limitations of social research

Organizing Your Social Sciences Research Paper

• Quantitative Methods
• Purpose of Guide
• Design Flaws to Avoid
• Independent and Dependent Variables
• Glossary of Research Terms
• Reading Research Effectively
• Narrowing a Topic Idea
• Broadening a Topic Idea
• Extending the Timeliness of a Topic Idea
• Academic Writing Style
• Choosing a Title
• Making an Outline
• Paragraph Development
• Research Process Video Series
• Executive Summary
• The C.A.R.S. Model
• Background Information
• The Research Problem/Question
• Theoretical Framework
• Citation Tracking
• Content Alert Services
• Evaluating Sources
• Primary Sources
• Secondary Sources
• Tiertiary Sources
• Scholarly vs. Popular Publications
• Qualitative Methods
• Insiderness
• Using Non-Textual Elements
• Limitations of the Study
• Common Grammar Mistakes
• Writing Concisely
• Avoiding Plagiarism
• Footnotes or Endnotes?
• Further Readings
• Generative AI and Writing
• USC Libraries Tutorials and Other Guides
• Bibliography

Quantitative methods emphasize objective measurements and the statistical, mathematical, or numerical analysis of data collected through polls, questionnaires, and surveys, or by manipulating pre-existing statistical data using computational techniques . Quantitative research focuses on gathering numerical data and generalizing it across groups of people or to explain a particular phenomenon.

Babbie, Earl R. The Practice of Social Research . 12th ed. Belmont, CA: Wadsworth Cengage, 2010; Muijs, Daniel. Doing Quantitative Research in Education with SPSS . 2nd edition. London: SAGE Publications, 2010.

Need Help Locating Statistics?

Resources for locating data and statistics can be found here:

Statistics & Data Research Guide

Characteristics of Quantitative Research

Your goal in conducting quantitative research study is to determine the relationship between one thing [an independent variable] and another [a dependent or outcome variable] within a population. Quantitative research designs are either descriptive [subjects usually measured once] or experimental [subjects measured before and after a treatment]. A descriptive study establishes only associations between variables; an experimental study establishes causality.

Quantitative research deals in numbers, logic, and an objective stance. Quantitative research focuses on numeric and unchanging data and detailed, convergent reasoning rather than divergent reasoning [i.e., the generation of a variety of ideas about a research problem in a spontaneous, free-flowing manner].

Its main characteristics are :

• The data is usually gathered using structured research instruments.
• The results are based on larger sample sizes that are representative of the population.
• The research study can usually be replicated or repeated, given its high reliability.
• Researcher has a clearly defined research question to which objective answers are sought.
• All aspects of the study are carefully designed before data is collected.
• Data are in the form of numbers and statistics, often arranged in tables, charts, figures, or other non-textual forms.
• Project can be used to generalize concepts more widely, predict future results, or investigate causal relationships.
• Researcher uses tools, such as questionnaires or computer software, to collect numerical data.

The overarching aim of a quantitative research study is to classify features, count them, and construct statistical models in an attempt to explain what is observed.

  Things to keep in mind when reporting the results of a study using quantitative methods :

• Explain the data collected and their statistical treatment as well as all relevant results in relation to the research problem you are investigating. Interpretation of results is not appropriate in this section.
• Report unanticipated events that occurred during your data collection. Explain how the actual analysis differs from the planned analysis. Explain your handling of missing data and why any missing data does not undermine the validity of your analysis.
• Explain the techniques you used to "clean" your data set.
• Choose a minimally sufficient statistical procedure ; provide a rationale for its use and a reference for it. Specify any computer programs used.
• Describe the assumptions for each procedure and the steps you took to ensure that they were not violated.
• When using inferential statistics , provide the descriptive statistics, confidence intervals, and sample sizes for each variable as well as the value of the test statistic, its direction, the degrees of freedom, and the significance level [report the actual p value].
• Avoid inferring causality , particularly in nonrandomized designs or without further experimentation.
• Use tables to provide exact values ; use figures to convey global effects. Keep figures small in size; include graphic representations of confidence intervals whenever possible.
• Always tell the reader what to look for in tables and figures .

NOTE:   When using pre-existing statistical data gathered and made available by anyone other than yourself [e.g., government agency], you still must report on the methods that were used to gather the data and describe any missing data that exists and, if there is any, provide a clear explanation why the missing data does not undermine the validity of your final analysis.

Babbie, Earl R. The Practice of Social Research . 12th ed. Belmont, CA: Wadsworth Cengage, 2010; Brians, Craig Leonard et al. Empirical Political Analysis: Quantitative and Qualitative Research Methods . 8th ed. Boston, MA: Longman, 2011; McNabb, David E. Research Methods in Public Administration and Nonprofit Management: Quantitative and Qualitative Approaches . 2nd ed. Armonk, NY: M.E. Sharpe, 2008; Quantitative Research Methods. Writing@CSU. Colorado State University; Singh, Kultar. Quantitative Social Research Methods . Los Angeles, CA: Sage, 2007.

Basic Research Design for Quantitative Studies

Before designing a quantitative research study, you must decide whether it will be descriptive or experimental because this will dictate how you gather, analyze, and interpret the results. A descriptive study is governed by the following rules: subjects are generally measured once; the intention is to only establish associations between variables; and, the study may include a sample population of hundreds or thousands of subjects to ensure that a valid estimate of a generalized relationship between variables has been obtained. An experimental design includes subjects measured before and after a particular treatment, the sample population may be very small and purposefully chosen, and it is intended to establish causality between variables. Introduction The introduction to a quantitative study is usually written in the present tense and from the third person point of view. It covers the following information:

• Identifies the research problem -- as with any academic study, you must state clearly and concisely the research problem being investigated.
• Reviews the literature -- review scholarship on the topic, synthesizing key themes and, if necessary, noting studies that have used similar methods of inquiry and analysis. Note where key gaps exist and how your study helps to fill these gaps or clarifies existing knowledge.
• Describes the theoretical framework -- provide an outline of the theory or hypothesis underpinning your study. If necessary, define unfamiliar or complex terms, concepts, or ideas and provide the appropriate background information to place the research problem in proper context [e.g., historical, cultural, economic, etc.].

Methodology The methods section of a quantitative study should describe how each objective of your study will be achieved. Be sure to provide enough detail to enable the reader can make an informed assessment of the methods being used to obtain results associated with the research problem. The methods section should be presented in the past tense.

• Study population and sampling -- where did the data come from; how robust is it; note where gaps exist or what was excluded. Note the procedures used for their selection;
• Data collection – describe the tools and methods used to collect information and identify the variables being measured; describe the methods used to obtain the data; and, note if the data was pre-existing [i.e., government data] or you gathered it yourself. If you gathered it yourself, describe what type of instrument you used and why. Note that no data set is perfect--describe any limitations in methods of gathering data.
• Data analysis -- describe the procedures for processing and analyzing the data. If appropriate, describe the specific instruments of analysis used to study each research objective, including mathematical techniques and the type of computer software used to manipulate the data.

Results The finding of your study should be written objectively and in a succinct and precise format. In quantitative studies, it is common to use graphs, tables, charts, and other non-textual elements to help the reader understand the data. Make sure that non-textual elements do not stand in isolation from the text but are being used to supplement the overall description of the results and to help clarify key points being made. Further information about how to effectively present data using charts and graphs can be found here .

• Statistical analysis -- how did you analyze the data? What were the key findings from the data? The findings should be present in a logical, sequential order. Describe but do not interpret these trends or negative results; save that for the discussion section. The results should be presented in the past tense.

Discussion Discussions should be analytic, logical, and comprehensive. The discussion should meld together your findings in relation to those identified in the literature review, and placed within the context of the theoretical framework underpinning the study. The discussion should be presented in the present tense.

• Interpretation of results -- reiterate the research problem being investigated and compare and contrast the findings with the research questions underlying the study. Did they affirm predicted outcomes or did the data refute it?
• Description of trends, comparison of groups, or relationships among variables -- describe any trends that emerged from your analysis and explain all unanticipated and statistical insignificant findings.
• Discussion of implications – what is the meaning of your results? Highlight key findings based on the overall results and note findings that you believe are important. How have the results helped fill gaps in understanding the research problem?
• Limitations -- describe any limitations or unavoidable bias in your study and, if necessary, note why these limitations did not inhibit effective interpretation of the results.

Conclusion End your study by to summarizing the topic and provide a final comment and assessment of the study.

• Summary of findings – synthesize the answers to your research questions. Do not report any statistical data here; just provide a narrative summary of the key findings and describe what was learned that you did not know before conducting the study.
• Recommendations – if appropriate to the aim of the assignment, tie key findings with policy recommendations or actions to be taken in practice.
• Future research – note the need for future research linked to your study’s limitations or to any remaining gaps in the literature that were not addressed in your study.

Black, Thomas R. Doing Quantitative Research in the Social Sciences: An Integrated Approach to Research Design, Measurement and Statistics . London: Sage, 1999; Gay,L. R. and Peter Airasain. Educational Research: Competencies for Analysis and Applications . 7th edition. Upper Saddle River, NJ: Merril Prentice Hall, 2003; Hector, Anestine. An Overview of Quantitative Research in Composition and TESOL . Department of English, Indiana University of Pennsylvania; Hopkins, Will G. “Quantitative Research Design.” Sportscience 4, 1 (2000); "A Strategy for Writing Up Research Results. The Structure, Format, Content, and Style of a Journal-Style Scientific Paper." Department of Biology. Bates College; Nenty, H. Johnson. "Writing a Quantitative Research Thesis." International Journal of Educational Science 1 (2009): 19-32; Ouyang, Ronghua (John). Basic Inquiry of Quantitative Research . Kennesaw State University.

Strengths of Using Quantitative Methods

Quantitative researchers try to recognize and isolate specific variables contained within the study framework, seek correlation, relationships and causality, and attempt to control the environment in which the data is collected to avoid the risk of variables, other than the one being studied, accounting for the relationships identified.

Among the specific strengths of using quantitative methods to study social science research problems:

• Allows for a broader study, involving a greater number of subjects, and enhancing the generalization of the results;
• Allows for greater objectivity and accuracy of results. Generally, quantitative methods are designed to provide summaries of data that support generalizations about the phenomenon under study. In order to accomplish this, quantitative research usually involves few variables and many cases, and employs prescribed procedures to ensure validity and reliability;
• Applying well established standards means that the research can be replicated, and then analyzed and compared with similar studies;
• You can summarize vast sources of information and make comparisons across categories and over time; and,
• Personal bias can be avoided by keeping a 'distance' from participating subjects and using accepted computational techniques .

Babbie, Earl R. The Practice of Social Research . 12th ed. Belmont, CA: Wadsworth Cengage, 2010; Brians, Craig Leonard et al. Empirical Political Analysis: Quantitative and Qualitative Research Methods . 8th ed. Boston, MA: Longman, 2011; McNabb, David E. Research Methods in Public Administration and Nonprofit Management: Quantitative and Qualitative Approaches . 2nd ed. Armonk, NY: M.E. Sharpe, 2008; Singh, Kultar. Quantitative Social Research Methods . Los Angeles, CA: Sage, 2007.

Limitations of Using Quantitative Methods

Quantitative methods presume to have an objective approach to studying research problems, where data is controlled and measured, to address the accumulation of facts, and to determine the causes of behavior. As a consequence, the results of quantitative research may be statistically significant but are often humanly insignificant.

Some specific limitations associated with using quantitative methods to study research problems in the social sciences include:

• Quantitative data is more efficient and able to test hypotheses, but may miss contextual detail;
• Uses a static and rigid approach and so employs an inflexible process of discovery;
• The development of standard questions by researchers can lead to "structural bias" and false representation, where the data actually reflects the view of the researcher instead of the participating subject;
• Results provide less detail on behavior, attitudes, and motivation;
• Researcher may collect a much narrower and sometimes superficial dataset;
• Results are limited as they provide numerical descriptions rather than detailed narrative and generally provide less elaborate accounts of human perception;
• The research is often carried out in an unnatural, artificial environment so that a level of control can be applied to the exercise. This level of control might not normally be in place in the real world thus yielding "laboratory results" as opposed to "real world results"; and,
• Preset answers will not necessarily reflect how people really feel about a subject and, in some cases, might just be the closest match to the preconceived hypothesis.

Research Tip

Finding Examples of How to Apply Different Types of Research Methods

SAGE publications is a major publisher of studies about how to design and conduct research in the social and behavioral sciences. Their SAGE Research Methods Online and Cases database includes contents from books, articles, encyclopedias, handbooks, and videos covering social science research design and methods including the complete Little Green Book Series of Quantitative Applications in the Social Sciences and the Little Blue Book Series of Qualitative Research techniques. The database also includes case studies outlining the research methods used in real research projects. This is an excellent source for finding definitions of key terms and descriptions of research design and practice, techniques of data gathering, analysis, and reporting, and information about theories of research [e.g., grounded theory]. The database covers both qualitative and quantitative research methods as well as mixed methods approaches to conducting research.

SAGE Research Methods Online and Cases

• << Previous: Qualitative Methods
• Next: Insiderness >>
• Last Updated: Apr 5, 2024 1:38 PM
• URL: https://libguides.usc.edu/writingguide

21 Research Limitations Examples

Research limitations refer to the potential weaknesses inherent in a study. All studies have limitations of some sort, meaning declaring limitations doesn’t necessarily need to be a bad thing, so long as your declaration of limitations is well thought-out and explained.

Rarely is a study perfect. Researchers have to make trade-offs when developing their studies, which are often based upon practical considerations such as time and monetary constraints, weighing the breadth of participants against the depth of insight, and choosing one methodology or another.

In research, studies can have limitations such as limited scope, researcher subjectivity, and lack of available research tools.

Acknowledging the limitations of your study should be seen as a strength. It demonstrates your willingness for transparency, humility, and submission to the scientific method and can bolster the integrity of the study. It can also inform future research direction.

Typically, scholars will explore the limitations of their study in either their methodology section, their conclusion section, or both.

Research Limitations Examples

Qualitative and quantitative research offer different perspectives and methods in exploring phenomena, each with its own strengths and limitations. So, I’ve split the limitations examples sections into qualitative and quantitative below.

Qualitative Research Limitations

Qualitative research seeks to understand phenomena in-depth and in context. It focuses on the ‘why’ and ‘how’ questions.

It’s often used to explore new or complex issues, and it provides rich, detailed insights into participants’ experiences, behaviors, and attitudes. However, these strengths also create certain limitations, as explained below.

1. Subjectivity

Qualitative research often requires the researcher to interpret subjective data. One researcher may examine a text and identify different themes or concepts as more dominant than others.

Close qualitative readings of texts are necessarily subjective – and while this may be a limitation, qualitative researchers argue this is the best way to deeply understand everything in context.

Suggested Solution and Response: To minimize subjectivity bias, you could consider cross-checking your own readings of themes and data against other scholars’ readings and interpretations. This may involve giving the raw data to a supervisor or colleague and asking them to code the data separately, then coming together to compare and contrast results.

2. Researcher Bias

The concept of researcher bias is related to, but slightly different from, subjectivity.

Researcher bias refers to the perspectives and opinions you bring with you when doing your research.

For example, a researcher who is explicitly of a certain philosophical or political persuasion may bring that persuasion to bear when interpreting data.

In many scholarly traditions, we will attempt to minimize researcher bias through the utilization of clear procedures that are set out in advance or through the use of statistical analysis tools.

However, in other traditions, such as in postmodern feminist research , declaration of bias is expected, and acknowledgment of bias is seen as a positive because, in those traditions, it is believed that bias cannot be eliminated from research, so instead, it is a matter of integrity to present it upfront.

Suggested Solution and Response: Acknowledge the potential for researcher bias and, depending on your theoretical framework , accept this, or identify procedures you have taken to seek a closer approximation to objectivity in your coding and analysis.

3. Generalizability

If you’re struggling to find a limitation to discuss in your own qualitative research study, then this one is for you: all qualitative research, of all persuasions and perspectives, cannot be generalized.

This is a core feature that sets qualitative data and quantitative data apart.

The point of qualitative data is to select case studies and similarly small corpora and dig deep through in-depth analysis and thick description of data.

Often, this will also mean that you have a non-randomized sample size.

While this is a positive – you’re going to get some really deep, contextualized, interesting insights – it also means that the findings may not be generalizable to a larger population that may not be representative of the small group of people in your study.

Suggested Solution and Response: Suggest future studies that take a quantitative approach to the question.

4. The Hawthorne Effect

The Hawthorne effect refers to the phenomenon where research participants change their ‘observed behavior’ when they’re aware that they are being observed.

This effect was first identified by Elton Mayo who conducted studies of the effects of various factors ton workers’ productivity. He noticed that no matter what he did – turning up the lights, turning down the lights, etc. – there was an increase in worker outputs compared to prior to the study taking place.

Mayo realized that the mere act of observing the workers made them work harder – his observation was what was changing behavior.

So, if you’re looking for a potential limitation to name for your observational research study , highlight the possible impact of the Hawthorne effect (and how you could reduce your footprint or visibility in order to decrease its likelihood).

Suggested Solution and Response: Highlight ways you have attempted to reduce your footprint while in the field, and guarantee anonymity to your research participants.

5. Replicability

Quantitative research has a great benefit in that the studies are replicable – a researcher can get a similar sample size, duplicate the variables, and re-test a study. But you can’t do that in qualitative research.

Qualitative research relies heavily on context – a specific case study or specific variables that make a certain instance worthy of analysis. As a result, it’s often difficult to re-enter the same setting with the same variables and repeat the study.

Furthermore, the individual researcher’s interpretation is more influential in qualitative research, meaning even if a new researcher enters an environment and makes observations, their observations may be different because subjectivity comes into play much more. This doesn’t make the research bad necessarily (great insights can be made in qualitative research), but it certainly does demonstrate a weakness of qualitative research.

6. Limited Scope

“Limited scope” is perhaps one of the most common limitations listed by researchers – and while this is often a catch-all way of saying, “well, I’m not studying that in this study”, it’s also a valid point.

No study can explore everything related to a topic. At some point, we have to make decisions about what’s included in the study and what is excluded from the study.

So, you could say that a limitation of your study is that it doesn’t look at an extra variable or concept that’s certainly worthy of study but will have to be explored in your next project because this project has a clearly and narrowly defined goal.

Suggested Solution and Response: Be clear about what’s in and out of the study when writing your research question.

7. Time Constraints

This is also a catch-all claim you can make about your research project: that you would have included more people in the study, looked at more variables, and so on. But you’ve got to submit this thing by the end of next semester! You’ve got time constraints.

And time constraints are a recognized reality in all research.

But this means you’ll need to explain how time has limited your decisions. As with “limited scope”, this may mean that you had to study a smaller group of subjects, limit the amount of time you spent in the field, and so forth.

Suggested Solution and Response: Suggest future studies that will build on your current work, possibly as a PhD project.

8. Resource Intensiveness

Qualitative research can be expensive due to the cost of transcription, the involvement of trained researchers, and potential travel for interviews or observations.

So, resource intensiveness is similar to the time constraints concept. If you don’t have the funds, you have to make decisions about which tools to use, which statistical software to employ, and how many research assistants you can dedicate to the study.

Suggested Solution and Response: Suggest future studies that will gain more funding on the back of this ‘ exploratory study ‘.

9. Coding Difficulties

Data analysis in qualitative research often involves coding, which can be subjective and complex, especially when dealing with ambiguous or contradicting data.

After naming this as a limitation in your research, it’s important to explain how you’ve attempted to address this. Some ways to ‘limit the limitation’ include:

• Triangulation: Have 2 other researchers code the data as well and cross-check your results with theirs to identify outliers that may need to be re-examined, debated with the other researchers, or removed altogether.
• Procedure: Use a clear coding procedure to demonstrate reliability in your coding process. I personally use the thematic network analysis method outlined in this academic article by Attride-Stirling (2001).

Suggested Solution and Response: Triangulate your coding findings with colleagues, and follow a thematic network analysis procedure.

10. Risk of Non-Responsiveness

There is always a risk in research that research participants will be unwilling or uncomfortable sharing their genuine thoughts and feelings in the study.

This is particularly true when you’re conducting research on sensitive topics, politicized topics, or topics where the participant is expressing vulnerability .

This is similar to the Hawthorne effect (aka participant bias), where participants change their behaviors in your presence; but it goes a step further, where participants actively hide their true thoughts and feelings from you.

Suggested Solution and Response: One way to manage this is to try to include a wider group of people with the expectation that there will be non-responsiveness from some participants.

11. Risk of Attrition

Attrition refers to the process of losing research participants throughout the study.

This occurs most commonly in longitudinal studies , where a researcher must return to conduct their analysis over spaced periods of time, often over a period of years.

Things happen to people over time – they move overseas, their life experiences change, they get sick, change their minds, and even die. The more time that passes, the greater the risk of attrition.

Suggested Solution and Response: One way to manage this is to try to include a wider group of people with the expectation that there will be attrition over time.

12. Difficulty in Maintaining Confidentiality and Anonymity

Given the detailed nature of qualitative data , ensuring participant anonymity can be challenging.

If you have a sensitive topic in a specific case study, even anonymizing research participants sometimes isn’t enough. People might be able to induce who you’re talking about.

Sometimes, this will mean you have to exclude some interesting data that you collected from your final report. Confidentiality and anonymity come before your findings in research ethics – and this is a necessary limiting factor.

Suggested Solution and Response: Highlight the efforts you have taken to anonymize data, and accept that confidentiality and accountability place extremely important constraints on academic research.

13. Difficulty in Finding Research Participants

A study that looks at a very specific phenomenon or even a specific set of cases within a phenomenon means that the pool of potential research participants can be very low.

Compile on top of this the fact that many people you approach may choose not to participate, and you could end up with a very small corpus of subjects to explore. This may limit your ability to make complete findings, even in a quantitative sense.

You may need to therefore limit your research question and objectives to something more realistic.

Suggested Solution and Response: Highlight that this is going to limit the study’s generalizability significantly.

14. Ethical Limitations

Ethical limitations refer to the things you cannot do based on ethical concerns identified either by yourself or your institution’s ethics review board.

This might include threats to the physical or psychological well-being of your research subjects, the potential of releasing data that could harm a person’s reputation, and so on.

Furthermore, even if your study follows all expected standards of ethics, you still, as an ethical researcher, need to allow a research participant to pull out at any point in time, after which you cannot use their data, which demonstrates an overlap between ethical constraints and participant attrition.

Suggested Solution and Response: Highlight that these ethical limitations are inevitable but important to sustain the integrity of the research.

For more on Qualitative Research, Explore my Qualitative Research Guide

Quantitative Research Limitations

Quantitative research focuses on quantifiable data and statistical, mathematical, or computational techniques. It’s often used to test hypotheses, assess relationships and causality, and generalize findings across larger populations.

Quantitative research is widely respected for its ability to provide reliable, measurable, and generalizable data (if done well!). Its structured methodology has strengths over qualitative research, such as the fact it allows for replication of the study, which underpins the validity of the research.

However, this approach is not without it limitations, explained below.

1. Over-Simplification

Quantitative research is powerful because it allows you to measure and analyze data in a systematic and standardized way. However, one of its limitations is that it can sometimes simplify complex phenomena or situations.

In other words, it might miss the subtleties or nuances of the research subject.

For example, if you’re studying why people choose a particular diet, a quantitative study might identify factors like age, income, or health status. But it might miss other aspects, such as cultural influences or personal beliefs, that can also significantly impact dietary choices.

When writing about this limitation, you can say that your quantitative approach, while providing precise measurements and comparisons, may not capture the full complexity of your subjects of study.

Suggested Solution and Response: Suggest a follow-up case study using the same research participants in order to gain additional context and depth.

2. Lack of Context

Another potential issue with quantitative research is that it often focuses on numbers and statistics at the expense of context or qualitative information.

Let’s say you’re studying the effect of classroom size on student performance. You might find that students in smaller classes generally perform better. However, this doesn’t take into account other variables, like teaching style , student motivation, or family support.

When describing this limitation, you might say, “Although our research provides important insights into the relationship between class size and student performance, it does not incorporate the impact of other potentially influential variables. Future research could benefit from a mixed-methods approach that combines quantitative analysis with qualitative insights.”

3. Applicability to Real-World Settings

Oftentimes, experimental research takes place in controlled environments to limit the influence of outside factors.

This control is great for isolation and understanding the specific phenomenon but can limit the applicability or “external validity” of the research to real-world settings.

For example, if you conduct a lab experiment to see how sleep deprivation impacts cognitive performance, the sterile, controlled lab environment might not reflect real-world conditions where people are dealing with multiple stressors.

Therefore, when explaining the limitations of your quantitative study in your methodology section, you could state:

“While our findings provide valuable information about [topic], the controlled conditions of the experiment may not accurately represent real-world scenarios where extraneous variables will exist. As such, the direct applicability of our results to broader contexts may be limited.”

Suggested Solution and Response: Suggest future studies that will engage in real-world observational research, such as ethnographic research.

4. Limited Flexibility

Once a quantitative study is underway, it can be challenging to make changes to it. This is because, unlike in grounded research, you’re putting in place your study in advance, and you can’t make changes part-way through.

Your study design, data collection methods, and analysis techniques need to be decided upon before you start collecting data.

For example, if you are conducting a survey on the impact of social media on teenage mental health, and halfway through, you realize that you should have included a question about their screen time, it’s generally too late to add it.

When discussing this limitation, you could write something like, “The structured nature of our quantitative approach allows for consistent data collection and analysis but also limits our flexibility to adapt and modify the research process in response to emerging insights and ideas.”

Suggested Solution and Response: Suggest future studies that will use mixed-methods or qualitative research methods to gain additional depth of insight.

5. Risk of Survey Error

Surveys are a common tool in quantitative research, but they carry risks of error.

There can be measurement errors (if a question is misunderstood), coverage errors (if some groups aren’t adequately represented), non-response errors (if certain people don’t respond), and sampling errors (if your sample isn’t representative of the population).

For instance, if you’re surveying college students about their study habits , but only daytime students respond because you conduct the survey during the day, your results will be skewed.

In discussing this limitation, you might say, “Despite our best efforts to develop a comprehensive survey, there remains a risk of survey error, including measurement, coverage, non-response, and sampling errors. These could potentially impact the reliability and generalizability of our findings.”

Suggested Solution and Response: Suggest future studies that will use other survey tools to compare and contrast results.

6. Limited Ability to Probe Answers

With quantitative research, you typically can’t ask follow-up questions or delve deeper into participants’ responses like you could in a qualitative interview.

For instance, imagine you are surveying 500 students about study habits in a questionnaire. A respondent might indicate that they study for two hours each night. You might want to follow up by asking them to elaborate on what those study sessions involve or how effective they feel their habits are.

However, quantitative research generally disallows this in the way a qualitative semi-structured interview could.

When discussing this limitation, you might write, “Given the structured nature of our survey, our ability to probe deeper into individual responses is limited. This means we may not fully understand the context or reasoning behind the responses, potentially limiting the depth of our findings.”

Suggested Solution and Response: Suggest future studies that engage in mixed-method or qualitative methodologies to address the issue from another angle.

7. Reliance on Instruments for Data Collection

In quantitative research, the collection of data heavily relies on instruments like questionnaires, surveys, or machines.

The limitation here is that the data you get is only as good as the instrument you’re using. If the instrument isn’t designed or calibrated well, your data can be flawed.

For instance, if you’re using a questionnaire to study customer satisfaction and the questions are vague, confusing, or biased, the responses may not accurately reflect the customers’ true feelings.

When discussing this limitation, you could say, “Our study depends on the use of questionnaires for data collection. Although we have put significant effort into designing and testing the instrument, it’s possible that inaccuracies or misunderstandings could potentially affect the validity of the data collected.”

Suggested Solution and Response: Suggest future studies that will use different instruments but examine the same variables to triangulate results.

8. Time and Resource Constraints (Specific to Quantitative Research)

Quantitative research can be time-consuming and resource-intensive, especially when dealing with large samples.

It often involves systematic sampling, rigorous design, and sometimes complex statistical analysis.

If resources and time are limited, it can restrict the scale of your research, the techniques you can employ, or the extent of your data analysis.

For example, you may want to conduct a nationwide survey on public opinion about a certain policy. However, due to limited resources, you might only be able to survey people in one city.

When writing about this limitation, you could say, “Given the scope of our research and the resources available, we are limited to conducting our survey within one city, which may not fully represent the nationwide public opinion. Hence, the generalizability of the results may be limited.”

Suggested Solution and Response: Suggest future studies that will have more funding or longer timeframes.

How to Discuss Your Research Limitations

1. in your research proposal and methodology section.

In the research proposal, which will become the methodology section of your dissertation, I would recommend taking the four following steps, in order:

• Be Explicit about your Scope – If you limit the scope of your study in your research question, aims, and objectives, then you can set yourself up well later in the methodology to say that certain questions are “outside the scope of the study.” For example, you may identify the fact that the study doesn’t address a certain variable, but you can follow up by stating that the research question is specifically focused on the variable that you are examining, so this limitation would need to be looked at in future studies.
• Acknowledge the Limitation – Acknowledging the limitations of your study demonstrates reflexivity and humility and can make your research more reliable and valid. It also pre-empts questions the people grading your paper may have, so instead of them down-grading you for your limitations; they will congratulate you on explaining the limitations and how you have addressed them!
• Explain your Decisions – You may have chosen your approach (despite its limitations) for a very specific reason. This might be because your approach remains, on balance, the best one to answer your research question. Or, it might be because of time and monetary constraints that are outside of your control.
• Highlight the Strengths of your Approach – Conclude your limitations section by strongly demonstrating that, despite limitations, you’ve worked hard to minimize the effects of the limitations and that you have chosen your specific approach and methodology because it’s also got some terrific strengths. Name the strengths.

Overall, you’ll want to acknowledge your own limitations but also explain that the limitations don’t detract from the value of your study as it stands.

2. In the Conclusion Section or Chapter

In the conclusion of your study, it is generally expected that you return to a discussion of the study’s limitations. Here, I recommend the following steps:

• Acknowledge issues faced – After completing your study, you will be increasingly aware of issues you may have faced that, if you re-did the study, you may have addressed earlier in order to avoid those issues. Acknowledge these issues as limitations, and frame them as recommendations for subsequent studies.
• Suggest further research – Scholarly research aims to fill gaps in the current literature and knowledge. Having established your expertise through your study, suggest lines of inquiry for future researchers. You could state that your study had certain limitations, and “future studies” can address those limitations.
• Suggest a mixed methods approach – Qualitative and quantitative research each have pros and cons. So, note those ‘cons’ of your approach, then say the next study should approach the topic using the opposite methodology or could approach it using a mixed-methods approach that could achieve the benefits of quantitative studies with the nuanced insights of associated qualitative insights as part of an in-study case-study.

Overall, be clear about both your limitations and how those limitations can inform future studies.

In sum, each type of research method has its own strengths and limitations. Qualitative research excels in exploring depth, context, and complexity, while quantitative research excels in examining breadth, generalizability, and quantifiable measures. Despite their individual limitations, each method contributes unique and valuable insights, and researchers often use them together to provide a more comprehensive understanding of the phenomenon being studied.

Attride-Stirling, J. (2001). Thematic networks: an analytic tool for qualitative research. Qualitative research , 1 (3), 385-405. ( Source )

Atkinson, P., Delamont, S., Cernat, A., Sakshaug, J., & Williams, R. A. (2021).  SAGE research methods foundations . London: Sage Publications.

Clark, T., Foster, L., Bryman, A., & Sloan, L. (2021).  Bryman’s social research methods . Oxford: Oxford University Press.

Köhler, T., Smith, A., & Bhakoo, V. (2022). Templates in qualitative research methods: Origins, limitations, and new directions.  Organizational Research Methods ,  25 (2), 183-210. ( Source )

Lenger, A. (2019). The rejection of qualitative research methods in economics.  Journal of Economic Issues ,  53 (4), 946-965. ( Source )

Taherdoost, H. (2022). What are different research approaches? Comprehensive review of qualitative, quantitative, and mixed method research, their applications, types, and limitations.  Journal of Management Science & Engineering Research ,  5 (1), 53-63. ( Source )

Walliman, N. (2021).  Research methods: The basics . New York: Routledge.

Chris Drew (PhD)

Dr. Chris Drew is the founder of the Helpful Professor. He holds a PhD in education and has published over 20 articles in scholarly journals. He is the former editor of the Journal of Learning Development in Higher Education. [Image Descriptor: Photo of Chris]

• Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd/ 5 Top Tips for Succeeding at University
• Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd/ 50 Durable Goods Examples
• Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd/ 100 Consumer Goods Examples
• Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd/ 30 Globalization Pros and Cons

Leave a Comment Cancel Reply

Your email address will not be published. Required fields are marked *

• Privacy Policy

Buy Me a Coffee

Home » Limitations in Research – Types, Examples and Writing Guide

Limitations in Research – Types, Examples and Writing Guide

Table of Contents

Limitations in Research

Limitations in research refer to the factors that may affect the results, conclusions , and generalizability of a study. These limitations can arise from various sources, such as the design of the study, the sampling methods used, the measurement tools employed, and the limitations of the data analysis techniques.

Types of Limitations in Research

Types of Limitations in Research are as follows:

Sample Size Limitations

This refers to the size of the group of people or subjects that are being studied. If the sample size is too small, then the results may not be representative of the population being studied. This can lead to a lack of generalizability of the results.

Time Limitations

Time limitations can be a constraint on the research process . This could mean that the study is unable to be conducted for a long enough period of time to observe the long-term effects of an intervention, or to collect enough data to draw accurate conclusions.

Selection Bias

This refers to a type of bias that can occur when the selection of participants in a study is not random. This can lead to a biased sample that is not representative of the population being studied.

Confounding Variables

Confounding variables are factors that can influence the outcome of a study, but are not being measured or controlled for. These can lead to inaccurate conclusions or a lack of clarity in the results.

Measurement Error

This refers to inaccuracies in the measurement of variables, such as using a faulty instrument or scale. This can lead to inaccurate results or a lack of validity in the study.

Ethical Limitations

Ethical limitations refer to the ethical constraints placed on research studies. For example, certain studies may not be allowed to be conducted due to ethical concerns, such as studies that involve harm to participants.

Examples of Limitations in Research

Some Examples of Limitations in Research are as follows:

Research Title: “The Effectiveness of Machine Learning Algorithms in Predicting Customer Behavior”

Limitations:

• The study only considered a limited number of machine learning algorithms and did not explore the effectiveness of other algorithms.
• The study used a specific dataset, which may not be representative of all customer behaviors or demographics.
• The study did not consider the potential ethical implications of using machine learning algorithms in predicting customer behavior.

Research Title: “The Impact of Online Learning on Student Performance in Computer Science Courses”

• The study was conducted during the COVID-19 pandemic, which may have affected the results due to the unique circumstances of remote learning.
• The study only included students from a single university, which may limit the generalizability of the findings to other institutions.
• The study did not consider the impact of individual differences, such as prior knowledge or motivation, on student performance in online learning environments.

Research Title: “The Effect of Gamification on User Engagement in Mobile Health Applications”

• The study only tested a specific gamification strategy and did not explore the effectiveness of other gamification techniques.
• The study relied on self-reported measures of user engagement, which may be subject to social desirability bias or measurement errors.
• The study only included a specific demographic group (e.g., young adults) and may not be generalizable to other populations with different preferences or needs.

How to Write Limitations in Research

When writing about the limitations of a research study, it is important to be honest and clear about the potential weaknesses of your work. Here are some tips for writing about limitations in research:

• Identify the limitations: Start by identifying the potential limitations of your research. These may include sample size, selection bias, measurement error, or other issues that could affect the validity and reliability of your findings.
• Be honest and objective: When describing the limitations of your research, be honest and objective. Do not try to minimize or downplay the limitations, but also do not exaggerate them. Be clear and concise in your description of the limitations.
• Provide context: It is important to provide context for the limitations of your research. For example, if your sample size was small, explain why this was the case and how it may have affected your results. Providing context can help readers understand the limitations in a broader context.
• Discuss implications : Discuss the implications of the limitations for your research findings. For example, if there was a selection bias in your sample, explain how this may have affected the generalizability of your findings. This can help readers understand the limitations in terms of their impact on the overall validity of your research.
• Provide suggestions for future research : Finally, provide suggestions for future research that can address the limitations of your study. This can help readers understand how your research fits into the broader field and can provide a roadmap for future studies.

Purpose of Limitations in Research

There are several purposes of limitations in research. Here are some of the most important ones:

• To acknowledge the boundaries of the study : Limitations help to define the scope of the research project and set realistic expectations for the findings. They can help to clarify what the study is not intended to address.
• To identify potential sources of bias: Limitations can help researchers identify potential sources of bias in their research design, data collection, or analysis. This can help to improve the validity and reliability of the findings.
• To provide opportunities for future research: Limitations can highlight areas for future research and suggest avenues for further exploration. This can help to advance knowledge in a particular field.
• To demonstrate transparency and accountability: By acknowledging the limitations of their research, researchers can demonstrate transparency and accountability to their readers, peers, and funders. This can help to build trust and credibility in the research community.
• To encourage critical thinking: Limitations can encourage readers to critically evaluate the study’s findings and consider alternative explanations or interpretations. This can help to promote a more nuanced and sophisticated understanding of the topic under investigation.

When to Write Limitations in Research

Limitations should be included in research when they help to provide a more complete understanding of the study’s results and implications. A limitation is any factor that could potentially impact the accuracy, reliability, or generalizability of the study’s findings.

It is important to identify and discuss limitations in research because doing so helps to ensure that the results are interpreted appropriately and that any conclusions drawn are supported by the available evidence. Limitations can also suggest areas for future research, highlight potential biases or confounding factors that may have affected the results, and provide context for the study’s findings.

Generally, limitations should be discussed in the conclusion section of a research paper or thesis, although they may also be mentioned in other sections, such as the introduction or methods. The specific limitations that are discussed will depend on the nature of the study, the research question being investigated, and the data that was collected.

Examples of limitations that might be discussed in research include sample size limitations, data collection methods, the validity and reliability of measures used, and potential biases or confounding factors that could have affected the results. It is important to note that limitations should not be used as a justification for poor research design or methodology, but rather as a way to enhance the understanding and interpretation of the study’s findings.

Importance of Limitations in Research

Here are some reasons why limitations are important in research:

• Enhances the credibility of research: Limitations highlight the potential weaknesses and threats to validity, which helps readers to understand the scope and boundaries of the study. This improves the credibility of research by acknowledging its limitations and providing a clear picture of what can and cannot be concluded from the study.
• Facilitates replication: By highlighting the limitations, researchers can provide detailed information about the study’s methodology, data collection, and analysis. This information helps other researchers to replicate the study and test the validity of the findings, which enhances the reliability of research.
• Guides future research : Limitations provide insights into areas for future research by identifying gaps or areas that require further investigation. This can help researchers to design more comprehensive and effective studies that build on existing knowledge.
• Provides a balanced view: Limitations help to provide a balanced view of the research by highlighting both strengths and weaknesses. This ensures that readers have a clear understanding of the study’s limitations and can make informed decisions about the generalizability and applicability of the findings.

Advantages of Limitations in Research

Here are some potential advantages of limitations in research:

• Focus : Limitations can help researchers focus their study on a specific area or population, which can make the research more relevant and useful.
• Realism : Limitations can make a study more realistic by reflecting the practical constraints and challenges of conducting research in the real world.
• Innovation : Limitations can spur researchers to be more innovative and creative in their research design and methodology, as they search for ways to work around the limitations.
• Rigor : Limitations can actually increase the rigor and credibility of a study, as researchers are forced to carefully consider the potential sources of bias and error, and address them to the best of their abilities.
• Generalizability : Limitations can actually improve the generalizability of a study by ensuring that it is not overly focused on a specific sample or situation, and that the results can be applied more broadly.

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

You may also like

How to Cite Research Paper – All Formats and...

Data Collection – Methods Types and Examples

Delimitations in Research – Types, Examples and...

Research Paper Format – Types, Examples and...

Research Process – Steps, Examples and Tips

Research Design – Types, Methods and Examples

The Strengths and Limitations of Social Work

• First Online: 15 November 2023

Cite this chapter

• Fiona McDermott   ORCID: orcid.org/0000-0002-9362-1441 6 ,
• Kerry Brydon   ORCID: orcid.org/0000-0003-4373-8112 7 ,
• Alex Haynes 8 &
• Felicity Moon   ORCID: orcid.org/0000-0002-0317-8598 9  

126 Accesses

The focus of this chapter is on describing the strengths of social work in order to present the case for building upon these strengths as social work continues to evolve and adapt in a world at the beginning of the twenty-first century, which has altered in so many ways due to such profound influences as advances in telecommunications and social media, climate change, the COVID-19 pandemic, mass migrations, the Russian invasion of Ukraine, to name just a few. These strengths are explored. This is followed by discussion of some limitations of current social work theorising particularly in relation to ‘wicked problems’; social workers’ responses to risk and uncertainty; the weaknesses of current static or fixed depictions of social reality at micro, meso and macro ‘levels’; and the inability of person-in-environment formulations to explain how exactly person and environment intersect and mutually influence each other. This critique provides the springboard for a discussion of complexity theory, which will be more fully explored in subsequent chapters.

• Social work strengths
• Social work limitations
• Reflective practice
• Social work theory
• Wicked problems

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

• Available as PDF
• Read on any device
• Instant download
• Own it forever
• Available as EPUB and PDF
• Durable hardcover edition
• Dispatched in 3 to 5 business days
• Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

AASW. (2020). Code of ethics https://www.aasw.asn.au/document/item/92

Asquith, S., Clark, C., & Waterhouse, L. (2005). The role of the social worker in the 21st century – A literature review, Edinburgh: Scottish Executive Education Department. Retrieved from: https://www.webarchive.org.uk/wayback/archive/3000/https://www.gov.scot/Resource/Doc/47121/0020821.pdf

Australian Institute of Health and Welfare. (2022). Social determinants of health . https://www.aihw.gov.au/reports/australias-health/social-determinants-of-health

Cameron, N., & McDermott, F. (2007). Social work and the body . Palgrave Macmillan.

Book   Google Scholar  

Cree, V., & Wallace, S. (2009). Risk and protection. In R. Adams, L. Dominelli, & M. Payne (Eds.), Practising social work in a complex world (2nd ed., pp. 42–56). Palgrave Macmillan.

Chapter   Google Scholar  

Davies, M. (1994). The essential social worker: An introduction to professional practice in the 1990s (3rd ed.). Ashgate.

Google Scholar  

Dominelli, L. (2002). Anti-oppressive social work theory and practice . Palgrave.

Evans, T., & Hardy, M. (2010). Skills in contemporary social work . Polity Press.

Flack, J., & Mitchell, M. (2020), Uncertain times: The pandemic is an unprecedented opportunity – Seeing human society as a complex systems opens a better future for us all, Aeon Essay . Retrieved from: https://aeon.co/essays/complex-systems-science-allows-us-to-see-new-paths-forward .

Furlong, M. (2013). Building the client’s relational base . The Policy Press.

Gitterman, A., & Germain, C. B. (2008). The life model of social work practice: Advances in knowledge and practice (3rd ed.). Columbia University Press.

Glass, D. (2021). The Ombudsman for human rights: A case book , Melbourne: Victorian Government Printer. Retrieved from: https://assets.ombudsman.vic.gov.au/assets/The-Ombudsman-for-Human-Rights-A-Casebook-Aug-2021.pdf .

Grant, S. (2021). With the falling of dusk . Harper Collins.

Hare, I. (2004). Defining social work for the 21st century: The International Federation of Social Workers revised definition of social work. International Social Work, 47 (3), 407–424. https://doi.org/10.1177/0020872804043973

Article   Google Scholar  

Howe, D. (2014). The compleat social worker . Palgrave.

International Federation of Social Workers. (2014). Global definition of social work. International Federation of Social Workers. Retrieved from: https://www.ifsw.org/what-is-social-work/global-definition-of-social-work/ .

International Federation of Social Workers. (2018). Global social work statement of ethical principles . https://www.ifsw.org/global-social-work-statement-of-ethical-principles/

Jackson, M. (2019). Critical systems thinking and the management of complexity . Wiley.

McDermott, F. (2014). Complexity theory, transdisciplinary working and reflective practice. In A. Pycroft & C. Bartollas (Eds.), Applying complexity theory . Policy Press.

McDermott, F., Henderson, A., & Quayle, C. (2017). Health social workers’ sources of knowledge for decision making in practice. Social Work in Health Care, 56 , 794. https://doi.org/10.1080/00981389.2017.1340391

Milner, J., Myers, S., & O’Byrne, P. (2020). Assessment in social work (5th ed.). Macmillan Education Ltd.

Payne, M. (2014). Modern social work theory (4th ed.). Lyceum Books.

Peters, B. (2017). What is so wicked about wicked problems? A conceptual analysis and a research program. Policy and Society, 36 (3), 385–396. https://doi.org/10.1080/14494035.2017.1361633

Rittell, H. W. J. & Webber, M. M. (1973). Dilemmas in a general theory of planning. Policy Sciences, 4 , 155–169.

Rollins, W. (2019). Social worker-client relationships: Social worker perspectives. Australian Social Work, 73 (4), 395–407. https://doi.org/10.1080/0312407X.2019.1669687

Schon, D. (1992). The reflective practitioner: How professionals think in action . Routledge.

Scoones, I. (2019). What is uncertainty and why does it matter . STEPS Centre Working Paper 105. Retrieved from: https://opendocs.ids.ac.uk/opendocs/bitstream/handle/20.500.12413/14470/STEPSWP_105_Scoones_final.pdf?sequence=1&isAllowed=y

Smith, J., Puckett, C., & Simon, W. (2016). Indigenous allyship: An overview . Wilfred Laurier University.

Social Determinants of Health. (n.d.). https://www.aihw.gov.au/reports/australias-health/social-determinants-of-health

Termeer, C., Dewulf, A., & Biesbroek, R. (2019). A critical assessment of the wicked problem concept and usefulness for policy science and practice. Policy and Society, 38 (2), 167–179. https://doi.org/10.1080/14494035.2019.1617971

Warren, K., Franklin, C., & Streeter, C. (1998). New directions in systems theory: Chaos and complexity. Social Work, 43 (4), 357–372.

Watts, L. (2021). Values, beliefs, and attitudes about reflective practice in Australian social work education and practice. Australian Social Work , 1. https://doi.org/10.1080/0312407X.2021.1874031

Wolf-Branigin, M. (2009). Applying complexity and emergence in social work education. Social Work Education, 28 (2), 115–127. https://doi.org/10.1080/02615470802028090

Zajda, J., Majhanovich, S., & Rust, V. (2006). Introduction: Education and social justice. International Review of Education, 52 (1), 9–22. https://doi.org/10.1007/s11159-005-5614-2

Download references

Author information

Authors and affiliations.

Department of Social Work, Faculty of Medicine, Nursing & Health Sciences, School of Primary & Allied Health Care, Monash University, Caulfield East, VIC, Australia

Fiona McDermott

Social Work Practitioner, Melbourne, VIC, Australia

Kerry Brydon

Whittlesea Community Connections Inc., Epping, VIC, Australia

Alex Haynes

Emergency Department, Royal Melbourne Hospital, Parkville, VIC, Australia

Felicity Moon

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Fiona McDermott .

Rights and permissions

Reprints and permissions

Copyright information

© 2024 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

McDermott, F., Brydon, K., Haynes, A., Moon, F. (2024). The Strengths and Limitations of Social Work. In: Complexity Theory for Social Work Practice. Springer, Cham. https://doi.org/10.1007/978-3-031-38677-0_2

Download citation

DOI : https://doi.org/10.1007/978-3-031-38677-0_2

Published : 15 November 2023

Publisher Name : Springer, Cham

Print ISBN : 978-3-031-38676-3

Online ISBN : 978-3-031-38677-0

eBook Packages : Social Sciences Social Sciences (R0)

Share this chapter

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Publish with us

Policies and ethics

• Find a journal
• Track your research

We will keep fighting for all libraries - stand with us!

Internet Archive Audio

• This Just In
• Grateful Dead
• Old Time Radio
• 78 RPMs and Cylinder Recordings
• Audio Books & Poetry
• Computers, Technology and Science
• Music, Arts & Culture
• News & Public Affairs
• Spirituality & Religion
• Radio News Archive

• Flickr Commons
• Occupy Wall Street Flickr
• NASA Images
• Solar System Collection
• Ames Research Center

• All Software
• Old School Emulation
• MS-DOS Games
• Historical Software
• Classic PC Games
• Software Library
• Kodi Archive and Support File
• Vintage Software
• CD-ROM Software
• CD-ROM Software Library
• Software Sites
• Tucows Software Library
• Shareware CD-ROMs
• Software Capsules Compilation
• CD-ROM Images
• ZX Spectrum
• DOOM Level CD

• Smithsonian Libraries
• FEDLINK (US)
• Lincoln Collection
• American Libraries
• Canadian Libraries
• Universal Library
• Project Gutenberg
• Children's Library
• Biodiversity Heritage Library
• Books by Language
• Additional Collections

• Prelinger Archives
• Democracy Now!
• Occupy Wall Street
• TV NSA Clip Library
• Animation & Cartoons
• Arts & Music
• Computers & Technology
• Cultural & Academic Films
• Ephemeral Films
• Sports Videos
• Videogame Videos
• Youth Media

Search the history of over 866 billion web pages on the Internet.

Mobile Apps

• Wayback Machine (iOS)
• Wayback Machine (Android)

Browser Extensions

Archive-it subscription.

• Explore the Collections
• Build Collections

Save Page Now

Capture a web page as it appears now for use as a trusted citation in the future.

Please enter a valid web address

• Donate Donate icon An illustration of a heart shape

The limitations of social research

Bookreader item preview, share or embed this item, flag this item for.

• Graphic Violence
• Explicit Sexual Content
• Hate Speech
• Misinformation/Disinformation
• Marketing/Phishing/Advertising
• Misleading/Inaccurate/Missing Metadata

obscured text

plus-circle Add Review comment Reviews

Download options.

No suitable files to display here.

IN COLLECTIONS

Uploaded by station16.cebu on December 10, 2019

SIMILAR ITEMS (based on metadata)

How to Write Limitations of the Study (with examples)

This blog emphasizes the importance of recognizing and effectively writing about limitations in research. It discusses the types of limitations, their significance, and provides guidelines for writing about them, highlighting their role in advancing scholarly research.

Updated on August 24, 2023

No matter how well thought out, every research endeavor encounters challenges. There is simply no way to predict all possible variances throughout the process.

These uncharted boundaries and abrupt constraints are known as limitations in research . Identifying and acknowledging limitations is crucial for conducting rigorous studies. Limitations provide context and shed light on gaps in the prevailing inquiry and literature.

This article explores the importance of recognizing limitations and discusses how to write them effectively. By interpreting limitations in research and considering prevalent examples, we aim to reframe the perception from shameful mistakes to respectable revelations.

What are limitations in research?

In the clearest terms, research limitations are the practical or theoretical shortcomings of a study that are often outside of the researcher’s control . While these weaknesses limit the generalizability of a study’s conclusions, they also present a foundation for future research.

Sometimes limitations arise from tangible circumstances like time and funding constraints, or equipment and participant availability. Other times the rationale is more obscure and buried within the research design. Common types of limitations and their ramifications include:

• Theoretical: limits the scope, depth, or applicability of a study.
• Methodological: limits the quality, quantity, or diversity of the data.
• Empirical: limits the representativeness, validity, or reliability of the data.
• Analytical: limits the accuracy, completeness, or significance of the findings.
• Ethical: limits the access, consent, or confidentiality of the data.

Regardless of how, when, or why they arise, limitations are a natural part of the research process and should never be ignored . Like all other aspects, they are vital in their own purpose.

Why is identifying limitations important?

Whether to seek acceptance or avoid struggle, humans often instinctively hide flaws and mistakes. Merging this thought process into research by attempting to hide limitations, however, is a bad idea. It has the potential to negate the validity of outcomes and damage the reputation of scholars.

By identifying and addressing limitations throughout a project, researchers strengthen their arguments and curtail the chance of peer censure based on overlooked mistakes. Pointing out these flaws shows an understanding of variable limits and a scrupulous research process.

Showing awareness of and taking responsibility for a project’s boundaries and challenges validates the integrity and transparency of a researcher. It further demonstrates the researchers understand the applicable literature and have thoroughly evaluated their chosen research methods.

Presenting limitations also benefits the readers by providing context for research findings. It guides them to interpret the project’s conclusions only within the scope of very specific conditions. By allowing for an appropriate generalization of the findings that is accurately confined by research boundaries and is not too broad, limitations boost a study’s credibility .

Limitations are true assets to the research process. They highlight opportunities for future research. When researchers identify the limitations of their particular approach to a study question, they enable precise transferability and improve chances for reproducibility. 

Simply stating a project’s limitations is not adequate for spurring further research, though. To spark the interest of other researchers, these acknowledgements must come with thorough explanations regarding how the limitations affected the current study and how they can potentially be overcome with amended methods.

How to write limitations

Typically, the information about a study’s limitations is situated either at the beginning of the discussion section to provide context for readers or at the conclusion of the discussion section to acknowledge the need for further research. However, it varies depending upon the target journal or publication guidelines. 

Don’t hide your limitations

It is also important to not bury a limitation in the body of the paper unless it has a unique connection to a topic in that section. If so, it needs to be reiterated with the other limitations or at the conclusion of the discussion section. Wherever it is included in the manuscript, ensure that the limitations section is prominently positioned and clearly introduced.

While maintaining transparency by disclosing limitations means taking a comprehensive approach, it is not necessary to discuss everything that could have potentially gone wrong during the research study. If there is no commitment to investigation in the introduction, it is unnecessary to consider the issue a limitation to the research. Wholly consider the term ‘limitations’ and ask, “Did it significantly change or limit the possible outcomes?” Then, qualify the occurrence as either a limitation to include in the current manuscript or as an idea to note for other projects. 

Writing limitations

Once the limitations are concretely identified and it is decided where they will be included in the paper, researchers are ready for the writing task. Including only what is pertinent, keeping explanations detailed but concise, and employing the following guidelines is key for crafting valuable limitations:

1) Identify and describe the limitations : Clearly introduce the limitation by classifying its form and specifying its origin. For example:

• An unintentional bias encountered during data collection
• An intentional use of unplanned post-hoc data analysis

2) Explain the implications : Describe how the limitation potentially influences the study’s findings and how the validity and generalizability are subsequently impacted. Provide examples and evidence to support claims of the limitations’ effects without making excuses or exaggerating their impact. Overall, be transparent and objective in presenting the limitations, without undermining the significance of the research. 

3) Provide alternative approaches for future studies : Offer specific suggestions for potential improvements or avenues for further investigation. Demonstrate a proactive approach by encouraging future research that addresses the identified gaps and, therefore, expands the knowledge base.

Whether presenting limitations as an individual section within the manuscript or as a subtopic in the discussion area, authors should use clear headings and straightforward language to facilitate readability. There is no need to complicate limitations with jargon, computations, or complex datasets.

Examples of common limitations

Limitations are generally grouped into two categories , methodology and research process .

Methodology limitations

Methodology may include limitations due to:

• Sample size
• Lack of available or reliable data
• Lack of prior research studies on the topic
• Measure used to collect the data
• Self-reported data

The researcher is addressing how the large sample size requires a reassessment of the measures used to collect and analyze the data.

Research process limitations

Limitations during the research process may arise from:

• Access to information
• Longitudinal effects
• Cultural and other biases
• Language fluency
• Time constraints

The author is pointing out that the model’s estimates are based on potentially biased observational studies.

Final thoughts

Successfully proving theories and touting great achievements are only two very narrow goals of scholarly research. The true passion and greatest efforts of researchers comes more in the form of confronting assumptions and exploring the obscure.

In many ways, recognizing and sharing the limitations of a research study both allows for and encourages this type of discovery that continuously pushes research forward. By using limitations to provide a transparent account of the project's boundaries and to contextualize the findings, researchers pave the way for even more robust and impactful research in the future.

Charla Viera, MS

See our "Privacy Policy"

Ensure your structure and ideas are consistent and clearly communicated

Pair your Premium Editing with our add-on service Presubmission Review for an overall assessment of your manuscript.

Want to create or adapt books like this? Learn more about how Pressbooks supports open publishing practices.

2.2 Paradigms, theories, and how they shape a researcher’s approach

Learning objectives.

• Define paradigm, and describe the significance of paradigms
• Identify and describe the four predominant paradigms found in the social sciences
• Define theory
• Describe the role that theory plays in social work research

The terms paradigm and theory are often used interchangeably in social science, although social scientists do not always agree whether these are identical or distinct concepts. This text makes a clear distinction between the two ideas because thinking about each concept as analytically distinct provides a useful framework for understanding the connections between research methods and social scientific ways of thinking.

Paradigms in social science

  For our purposes, we’ll define paradigm as a way of viewing the world (or “analytic lens” akin to a set of glasses) and a framework from which to understand the human experience (Kuhn, 1962). It can be difficult to fully grasp the idea of paradigmatic assumptions because we are very ingrained in our own, personal everyday way of thinking. For example, let’s look at people’s views on abortion. To some, abortion is a medical procedure that should be undertaken at the discretion of each individual woman. To others, abortion is murder and members of society should collectively have the right to decide when, if at all, abortion should be undertaken. Chances are, if you have an opinion about this topic, you are pretty certain about the veracity of your perspective. Then again, the person who sits next to you in class may have a very different opinion and yet be equally confident about the truth of their perspective. Who is correct?

You are each operating under a set of assumptions about the way the world does—or at least should—work. Perhaps your assumptions come from your political perspective, which helps shape your view on a variety of social issues, or perhaps your assumptions are based on what you learned from your parents or in church. In any case, there is a paradigm that shapes your stance on the issue. Those paradigms are a set of assumptions. Your classmate might assume that life begins at conception and the fetus’ life should be at the center of moral analysis. Conversely, you may assume that life begins when the fetus is viable outside the womb and that a mother’s choice is more important than a fetus’s life. There is no way to scientifically test when life begins, whose interests are more important, or the value of choice. They are merely philosophical assumptions or beliefs. Thus, a pro-life paradigm may rest in part on a belief in divine morality and fetal rights. A pro-choice paradigm may rest on a mother’s self-determination and a belief that the positive consequences of abortion outweigh the negative ones. These beliefs and assumptions influence how we think about any aspect of the issue.

In Chapter 1, we discussed the various ways that we know what we know. Paradigms are a way of framing what we know, what we can know, and how we can know it. In social science, there are several predominant paradigms, each with its own unique ontological and epistemological perspective. Recall that ontology is the study of what is real, and epistemology is the study of how we come to know what is real. Let’s look at four of the most common social scientific paradigms that might guide you as you begin to think about conducting research.

The first paradigm we’ll consider, called positivism, is the framework that likely comes to mind for many of you when you think of science. Positivism is guided by the principles of objectivity, knowability, and deductive logic. Deductive logic is discussed in more detail in next section of this chapter. The positivist framework operates from the assumption that society can and should be studied empirically and scientifically. Positivism also calls for a value-free science, one in which researchers aim to abandon their biases and values in a quest for objective, empirical, and knowable truth.

Another predominant paradigm in social work is social constructionism . Peter Berger and Thomas Luckman (1966) are credited by many for having developed this perspective in sociology. While positivists seek “the truth,” the social constructionist framework posits that “truth” varies. Truth is different based on who you ask, and people change their definitions of truth all the time based on their interactions with other people. This is because we, according to this paradigm, create reality ourselves (as opposed to it simply existing and us working to discover it) through our interactions and our interpretations of those interactions. Key to the social constructionist perspective is the idea that social context and interaction frame our realities.

Researchers operating within this framework take keen interest in how people come to socially agree, or disagree, about what is real and true. Consideration of how meanings of different hand gestures vary across different regions of the world aptly demonstrates that meanings are constructed socially and collectively. Think about what it means to you when you see a person raise their middle finger. In the United States, people probably understand that person isn’t very happy (nor is the person to whom the finger is being directed). In some societies, it is another gesture, such as the thumbs up gesture, that raises eyebrows. While the thumbs up gesture may have a particular meaning in North American culture, that meaning is not shared across cultures (Wong, 2007). So, what is the “truth” of the middle finger or thumbs up? It depends on what the person giving it intended, how the person receiving it interpreted it, and the social context in which the action occurred.

It would be a mistake to think of the social constructionist perspective as only individualistic. While individuals may construct their own realities, groups—from a small one such as a married couple to large ones such as nations—often agree on notions of what is true and what “is.” In other words, the meanings that we construct have power beyond the individual people who create them. Therefore, the ways that people and communities work to create and change such meanings is of as much interest to social constructionists as how they were created in the first place.

A third paradigm is the critical paradigm. At its core, the critical paradigm is focused on power, inequality, and social change. Although some rather diverse perspectives are included here, the critical paradigm, in general, includes ideas developed by early social theorists, such as Max Horkheimer (Calhoun, Gerteis, Moody, Pfaff, & Virk, 2007), and later works developed by feminist scholars, such as Nancy Fraser (1989). Unlike the positivist paradigm, the critical paradigm posits that social science can never be truly objective or value-free. Further, this paradigm operates from the perspective that scientific investigation should be conducted with the express goal of social change in mind. Researchers in the critical paradigm might start with the knowledge that systems are biased against, for example, women or ethnic minorities. Moreover, their research projects are designed not only to collect data, but also change the participants in the research as well as the systems being studied. The critical paradigm not only studies power imbalances but seeks to change those power imbalances.

Finally, postmodernism is a paradigm that challenges almost every way of knowing that many social scientists take for granted (Best & Kellner, 1991). While positivists claim that there is an objective, knowable truth, postmodernists would say that there is not. While social constructionists may argue that truth is in the eye of the beholder (or in the eye of the group that agrees on it), postmodernists may claim that we can never really know such truth because, in the studying and reporting of others’ truths, the researcher stamps their own truth on the investigation. Finally, while the critical paradigm may argue that power, inequality, and change shape reality and truth, a postmodernist may in turn ask whose power, whose inequality, whose change, whose reality, and whose truth. As you might imagine, the postmodernist paradigm poses quite a challenge for researchers. How do you study something that may or may not be real or that is only real in your current and unique experience of it? This fascinating question is worth pondering as you begin to think about conducting your own research. Part of the value of the postmodern paradigm is its emphasis on the limitations of human knowledge. Table 2.1 summarizes each of the paradigms discussed here.

Let’s work through an example. If we are examining a problem like substance abuse, what would a social scientific investigation look like in each paradigm? A positivist study may focus on precisely measuring substance abuse and finding out the key causes of substance abuse during adolescence. Forgoing the objectivity of precisely measuring substance abuse, social constructionist study might focus on how people who abuse substances understand their lives and relationships with various drugs of abuse. In so doing, it seeks out the subjective truth of each participant in the study. A study from the critical paradigm would investigate how people who have substance abuse problems are an oppressed group in society and seek to liberate them from external sources of oppression, like punitive drug laws, and internal sources of oppression, like internalized fear and shame. A postmodern study may involve one person’s self-reported journey into substance abuse and changes that occurred in their self-perception that accompanied their transition from recreational to problematic drug use. These examples should illustrate how one topic can be investigated across each paradigm.

Social science theories

Much like paradigms, theories provide a way of looking at the world and of understanding human interaction. Paradigms are grounded in big assumptions about the world—what is real, how do we create knowledge—whereas theories describe more specific phenomena. A common definition for theory in social work is “a systematic set of interrelated statements intended to explain some aspect of social life” (Rubin & Babbie, 2017, p. 615). At their core, theories can be used to provide explanations of any number or variety of phenomena. They help us answer the “why” questions we often have about the patterns we observe in social life. Theories also often help us answer our “how” questions. While paradigms may point us in a particular direction with respect to our “why” questions, theories more specifically map out the explanation, or the “how,” behind the “why.”

Introductory social work textbooks introduce students to the major theories in social work—conflict theory, symbolic interactionism, social exchange theory, and systems theory. As social workers study longer, they are introduced to more specific theories in their area of focus, as well as perspectives and models (e.g., the strengths perspective), which provide more practice-focused approaches to understanding social work.

As you may recall from a class on social work theory, systems theorists view all parts of society as interconnected and focus on the relationships, boundaries, and flows of energy between these systems and subsystems (Schriver, 2011). Conflict theorists are interested in questions of power and who wins and who loses based on the way that society is organized. Symbolic interactionists focus on how meaning is created and negotiated through meaningful (i.e., symbolic) interactions. Finally, social exchange theorists examine how human beings base their behavior on a rational calculation of rewards and costs.

Just as researchers might examine the same topic from different levels of inquiry or paradigms, they could also investigate the same topic from different theoretical perspectives. In this case, even their research questions could be the same, but the way they make sense of whatever phenomenon it is they are investigating will be shaped in large part by theory. Table 2.2 summarizes the major points of focus for four major theories and outlines how a researcher might approach the study of the same topic, in this case the study of substance abuse, from each of the perspectives.

Within each area of specialization in social work, there are many other theories that aim to explain more specific types of interactions. For example, within the study of sexual harassment, different theories posit different explanations for why harassment occurs. One theory, first developed by criminologists, is called routine activities theory. It posits that sexual harassment is most likely to occur when a workplace lacks unified groups and when potentially vulnerable targets and motivated offenders are both present (DeCoster, Estes, & Mueller, 1999). Other theories of sexual harassment, called relational theories, suggest that a person’s relationships, such as their marriages or friendships, are the key to understanding why and how workplace sexual harassment occurs and how people will respond to it when it does occur (Morgan, 1999). Relational theories focus on the power that different social relationships provide (e.g., married people who have supportive partners at home might be more likely than those who lack support at home to report sexual harassment when it occurs). Finally, feminist theories of sexual harassment take a different stance. These theories posit that the way our current gender system is organized, where those who are the most masculine have the most power, best explains why and how workplace sexual harassment occurs (MacKinnon, 1979). As you might imagine, which theory a researcher applies to examine the topic of sexual harassment will shape the questions the researcher asks about harassment. It will also shape the explanations the researcher provides for why harassment occurs.

For an undergraduate student beginning their study of a new topic, it may be intimidating to learn that there are so many theories beyond what you’ve learned in your theory classes. What’s worse is that there is no central database of different theories on your topic. However, as you review the literature in your topic area, you will learn more about the theories that scientists have created to explain how your topic works in the real world. In addition to peer-reviewed journal articles, another good source of theories is a book about your topic. Books often contain works of theoretical and philosophical importance that are beyond the scope of an academic journal.

Paradigm and theory in social work

Theories, paradigms, levels of analysis, and the order in which one proceeds in the research process all play an important role in shaping what we ask about the social world, how we ask it, and in some cases, even what we are likely to find. A micro-level study of gangs will look much different than a macro-level study of gangs. In some cases, you could apply multiple levels of analysis to your investigation, but doing so isn’t always practical or feasible. Therefore, understanding the different levels of analysis and being aware of which level you happen to be employing is crucial. One’s theoretical perspective will also shape a study. In particular, the theory invoked will likely shape not only the way a question about a topic is asked but also which topic gets investigated in the first place. Further, if you find yourself especially committed to one theory over another, it may limit the kinds of questions you pose. As a result, you may miss other possible explanations.

The limitations of paradigms and theories do not mean that social science is fundamentally biased. At the same time, we can never claim to be entirely value free. Social constructionists and postmodernists might point out that bias is always a part of research to at least some degree. Our job as researchers is to recognize and address our biases as part of the research process, if an imperfect part. We all use our own approaches, be they theories, levels of analysis, or temporal processes, to frame and conduct our work. Understanding those frames and approaches is crucial not only for successfully embarking upon and completing any research-based investigation, but also for responsibly reading and understanding others’ work.

Spotlight on UTA School of Social Work

Catherine labrenz connects social theory and child welfare research.

When Catherine LaBrenz, an assistant professor at the University of Texas at Arlington’s School of Social Work was a child welfare practitioner, she noticed that several children who had reunified with their biological parents from the foster care system were re-entering care because of continued exposure to child maltreatment. As she observed the challenging behaviors these children often presented, she wondered how the agency might better support families to prevent children from re-entering foster care after permanence. In her doctoral studies, she used her practice experience to form a research project with the goal of better understanding how agencies could better support families post-reunification.

From a critical paradigm, Dr. LaBrenz approached this question with the understanding that families that come into contact with child welfare systems often experience disadvantage and are subjected to unequal power distributions when accessing services, going to court, and participating in case decision-making (LaBrenz & Fong, 2016). Furthermore, the goal of this research was to change some of the aspects of the child welfare system, particularly within the practitioner’s agency, to better support families.

To better understand why some families may be more at-risk for multiple entries into foster care, Dr. LaBrenz began with an extensive literature review that identified diverse theories that explained factors at the child, family, and system- level that could impact post-permanence success. Figure 2.1 displays the micro-, meso-, and macro-level theories that she and her research team identified and decided to explore further.

At the child-level, Attachment theory posits that consistent, stable nurturing during infancy impacts children’s ability to form relationships with others throughout their life (Ainsworth, Blehar, Waters, & Wall, 1978; Bowlby, 1969). At the family-level, Family systems theory posits that family interactions impact functioning among all members of a family unit (Broderick 1971). At the macro-level, Critical race theory (Delgado & Stefancic, 2001) can help understand racial disparities in child welfare systems. Moreover, Systems theory (Bronfenbrenner, 1986) can help examine interactions among the micro-, meso- and macro-levels to assess diverse systems that impact families involved in child welfare services.

In the next step of the project, national datasets were used to examine child-, family-, and system- factors that impacted rates of successful reunification, or reunification with no future re-entries into foster care. Then, a systematic review of the literature was conducted to determine what evidence existed for interventions to increase rates of successful reunification. Finally, a different national dataset was used to examine how effective diverse interventions were for specific groups of families, such as those with infants and toddlers.

Figure 2.2 displays the principal findings from the research project and connects each main finding to one of the theoretical frameworks.

The first part of the research project found parents who felt unable to cope with their parental role, and families with previous attachment disruptions, to have higher rates of re-entry into foster care. This connects with Attachment theory, in that families with more instability and inconsistency in caregiving felt less able to fulfill their parental roles, which in turn led to further disruption in the child’s attachment.

With regards to family-level theories, Dr. LaBrenz found that family-level risk and protective factors were more predictive of re-entry to foster care than child- or agency-level factors. The systematic review also found that interventions that targeted parents, such as Family Drug Treatment Courts, led to better outcomes for children and families. This aligns with Family systems theory in that family-centered interventions and targeting the entire family leads to better family functioning and fewer re-entries into foster care.

In parallel, the systematic review concluded that interventions that integrated multiple systems, such as child welfare and substance use, increased the likelihood of successful reunification. This supports Systems theory, in that multiple systems can be engaged to provide ongoing support for families in child welfare systems (Trucco, 2012). Furthermore, the results from the analyses of the national datasets found that rates of re-entry into foster care for African American and Latino families varied significantly by state. Thus, racial and ethnic disparities remained in some, but not all, state child welfare systems.

Overall, the findings from the research project supported Attachment theory, Family systems theory, Systems theory, and Critical race theory as guiding explanations for why some children and families experience foster care re-entry while others do not. Dr. LaBrenz was able to present these findings and connect them to direct implications for practices and policies that could support attachment, multi-system collaborations, and family-centered practices.

Key Takeaways

• Paradigms shape our everyday view of the world.
• Researchers use theory to help frame their research questions and to help them make sense of the answers to those questions.
• Applying the four key theories of social work is a good start, but you will likely have to look for more specific theories about your topic.
• Critical paradigm- a paradigm in social science research focused on power, inequality, and social change
• Paradigm- a way of viewing the world and a framework from which to understand the human experience
• Positivism- a paradigm guided by the principles of objectivity, knowability, and deductive logic
• Postmodernism- a paradigm focused on the historical and contextual embeddedness of scientific knowledge and a skepticism towards certainty and grand explanations in social science
• Social constructionism- a paradigm based on the idea that social context and interaction frame our realities
• Theory- “a systematic set of interrelated statements intended to explain some aspect of social life” (Rubin & Babbie, 2017, p. 615)

Image attributions

point mold and cloud mold by tasaikensuke CC-0

why by GDJ CC-0

Foundations of Social Work Research Copyright © 2020 by Rebecca L. Mauldin is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

Share This Book

LEARN WITH RAJAKRISHNAN

Dr. Rajakrishnan M, Assistant Professor in Commerce, PSG College of Arts & Science, Coimbatore, Tamil Nadu, India.

Notification

• Meaning, Functions or Uses and Limitations of Social Science Research

MEANING OF SOCIAL SCIENCE RESEARCH: “Social science research is a systematic method o exploring, analysing and conceptualizing human life in order to extend, correct or verify knowledge of human behaviour and social life.” In other words, social science research seek to find explanations to unexplained social phenomena, to clarify the doubtful and correct the misconceived facts of social life. FUNCTIONS OR USES OF SOCIAL SCIENCE RESEARCH: 1 Discovery of facts and their Interpretation: Research provides answer to questions of what, where, when, how and why of man, social life and institutions. They are half-truths pseudo truths and superstitions. Discovery of facts and their interpretation help us discard such distortions and thus enlighten us and contribute to our understanding of social reality research strengthens our desire for truth and opens up before our eyes, hidden social mysteries. 2 Diagnosis of problems and their analysis: The developing courtiers have innumerable problems such as poverty, unemployment, economic imbalance, economic inequality, social tension, low productivity, technological backwardness, etc. The nature and dimensions of such problems have to be diagnosed and analysed; social science research plays a significant role in this respect. An analysis of problems leads to an identification of appropriate remedial actions. 3 Systematization of knowledge: The facts discovered through research are systematized and the body of knowledge is developed. Thus research contributes to the growth of various social sciences and theory building. 4 Control over social phenomena: Research in social science areas equips us with first-hand knowledge about the organizing and working of the society and its institutions. This knowledge gives us a greater power of control over the social phenomena. 5 Prediction: Research aims at findings an order among social facts and their casual relation. This affords a sound basis for prediction in several cases. Although the predictions cannot be perfect because of the inherent limitations of social sciences, they will be fairly useful for better social planning and control. 6 Development planning: Planning for socio-economic development calls for baseline data on the various aspects of our society and economy, resource endowment, peoples needs and aspirations, etc. systematic research can give us the required data base for planning and designing developmental schemes and programmes. Analytical studies can illuminate critical areas of policy and testing the validity of planning assumptions. Evaluation studies point the impact of plan, policies and programmes and throw out suggestions for their proper reformulation. 7 Social Welfare: Social research can unfold and identify the causes of social evils problems. It can thus help in taking appropriate remedial actions. It can also give us sound guidelines for appropriate positive measures of reform and social welfare. LIMITATIONS OF SOCIAL SCIENCES RESEARCH Research in social sciences has certain limitations and problems when compared with research in physical sciences. They are discussed below: a)      Scientists a part of what is studied: The fact that social scientist is part of the human society which he studies gives rise to certain limitations. Man must have to be his won guinea pig. as pointed out by Jalian Huxley. This has a number of methodological consequences. For example, it restricts the scope for controlled experiments. It limits the scope for objectivity in social science research. b)      Complexity of the subject matter: The subject matter of research in social science, viz. human society and human behaviour is too complex varied and changing to yield to the scientific categorization, measurement, analysis and prediction. The multiplicity and complexity of causation make it difficult to apply the technique of experimentation. Human behaviour can be studied only be other human beings, and this always distorts fundamentally the facts being studied so that there can be no objective procedure for achieving the truth. c)      Human Problems: A social scientist faces certain human problems, which the natural scientist is sparred. These problems are varied and include refusal of respondents improper understanding of questions by them their loss of memory, their reluctance to furnish certain information, etc. All these problems cause biases and invalidate the research findings and conclusions. d)      Personal Values: Subjects and clients, as well as investigators, have personal values, which are apt to become involved in the research process. One should not assume that these are freely exploitable. The investigator must have respect for the client’s values. e)      Anthropomorphization: Another hazard of social science research is the danger of the temptation to anthropomorphize about humans, it results in using observation obtained by sheer intuition or empathy in conceptualizing in anthropomorphic manner. f)       Wrong Decisions: The quality of research findings depends upon the soundness of decisions made by the social scientist on such crucial stages of his research process as definition of the unit of study operationalization of concepts, selection of sampling techniques and statistical techniques. Any mistake in any of these decisions will vitiate the validity of his findings. Reference : Research Methodology by C R Kothari Research Methodology   - Pondicherry University Research Methodology   - Calicut University Other Sources - Internet

No comments

Search this blog.

• News Paper and Magazine
• Academic Events
• Advanced Accounting
• Advanced Excel
• Article / Publication
• Business Environment
• Business Law
• Career and Employment
• Commerce News
• Commercial Correspondence
• Commercial Law
• Communicative English
• Company Law
• Competitive exams
• Computer Skills
• Corporate Accounting
• Cost Accounting
• Current Affairs
• Data Analysis
• English Grammar
• Enterprise Resource Planning
• Environmental Management
• Financial Accounting
• FrontAccounting
• Fundamental and Technical Analysis
• Fundamentals of e-commerce & m-commerce
• Futures and Options
• General Information
• General Knowledge
• Guest Lecture
• Human Resource Management
• Idiom of the Day
• Indian Stock Exchange
• Indirect Taxes
• Industrial Training Report.
• Introduction to Computers
• Learn English Through Tamil
• Management Accounting
• Marketing Management
• Mobile Computing
• Online Business Techniques
• Online Courses
• Primary and Secondary Market
• principles of management
• R Programming Tutorial
• Research Methodology
• Research Project
• Revolution in India
• Spoken Tutorial
• Student Creation
• Thoughts of the Day
• Useful Websites
• சிறுகதை
• தினம் ஒரு திருக்குறள்
• Employment News
• Staff Selection Commission
• Department of Employment and Training
• RRB Chennai

தமிழமுது

• தேர்ந்தெடுத்த சிறுகதைகள்

Notable Blogs

• Student Corner
• Senthil Prabhu Sivasamy
• Sangeetha's View
• Prema's Blog
• Stock Exchange Tips
• Learning Joy of DD
• Iniya Tamizhi

Educational Institutions

• PSG College of Arts & Science
• Bharathiar University

Popular Posts

Flag Counter

Total Pageviews

Blog archive, commerce e- resources.

• MS - Office
• Tally. ERP 9
• Business Research Methods
• Primary & Secondary Market
• Fundamentals of E-Commerce & M-Commerce

• Open access
• Published: 29 March 2024

“These are just finishing our medicines”: older persons’ perceptions and experiences of access to healthcare in public and private health facilities in Uganda

• Stephen Ojiambo Wandera 1 , 2 ,
• Valerie Golaz 3 ,
• Betty Kwagala 1 ,
• James P. M. Ntozi 1 &
• David Otundo Ayuku 2  

BMC Health Services Research volume  24 , Article number:  396 ( 2024 ) Cite this article

452 Accesses

5 Altmetric

Metrics details

There is limited research on the experiences of access to medicines for non-communicable diseases (NCDs) in health facilities among older persons in Uganda. This paper explores the perspectives of older persons and healthcare providers concerning older persons’ access to essential medicines in Uganda.

It is based on qualitative data from three districts of Hoima, Kiboga, and Busia in Uganda. Data collection methods included seven (07) focus group discussions (FGDs) and eighteen (18) in-depth interviews with older persons. Nine (9) key informant interviews with healthcare providers were conducted. Deductive and inductive thematic analysis (using Health Access Livelihood Framework) was used to analyze the barriers and facilitators of access to healthcare using QSR International NVivo software.

The key facilitators and barriers to access to healthcare included both health system and individual-level factors. The facilitators of access to essential medicines included family or social support, earning some income or Social Assistance Grants for Empowerment (SAGE) money, and knowing a healthcare provider at a health facility. The health system barriers included the unavailability of specialized personnel, equipment, and essential medicines for non-communicable diseases, frequent stock-outs, financial challenges, long waiting times, high costs for medicines for NCDs, and long distances to health facilities.

Access to essential medicines for NCDs is a critical challenge for older persons in Uganda. The Ministry of Health should make essential drugs for NCDS to be readily available and train geriatricians to provide specialized healthcare for older persons to reduce health inequities in old age. Social support systems need to be strengthened to enable older persons to access healthcare.

Peer Review reports

Globally, the demographic transition associated with increment in longevity is expected to increase the proportion of adults age 50 and older. Currently, the proportion of older persons (those age 60) and older is 11% and is expected to increase to 20% by 2050. The absolute number of older people increased from 205 million in 1950 to 810 million in 201. Projections for 2022 and 2050 are one billion and 2 billion respectively, outnumbering children age 0–14 years [ 1 , 2 ]. In sub-Saharan Africa (SSA), the absolute number of older persons (aged 60+) is 43 million, forming 5% of the population [ 3 ] and is projected to increase to 163 million (8.3% of the population) by 2050 [ 2 ]. In Uganda, the number of older persons has increased from 1.1 million in 2002 (4.5% of the population) to 1.3 million in 2010 [ 4 ] and shall increase to 5.5 million (5.7% of the population) by 2050 [ 2 ]. About 10% of the older persons were living alone by 2010 Uganda national household survey [ 5 ]. The average household size was 4.7 persons according to the Uganda Population and Housing Census of 2014 [ 6 ].

The World Health Organization (WHO) uses age 50 and older to define older persons in sub-Saharan African (SSA) countries due to lower life expectancy [ 7 ]. Several studies in SSA have used this definition [ 8 , 9 , 10 , 11 ]. On the other hand, the United Nations (UN) uses age 60 and older to define older persons [ 7 , 12 ]. Likewise, the Ministry of Gender, Labour and Social Development (MoGLSD) in Uganda uses the same definition [ 4 , 13 ]. Some reports on older people use this definition [ 1 ]. For this article, age 50 and older was used.

The prevalence of non-communicable diseases (NCDs) has been reported in some surveys in Uganda. Hypertension has been reported at 6.3% in the rural Uganda non-communicable disease (RUNCD) study [ 14 ]. A higher prevalence of hypertension (21%) has been reported among HIV patients [ 15 ]. A prevalence of hypertension of 21% has been reported in a sample of 611 people in a WHO STEPS tool study in Kasese [ 16 ]. Hypertension is the most reported NCD followed by obesity and diabetes in a scoping review for sub-Saharan Africa [ 17 ]. Among 2,382 older persons, about a quarter (23%) of the older persons reported an NCD in a 2010 national survey in Uganda [ 18 ]. Finally, in East Africa, 40% of deaths in 2015 were attributed to NCDs [ 19 ] and 53% were attributed to NCDs in eastern Uganda [ 20 ]. Therefore, NCDs are becoming an increasing health need in Uganda and are estimated at 26% [ 21 ].

In Uganda, the public healthcare system is hierarchically organized. At the top is the national referral hospitals: Mulago and Butabika. From Mulago national referral hospital, there are regional referral hospitals, health center (HC) from levels IV (district), III (sub-county), II (Parish) and I (village). Regional referral hospitals exist in each of the four regions of Uganda (central, eastern, western, and northern). At the lower levels, are health center IVs (district level) and IIIs (sub-county level). At the lowest levels namely parish and village are health center II and I, respectively [ 22 , 23 , 24 , 25 , 26 , 27 , 28 ].

Ageing is associated with several healthcare needs [ 29 ]. One of the critical needs of older persons is managing the worsening health outcomes [ 30 ] including non-communicable diseases (NCDs) and disabilities. NCDs increase the need for healthcare among older persons [ 31 , 32 ]. This has been observed in Hong Kong [ 31 ], Singapore [ 33 ] and in rural South Africa [ 34 ]. However, in some low- and middle-income countries (LMICs), older persons with NCDs have limited access to healthcare. Examples include in India [ 35 ], China [ 36 ] and Hong Kong [ 31 ]. Generally, older persons face barriers of access to healthcare due to increased vulnerability and deprivation in old age [ 3 , 30 , 37 , 38 ].

Studies on access to healthcare in general and access to essential medicines for NCDs and healthcare by older persons in Uganda are limited [ 39 , 40 , 41 , 42 ]. Available evidence on older people’s health have focused on HIV/AIDS [ 43 , 44 , 45 ]; caregiving roles of older persons [ 46 , 47 , 48 , 49 ] and various vulnerabilities [ 50 , 51 ]. Studies which have addressed access to healthcare used quantitative secondary data and focused on patient level factors [ 32 ]. Others have focused on specific interest groups like the diabetics and not necessarily the older population [ 38 , 52 , 53 ]. Therefore, the aim of this paper was to explore perceptions and experiences about the health system and individual barriers and facilitators of access to healthcare among older persons in health facilities in Uganda. In addition, the perspectives of healthcare providers and community workers are explored using key informant interviews.

Study design, setting and sampling

This study used a cross-sectional study design. This qualitative study was a follow up to the secondary data analysis of the factors which predicted access to healthcare using a nationally representative household survey whose results are published elsewhere [ 32 ].

Three districts were purposively selected as study sites namely: Hoima, Kiboga and Busia, taking geographical and regional variations into consideration. Hoima was selected in western, Kiboga for central and Busia for eastern region.

Purposive sampling was used to select the study participants. Local leaders at the local council level guided the identification of older persons’ households. To recruit more participants, snow ball sampling was also used.

Data sources

This paper primarily uses interviews from a qualitative study conducted in Busia, Kiboga and Hoima districts of Uganda in 2014 [ 54 ]. This study was part of a doctoral thesis for the the first author. Some of the survey data and findings are published in another paper [ 32 ]. In addition, preliminary interviews were conducted in 2012 in Hoima in a collaborative research framework on Poverty, Resource Accessibility and Spatial Mobility in East Africa [ 55 ]. Even though the data were collected in 2014, the findings are still relevant. First, there is limited evidence on the subject – experiences of older people with the public health system in Uganda. Some data which is yet to be published in other settings still points to the health system challenges for folder people. Recently, the Ministry of Health (MoH) in Uganda is in the process of developing a national healthcare strategy for older persons. Some of the findings have been used to inform this policy formulation process. Similarly, the Ministry of Gender, Labor and Social Development (MGLSD) is developing the national guidelines for mainstreaming ageing in Uganda.

Data collection

The interviews with older persons included 18 In-depth interviews (IDIs) and seven focus group discussions (FGDs) collectively comprising 52 participants. We aimed to balance the gender of the different participants among the IDIs and the FGDs. Also, we aimed to do the same number of interviews in each district. The IDIs focused on exploring the perceptions and experiences of older persons about the barriers and facilitators of access to essential medicines for non-communicable diseases in health facilities. In addition, 9 key informant interviews (KIIs) were conducted with healthcare providers at public or private health facilities to facilitate triangulation of data. Healthcare providers were from Hoima regional referral hospital (Hoima), Bukomero health centre (HC) IV (Kiboga), Lumino HC III and Friends of Christ Revival Ministries (FOCREV) clinic (Busia district). The KIIs focused on the barriers and facilitators of access to essential medicines among older persons in Uganda. All the interviews were audio recorded. Entry into community was sought through village local council (LCs) chairpersons, older person’s associations in Hoima and Busia, and SAGE coordinators in Kiboga district and health facility in charges.

Ethical considerations

The study was approved by the Research Ethics Committee / Institutional Review Board (IRB) of the Uganda National Council of Science and Technology (UNCST) (SS 3198). The multi-disciplinary study on Poverty, resource accessibility and spatial mobility in East Africa (MPRAM) research programme was also approved by the IRB of the UNCST (SS 2726).

All experiments / research processes were performed in accordance with relevant guidelines and regulations (such as the Declaration of Helsinki).

All the respondents gave their written and informed consent to participate in the study. During the informed consent process, we provided assurance of confidentiality, participation on voluntary basis, freedom to withdraw or to decline and to answer any question without negative consequences. Finally, during the reporting and publication phase, we anonymized the interviews to ensure confidentiality of the interviewees.

Inclusion and exclusion criteria

The inclusion criteria were being age 50 years and older, being in the right mind and the ability to comprehend. In addition, we aimed to interview older persons who were not ill by the time of the interview. Also, eligibility criteria included older persons who were in their right mind and could comprehend and were not ill by the time of the interview.

Data analysis

All recorded interviews were transcribed verbatim. All transcriptions were checked to ensure accuracy in transcription and translation from local languages (Lunyoro, Lusamia and Luganda for Hoima, Busia and Kiboga respectively) to English. Transcriptions were later, imported into QSR International NVivo software (version 9) for thematic and / or framework analysis [ 56 ].

Both deductive and inductive thematic analysis were used in the coding exercise [ 57 ]. Themes were developed following the Health Access Livelihood Framework (HALF model) related to access to healthcare [ 58 ]. The HALF model describes five dimensions of access to healthcare: availability, affordability, accessibility, adequacy and acceptability and five dimensions of livelihood assets [ 58 ]. The inductive thematic analysis involved adding themes or codes that were emerging from the transcriptions during the coding exercise.

This section presents the facilitators and barriers of access to healthcare among older persons. Perceptions and experiences are explored from the older persons and healthcare providers. We start with the facilitators and end with the barriers.

Facilitators of access to healthcare among older people

The facilitators of access to healthcare included availability of public health facilities, social support, support from NGOs, access to financial resources, transportation, access to village health teams, and having a healthcare provider who is a relative.

Availability of free services in public health facilities

Availability of public health facilities which are expected to provide free medical services was highlighted as a motivation for visiting health facilities. In addition, non-communicable diseases create demand for healthcare. Private health facilities are not easily afforded by older people. They prefer to visit public health facilities:

… we go there when we fail to get money to take us to private health facilities…When a person is very cold and you make a fire, you do not have to invite him. He will bring himself. We go there because we are sick… You wonder whether they will give you medicine or not… [Male FGD, Hoima]

Putting a special clinic day for older persons was considered as a facility for access to healthcare in Hoima. Older persons continued to access healthcare on all days. However, a special day was designated to provide extra care for older persons. After some time, this was removed. However, this was not standard practice across all the three districts. It was the best practice in Hoima only. This was being at the regional referral hospital. Conversely, older persons complained that “sickness does not wait for you on a special day”. As much they were happy with a special or clinic day for older persons, they expressed concerns about its effectiveness.

Family and social support

Family support includes the support of spouses, relatives, brothers and sisters, adult children, and grandchildren. The form of support could be material, financial, or physical/caretaking. Older persons with highly educated working children, and those with children working abroad tend to receive significant support. Relatives play a major role in patient attendance and interacting with health personnel. In kind /material support for instance includes purchase of food, eyeglasses, and transfer to better health facilities around the city. Older persons with relatives working in health facilities favour them by helping them to “jump” the queue. Many older persons receive support from family members in form of means of transportation to health facilities and payment of medical bills.

Some of us have educated our children like you [refers to moderator]. That is a real bank. When you educate a child and he gets a job, that is a bank [Male FGD, Hoima]

However, family, or social support dynamics are changing. Some older persons reported that family support is limited and is not reliable. Some older persons with relatives who can transport them to hospital and pay the bills are very few. This was stated in an FGD in Kiboga. Children whose resources are meagre are unable even though they would be willing to support their parents because they also must cater for their own children/families. Other children may not even help when they are able to. This was emphasized in one FGD:

… The health of old people is very poor. Some have children who do not care for them. Even those who have no children have nobody to care for them… [Male FGD, Hoima]

Support from non-governmental organizations (NGOs)

Some NGOs in Busia provided support to older persons including Compassion International. Compassion International in Busia provided some support to older persons as caregivers of children, when they have chronic illnesses such as TB, HIV, and cancer. In Hoima, the Uganda Reach the Aged Association (URAA), World Vision, Sans Frontiers, Sight Savers International, Infectious Diseases Institute (IDI) and Little Hospice Hoima provided health support. In Kiboga, Stearkey (based in Ntinda), provided support to older people.

When they have chronic illnesses, we intervene …like TB, we support like HIV groups for HIV positive…. umm they are mostly old people [Community Worker, Busia]

The URAA trained home-based care givers in Hoima who offered basic treatment to older persons from their homes. However, the program ceased due to lack of funding.

There was an NGO helping the elderly. They trained the home-based caregivers. They could bring drugs for the elderly… It was Uganda Reach the Aged Association, URAA… But they ran short of money and all that… [Female FGD, Hoima]

Little Hospice takes care of severe chronic illness such as stroke or cancer for older persons who are on HIV treatment. Infectious Diseases Institute (IDI) was supporting HIV ART in Hoima regional referral hospital where older persons were beneficiaries. Sight Savers and Sans Frontiers provide eye care, provision of eyeglasses inclusive and hearing aids respectively. STEARKEY from Ntinda, Kampala, Uganda, also supports older persons with hearing aids in Kiboga.

…with sight, we have got the Sight Savers… at least that one yes… umm sight savers and also hearing umm at least there there people Sans Frontiers, who usually come around. and then after checking… I think they give out spectacles… free free… Sans Frontiers they they cross check they check for the the the ears impairment [Traditional Minister, Bunyoro Kingdom, Hoima]

Some older people with disability received some transportation assistance from the National Union of Disabled Persons Uganda (NUDIPU).

Financial resources

Having financial resources / money helped older persons to access private health facilities, where the services / handling was perceived to be better than in public health facilities. Generally, poor older persons use public health facilities while the rich or the middle class use private health facilities. Financial resources are essential in purchasing essential medicines or drugs for NCDs and paying for extra charges at public facilities. A community worker noted:

…the haves go to private (facilities), the have-nots they stay in queues waiting for medicines [public health facilities] … and the have-nots, they have no choice they have to wait in the queues… when you have your money, why should you wait? [Community worker, Hoima]

Older persons in Kiboga, who received the monthly Social Assistance Grants for Empowerment (SAGE) funds, were able to use some of the resources to access healthcare. Older persons in Busia and Hoima were not receiving the SAGE grant by that time. These two districts were not yet included on the beneficiary list. A community worker in Kiboga asserted:

…the biggest challenge for the elderly is that they have been lacking money… now when you give them an opportunity to have cash [SAGE grant] … even if he falls sick, he still is able to … buy drugs [Community worker, Bukomero, Kiboga]

Availability of transport to access healthcare

Availability of transport to visit the health facilities was a key facilitator. The means of transport are usually provided by older persons’ relatives, children and sometimes, NGOs. A community worker in Hoima noted:

… those who have relatives who are able… to move them on boda bodas or even bicycles… or even vehicles…there are some rich people [Community worker, Hoima]

Some NGOs like World Vision and Bukomero Development Foundation in Kiboga provided transport to older persons in Kiboga to access better treatment in Kampala. A community worker in Kiboga stated that:

There are those older people especially those that are suffering from HIV and AIDS, … we have been able to give them transport to go for medication may be in Mulago … to be able to access better treatment from Kampala [Community worker, Kiboga]

Access to village health teams (VHTs)

The community health system in Uganda includes village health teams (VHTS), community health workers (CHWs), health assistants (HAs), expert clients and the AIDS community volunteers (ACVs). VHTs and CHWs identify, refer to health facilities, and give health education to older persons. This has helped TB and HIV patients to access treatment. This was the major outreach strategy in Lumino HC 3 (Busia) and Mparangasi HC 3 (Hoima district). Some older persons visit health facilities after such referrals. A healthcare provider in Busia reported:

… we have some patients in the village who are chronically sick…they do not go to hospitals … so the VHTs or the CHWs identifies them… visits them and they have referral notes, they do refer them to us… so some of them come … [Healthcare provider, Busia]

Those who do not turn up are followed by medical staff from the health facility, which is an outreach strategy to the community. The VHTs majorly deal with malaria treatment among children and pregnant women. One KII in Busia emphasized:

…at times those who are referred, and they do not come… So, we send our people now… we even send these nurses… to go and visit these patients in the village…. it is more active on TB and the ART clinics [Healthcare provider, Busia]

However, in Kiboga, some participants noted that VHTs focus on children and not older persons:

…We also have VHTs… they are dealing with treatment of children… specifically malaria but they do sensitization and mobilization… they are supposed to tell the old people, … to even advocate for them [Healthcare provider, Kiboga]

Knowing a healthcare provider at a health facility was a great motivator

Access to healthcare was much easier when an older person knew a healthcare provider - as a relative or a son or daughter of a friend. In such cases, he or she is helped to jump the queue. He or she is removed from the line and treated first irrespective of whether he or she came earlier or later than other patients. In some cases, relatives who can talk well to providers also help them jump the queue. In some other instances, providers offer direct assistance to older persons. An older woman in Busia asserted:

No, for me they make me jump the queue… Yes, there are those I know… There is Sam (Pesudo name), he just picks me… I don’t know the work he does but he comes that ‘elder come they work on you and you go’… They can complain about it when am not there…They finish complaining and for me, I am gone. It is upon them as a person who backbites you after you had left, can you hear? [Older woman, age about 70, Busia]

In Hoima, mention of such assistance also came up in the male FGD:

If you know some member of staff, someone’s child working there… I know the doctor. The relationship at that level. Someone can leave the health facility in Kasomoro and come to Booma because there is the child of the aunt working there [Male FGD, Hoima]

Barriers of access to healthcare

The barriers of access to healthcare for older people were numerous. They ranged from lack of essential medicines to ageism against older people, absence of geriatricians, treatment adherence issues, accessibility, affordability challenges, and acceptability issues. These are described as follows:

Availability of essential medicines for non-communicable diseases is a critical gap

This was the most frequently discussed theme in al the interviews. Both older persons and healthcare providers acknowledged unavailability or frequent stockouts of essential drugs for non-communicable diseases (NCDs) for older people in public health facilities. Public health facilities normally refer older people to private clinics to buy medicines, which is a huge barrier for them. Many older persons reported frequent drug stockouts at public health facilities due to large numbers of patients Footnote 1 . An older man in Busia witnessed a situation where the medicines, which were received at a health centre III in Busia district, only included septrin and paracetamol. In Busia, older persons reported challenges with the distribution of drugs:

When we go to VHTs, they tell us the drugs are for the young children; that we should go to the health facility to get ours. But when we go to health centres, we do not find the drugs there [Male FGD, Hoima district]

There was a belief that public health facilities receive medicines that do not match “older people’s” sicknesses (refers to NCDs) in health centre IIIs. According to one of the health providers in a health centre III, it is rare to find drugs for hypertension, diabetes, and typhoid at health centre IIIs Footnote 2 and lower levels.

Some older persons in Busia suspected drug pilferage by health providers - that the drugs are then sold in health providers’ private clinics. However, health providers in Busia attributed unavailability of some drugs to frequent stock outs because of the government push system , which predetermines which drugs are sent to HC III and II and the heavy client flow in public health facilities. In addition, absence of storage facilities for insulin explained the shortage of insulin for diabetes in one of the regional referral hospitals in Hoima Footnote 3 .

One of the health providers in a health centre III explained that health centres IIIs receive medicines from district hospitals because of the government “push system” (KII, Busia). Although medicines or drugs in public facilities are supposed to be free, patients are sometimes asked to pay some money to the dispensers to help them purchase the drugs which are not available from an outside private pharmacy. Participants perceived this to be a form of extortion as noted:

Dispensers tell you that the drug is out of stock. Once you give him the money, he just pockets it and then picks up the medicine and gives it to you…. assuming that he has just bought it from outside the clinic [Community worker, Hoima]

Absence of specialized health personnel including geriatricians

The second most pressing barrier was concerned with healthcare providers especially geriatricians. The unavailability of health personnel trained in geriatrics and gerontology makes it difficult to adequately addressing older persons’ health problems. A key informant referring to lower-level health facilities alluded to the need to have trained doctors in Hoima:

The health facilities exist but health providers cannot manage the complications of the diseases of the elderly… because most of these health centers are managed by nurses. A man may have problems associated with hypertension, or the heart; such health centers cannot handle even if they are near [Community worker, Hoima]

Ageism against older people by young healthcare providers

One of the key factors was ageist and negative attitudes against older people by young health providers in public health facilities. Older people in Busia reported ageism perpetrated by young health providers. Older persons were reprimanded for trying to access medicines instead of giving space and priority to younger persons. Female FGD participants in Busia cited a health provider’s statement as follows:

‘These (older persons) are just finishing our medicines; don’t they have grandchildren?’ With such observations from health providers, … we get tired of going to the hospital… They tell us that we finish medicines for our grandchildren…. Now they say we are useless to people [Female FGD, Busia district]

Poor handling of older people by healthcare providers was attributed to both the overwhelming workload and the intentional mistreatment by young nurses. The most vulnerable older persons are those that seek for care on their own (alone).

Affordability and financial challenges

Poverty or financial barriers was the fourth most reported problem in accessing healthcare. Older persons found challenges in paying for medical bills, drugs, transport costs and extra charges. In addition, specialized tests and services were unaffordable. Specialist services included eye care, surgical operations for appendicitis, tubal blockage, and hernia. Specialized tests like X-ray and CT scans were costly for older persons. An older woman in Busia, who was blind due to cataracts, had not gone to Mbale hospital, where she was referred because of money problems. In Hoima, older women in an FGD had this to say:

…You do not have money to buy medicine every time you go to the health facility. This disease … high blood pressure does not get healed. It is like AIDS or even more than AIDS… [Female FGD, Hoima district]

Referrals and prescription challenges

Most older people find it difficult to follow referrals to buy medicines or drugs from private clinics because of financial and literacy barriers. In addition, they were challenged to adhere to treatment prescriptions. On the other hand, private health facilities stock drugs for NCDs but at a fee, that is often very expensive for many older persons. A health provider in Busia described referral process for older persons as a “mountain climbing” experience:

Due to financial limitations, in some cases, older persons purchased incomplete dosage depending on their wallets Footnote 4 : An older person in Hoima district noted the following:

Health providers can prescribe a full dose that may cost 9000 shillings, but you cannot raise it at that time. You buy half dose for 4500 shillings which you can afford at that time [Older man, age 70+, Hoima]

Referrals to buy essential drugs for NCDs from private facilities, which are not available in public health facilities, were unaffordable to older persons. Besides, private clinics were found to be expensive.

Shortage of specialized equipment to screen and test for NCDs

Many public health facilities lacked some specialized equipment and health services for screening and diagnosing NCDs. For example, the computerised tomography scan (CT scan) and ultrasound scans. By the time of the interview (during the M-PRAM project in 2012), Hoima regional referral hospital (RRH) neither had a CT scan machine, nor an ultrasound scan. In private clinics, CT and ultrasound scans cost between 30,000 and 50,000 UGX, which is expensive for many older persons. In addition, X-ray cost 15,000 UGX even in Hoima RRH by the time of the study. Concerning health services, a key informant noted:

… Western medicine is not affordable. You must go to a clinic, pay money for checkup, and the medicine, because in the government facilities, the CT scan services are not available [Community worker, Hoima]

Accessibility challenges

Long distance to health facilities limited older persons’ access to healthcare. This challenge is compounded by physical disabilities and caretakers’ reluctance to take older people to health facilities. Consequently, older persons fail to keep appointments with health providers for instance, crucial ones like diabetes management.

In addition, a lack of means of transport was another barrier to accessing healthcare or visiting distant health facilities in the event of referral. Public transport is not readily accessible in remote areas. Ambulances in public health facilities are non-functional due to mechanical challenges or fuel shortages.

Transport costs are a serious challenge to older persons. Some older people do not have money to pay for transportation to a health facility. Means of transportation used ranged from a bicycle, boda boda (motorcycle) which is the most common, to a vehicle.

Physical disabilities among older people usually make it difficult to access health facilities. They may be unable to walk on their own when the illness is severe. Sometimes, they are unable to ride bicycles by themselves or they don’t even own one. They may not have funds to pay a boda-boda (motorcycle). Older people with disability could not walk to health facilities on their own. They depend on caretakers.

…with age, they come complaining … of painful legs, painful lower limbs …by the time they become real disabled, you can’t see them in hospital… they … stay home… they may fail to bring them to hospital [Health provider, Hoima hospital]

Social stigma also prevented many disabled older persons from being brought by their care takers to health facilities. A community worker narrated the ordeal:

… a totally blind HIV positive older person died alone in the house in Hoima and was buried on 26th July 2012 [Community worker, Hoima]

Adequacy and quality considerations in public health facilities

Some hospitals organized health services on specific days which made it difficult for older people to access care on the non-scheduled days. In addition, irregular or short working hours were reported as critical impediments to access to and utilization of health services. For example, older patients complained about late opening time (about 10 am) and early closing time (about 4 pm) except for special clinic days for children and expectant mothers.

In addition, mixing older persons with younger patients (especially children and women) who are stronger was reported as another barrier. Older persons reported that they had no strength to queue for services for long hours. This is a major impediment to their access to services in public health facilities, which are usually crowded with sick children and their mothers. Owing to long waiting hours in queues some older persons reported that fail to retain urine and as a result, they get ashamed in public. Apart from the heavy client flow in public facilities long queues and waiting time were attributed to staff shortages. For example, the doctor to patient ratio in Hoima regional referral hospital was about 1:100.

…One doctor can see over 100 patients… so they have to keep in the line, and when they come, you have to send them to the lab for a random blood sugar test… by the time she comes again she has to queue again … that becomes a problem [Health provider, Hoima]

Acceptability problems

Personal stigma limited-service acceptability by older persons. Some older persons expressed self-directed stigma - a feeling that they would not be cared for by health providers when they visited health facilities. In addition, some older persons reported not accessing care because of lack of presentable clothes to wear for health facility visits. Some who had bad experiences are health facilities indicated that they preferred death to discrimination and disgrace at public health facilities. According to them, death would mean rest from suffering. A community worker who interacts with older persons made the following observation.

…some older persons have given up accessing services at public health facilities. Even if you tell them to go to hospital, they say ‘no, don’t take me there’, because they know, the moment they are taken to hospital, they are mistreated… they are as rejects. Old people say ‘please leave me alone if am to die, let me just die peacefully at home other than being tossed about [Community worker, Hoima]

Traditional and religious beliefs in some communities promoted herbal medicine and discouraged western medicine. In Hoima district, some adherents of the religious sect called “Wobusobozi” [meaning he is able] led by “Bisaaka” do not believe in modern or western medicine:

The fear of Bishaaka himself he has made them believe that he knows whatever they do … or what they think. So, his word is final… health wise, it’s because he did not believe in modern medicine but when he saw that that it was putting him on a clash with government, he has changed [Community worker, Hoima]

The aim of this paper was to investigate the barriers and facilitators of access to healthcare among older persons in Uganda at both the health system and individual levels. Our findings indicated that barriers outweighed facilitators. The barriers and facilitators of access to healthcare tended to overlap. Key facilitators included availability of free services, social support, financial affordability, transportation, village health teams and knowing a healthcare provider. On the other hand, the barriers included unavailability of essential medicines for NCDs, specialized personnel and equipment, ageism among healthcare providers, financial challenges, poor quality and acceptability problems of public health facilities. The facilitators and barriers are either health system or patient factors.

A challenging health system

A series of challenges stemming from the health system itself, that is acknowledged by community workers, health sector workers as well as by the older persons, stem out from this study. From the health system side, absence of geriatricians, unavailability of essential medicines for NCDs, ageism, affordability limitations and acceptability challenges were critical gaps in Uganda.

The unavailability of essential drugs for NCDs in lower public health facilities (health center IIIs and lower) was a major barrier of access to healthcare for older people. The perceptions of the older persons and community workers generally were that “healthcare providers sell drugs through their clinics”. Conversely, healthcare providers explained that the government uses a push system which provides basic medicines to lower health facilities. The government pushes medical supplies and medicines to lower health facilities (health centers I to III). That is, “larger public health facilities express significantly greater facility-level autonomy in drug ordering compared with smaller facilities, which indicates ongoing changes in the Ugandan medical supply chain to a hybrid ‘push-pull’ system” [ 59 ]. Larger health facilities include national, regional and district health facilities. These make orders for their medicines depending on need of the people served. There is tension about these perceptions from older people and the explanation by healthcare providers. Some studies have reported this challenge, absence of essential medicines for NCDs in the Ugandan heath system [ 23 , 38 , 39 , 40 , 41 , 60 , 61 , 62 ]. The same shortage of supply of essential medicines for NCDs is reported in Kenya, Cameroon and the DRC [ 62 , 63 ].

In Uganda, the Ministry of Health (MoH) adopted the dual “pull and push” system in 2010 in the delivery of essential medicines and health supplies (EMHS) [ 42 , 64 ]. The pull system was maintained for HC IVs and hospitals while the push system was introduced for rural and hard to reach health facilities including HC III and IIs. Lower-level health facilities no longer request for drugs based on the diseases’ burden and the population served [ 42 , 65 , 66 , 67 ]. HC IIIs do not request for the drugs they need except for tuberculosis (TB) and antiretroviral drugs [ 42 , 64 ]. In lower public health facilities (HC I-III), older persons are given drugs that are available and referred with prescriptions to buy drugs from private clinics for those that are not available Footnote 5 . The implication is the unavailability of essential medicines for NCDs in HC IIIs and IIs, which are accessible to older persons, because they no longer request for drugs /medicines based on the diseases’ burden and the population served [ 65 , 66 , 67 ]. Older people who visit public health facilities cannot obtain treatment according to prescriptions in lower-level health facilities. Referrals to purchase medicines from private facilities is a nightmare to them. They end up with no treatment or accessing less than the required dosage. This has negative implications on older persons’ health outcomes including disease progression and drug resistance [ 40 , 63 ]. NCDs require long term adherence to treatment regimes. This is interrupted when availability of medicines and supplies ins interrupted [ 40 ]. In the absence of essential medicines, some older persons resort to herbal medicine. However, their preference would be essential medicines from health facilities.

Generally, there is an acute scarcity of skilled healthcare providers for handling NCDs among older people in Uganda, particularly geriatricians and gerontologists. This was a serious concern among healthcare providers, older persons, and other community workers. Older people also agreed with the situation as they indicated that most times, they were handled by nurses and clinical officers and few doctors. Older persons are handled by clinicians, physicians and nurses who sometimes have no clue about handling multi-morbidity and polypharmacy among older people. This was an issue of consensus across all interview types. Other studies also report the absence of skilled providers as major barrier [ 60 , 61 ]. Chronic non-communicable diseases create greater need for healthcare [ 31 ], in countries such as Hong Kong [ 31 ], Singapore [ 33 ], and in rural South Africa [ 34 ]. Older persons still report limited access to healthcare [ 35 ].

Ageism in healthcare delivery was reported among some young healthcare providers especially nurses. Sometimes, lower-level healthcare providers do not have training to handle NCDs and therefore, end up manifesting ageist attitudes to older people in their delivery of healthcare. Although some older people reported ageist attitudes by some healthcare providers, others reported good experiences with some especially when they knew them. The experiences vary from one individual to another. Ageism is reported as a critical impediment for older persons’ access to healthcare [ 29 ].

Health services were considered inadequate and of poor quality by both older persons and healthcare providers. Adequacy relates to how healthcare is organized and whether that meets patients’ expectations [ 53 ]. For example, opening hours and waiting times. In addition, it covers hygiene, and quality of care [ 58 , 68 ]. Irregular working hours have been reported as major barriers to access to healthcare in Uganda [ 58 , 60 , 68 ]. Long waiting times are documented as critical impediments to access to and utilization of health services in Uganda [ 60 , 68 ]. Generally, public health facilities were perceived as those which provide poor quality services [ 63 ]. Private health services were perceived as those with better quality but not affordable to older people.

Finally, acceptability challenges were reported in the health system. Acceptability refers to cultural access [ 69 ] or socio-cultural access [ 68 ]. It relates to providers’ and patients’ attitudes, beliefs and expectations of each other [ 69 ]. It also includes patients’ perceived quality of care [ 61 , 68 ] and satisfaction with care [ 68 ]. Obrist et al. (2007) argues that for effective healthcare access, the patients must feel welcome, cared for by service providers and must trust in the competence and personality of the healthcare providers” (Obrist et al., 2007). The consensus among older people was that public health facilities were not acceptable to them. The essential medicines were lacking, specialized equipment for diagnosis were either absent or if present, very costly for them and the providers were nurses who did not understand how to handle or manage NCDs. However, a special clinic day for older persons was a great facilitator. It was an effective intervention for older people.

Individual challenges

Physical disability and mobility limitations was a significant barrier of access to healthcare. Disability reduced physical accessibility to health facilities. Accessibility focuses on the geographic distance and travel time between users’ homes and the nearest health facilities (Obrist et al., 2007; Peters et al., 2008). It also includes (un)availability of public transport and ownership of a means of transport e.g. bicycle or motorcycle [ 58 ]. This finding was reported in the quantitative data as well [ 32 ]. The health access livelihood framework (HALF) posits that vulnerability context affects access to healthcare [ 58 ]. Disabled older persons are unable to move to health facilities on their own. They need a means of transport and a caretaker to assist them move to a health facility. Some care takers are either unwilling or lack the means to transport older persons to health facilities.

Family support and its absence have been mentioned as both a facilitator and a barrier when absent [ 41 ]. This is important in terms of financial means, support for transport but also care, responsibility. Children are call upon by older parents to take them through the difficulties they face – here specifically health issues, by swiftly making the right decisions. Yet, children are sometimes far away and not in a position to provide the expected support. Availability and absence of financial means affects affordability of healthcare for older people.

Affordability of specialized healthcare for NCDs is a major limitation for older persons. Most older persons lack health insurance in the absence of a national health insurance scheme in Uganda. Paying out of the pocket medical expenses is unattainable since most older persons do not have pensions in old age [ 13 , 40 , 70 ]. Olde age poverty is a big problem in Uganda [ 50 ]. In addition, most NCDs treatment is very costly even though it is readily available in private health facilities, but not public ones. Older persons end up leaving hospitals without medicines or with half dosages or resorting to non-medical alternatives [ 40 , 63 ]. Referral to purchase medicines in private facilities and pharmacies is a big problem [ 40 ]. In Uganda, health insurance schemes do not cover some or most NCDs [ 41 ]. Affordability refers to financial access [ 69 ] or financial accessibility [ 68 ]. The costs of healthcare services are expected to fit the clients’ resources or income and willingness and ability to pay (McIntyre et al., 2009; Obrist et al., 2007; Peters et al., 2008). Affordability relates to direct costs e.g. user fees, payment for drugs; indirect costs e.g. in terms of transport costs, lost time and income and other “unofficial charges” such as paying bribes (Obrist et al., 2007). Some study indicated the acute affordability challenge of medicines for NCDs in Congo DRC and Cameroon [ 62 ] and Kenya [ 63 ]. Finally, access to healthcare among older persons is affected by the individual’s confidence in the health system, the ability of the patient to afford care, the health system’s capacity to respond to individual needs with respect and dignity.

Strength and limitations

This study was a follow up of a quantitative study whose results have already been published [ 32 ]. Here, the triangulation of qualitative data collection methods (FGDs, IDIs and KIIs) improves the validity and reliability of the data. The integration of healthcare providers’ perspectives with those of the older persons, gives a consistent picture to the barriers and facilitators of access to healthcare among older persons in Uganda.

It would have been possible to go further in the analysis of factors and barriers in access to healthcare with follow up interviews and observation sessions of situations when older people access healthcare or would want to and of service delivery in healthcare facilities. This would call for participant observations, within villages and around some health facilities which handle older persons which wasn’t planed for in our overall project using an explanatory mixed methods research design. It however remains the major limitation of this qualitative study.

Finally, using the data when the interviews were conducted in 2012 and 2014 needs to be acknowledged. The timing is quite long. One would argue that times and seasons have changed regarding access to healthcare! However, the firs author has been involved in the policy formulation process for developing the national healthcare strategy for older persons in Uganda by the World Health Organization and the Ministry of Health. The findings are still relevant and the new evidence from the MOH officials tallies with some of the reported findings.

Conclusions & recommendations

Older persons face immense health system and patient level barriers when accessing healthcare in Uganda. Older persons have greater heath needs because of NCDs and functional limitations. However, the health system in Uganda is still unresponsive and insensitive to the health needs of older persons.

Major health system barriers include inadequate supply of essential drugs for NCDs, absence of geriatricians among healthcare personnel, low acceptability by younger healthcare providers, long waiting times, long queues, unaffordability of certain specialized services, inaccessibility of some facilities, and discrimination in the health services’ delivery.

At the patient level, there are social inequalities in access to healthcare among older people. The major barriers are financial, transport challenges, physical disability, and multi-morbidity because of NCDs.

Key recommendations to improve access to healthcare for older persons include the following: First, the health system needs strengthening to be able to respond to the health needs of older people in Uganda. Second, the tracking of the supply of essential medicines for NCDs for lower-level health facilities is critical. Third, training of geriatricians for the health system and social gerontologists, would be key interventions urgently needed to address this gap. Fourth, a national health insurance scheme to cover all vulnerable groups including older persons is warranted. Finally, developing a national policy and health strategy for addressing access to healthcare by older persons is urgently needed.

Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

IDI 15, older man age 70, Busia district. He visited HC thrice and missed drugs once when he was referred to buy and did not have the money. He also stated that the prescription was written in English which he could not understand.

KII_13, provider at HC III, Busia.

KII_05, Hoima regional referral hospital.

IDI 01, older man age 64, Hoima. Had high blood pressure but was better off economically.

IDI 13, older man age 56, Busia district. He also reported that he was once injected with an expired drug in one of the clinics by a nurse, who didn’t check the label/expiry date of the drug.

UNFPA HAI. Ageing in the twenty-First Century: a celebration and a challenge. New York, and HelpAge International, London: United Nations Population Fund (UNFPA); 2012.

Google Scholar  

UN, World Population Prospects. The 2010 Revision New York: United Nations, Department of Economic and Social Affairs, Population Division 2013. Available from: http://esa.un.org/unpd/wpp/unpp/p2k0data.asp .

Aboderin I, Ferreira M. Linking ageing to Development Agendas in Sub-saharan Africa: challenges and approaches Population Ageing. 2008;1:51–73.

UBOS. Uganda National Household Survey 2009–2010. Socio-economic module. Abridged report. Kampala, Uganda: Uganda Bureau of Statistics; 2010 November.

Wandera SO, Ddumba I, Akinyemi JO, Adedini SA, Odimegwu C. Living alone among older persons in Uganda: Prevalence and Associated factors. Ageing Int. 2017;42(4):429–46.

Article   PubMed   PubMed Central   Google Scholar  

UBOS. Uganda Population and Housing Census 2014. Kampala, Uganda: Uganda Bureau of Statistics; 2014.

WHO. Definition of an older or elderly person: Proposed Working Definition of an Older Person in Africa for the MDS Project Geneva, Switzerland: World Health Organization. ; 2015. Available from: http://www.who.int/healthinfo/survey/ageingdefnolder/en/ .

Minh HV, Byass P, Chuc NTK, Wall S. Patterns of health status and quality of life among older people in rural Viet Nam. 2010. 2010;3(Supplementary 2):64– 9.

Mwanyangala MA, Mayombana C, Urassa H, Charles J, Mahutanga C, Abdullah S, et al. Health status and quality of life among older adults in rural Tanzania. Global Health Action. 2010;3(Supplement 2):36–44.

Ng N, Hakimi M, Byass P, Wilopo S, Wall S. Health and quality of life among older rural people in Purworejo District, Indonesia. Global Health Action 2010(Supplement 2).

Ng N, Minh HV, Juvekar S, Razzaque A, Bich TH, Kanungsukkasem U et al. Using the INDEPTH HDSS to build capacity for chronic non-communicable disease risk factor surveillance in low and middle income countries. Global Health Action. 2009;2(1984).

AU, Africa Health S. 2007–2015. Addis Ababa: African Union; 2007.

MoGLSD. National Policy for Older Persons. Ageing with security and Dignity Kampala. Uganda: Ministry of Gender, Labour and Social Development; 2009.

Siddharthan T, Kalyesubula R, Morgan B, Ermer T, Rabin TL, Kayongo A, et al. The rural Uganda non-communicable disease (RUNCD) study: prevalence and risk factors of self-reported NCDs from a cross sectional survey. BMC Public Health. 2021;21(1):2036.

Kansiime S, Mwesigire D, Mugerwa H. Prevalence of non-communicable diseases among HIV positive patients on antiretroviral therapy at joint clinical research centre, Lubowa, Uganda. PLoS ONE. 2019;14(8):e0221022.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Mondo CK, Otim MA, Akol G, Musoke R, Orem J. The prevalence and distribution of non-communicable diseases and their risk factors in Kasese district, Uganda. Cardiovasc J Afr. 2013;24(3):52–7.

Article   PubMed   Google Scholar  

Mudie K, Jin MM, Tan, Kendall L, Addo J, Dos-Santos-Silva I, et al. Non-communicable diseases in sub-saharan Africa: a scoping review of large cohort studies. J Glob Health. 2019;9(2):020409.

Wandera SO, Kwagala B, Ntozi J. Prevalence and risk factors for self-reported non-communicable diseases among older ugandans: a cross-sectional study. Glob Health Action. 2015;8:27923.

Kraef C, Juma PA, Mucumbitsi J, Ramaiya K, Ndikumwenayo F, Kallestrup P et al. Fighting non-communicable diseases in East Africa: assessing progress and identifying the next steps. BMJ Glob Health. 2020;5(11).

Natukwatsa D, Wosu AC, Ndyomugyenyi DB, Waibi M, Kajungu D. An assessment of non-communicable disease mortality among adults in Eastern Uganda, 2010–2016. PLoS ONE. 2021;16(3):e0248966.

Meghani A, Ssemugabo C, Pariyo G, Hyder AA, Rutebemberwa E, Gibson DG. Curbing the rise of noncommunicable diseases in Uganda: perspectives of policy actors. Glob Health Sci Pract. 2021;9(1):149–59.

Ssensamba JT, Nakafeero M, Musana H, Amollo M, Ssennyonjo A, Kiwanuka SN. Primary care provider notions on instituting community-based geriatric support in Uganda. BMC Geriatr. 2022;22(1):258.

Bakeera S, Petzold M, Pariyo G, Galea S, Tomson G, Wamala S. Community social capital and the use of health care services in Uganda. J Public Health Epidemiol. 2010;2:189–98.

Bakeera S, Wamala S, Galea S, State A, Peterson S, Pariyo G. Community perceptions and factors influencing utilization of health services in Uganda. Int J Equity Health. 2009;8(1):25.

Odaga J. Health inequity in Uganda: the role of financial and non-financial barriers. Health Policy Dev. 2004;2(3):192–208.

Pariyo G, Ekirapa-Kiracho E, Okui O, Rahman M, Peterson S, Bishai D, et al. Changes in utilization of health services among poor and rural residents in Uganda: are reforms benefitting the poor? Int J Equity Health. 2009;8(1):39.

Ssengooba F, Rahman S, Hongoro C, Rutebemberwa E, Mustafa A, Kielmann T, et al. Health sector reforms and human resources for health in Uganda and Bangladesh: mechanisms of effect. Hum Resour Health. 2007;5(1):3.

Kasujja FX, Nuwaha F, Daivadanam M, Kiguli J, Etajak S, Mayega RW. Understanding the diagnostic delays and pathways for diabetes in eastern Uganda: a qualitative study. PLoS ONE. 2021;16(4):e0250421.

Inouye SK. Creating an anti-ageist healthcare system to improve care for our current and future selves. Nat Aging. 2021;1(2):150–2.

Aboderin I. Understanding and advancing the health of older populations in sub-saharan Africa: policy perspectives and evidence needs. Public Health Rev. 2010;32:357–76.

Article   Google Scholar  

Yam H-K, Mercer SW, Wong L-Y, Chan W-K, Yeoh E-K. Public and private healthcare services utilization by non-institutional elderly in Hong Kong: is the inverse care law operating? Health Policy. 2009;91(3):229–38.

Wandera SO, Kwagala B, Ntozi J. Determinants of access to healthcare by older persons in Uganda: a cross-sectional study. Int J Equity Health. 2015;14(1):26.

George P, Heng B, De Castro Molina J, Wong L, Wei Lin N, Cheah JT. Self-reported chronic diseases and health status and health service utilization - results from a community health survey in Singapore. Int J Equity Health. 2012;11(1):44.

Gómez-Olivé FX, Thorogood M, Clark B, Kahn K, Tollman S. Self-reported health and health care use in an ageing population in the Agincourt sub-district of rural South Africa. Global Health Action. 2013;6:19305.

Channon AA, Andrade MV, Noronha K, Leone T, Dilip TR. Inpatient care of the elderly in Brazil and India: assessing social inequalities. Soc Sci Med. 2012;75(12):2394–402.

Luo J, Zhang X, Jin C, Wang D. Inequality of access to health care among the urban elderly in northwestern China. Health Policy. 2009;93(2–3):111–7.

UN. Madrid International Plan of Action on Ageing (MIPAA) New York (NY). United Nations; 2002.

Mulumba M, Nantaba J, Brolan C, Ruano A, Brooker K, Hammonds R. Perceptions and experiences of access to public healthcare by people with disabilities and older people in Uganda. Int J Equity Health. 2014;13(1):76.

Armstrong-Hough M, Sharma S, Kishore SP, Akiteng AR, Schwartz JI. Variation in the availability and cost of essential medicines for non-communicable diseases in Uganda: a descriptive time series analysis. PLoS ONE. 2020;15(12):e0241555.

Tusubira AK, Akiteng AR, Nakirya BD, Nalwoga R, Ssinabulya I, Nalwadda CK, et al. Accessing medicines for non-communicable diseases: patients and health care workers’ experiences at public and private health facilities in Uganda. PLoS ONE. 2020;15(7):e0235696.

Ng G, Raskin E, Wirtz VJ, Banks KP, Laing RO, Kiragu ZW, et al. Coping with access barriers to non-communicable disease medicines: qualitative patient interviews in eight counties in Kenya. BMC Health Serv Res. 2021;21(1):417.

Rogers HE, Akiteng AR, Mutungi G, Ettinger AS, Schwartz JI. Capacity of Ugandan public sector health facilities to prevent and control non-communicable diseases: an assessment based upon WHO-PEN standards. BMC Health Serv Res. 2018;18(1):606.

MRC UVRI. Direct and indirect effects of HIV/AIDS and anti-retroviral treatment on the health and wellbeing of older people. Kampala: Uganda Virus Research Institute & Medical Research Council; 2011.

Kuteesa MO, Seeley J, Cumming RG, Negin J. Older people living with HIV in Uganda: understanding their experience and needs. Afr J AIDS Res. 2012;11(4):295–305.

Zakumumpa H, Kiweewa FM, Khuluza F, Kitutu FE. The number of clients is increasing but the supplies are reducing: provider strategies for responding to chronic antiretroviral (ARV) medicines stock-outs in resource-limited settings: a qualitative study from Uganda. BMC Health Serv Res. 2019;19(1):312.

Nankwanga A, Phillips J, Neema S. Exploring and curbing the effects of HIV/AIDS on elderly people in Uganda. J Community Health Sci. 2009;4(2):19–30.

Ntozi JPM, Nakayiwa S. AIDS in Uganda: how has the household coped with the epidemic. The continuing African HIV/AIDS epidemic. 1999;2:155– 81.

Seeley J, Kabunga E, Tumwekwase G, Wolff B, Grosskurth H. The Impact of the AIDS Epidemic on the Lives of Older People in Rural Uganda. DEV Working Paper 04; 2008.

Seeley J, Wolff B, Kabunga E, Tumwekwase G, Grosskurth H. This is where we buried our sons’: people of advanced old age coping with the impact of the AIDS epidemic in a resource-poor setting in rural Uganda. Aging Soc. 2009;29(1):115.

Golaz V, Rutaremwa G. The vulnerability of older adults: what do census data say? An application to Uganda. Afr Popul Stud. 2011;26(1):605–22.

Golaz V, Rutaremwa G, Wandera SO. Les solidarités familiales autour des personnes âgées en Ouganda. In: Adjamagbo A, Antoine P, editors. Démographie et politiques sociales (Actes Du XVIIe colloque, Ouagadougou, Novembre 2012). Association Internationale Des Démographes De Langue Française (AIDELF), 2015. Paris, France: Karthala; 2015.

Hjelm K, Atwine F. Health-care seeking behaviour among persons with diabetes in Uganda: an interview study. BMC Int Health Hum Rights. 2011;11(11).

Birabwa C, Bwambale MF, Waiswa P, Mayega RW. Quality and barriers of outpatient diabetes care in rural health facilities in Uganda - a mixed methods study. BMC Health Serv Res. 2019;19(1):706.

Wandera SO. Disparities in Health and Access to Healthcare Among Older Persons in Uganda [Thesis by Publications ]. Kampala, Uganda: Makerere University. 2016.

MPRAM. Multi-disciplinary Partner Team on Poverty, Resource Accessibility, and spatial Mobility in East Africa: MPRAM. ; 2016. Available from: https://mpramea.wordpress.com/our-projects/bunyoro/ .

Gale N, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol. 2013;13(1):117.

Ostlund U, Kidd L, Wengstrom Y, Rowa-Dewar N. Combining qualitative and quantitative research within mixed method research designs: a methodological review. Int J Nurs Stud. 2010.

Obrist B, Iteba N, Lengeler C, Makemba A, Mshana C, Nathan R, et al. Access to Health Care in contexts of Livelihood Insecurity: a Framework for Analysis and Action. PLoS Med. 2007;4(10):e308.

Chen J, Ssennyonjo A, Wabwire-Mangen F, Kim JH, Bell G, Hirschhorn L. Does decentralization of health systems translate into decentralization of authority? A decision space analysis of Ugandan healthcare facilities. Health Policy Plan. 2021;36(9):1408–17.

Kiwanuka SN, Ekirapaa EK, Peterson S, Okuia O, Hafizur Rahman M, Peters D, et al. Access to and utilisation of health services for the poor in Uganda: a systematic review of available evidence. Royal Soc Trop Med Hygiene. 2008;102:1067–74.

Article   CAS   Google Scholar  

Mamdani M, Bangser M. Poor People’s Experiences of Health Services in Tanzania. Reprod Health Matters. 2004;12(24):138–53.

Schäfermann S, Neci R, Ndze EN, Nyaah F, Pondo VB, Heide L. Availability, prices and affordability of selected antibiotics and medicines against non-communicable diseases in western Cameroon and northeast DR Congo. PLoS ONE. 2020;15(1):e0227515.

Onyango MA, Vian T, Hirsch I, Salvi DD, Laing R, Rockers PC, et al. Perceptions of Kenyan adults on access to medicines for non-communicable diseases: a qualitative study. PLoS ONE. 2018;13(8):e0201917.

Lugada E, Komakech H, Ochola I, Mwebaze S, Olowo Oteba M, Okidi Ladwar D. Health supply chain system in Uganda: current issues, structure, performance, and implications for systems strengthening. J Pharm Policy Pract. 2022;15(1):14.

Masters SH, Burstein R, DeCenso B, Moore K, Haakenstad A, Ikilezi G, et al. Pharmaceutical availability across levels of care: evidence from facility surveys in Ghana, Kenya, and Uganda. PLoS ONE. 2014;9(12):e114762.

Okiror B, Onchweri AN, Miruka CO, Maniga JN. Availability of essential Medicines and supplies during the Dual pull-push System of Drugs Acquisition in Kaliro District, Uganda. Pharma Care Health Sys. 2015;S2:006.

Bukuluki P, Byansi PK, Sengendo J, Nyanzi ID, Banoba P, Kaawa-Mafigiri D. Changing from the pull to the Push System of Distributing Essential Medicines and Health Supplies in Uganda: implications for efficient allocation of Medicines and Meeting the Localized Needs of Health Facilities. GLOBAL HEALTH Gov. 2013;6(2):1–11.

Peters DH, Garg A, Bloom G, Walker DG, Brieger WR, Rahman MH. Poverty and access to health care in developing countries. Ann N Y Acad Sci. 2008;1136:161–71.

McIntyre D, Thiede M, Birch S. Access as a policy-relevant concept in low- and middle-income countries. Health Econ Policy Law. 2009;4(Pt 2):179–93.

MoGLSD. Income Security for all ugandans in Old Age. Kampala: Ministry of Gender, Labor and Social Development; 2011.

Download references

Acknowledgements

Not Applicable.

This research was partially supported by the Consortium for Advanced Research Training in Africa (CARTA). CARTA is jointly led by the African Population and Health Research Center and the University of the Witwatersrand and funded by the Wellcome Trust (UK) (Grant No: 087547/Z/08/Z), the Department for International Development (DfID) under the Development Partnerships in Higher Education (DelPHE), the Carnegie Corporation of New York (Grant No: B 8606), the Ford Foundation (Grant No: 1100 − 0399), Google.Org (Grant No: 191994), SIDA (Grant No: 54100029), MacArthur Foundation (Grant No: 10-95915-000-INP), the Uppsala Monitoring Center, and the Norwegian Agency for Development Cooperation (NORAD). The qualitative data collection in 2014 was funded by the Carnegie Corporation of New York to Makerere University. The time to do the final write up of the manuscript was funded by the CARTA Postdoctoral Research Fellowship (2022–2023) at Moi University. In addition, preliminary interviews were conducted in 2012 in Hoima in a collaborative research framework on Poverty, Resource Accessibility and Spatial Mobility in East Africa [ 55 ]. The statements made and views expressed are solely the responsibility of the Fellow.

Author information

Authors and affiliations.

Department of Population Studies, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda

Stephen Ojiambo Wandera, Betty Kwagala & James P. M. Ntozi

Department of Mental Health and Behavioral Sciences and Mental Health, Moi University, Eldoret, Kenya

Stephen Ojiambo Wandera & David Otundo Ayuku

Institut National d’Etudes Demographiques (INED), Paris, Aubervilliers, France

Valerie Golaz

You can also search for this author in PubMed   Google Scholar

Contributions

SOW, BK, VG, and JPMN led the Conception and design, Data Curation, Formal Analysis, Investigation, Methodology development, Writing – Original Draft Preparation, and Writing – Review & Editing. SOW handled Funding Acquisition. DOA provided Supervision to SOW and supported the Writing – Review and Editing. All authors contributed to Validation, Visualization and Writing – Review and Editing. All the authors reviewed and approved the final manuscript.

Corresponding author

Correspondence to Stephen Ojiambo Wandera .

Ethics declarations

Ethics approval and consent to participate.

The study was approved by the Research Ethics Committee / Institutional Review Board (IRB) of the Uganda National Council of Science and Technology (UNCST) (SS 3198). The multi-disciplinary study on Poverty, resource accessibility and spatial mobility in East Africa (MPRAM) research programme was also approved by the IRB of the UNCST (SS 2726). All experiments / research processes were performed in accordance with relevant guidelines and regulations (such as the Declaration of Helsinki). All the respondents gave their written and informed consent to participate in the study. During the informed consent process, we provided assurance of confidentiality, participation on voluntary basis, freedom to withdraw or to decline and to answer any question without negative consequences. Finally, during the reporting and publication phase, we anonymized the interviews to ensure confidentiality of the interviewees.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Wandera, S.O., Golaz, V., Kwagala, B. et al. “These are just finishing our medicines”: older persons’ perceptions and experiences of access to healthcare in public and private health facilities in Uganda. BMC Health Serv Res 24 , 396 (2024). https://doi.org/10.1186/s12913-024-10741-6

Download citation

Received : 30 May 2023

Accepted : 18 February 2024

Published : 29 March 2024

DOI : https://doi.org/10.1186/s12913-024-10741-6

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Public health facility
• Private health facility
• Health system
• Facilitators
• Sub-Saharan Africa

BMC Health Services Research

ISSN: 1472-6963

• General enquiries: [email protected]