISMA checklist Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) is an evidence-based minimum set of items for reporting in systematic reviews and meta-analyses.
• PRISMA-P Standards An updated version of the original PRISMA standards for protocol development.
• PRISMA - ScR Reporting guidelines for scoping reviews and evidence maps
• PRISMA-IPD Standards Extension of the original PRISMA standards for systematic reviews and meta-analyses of individual participant data.
• EQUATOR Network The EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network is an international initiative that seeks to improve the reliability and value of published health research literature by promoting transparent and accurate reporting and wider use of robust reporting guidelines. They provide a list of various standards for reporting in systematic reviews.

Video: Guidelines and reporting standards

PRISMA flow diagram

The PRISMA flow diagram depicts the flow of information through the different phases of an evidence synthesis. It maps the search (number of records identified), screening (number of records included and excluded), and selection (reasons for exclusion). Many evidence syntheses include a PRISMA flow diagram in the published manuscript.

See below for resources to help you generate your own PRISMA flow diagram.

• PRISMA Flow Diagram Tool
• PRISMA Flow Diagram Word Template
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Synthetic literature reviews: An introduction

By Steve Wallis and Bernadette Wright 26/05/2020

Whether you are writing a funding proposal or an academic paper, you will most likely be required to start with a literature review of some kind. Despite (or because of) the work involved, a literature review is a great opportunity to showcase your knowledge on a topic. In this post, we’re going to take it one step further. We’re going to tell you a very practical approach to conducting literature reviews that allows you to show that you are advancing scientific knowledge before your project even begins. Also – and this is no small bonus – this approach lets you show how your literature review will lead to a more successful project.

Literature review – start with the basics

A literature review helps you shape effective solutions to the problems you (and your organisation) are facing. A literature review also helps you demonstrate the value of your activities. You can show how much you add to the process before you spend any money collecting new data. Finally, your literature review helps you avoid reinventing the wheel by showing you what relevant research already exists, so that you can target your new research more efficiently and more effectively.

We all want to conduct good research and have a meaningful impact on people’s lives. To do this, a literature review is a critical step. For funders, a literature review is especially important because it shows how much useful knowledge the writer already has.

Past methods of literature reviews tend to be focused on ‘muscle power’, that is spending more time and more effort to review more papers and adhering more closely to accepted standards. Examples of standards for conducting literature reviews include the PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions and the guidelines for assessing the quality and applicability of systematic reviews developed by the Task Force on Systematic Review and Guidelines . Given the untold millions of papers in many disciplines, even a large literature review that adheres to the best guidelines does little to move us toward integrated knowledge in and across disciplines.

In short, we need we need to work smarter, not harder!

Synthetic literature reviews

One approach that can provide more benefit is the synthetic literature review. Synthetic meaning synthesised or integrated, not artificial. Rather than explaining and reflecting on the results of previous studies (as is typically done in literature reviews), a synthetic literature review strives to create a new and more useful theoretical perspective by rigorously integrating the results of previous studies.

Many people find the process of synthesis difficult, elusive, or mysterious. When presenting their views and making recommendations for research, they tend to fall back on intuition (which is neither harder nor smarter).

After defining your research topic (‘poverty’ for example), the next step is to search the literature for existing theories or models of poverty that have been developed from research. You can use Google Scholar or your institutional database, or the assistance of a research librarian. A broad topic such as ‘poverty’, however, will lead you to millions of articles. You’ll narrow that field by focusing more closely on your topic and adding search terms. For example, you might be more interested in poverty among Latino communities in central California. You might also focus your search according to the date of the study (often, but not always, more recent results are preferred), or by geographic location. Continue refining and focusing your search until you have a workable number of papers (depending on your available time and resources). You might also take this time to throw out the papers that seem to be less relevant.

Skim those papers to be sure that they are really relevant to your topic. Once you have chosen a workable number of relevant papers, it is time to start integrating them.

Next, sort them according to the quality of their data.

Next, read the theory presented in each paper and create a diagram of the theory. The theory may be found in a section called ‘theory’ or sometimes in the ‘introduction’. For research papers, that presented theory may have changed during the research process, so you should look for the theory in the ‘findings’, ‘results’, or ‘discussion’ sections.

That diagram should include all relevant concepts from the theory and show the causal connections between the concepts that have been supported by research (some papers will present two theories, one before and one after the research – use the second one – only the hypotheses that have been supported by the research).

For a couple of brief and partial example from a recent interdisciplinary research paper, one theory of poverty might say ‘Having more education will help people to stay out of poverty’, while another might say ‘The more that the economy develops, the less poverty there will be’.

We then use those statements to create a diagram as we have in Figure 1.

Figure 1. Two (simple, partial) theories of poverty. (We like to use dashed lines to indicate ’causes less’, and solid lines to indicate ’causes more’)

When you have completed a diagram for each theory, the next step is to synthesise (integrate) them where the concepts are the same (or substantively similar) between two or more theories. With causal diagrams such as these, the process of synthesis becomes pretty direct. We simply combine the two (or more) theories to create a synthesised theory, such as in Figure 2.

Figure 2. Two theories synthesised where they overlap (in this case theories of poverty)

Much like a road map, a causal diagram of a theory with more concepts and more connecting arrows is more useful for navigation. You can show that your literature review is better than previous reviews by showing that you have taken a number of fragmented theories (as in Figure 1) and synthesised them to create a more coherent theory (as in Figure 2).

To go a step further, you may use Integrative Propositional Analysis (IPA) to quantify the extent to which your research has improved the structure and potential usefulness of your knowledge through the synthesis. Another source is our new book from Practical Mapping for Applied Research and Program Evaluation (see especially Chapter 5). (For the basics, you can look at Chapter One for free on the publisher’s site by clicking on the ‘Preview’ tab here. )

Once you become comfortable with the process, you will certainly be working ‘smarter’ and showcasing your knowledge to funders!

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Synthesising the literature as part of a literature review

Affiliation.

• 1 University of Manchester, England.
• PMID: 25783281
• DOI: 10.7748/ns.29.29.44.e8957

This article examines how to synthesise and critique research literature. To place the process of synthesising the research literature into context, the article explores the critiquing process by breaking it down into seven sequential steps. The article explains how and why these steps need to be kept in mind if a robust comprehensive literature search and analysis are to be achieved. The article outlines how to engage in the critiquing process and explains how the literature review needs to be assembled to generate a logical and reasoned debate to examine a topic of interest or research in more detail.

Keywords: Critical analysis; critique; evaluation; integrative review; literature review; literature search; research; research question; search strategy; synthesis.

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• Searching and critiquing the research literature. Wakefield A. Wakefield A. Nurs Stand. 2014 Jun 3;28(39):49-57. doi: 10.7748/ns.28.39.49.e8867. Nurs Stand. 2014. PMID: 24866671 Review.
• How to perform a critically appraised topic: part 1, ask, search, and apply. Kelly AM, Cronin P. Kelly AM, et al. AJR Am J Roentgenol. 2011 Nov;197(5):1039-47. doi: 10.2214/AJR.09.7205. AJR Am J Roentgenol. 2011. PMID: 22021494
• Reviewing Literature in Bioethics Research: Increasing Rigour in Non-Systematic Reviews. McDougall R. McDougall R. Bioethics. 2015 Sep;29(7):523-8. doi: 10.1111/bioe.12149. Epub 2015 Feb 6. Bioethics. 2015. PMID: 25655982
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• Making sense of research: A guide for critiquing a paper. Stockhausen L, Conrick M. Stockhausen L, et al. Contemp Nurse. 2002 Dec;14(1):38-48. doi: 10.5172/conu.14.1.38. Contemp Nurse. 2002. PMID: 16114192 Review.
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Evidence Synthesis Service

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Evidence Synthesis Service: Introduction

WSU Health Sciences Library offers an evidence synthesis service for any WSU health sciences faculty and students who are working toward  publishable secondary research. This service allows you to add a librarian to your research team, who will guide the creation, implementation, and write-up of the literature search methodology. 

Why should you consider adding a librarian to your team?

Evidence synthesis projects that include a librarian have been shown to be of higher quality than those without a librarian. Therefore, adding a librarian is a way to improve the quality of your evidence synthesis research. This is because librarians are experts at conducting comprehensive literature searches. Creating a strong methodology is essential to the success of the study, and librarians have extensive experience creating and using search strategies that identify all of the relevant literature.

• Librarian co-authors correlated with higher quality reported search strategies in general internal medicine systematic reviews Rethlefsen ML, Farrell AM, Osterhaus Trzasko LC, Brigham TJ. Librarian co-authors correlated with higher quality reported search strategies in general internal medicine systematic reviews. J Clin Epidemiol. 2015;68(6):617-626. doi:10.1016/j.jclinepi.2014.11.025
• Librarian involvement in systematic reviews was associated with higher quality of reported search methods: a cross-sectional survey Pawliuk C, Cheng S, Zheng A, Siden HH. Librarian involvement in systematic reviews was associated with higher quality of reported search methods: a cross-sectional survey. J Clin Epidemiol. 2024;166:111237. doi:10.1016/j.jclinepi.2023.111237

What does a librarian do on an evidence synthesis team?

The librarian is responsible for the methodology of the literature review. This includes:

• Meeting(s) to discuss the research question, scope, inclusion/exclusion criteria, and refine the strategy
• Iterative, interactive process to draft and refine search string
• Interactive process to determine which databases to search, and translation of the final search string into relevant databases
• Running and documenting the search itself
• Importing the citations into evidence synthesis software (Covidence)
• Writing the methods section relevant to the search, both for the protocol and published paper

Illustration of evidence synthesis process

This diagram illustrates the evidence synthesis process, which would then culminate in the preparation of a manuscript for publication. 

Who does the librarian work with?

The Principal Investigator must work with the librarian through the identification and refinement of the research question and strategy. Future meetings that get into greater detail regarding search terms may be with other research team members, so long as the PI is kept abreast of the progress of the work. 

What acknowledgement is required for the librarian's role?

This level of involvement in the research team is consistent with co-authorship. Specific placement within the list of authors is negotiated based on the details of the project. 

• Defining the Role of Authors and Contributors | ICMJE The International Committee of Medical Journal Editors explores the criteria for authorship.

Can you meet with a librarian about your evidence synthesis search without including them on the team?

Yes, you may choose to meet with a librarian to discuss your research and learn more about search strategies. This type of consultation can take place over the course of one or two meetings, and should be documented in the published article as an acknowledgement. However, it's important to note that the librarian's role on an evidence synthesis team cannot be replicated by discussing search strategies or techniques. While there is extensive instruction on search techniques freely available online, the expertise to conduct a reproducible search takes a great deal of time and effort to acquire. This guide focuses on adding a librarian to the research team as co-author, but we encourage you to request a meeting  for consultations or learning more about the service.

What if you are not a member of the health sciences?

WSU faculty who are not part of the health sciences (i.e. College of Medicine, College of Nursing, or College of Pharmacy & Pharmaceutical Sciences) are not currently eligible for the Health Sciences Library's Evidence Synthesis Service. We recommend that you consider meeting with your subject librarian to identify their subject-specific recommendations for a successful search.

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• Systematic Review
• Open access
• Published: 17 August 2024

Direct and indirect effects of economic sanctions on health: a systematic narrative literature review

• Vahid Yazdi-Feyzabadi 1 ,
• Atefeh Zolfagharnasab 2 ,
• Soheila Naghavi 3 ,
• Anahita Behzadi 1 ,
• Maysam Yousefi 4 &
• Mohammad Bazyar   ORCID: orcid.org/0000-0003-2543-1862 5  

BMC Public Health volume  24 , Article number:  2242 ( 2024 ) Cite this article

43 Accesses

Metrics details

Economic sanctions are defined as restrictions imposed by other countries against individuals, groups, or governments of other countries. These sanctions have a detrimental impact on the economies of countries and can also limit access to healthcare services for people as a secondary consequence. This study aims to systematically review the literature to examine the direct and indirect effects of economic sanctions on health through a narrative synthesis.

This systematic literature review was limited to papers published between January 1990 and July 2023. Relevant documents published in English and Persian were searched for in databases including Cochrane Library, PubMed, Embase, Scopus, Web of Science, SID, Magiran, and Irandoc. The direct and indirect effects of sanctions on health were classified using two frameworks proposed by the World Health Organization (WHO): the Health System Building Blocks and “Social Determinants of Health”.

Out of a total of 18,219 articles, 59 were selected based on inclusion criteria. The effects of sanctions were divided into direct and indirect groups. Direct effects encompassed seven main themes: access to essential medicine, medical products, vaccines and technologies; financing; health workforce; service delivery; research and health information systems; health outcomes; and financial risk protection. Indirect effects also were classified into six main themes: socioeconomic status; food and agricultural products; stress; early life conditions; high-risk behaviors and addiction; and transport. Most studies focused on the access to medicines, food, economic and social status.

Conclusions

Economic sanctions have had profoundly negative impacts on all aspects of the healthcare system. The international community must address these effects on health and take necessary measures to prevent or mitigate them, particularly in ensuring the provision of basic and essential healthcare needs for individuals and communities.

Peer Review reports

Sanctions are purposeful and determined restrictions imposed by one or more countries against another individual, group or countries’ government. Sanctions are usually imposed by international organizations as a pressure tool for responding to the course of actions of any country that opposes them [ 1 ].

Economic sanctions are the most common type of these restrictions. The two main types of these sanctions are trade and financial restrictions. Trade sanctions restrict imports to and exports from the countries under sanctions while financial sanctions are closely related to economic ones, but their focus is on banning the money flows and financial resources into or out of the country. These sanctions can include blocking government assets, restricting access to financial markets, loans and credits limitations, restricting international financial exchange, and also sales and trade abroad [ 2 ].

Economic sanctions reduce people’s access to basic necessities of life by debilitating the economic situation, decreasing welfare and weakening the functions of the target country’s social systems. One of the most important areas affected through these boycotts is health. Due to the expansion of health scope, these limitations affect different parts of health system itself and as a result endanger people’s life [ 3 , 4 ].

Studies in various countries, including Iran, Iraq, Cuba, Yugoslavia and Haiti, discussed the effects of sanctions on health. In Haiti, economic sanctions have reduced incomes, increased unemployment and poverty along with mortality by 1 to 4 years, and destroyed families [ 5 ]. In Iran, especially in healthcare area, sanctions have resulted in increasing the cost of essential procedures and drugs such as diagnostic procedures for cancers and chemotherapy drugs. The difficulties in getting required licenses for financial transactions and transportation insurance due to sanctions has left the country with a shortage of drugs and health equipment [ 6 ].

Sanctions have devastating effects on the health of vulnerable patients or health systems customers too. Patients who are suffering from diseases such as asthma, thalassemia, hemophilia, chronic diseases, blood disorders, multiple sclerosis and HIV/AIDS have limited access to drugs [ 7 ]. While comparing, in developed countries mortality rates decreased using appropriate drugs [ 8 , 9 ].

Different countries may use broad policies to prevent or adjust the negative effects of economic problems on health systems, although these policies may not be successful in ensuring continued access to health services [ 10 , 11 ].

Although sanctions may be designed for excluding medical products from the list, they can still have an inevitable impact on access to health services. Thus, the imposition of economic sanctions can threaten public health directly [ 12 ].

Furthermore, economic sanctions suppress the health indirectly by adversely impacting on other related parts known as social determinants of health (SDH) and Sustainable Development Goals (SDGs). Economic sanctions impact all aspects of the social determinants of health (SDH) framework, leading to negative effects on health equity and well-being. Sanctions can alter social and political systems, such as governance, labor markets, education, trade, housing, and redistributive policies, influencing people’s health. Structural determinants like income, education, and occupation are affected by sanctions, changing health opportunities and status, especially for the economically disadvantaged. Intermediary determinants, including material and psychosocial circumstances, are also influenced negatively by sanctions. For instance, housing quality declines post-sanctions due to increased costs of land and materials, while food consumption patterns shift towards cheaper, less nutritious options. Sanctions create psychosocial stressors like job insecurity and uncertainty, leading to frustration and stress [ 13 , 14 , 15 , 16 ].

Continued sanctions may hinder countries’ progress towards achieving Sustainable Development Goals (SDGs), particularly SDG-3 for healthy lives and well-being. Economic stability is crucial for meeting health-related SDGs, and any failures in this regard would disproportionately impact citizens in targeted countries. In the context of developing countries, where progress toward SDGs is often hindered by limited resources and systemic disparities, the impact of economic sanctions on health systems and overall well-being is profound. SDGs, with their emphasis on health (Goal 3) and the overarching aim of leaving no one behind, seek to address disparities and ensure equitable access to healthcare services. Economic sanctions, however, disrupt this delicate balance, exacerbating existing inequalities and impeding the ability of nations to meet the health-related targets outlined in the SDGs [ 13 ].

Given that, the effects of sanctions depend on the situation of countries and vary from one to another, there is no complete evidence of a comprehensive impact of sanctions on different part of society’s system especially in health despite of its importance. To comprehensively address these issues, a rigorous examination of evidence through narrative systematic reviews becomes imperative. This study aims to provide a detailed narrative synthesis of the direct and indirect effects of economic sanctions on health system building blocks and public health focusing on social determinants of health, thereby contributing to a better understanding of the broader consequences of such measures.

The following steps were taken to review literature systematically [ 17 , 18 ].

Research question

The main question that we wanted to answer in this study was to investigate and categorize the effects that economic sanctions impose on health directly and indirectly.

Search strategy and identifying literature

This systematic review was carried out according to the latest version of PRISMA guidelines [ 19 , 20 ]. For the purposes of the study, following databases were searched by one of the authors experienced in systematic research: Cochrane Library, PubMed, Embase, Scopus, Web of Science, SID, Magiran, Irandoc. The search strategy (see Additional file 1 for an example) was first devised for use in PubMed and subsequently adapted for the other databases. The search was limited to papers published between January 1990 and July 2023 and to studies involving economic sanctions independently as a hard power exercise. Other hard power exercises to achieve foreign policy goals such as war and conflicts were excluded. We selected the appropriate keywords from studying similar studies, discussion among research team and intended frameworks for extracting the data. The search term “sanctions” and “public health” were used for PubMed; terms associated with “economic sanctions” and “public health” were used for the title or abstract in the other databases if required (MeSH term; major focus and/or exploded depending on the database). In brief the following terms were searched using Boolean operators: sanction, embargo, health, human resource, medical instrument, medicine, pharmaceutics, disease, mortality, medical equipment, medical devices, drug, health care, Taskforce, health personnel, health workers, morbidity, illness, and food.

Screening and article selection criteria

Duplicate results were removed after searching the databases using Endnote software version X8. After removing the duplications, a screening of publications, based on titles and abstracts was performed by two researchers independently. In second screening, then, the suspected documents were re-examined by a third person from the research team to decide whether to enter or not.

As the final step of screening, the full texts of the remaining publications were independently assessed for inclusion by pairs of reviewers once more and any potential disagreements were resolved through consensus and if necessary by the third opinion from the research team.

The articles not meeting the below criteria were excluded:

Articles published in languages other than English and Persian.

Articles available in preprint servers.

Articles did not match the question and objectives of the research like those related to the effects of wars and conflict on health.

Conference abstracts, books, reports and dissertations.

Records not in line with the quantitative, qualitative and mixed-method original articles including letter to Editor, commentary, opinion/viewpoint/perspective.

Articles published before 1990.

After reaching the final list of studies to be reviewed thoroughly, we supplemented our database search by screening bibliographic of chosen articles to identify any additional relevant publications. The bibliographic of other relevant systematic articles were also searched actively for retrieving other missing articles.

Data extraction

After finalizing the final list of articles, the full text of the selected articles were studied precisely and required information was extracted. In order to capture the maximum available evidence regarding the effects of economic sanctions, no quality assessment was employed in our systematic literature review. This approach allowed us to include a wide range of studies, regardless of their methodological quality, thus providing a comprehensive overview of the existing literature. This method is consistent with approaches used in narrative synthesis where the primary aim is to summarize broad evidence on a topic rather than critically appraise each study’s quality. The extracted information was divided into two sections. The first one, consisting the bibliographic information included the title of article, the year of publication, the first author, and the title of the journal and the second section reports the frequency of articles according to the main topics addressed in their results.

Data analysis and presenting results

For identifying key concepts and main themes, each of selected articles studied carefully. After completing the data extraction table, the researchers shared the concepts with other members of the research team, and agreement was reached. As many other factors outside the borders of health system affects the health, generally known as social determinants of health (SDH), we applied two common popular frameworks to categorize the direct and indirect effects impacts of sanctions on health system and public health. To address the direct impact of sanctions on health, Health System Building Blocks framework proposed by World Health Organization (WHO) was proposed which consists of six key components including “service delivery”, “health workforce”, “health information systems”, “access to essential medicines”, “financing” and “government/ leadership”. This framework also covers intermediate (e.g. access, coverage, quality and safety) and four final goals including Improved health (level and equity), Responsiveness, Social and financial risk protection, and Improved efficiency [ 21 , 22 ].

To cover other effects of sanctions occurring in other sections beyond the health system but affecting health indirectly, the approach of “Social Determinants of Health” was applied which comprises of the following 10 elements, “The social gradient”, “Stress”, “Early life conditions”, “Social exclusion”, “Work”, “Unemployment”, “Social support”, “Addiction”, “Food”, and “Transport“ [ 23 ].

Search process

A total number of 18,219 articles were identified, which after removing the overlaps, 12,838 articles remained. Following the initial review of the title and abstract of all retrieved articles, a further 12,439 articles were excluded. Out of 399 records, the full text of 390 articles were retrieved and evaluated for eligibility.

After a final review, 331 articles were excluded due to not intended study design or not addressing the question and aims of the current research. Finally 59 research articles were included in the study (Fig.  1 ). A summary of included studies’ features is reported in Table  1 .

The PRISMA algorithm of study selection process

Study features

The study information collected from 11 countries which included Iran, Iraq, Cuba, Syria, Haiti, Yugoslavia, Lebanon, Serbia, Nicaragua, Sri Lanka, Russia and South Africa. Iraq [ 4 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ] and Iran [ 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ] had the maximum number of studies. Most of the studies were descriptive or analytical. Four were qualitative and also three studies were designed as a mix-method. The share of different regions from economic sanctions studies is shown in Fig.  2 .

The different regions share of economic sanctions studies

Study areas

Included studies have examined the impact of sanctions in various areas. The amount of available and accessible information about the effect of sanctions varied from one area to another. Most studies addressed the impact of economic sanctions on access to medicine or food and also socioeconomic status.

Almost half of studies mentioned the effect of sanctions on access to drugs, these studies covered approximately all countries targeted by sanctions. More than a quarter, discussed the socioeconomic situation. Food access and malnutrition were also explained in about another quarter of the articles. According to studies, the vulnerable groups which affected most by sanctions were the poor, patients, women and children. The proportion of different parts of health system and different social health determinants affected by economic sanctions is reported in Table  2 ; Fig.  3 .

The proportion of different parts of health system and social determinants of health mentioned in retrieved studies which are affected by economic sanctions

The Table  2 provides an overview of the frequency of direct and indirect effects of sanctions on health, based on findings from 59 selected articles. The data is categorized into direct effects on the health system and indirect effects on population/public health, highlighting both the immediate and broader consequences of sanctions. The most frequently mentioned direct effect was the impact on access to essential medicine, medical products, vaccines, and technologies, with 22 documents, accounting for 37.3% of the papers. On the other hand, the most frequently cited indirect effect was on the socioeconomic situation, mentioned in 9 documents (15.2%).

Themes and sub-themes

The effects of sanctions on health were categorized into two broad direct and indirect groups. Following the WHO’ Health System Building Blocks, direct effects include 7 main themes as followed: access to essential medicine, medical products, vaccines and technologies; financing; health workforce; service delivery; research and health information systems; health outcomes; and financial risk protection (Table  3 ). Indirect effects also were summarized in 6 main themes consisting: socioeconomic status; food and agricultural products; stress; early life conditions; high-risk behaviors and addiction; and transportation (Table  4 ).

Direct effects

Access to medicines, medical products, vaccines, and technologies.

Access to medicine is one of the main goals of health systems. Numerous studies have been reported on drug shortages and public concerns about patients’ difficulties for getting their essential’s [ 46 ]. The findings related to access to medicine were divided further into three sub-themes: reduced access to imported raw materials, decreased access to imported or foreign drugs, and increased drug prices.

There are some findings indicated that sanctions prevent the import of essential medical supplies [ 29 , 36 , 44 , 47 , 48 ]. Therefore, the manufacture of local drugs is affected and access to them is reduced.

For example, Iran experienced a significant decrease in access to asthma drugs which produced locally in Iran, because of local producers relied on imported raw materials [ 36 ]. In Yugoslavia, as a result of imposing restrictions on pharmaceutical industry, the available essential drugs decreased by more than 50% [ 47 ]. Syria also faced a shortage of raw materials for producing domestic drugs for heart disease, cancer and diabetes [ 48 ]. In a similar way, in Iraq, the provision of laboratory services reduced because of raw chemicals shortage [ 29 ].

Limited access to imported drugs was another direct effect [ 49 ]. The shortage of essential medicines in countries suffering from sanctions was a main concern and access to such medicines including chemotherapy, chronically illness treatments, psychiatric services, MS and antiepileptic drugs was limited considerably [ 29 , 31 , 36 , 37 , 40 , 42 , 44 , 47 , 50 ]. Access to hemophilia and thalassemia drugs was severely affected too [ 39 ]. Problems caused by economic sanctions also affected the pharmaceutical market which as a result, lead to an sharp increase in the prices [ 5 , 42 , 51 ].

Studies showed that economic sanctions reduced the import of and access to medical equipment to great extent [ 3 , 24 , 29 , 52 ]. In Cuba, the number of X-rays decreased by 75% [ 3 ]. Many American companies refused to sell drugs or medical equipment assigned for Nicaragua. Severe shortage of medical products in health system became apparent in 1985 and worsened in 1986 [ 24 ].

Also, studies revealed that economic sanctions have reduced access to vaccines and caused less immunization against infectious diseases [ 25 , 53 ].

In case of Cuba, the country’s ability to produce chlorine decreased and the number of populations with no access to safe drinking water increased, therefore population covered by chlorine water systems decreased from 98% in 1988 to 26% in 1994 [ 3 ].

Health financing

Health financing counts as essential ability of health systems to maintain and improve the community well-being. The economic crisis is affecting the financial capacity of health care system and has hampered the financial support for providing health services [ 52 , 54 ]. During the economic sanctions, budget constraints also prevented some health care programs from being fully implemented [ 31 ].

Health workforce

A study done in Iraq showed that economic sanctions resulted in widespread expulsions of health care professionals, while many of them were belong to foreign nationals. Also, physicians had to do a lot of extra work, along with increasing pressures which caused them.

leave their jobs behind [ 29 , 31 ].

Health services delivery

The imposition of economic sanctions, resulted in labor shortages, limited access to medical equipment, affecting the process of providing health services and made it worse. This imposed much more pressure on the ability of health system as whole particularly during crises like the COVID-19 pandemic [ 55 ]. Meanwhile various studies showed a reduction in quantity and quality of provided services too [ 5 , 29 , 31 , 52 , 56 , 57 ]. A study in Iran showed that due to economic sanctions, from 18 brachytherapy centers in 2018, only two centers were usable since 2015 and also the gap between Iran’s available facilities for radiation therapy and international standards deepened [ 58 ]. According to the Program of Action for Cancer Therapy, sanctions have disrupted Iran’s National Cancer Control Program (NCCP) as they have influenced all phases of treatment from prevention, to diagnosis/treatment, palliative care, monitoring, and also technology and drug availability [ 59 ].

Research and health information systems

The effects of economic sanctions on research and health information systems were divided into three sub-themes: reduced access to scientific resources and virtual sites, disruption of international interactions and conferences, and restricted research activities. Sanctions also limited access to scientific magazines and books [ 29 , 52 ]. Specialists were unable to get visas and travel abroad to attend international conferences, which reduced scientific exchanges [ 52 ].

The severe financial pressure of sanctions intensified restrictions of scientific travels and communications with the outside world led to a lack of access to educational materials and global medical advances [ 31 ].

Economic sanctions also had negative effects on both research and science production activities, including smaller scientific communication, difficulties in research processes, and consequently, decline in the quality along with quantity of research and science development activities [ 14 , 45 , 60 ].

Health outcomes and financing risk protection

International evidence about the UN sanctions indicates that they reduces life expectancy by about 1.2–1.4 years on average. It was also shown that this reduction is much more severe in vulnerable groups of society like women. This lower life expectancy in the studied countries occurred to great extent due to higher child mortality and Cholera deaths and also spending less amount of public budget on health care [ 61 , 62 ]. Studies from Iran show that multiple sclerosis patients faced higher out-of-pocket payments, catastrophic health expenditures and the poverty index [ 63 ]. Similarly, studies from other countries show higher mortality rate from infectious diseases and more difficulties for optic and neuropathic patients [ 64 , 65 ]. Physical rehabilitation experts in Iran also concern about high price that people with physical problems have to pay for prostheses which in turn have negative consequences for practitioners themselves [ 66 ].

Indirect effects

The effects of economic sanctions are not targeted and they also influence sectors other than health which can affect general health indirectly. These effects can be categorized under a general concept as social determinants of health (SDH). The main SDHs extracted from the retrieved studies are as follows:

Economic and social status

The main target of economic sanctions is the economy and money flows of countries which had negative consequences for countries’ economy themselves and other related areas [ 67 ]. The indirect outcomes in the area of Economic and Social Status were categorized into 6 sub-themes including: rising unemployment, decreasing income, declining welfare, increasing poverty, trade barriers, rising prices and decreasing purchasing power.

Majority of studies in Iran, Iraq, Cuba, Haiti, Syria, South Africa addressed the effects of sanctions on the socioeconomic situation [ 4 , 5 , 29 , 44 , 47 , 48 , 52 , 68 ]. These sanctions banned and reduced the exports of products which in turn caused unemployment among those who relied on importing such products to make money. Unemployment rose sharply in Haiti with the cessation of mango exports, on which many poor people depended [ 47 ]. Also, in this country some of factories such as clothing, sports and assembly, reduced the number of workers, which was accompanied by rising the rate of job loss [ 5 ].

Continuing this situation, economic problems became more and more prevalent. In Haiti, many people lost their main source of income [ 5 ]. In Iraq, wage fell and there was hardly enough to buy the necessities of daily life [ 29 ]. A review of studies during this period revealed that the reason of increasing social problems and the disintegration of many family structures was the fall in incomes [ 5 , 44 ].

On the other hand, poverty increased as soon as economic problems intensified. Some of the middle classes’ families were forced to sell their houses and apartments [ 29 ]. Also, school enrollment declined due to the poverty [ 5 ].

Another important effect was trade barriers so that reduced the rate of investment and the number of foreign companies. The number of active American companies in South Africa fell from 267 in 1986 to 104 in 1991 [ 47 ]. Loss of markets, credits, and favorable trade conditions, devaluation of the national currency against the US dollar, the oil exports stoppage, alongside the reduction of basic goods imports were among the other effects [ 29 , 47 , 48 ]. On the other hand, prices increased while purchasing power decreased [ 4 , 5 , 48 , 52 ].

Food and agriculture

Numerous studies in Iran, Cuba, Iraq, and Haiti have shown that economic sanctions reduced food imports while increased their prices, and restricted proper diet 41) [ 3 , 5 , 24 , 29 , 47 ]. In Cuba, food imports decreased by almost 50% from 1989 to 1993 as a result of falling rate of imports while shifting to low-quality protein products which posed serious threats on population’s health. In Haiti, staple food prices increased fivefold from 1991 to 1993 [ 47 ]. Likewise, the prices of all food groups increased significantly in Iran in 2018 due to the limitations in international financial exchanges, right after the re-imposition of sanctions. The price increase was higher in vegetable, meat, and fruit groups which made it nearly impossible to follow a healthy diet [ 69 ].

Prices of basic commodities such as wheat, rice and sugar rose in Iraq, too [ 29 ]. On the other hand, the lack of foods containing B vitamins group in Cuba led to the epidemic of neuropathy [ 47 ]. Poor nutrition among pregnant women in Iraq increased anemia [ 24 ]. Meal and per capita protein intake decreased [ 3 , 5 ]. At the same time malnutrition also increased during restrictions [ 5 , 35 , 47 , 70 ] and furthermore caused reduction in crop production and agricultural support [ 5 , 71 ]. Other studies also revealed that availability and stability were the most affected dimensions of food security following imposing economic sanctions [ 72 ]. A study about the impact of the UN and US economic sanctions on the environment in Iran found that while these sanctions initially improved Iran’s environment in the short term, they had long-term damaging effects [ 73 ].

Economic sanctions exacerbate stressful conditions. According to studies, increased fear and uncertainty, and increased mental health problems are among the negative effects of sanctions in this category [ 5 , 31 , 48 , 53 , 74 ].

Early life conditions

A good start in life means supporting mothers and young children. A study found the exposure to adverse economic conditions in infancy and early childhood was effective in long-term negative health outcomes [ 75 ].

High-risk and addictive behaviors

People turning to high-risk behaviors and addiction along with their consumption patterns can be affected and intensified by economic and social conditions. According to the findings, the effects of economic sanctions in case of risky and addictive behavior were categorized into two sub-groups consist of increasing high-risk behaviors and addiction.

As evidences revealed, economic sanctions increased suicide and violence. Studies shown that the rate of deaths caused by violence and suicides have increased in Yugoslavia and Cuba during limitation periods [ 3 , 47 ]. In Haiti, charges against children, criminal conspiracy, robbery, and drug use were much more serious [ 5 ] and this happened along with another important result which was changing in drug use patterns and increased drug abuse problems.

The common use of syringes for drug injection has increased, posing a risk to abusers. Due to economic problems, people entered mass drug distribution networks and drug trafficking to make money; tried steal or other illegal ways to earn money for buying or supplying drugs. Rising drug prices have led to the neglect family economic basket and reduced attention to the factors such as education and health care, which have resulted in low quality of life for consumers and their families [ 41 ].

According to the studies, economic sanctions in different countries affected communities’ health in different ways. Economic sanctions are supposed to force a country’s government to reconsider its policies by putting and imposing economic pressure. Although they should not target humanitarian goods, studies in various countries have revealed their direct and indirect effects on community’s health and threats for people’s right to health. The most important effects were found in the access to medicine and change in socio-economic conditions, while ensuring access to medicines for people who needed them, is one of the most emphasized goals of health systems all around the world [ 76 ]. Clearly economic sanctions suppress economic growth of the targeted countries in different ways and the lower economic situation can influence all aspects of the whole community and people’ life including their health status directly and indirectly. The World Bank data confirm that sanctions reduced Iran’s economic growth by 38% within three years, as GDP per capita dropped from US$ 7833 in 2012 to US$ 4862 in 2015. Moreover, unemployment increased from 10.4% in 2013 to 13.1% in 2017, and the economic inequality in household expenditure, measured by Gini coefficient, increased from 37 to 41%, since 2012, due to economic sanction. Clearly this economic inequality can lead to health inequity in population [ 77 ]. When the economic situation worsens in general, the financial capacity of health system and also the financial power of people will be affected. Evidence from different studies proved that the general budget of health decreased and out-of-pocket payments increased especially for those patients who depend on foreign and imported drugs [ 54 , 63 ].

In the present study, surveys in different countries showed that economic sanctions through devaluing the national currency, affected access to health goods and services, including drugs and medical equipment. Countries depending on drug technology, requiring the imported raw materials, experienced a severe restriction for accessing to medicine and drugs. On the other hand, these limitations caused a sudden increase or inflation in the prices of medicine and equipment. This effect would be worse for people who suffer from chronic diseases and are unable to purchase or use health care services [ 16 ]. For example, sanctions in 2011 caused a 14 times increase in the price of formula in Iran for infants suffering from food allergies. Besides that, uncertainty about the availability of drugs following sanctions also changes the behavior of people as the stored formula for infants not needing a specific formula which was enough for 2 months was distributed only within 4 days in September, 2018 [ 78 ].

This is while the economic sanctions reducing the power of supporting health services by limiting budgets and funds. Health financing is essential for the ability of health systems to maintain and improve human health through keeping them capable to fund and provide health services. Without the necessary funding, no health workers will be hired, no medication will be available, and as the same way, no health promotion or prevention will take place [ 23 ]. As a result, considering the negative impact of sanctions, the financing system faces serious problems in three main functions of resource collection, pooling, and purchasing. The ability of countries to achieve health system’s goals largely depends on the knowledge, skills, motivation and deployment of individuals to organize and provide health services [ 23 ]. Numerous studies showed evidence of a direct relationship between health human resource and population outcomes [ 79 , 80 ].

Sanctions made it impossible to strengthen service delivery for achieving the Millennium Development Goals (MDGs) related to health by reducing the rate of occupied health workforce and forcing them to migrate. Studies assessed the impact of economic crises shown that these restrictions affected the health sector by increasing public vulnerability as same as the inability to meet public needs and expectations due to limited resources [ 81 , 82 , 83 ]. The findings from Iran show that sanctions can influence health care delivery adversely during health pandemics like COVID-19 disease in various direct and indirect ways [ 55 ]. Therefore, if sanctions continue, the reduction of inputs will hinder the improvement of service delivery and access to them. On the other hand, they disrupt access to health services even though with minimum quality standards.

About the research, sanctions limited and disqualified research activities by banning the access to most scientific and valid resources and disrupting international interactions and conferences. The small and isolated scientific communication has slowed down the health promotion progresses and limited the access to standards and protocols for promoting public health based on scientific evidence [ 31 , 45 ].

At the same time, economic sanctions affected on social determinants of health in various dimensions. Loss of markets, credits and favorable trading conditions reduces the value of the national currency and the ability to import goods. While, the cost of basic goods is strongly affected and prices increased [ 47 , 48 ]. Thus, sanctions forced severe negative effects on people’s health status by reduction of income, welfare, along with increasing unemployment and poverty [ 5 , 29 , 84 ]. This negative impact is more evident on the poor. These people cannot access or buy high or even sometimes low quality health care services.

Another effect of sanctions is reducing access to the food. Sanctions will restrict access to enough food for countries which import their agricultural products. Countries producing their own food products have better resilience. Limitation on access to basic material and food, as well as the economic pressures and declining incomes, affect the pattern of food consumption. Increasing the price of all kinds of food, turning to poor quality and unhealthy foods, as well as buying cheaper, low-nutrient ones, exacerbate malnutrition and make following a healthy diet impossible [ 69 , 70 , 85 ]. It should be noted that imposing sanctions are not always bad and sometimes they force countries to redesign their internal processes. The experience of Russian shows that although sanctions adversely influence agriculture to some extent but instead they played as the new momentum and help its dairy and milk sector to devise positive changes and increase the volume of inter-regional trade in milk and dairy products [ 86 ].

From a psychological point of view, the poor and fragile economic situation reduces the value of assets as same as the loss of purchasing power, which leads to increased frustration and stress in people. Frustration and despair cause and exacerbate various diseases [ 87 ]. Stressful situations also make people feel anxious, worried and unable to cope with. Psychosocial risks accumulate throughout life and increase the likelihood of poor mental health and premature death [ 23 ]. Findings from Iran proved that sanctions also affect mental health adversely. According to the WHO’ data, sanctions led to an increase in death due to self-harm and interpersonal violence in Iran (from 5.9 to 6.1 and from an average of 2.0 to 2.7 per 100,000 persons respectively) during the 2011–2014 period. Interestingly the self-harm related death reduced again in 2016, a year after lifting the sanctions [ 77 ].

Risky behaviors and addiction are taking as new behaviors patterns as a result of economic hardships and raised prices. Drug abuse has devastating effects on human health, while increase the rates of crime and mortality [ 88 ]. The highest incidence rate of HIV is among drug abusers and their sexual partners [ 89 ]. Thus, sanctions intensify these behaviors and patterns with a growing trend, which counts as a great threat to society and especially health system. A review of literature provides many evidence of sanctions effects on health while evidence was provided for most affected areas.

Many studies looked at the effects on access to medicines and medical equipment, research and health information systems, the socioeconomic situation, food and agriculture, and provided a clear picture of consequences. Although some others, focused on one specific area, the others discussed about the issues such as government or leadership, early life conditions, social isolation, social support, transportation which were less in number with no complete and clear evidence that needs further investigation. The most studies in our review examined the effects of sanctions using data and their analysis, or the pre- and post-sanctions situation. Therefore, according to our methodology and included studies, the extracted evidence is very valuable and reliable.

Understanding the impact of economic sanctions on health systems and social determinants of health is crucial for policymakers, highlighting the importance of collaborative global health governance. To address these challenges, a comprehensive approach is needed to minimize harm to vulnerable populations and promote a more equitable and resilient global health environment. Policymakers must reevaluate the effectiveness and unintended consequences of sanctions on health systems, prioritizing humanitarian concerns and ensuring that public health is not disproportionately affected. It is essential to explore alternative diplomatic strategies that allow for humanitarian exemptions within sanctions to guarantee the continued access to essential medical supplies for affected populations. Global health diplomacy should be leveraged to advocate for the removal or modification of sanctions hindering progress towards health-related Sustainable Development Goals (SDGs). Dialogue and negotiation should be prioritized to address underlying tensions while safeguarding the health and well-being of impacted communities. Establishing robust monitoring systems to track the impact of sanctions on health outcomes and social determinants is crucial. Strengthening multilateral collaborations and partnerships to address the health effects of sanctions is imperative, with international organizations like the World Health Organization (WHO) and United Nations (UN) playing a pivotal role in promoting global cooperation and finding solutions.

Strengths and limitations of the study

One of our limitations was the lack of access to the full text of some articles due to their publication time. Other studies may have been published in other languages about sanctions are excluded because of inclusion criteria. Other limitations may include losing articles about the impact of sanctions on various aspects of the health system that have lost their chance to be published due to political reasons.

Although the present study examined the impact of sanctions on the health system based on the Health System Building Blocks framework of the World Health Organization and using the approach of European SDH, it seems that in some areas the effects are not clear and further studies need to be done. However, given that the impact of sanctions varies from one country to another, the study has provided comprehensive evidence of the impacts along with consequences on health. The present evidence provides guide and helps with the adoption of international policies considering the goals of the WHO and the promotion of peace all around the world.

The results showed that economic sanctions imposed on different countries, directly and indirectly have strong negative impacts on health. Escalation of sanctions will be a severe threat and barrier for achieving the goal of global health coverage for everyone and everywhere. The international communities must work and focus on reducing the negative effects of these restrictions. They must anticipate the human effects and use whatever means are needed to prevent them. Some of these negative effects like disability and death, are irreversible. Therefore, it seems better for decision makers to recommend an international prescriptive to prevent such irreparable effects on the population of target countries before imposing sanctions.

Data availability

All data generated during the current study would be available from the corresponding author on reasonable request.

Abbreviations

Social Determinants of Health

Sustainable Development Goals

World Health Organization

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Acknowledgements

We are thankful to Kerman University of medical Sciences for preparing the required fund to do the study.

This study was supported financially by Institute for Futures Studies in Health, affiliated with Vice-Chancellery for Research and Technology of Kerman University of Medical Sciences.

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Vahid Yazdi-Feyzabadi & Anahita Behzadi

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Atefeh Zolfagharnasab

Soheila Naghavi

Research Center of Tropical and Infectious Diseases, Kerman University of medical sciences, Kerman, Iran

Maysam Yousefi

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VYF proposed the topic, VYF and MB designed the study; AZ did the search strategy and identified articles. MB and SN screened the articles and extracted and classified the data; AB and MY supervised and contributed in classifications of findings. VYF and AB supervised the whole process of study from literature review to data extraction. MB and AB prepared and finalized the manuscript. All authors read and approved the manuscript for submission.

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Yazdi-Feyzabadi, V., Zolfagharnasab, A., Naghavi, S. et al. Direct and indirect effects of economic sanctions on health: a systematic narrative literature review. BMC Public Health 24 , 2242 (2024). https://doi.org/10.1186/s12889-024-19750-w

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The purpose of this paper is to systematically review and analyze the academic literature on integrating equity, diversity, and inclusion (EDI) into knowledge mobilization (KMb).

Design/methodology/approach

This systematic literature review of the body of scholarly literature published on integrating EDI with KMb follows established methods and protocols proposed by Popay et al . (2006) and Page et al . (2021). Using a relevant keyword string, a search was conducted in ProQuest and SCOPUS to find peer-reviewed articles, which were then screened using predetermined inclusion and exclusion criteria. Finally, inductive and deductive analyses were conducted on the selected articles.

The findings suggest that most of the authors are based in the Global North, the majority of literature was published in the last two years, and that it is conceptual. This synthesis highlights five solution-oriented themes: acknowledging inherent bias, centering marginalized groups, promoting responsible knowledge mobilization, establishing partnerships, and advocating for transformational and systemic change. This study also identifies four broad barriers: inherent, unconscious, and implicit biases, a lack of evidence-based best practices, siloing of research and information, and a lack of institutional support and resources. Findings also highlight the value of further research into barriers, gaps and opportunities.

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By studying the intersection of EDI and KMb, this contemporary synthesis of the state of the field presents opportunities for future research into gaps, barriers and potential solutions.

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Cornelius-Hernandez, T. and Clarke, A. (2024), "The current state of integrating equity, diversity and inclusion into knowledge mobilization: a systematic literature review", Equality, Diversity and Inclusion , Vol. ahead-of-print No. ahead-of-print. https://doi.org/10.1108/EDI-04-2023-0134

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The power of a belief system: a systematic qualitative synthesis of spiritual care for patients with brain tumors.

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Mehta, N.H.; Prajapati, M.; Aeleti, R.; Kinariwala, K.; Ohri, K.; McCabe, S.; Buller, Z.; Leskinen, S.; Nawabi, N.L.; Bhatt, V.; et al. The Power of a Belief System: A Systematic Qualitative Synthesis of Spiritual Care for Patients with Brain Tumors. J. Clin. Med. 2024 , 13 , 4871. https://doi.org/10.3390/jcm13164871

Mehta NH, Prajapati M, Aeleti R, Kinariwala K, Ohri K, McCabe S, Buller Z, Leskinen S, Nawabi NL, Bhatt V, et al. The Power of a Belief System: A Systematic Qualitative Synthesis of Spiritual Care for Patients with Brain Tumors. Journal of Clinical Medicine . 2024; 13(16):4871. https://doi.org/10.3390/jcm13164871

Mehta, Neel H., Megh Prajapati, Rishi Aeleti, Kush Kinariwala, Karina Ohri, Sean McCabe, Zachary Buller, Sandra Leskinen, Noah L. Nawabi, Vatsal Bhatt, and et al. 2024. "The Power of a Belief System: A Systematic Qualitative Synthesis of Spiritual Care for Patients with Brain Tumors" Journal of Clinical Medicine 13, no. 16: 4871. https://doi.org/10.3390/jcm13164871

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Solution-Free Melt-Grown CsGeI 3 Polycrystals for Lead-Free Perovskite Photovoltaics: Synthesis, Characterization, and Theoretical Insights

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• Published: 19 August 2024

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• Mariot Jose Panjikaran 1 ,
• A. Pramitha 1 ,
• Vikash Mishra 1 ,
• Ganesh Shridhar Hegde 1 , 2 ,
• Ashwatha Narayana Prabhu 1 ,
• Nagabhushan Jnaneshwar Choudhari 1 ,
• Abdelmajid Timoumi 3 &
• Y. Raviprakash   ORCID: orcid.org/0000-0003-1766-5394 1  

Inorganic lead-free metal halide perovskites are being rigorously explored as a substitute for organic lead-based materials for various energy device applications. Germanium as a replacement for lead has been proven to give exemplary results theoretically, and there have been promising results. The current work presents the investigation of CsGeI 3 (CGI) polycrystals grown using a solution-free melt-growth technique with low-cost precursors. A soak-ramp profile was designed to synthesize polycrystalline powders, which were evaluated for stability. X-ray diffraction and Raman spectroscopy analysis suggest the formation of CsGeI 3 perovskite powders, matching the reported literature. Diffuse reflectance spectroscopy measurements showed the bandgap of the polycrystals to be around 1.6 eV. A prominent photoluminescence peak was obtained at 767 nm. The powders were examined using thermogravimetric analysis to assess the thermal degradation pathways. The as-grown inorganic perovskite polycrystals were relatively stable during storage under ambient conditions. Theoretical studies were also carried out to support the experimental data. Calculations were performed with different approximations, including local density approximation (LDA), generalized gradient approximation (GGA), and Heyd–Scuseria–Ernzerhof (HSE) approximation, out of which the HSE approximation yielded the most accurate results that matched the experimental findings. Moreover, for the CGI device with Ag electrodes simulated using SCAPS-1D software, highest incident photon-to-electron conversion efficiency was observed. The obtained optical and structural properties indicate the suitability of the synthesized CsGeI 3 perovskite polycrystals for photovoltaic applications, specifically solar cells and light-emitting diodes.

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Introduction

Metal halide perovskite (MHP) materials have occupied the frontlines of optoelectronic research for over a decade, since 2009. Although the initial pioneering research on perovskites was entirely for photovoltaic (PV) applications, there has recently been a shift to exploration of other applications such as thermoelectric, 1 , 2 solar capacitors, 1 supercapacitors, 3 , 4 photoelectrochemical water splitting, photocatalysis, 5 , 6 photodetectors, 7 , 8 , 9 , 10 x-ray detectors, 11 , 12 and many more. 13 , 14 , 15 Considering PV application, MHPs have realized groundbreaking progress in terms of efficiency, with an over sixfold leap from efficiency of 3.8% (CH 3 NH 3 PbI 3 perovskite) in 2009 16 to 25.6% in 2021 (CH(NH 2 ) 2 PbI 3 perovskite). 17 However, MHPs face a notable disadvantage in terms of stable performance under ambient environmental conditions. One of the major causes for the degradation of perovskite solar cells (PSCs) is the presence of hygroscopic organic cations such as methyl ammonium (CH 3 NH 3 /MA) and formamidinium (CH(NH 2 ) 2 /FA). Further, the presence of lead (Pb) in the composition makes them unsuitable for consideration as a green energy solution. 18 , 19 , 20 , 21 , 22

Over the years, various plausible solutions have been suggested to realize stable, environmentally friendly PSCs with good efficiency. 23 , 24 Research has been taken in multiple directions, with attempts to tailor the basic ABX 3 perovskite structure at the A, B, and X sites to achieve the desired properties. 25 , 26 , 27 In this regard, inorganic lead-free MHPs are being extensively pursued by researchers, as the materials possess stellar optoelectronic properties that can be tuned to achieve benchmark performance. The most popular alternatives for replacing Pb at the B site are germanium (Ge), 10 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 tin (Sn), 23 , 40 , 41 , 42 , 43 , 44 , 45 antimony (Sb), 46 , 47 , 48 , 49 bismuth (Bi), 50 , 51 , 52 indium (In), 53 , 54 , 55 titanium (Ti), 56 , 57 , 58 , 59 and tellurium (Te). 60 , 61 , 62 Among these, Ge-based perovskites have proven to provide better stability and promising optoelectronic properties. 10 , 28 , 29 , 35 , 37 , 63 , 64 However, one factor that limits further experimental exploration of germanium-based perovskites is the high cost of the necessary precursors, especially germanium iodide (GeI 2 ). Also, the currently reported methods for the synthesis of CsGeI 3 powders are solution-based, 29 which is difficult to process for bulk and facile production.

In this work, we present a novel route for the synthesis of CsGeI 3 (CGI) polycrystals using low-cost precursors from the available alternatives. Instead of using germanium iodide, we propose the use of pure germanium precursor separately along with pure iodine and cesium iodide precursors to obtain the necessary composition. This method of using germanium powders and iodine crystals separately is found to significantly reduce the precursor cost (with a rough estimate of the current market prices, 10 times lower cost) for the synthesis of germanium iodide-based perovskites. Also, the devised route is a solution-free technique, which is more facile, provides better crystallinity, and contributes to the enhanced stability of the synthesized polycrystals. Fortunately, compared to 3 days, there was very little degradation of the CGI polycrystals observed over 45 days. Further, the experimental results correlated closely with the simulation outcomes undertaken via density functional theory (DFT) studies. Additionally, theoretical studies were performed on the CGI device configuration using various electrode materials.

Experimental Procedure

Synthesis of csgei 3 (cgi) polycrystals.

Inorganic lead-free MHP crystals have been successfully synthesized using the melt-quenching technique. In the present work, CGI polycrystals were synthesized using the solid-state reaction technique. Ge metal pieces (Alfa Aesar, 99.999%) and CsI powder (Alfa Aesar, 99.999%) were ground together for 2 h using an agate mortar and pestle. The finely ground sample was transferred to a clean quartz ampoule and loaded into the crystal puller. Resublimed iodine (I 2 , Merck, 99.8%) crystals were added to the mixture just before loading into the crystal puller because of the volatile nature of iodine. Initially, the temperature was increased to 150°C and maintained for 10 h, then increased to 925°C and maintained for 24 h to ensure mixing, further maintained at 700°C for 24 h for homogeneity, and eventually cooled to room temperature. The process flowchart is presented in Fig. 1 . The melt-quenching technique described by Xiao et al. 61 for the preparation of Cs 2 TeI 6 crystals was modified according to the source materials and melting point of the compounds.

Process flowchart.

Characterization of Synthesized CsGeI 3 (CGI) Polycrystals

The structural analysis of the synthesized CGI polycrystals was carried out using x-ray diffraction (XRD) with Cu Kα [λ = 1.5405 Å] radiation at 40 kV and 15 mA in the 2 θ range of 20°–60° (Rigaku MiniFlex 600). Raman spectroscopy was performed at an excitation wavelength of 532 nm using a LabRAM HR (UV). The prepared polycrystals were ground into powder, and the photoluminescence (PL) emission was studied using a Jasco FP-8300 fluorescence spectrometer using a 450 W xenon lamp. Also, the reflectance spectra were obtained for the powdered samples using a Lambda 950 UV–visible–near-infrared (NIR) spectrophotometer equipped with an integrating sphere (PerkinElmer, Waltham, MA, USA). Thermogravimetric analysis (TGA) was performed using a PerkinElmer TGA 4000 to observe the behaviour of the powders under temperature exposure.

Theoretical Studies

Quantum Espresso (QE) code was used for all the density functional theory (DFT)-based calculations. 65 All calculations were performed with 3 × 3 × 2 supercells, for pure CGI structures, and a k-point grid of 7 × 7 × 3 was used for integrations over the Brillouin zone. We used various approximations including the local density approximation (LDA), generalized gradient approximation (GGA), and Heyd–Scuseria–Ernzerhof (HSE) for the calculations. 66 Seo et al. showed that when using HSE to calculate the bandgaps of metal compounds which contain valence electrons in different orbitals, the mixing parameters must be optimized from typical values to see the variation in orbital overlapping. 67 , 68 Thus, to obtain a more accurate bandgap for CsGeI 3 , the HSE calculation was used, with mixing parameters of 0.25 for all the calculations. Initially, we optimized the structures until the convergence of energy decreased to 5 × 10 −5  eV and the value of force per atom reached 0.04 eV. 69 SCAPS-1D software was used to determine quantum efficiency measurements. 70

Results and Discussion

Figure 2 a shows the XRD diffractogram of the as-synthesized CGI polycrystals. The XRD pattern of the CGI crystals synthesized using the melt-quenching technique showed an excellent match with existing CsGeI 3 reports (JCPDS #01-085-1274). 64 The XRD pattern of the powdered ingot was acquired immediately after breaking the quartz ampoule and after an interval of 3 days to evaluate the sample's stability. The XRD pattern shows peaks corresponding to Ge and CsI, which could indicate possible decomposition of CsGeI 3 into its constituents CsI and Ge within just hours of exposure to an open environment. The XRD patterns obtained on day 3 further suggest the degradation of the sample, as shown in Fig. 2 b. This agrees with the observations of Yue et al. 64 However, it is notable that even after 45 days of storage under ambient conditions, there is no further degradation observable for the CGI polycrystals. Also, such behaviour suggests the suitability of the synthesis route for employing solution-free solid-state methods to synthesize inorganic MHPs.

(a) X-ray diffractogram of the as-synthesized CGI polycrystals. (b) Comparison of XRD patterns of CGI polycrystals: 3rd day and 45th day.

The Raman spectra shown in Fig. 3 agree with the reported data. 29 The strongest Raman peaks of the CGI crystal at 165 cm −1 can be attributed to the A 1 (longitudinal mode). 71 A minor peak detected at 337 cm −1 aligns with the overtone of CsI, 72 thereby confirming the existence of CsI, as indicated by XRD analysis. The low phonon frequencies observed in CGI suggest that its transparency range could be extended into the far-IR region. 73

Raman spectra of CGI polycrystals.

Further, diffuse reflectance spectroscopy (DRS) was performed, and the bandgap was found to be 1.6 eV, very close to previously reported values. Also, there was no change observed in the bandgap measured after 45 days. Kubelka–Munk theory was applied to estimate the bandgap from the reflectance spectra, with n  = 1/2. The bandgap estimation from the plot is presented in Fig. 4 . The estimated bandgap suggests the suitability of the synthesized CGI polycrystals for use in optoelectronic applications after being made into pellet or thin-film format, as has been previously reported. 10

Diffuse reflectance spectrum of the as-synthesized CGI polycrystals.

To match the experimentally obtained energy bandgap of CsGeI 3 , theoretical studies were carried out. Accordingly, DFT calculations using QE code with different approximations were done to correlate with the DRS results. From Table I it is clear that out of all approximations, HSE calculation gives more accurate values of the electronic bandgap of CGI in comparison with the experimental outcome. The density of states is a crucial physical parameter for understanding the electronic properties of materials. Figure 5 shows the total density of states (TDOS) and partial density of states (PDOS) for CsGeI 3 simulated using the HSE approximation. It is clear that the highest energy level of the valence band in CsGeI 3 is primarily influenced by the halogen element iodine, while for the lowest occupied levels of the conduction band, Ge contributed the most.

Simulated total and partial density of states of CsGeI 3 .

The experimentally obtained CsGeI 3 polycrystals with the bandgap ranging between 1.5 and 1.6 eV (both theoretically and experimentally) have great potential for use in photovoltaics and photodetectors. In this direction, the device suitability of the CsGeI 3 polycrystals was checked theoretically with different type of electrodes. Systematic simulations were undertaken to investigate how different electrodes can have a notable impact on the performance of CsGeI 3 in photovoltaics and photodetection processes. Figure 6 depicts the simulation results of quantum efficiency studies. Figure 6 a–c shows the circuit diagrams of the CGI device with different electrodes (Ag, Au, Pt). The estimated current density and incident photon-to-electron conversion efficiency (IPCE%) of the proposed devices clearly indicate the significant influence of different electrode materials on CsGeI 3 performance. It can be seen from Fig. 6 d and e that the current density of CGI starts increasing with lower bias voltage in the case of the Au electrode, while the maximum IPCE% was observed for the Ag electrode. Moreover, the highest IPCE% was found to be independent of the electrodes and was seen at a wavelength of 760 nm.

(a–c) Schematic of the device structure of CsGeI 3 with (a) Ag, (b) Au, and (c) Pt electrodes. (d) Plot of current density vs bias voltage and (e) IPCE% vs wavelength with different electrodes.

The photoluminescence studies conducted with an excitation wavelength of 660 nm reveal an intense broad peak centred around 798 nm and a peak of low intensity around 824 nm, as seen in Fig. 7 . It can be observed that the emission at 798 nm corresponds to E g  = 1.55 eV, which is very close to the theoretical prediction (1.58 eV) as well as the experimentally observed (1.60 eV) bandgap. This high intense peak is attributed to electron transitions of the GeI 3 matrix and matches with reported data in the literature. 10 The peak around 824 nm is due to the perovskite matrix and observed for other inorganic MHPs as well. 74 Inter-band transitions in the perovskite matrix give rise to these emissions. 75

Photoluminescence (PL) spectrum of the as-synthesized CGI polycrystals.

The results of the thermogravimetric analysis of the as-prepared CGI powders are presented in Fig. 8 . Transition temperatures of 415°C, 450°C, 500°C, 720°C, and 800°C were found for the respective compounds. TGA was employed to investigate the decomposition of these perovskites under controlled, high-temperature conditions in air atmosphere from room temperature to 1000°C. The decomposition pathway under air atmosphere was accounted for by the apparent sharp weight loss observed. It was noted that the compound requires multiple steps for decomposition. The first stage is associated with the production of iodide molecules, escaping around 200–600°C. A subsequent steep weight loss in the second step is ascribable to the sublimation of GeI 2 . At around 600°C, weight loss of about 50% of the initial weight is observed. The compound has a melting point of 790°C, which can also be seen from the TGA curves, which indicate complete disintegration around the same temperature.

Thermogravimetric analysis (TGA) curve of the as-synthesized CGI polycrystals.

Conclusions

In summary, CsGeI 3 (CGI) polycrystals were synthesized using the solution-free melt-growth technique, and their stability up to 45 days was investigated. X-ray diffraction and Raman studies confirmed the CGI structure with the appearance of some impurity phases because of the decomposition. After 3 days, there was slight degradation of the polycrystals. However, up until the 45th day, they remained largely steady in comparison to the third day. Further, optical studies suggested that the bandgap of the synthesized powder was within the region of 1.6 eV. Also, a better correlation to the experimental results was achieved through DFT calculations with suitable approximation. The highest incident photon-to-electron conversion efficiency was observed for the CGI device with Ag electrodes. These CsGeI 3 powders can be further used for producing pellets or thin films. Moreover, the devised method can be applied to produce inorganic MHPs with enhanced stability. The experimental and theoretical outcomes suggest the suitability of the CGI for various optoelectronic applications. However, the observed decomposition of the polycrystals hinders its practical applicability. Strategies such as doping or halide cation composition optimization can be used to further increase the stability of these polycrystals by addressing structural defects, controlling ion migration, and optimizing the electronic properties of the material.

Data availability

Data will be made available on request.

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Acknowledgments

The authors wish to acknowledge the Manipal Academy of Higher Education, Manipal, for providing all the support to carry out this research work. One of the authors (GSH) would like to thank REVA University for supporting this collaborative work.

Open access funding provided by Manipal Academy of Higher Education, Manipal. The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Department of Physics, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India

Mariot Jose Panjikaran, A. Pramitha, Vikash Mishra, Ganesh Shridhar Hegde, Ashwatha Narayana Prabhu, Nagabhushan Jnaneshwar Choudhari & Y. Raviprakash

Department of Physics, School of Applied Sciences, Reva University, Bengaluru, India

Ganesh Shridhar Hegde

Department of Physics, Faculty of Applied Science, Umm AL-Qura University, 21955, Mecca, Saudi Arabia

Abdelmajid Timoumi

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Mariot Jose Panjikaran: Conceptualization, Investigation, Formal analysis, Writing—original draft. Pramitha A: Formal analysis, Validation, Writing—review & editing. Vikash Mishra: Software, Validation, Writing—review & editing. Nagabhushan Jnaneshwar Choudhari: Validation, Writing—critical review & editing. Dr Ganesh Shridhar Hegde: Validation, Resources, Writing—review & editing. Dr Ashwatha Narayana Prabhu: Validation, Resources, Writing—review & editing. Abdelmajid Timoumi: Validation, Writing—review & editing. Dr Raviprakash Y: Conceptualization, Visualization, Validation, Writing—review & editing, Resources and Supervision.

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Correspondence to Y. Raviprakash .

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Panjikaran, M.J., Pramitha, A., Mishra, V. et al. Solution-Free Melt-Grown CsGeI 3 Polycrystals for Lead-Free Perovskite Photovoltaics: Synthesis, Characterization, and Theoretical Insights. J. Electron. Mater. (2024). https://doi.org/10.1007/s11664-024-11377-2

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Received : 24 April 2024

Accepted : 07 August 2024

Published : 19 August 2024

DOI : https://doi.org/10.1007/s11664-024-11377-2

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