PCLM-D-25-00430

Translating national climate policies to resilience actions at the subnational level in low resource settings: Lessons from Ghana’s health systems.

PLOS Climate

Dear Dr. Abugnaba-Abanga,

Thank you for submitting your manuscript to PLOS Climate. After careful consideration, we feel that it has merit but does not fully meet PLOS Climate’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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Teodoro Georgiadis

Academic Editor

PLOS Climate

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Additional Editor Comments (if provided):

The reviewers have a great agreement in suggestion slight revision to the manuscript and both suggested minor revision to improve its content. I suggest the authors to revise the manuscript accordingly to the suggestions provided

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does this manuscript meet PLOS Climate’s publication criteria?>

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?-->?>

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available (please refer to the Data Availability Statement at the start of the manuscript PDF file)??>

The PLOS Data policy

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Abstract: Kindly try to incorporate and differentiate clearly the distinction between system-level (PHC systems) versus facility-level (PHC facilities) findings in the abstract.

Methodology

- How were inter-rater differences handled in vulnerability scoring among DHMT members?

-What steps were taken to minimize social desirability or institutional bias, given that facility managers assessed their own facilities?

-Could the rationale for restricting the assessment to short-term risks (<10 years) be more clearly justified conceptually?

-Is it possible to try and provide/add a brief positionality statement that would help strengthen transparency, given the applied policy context?

Results

Try as much a spossible to streamline the results by reducing table density and repetition, especially Table.

-Are the policy-relevant contrasts (e.g., hospitals vs. CHPS) sufficiently highlighted in the narrative?

-I t Would be ideal if the subheadings are explicitly aligned to WHO building blocks improve readability

Discussions-Ad a short sentence on policy implication of this novel research to the decision makers

Reviewer #2: The article is well structured and, when summarised in the abstract, is explained in detail in the subsequent chapters.

The topics covered and their interpretation are key issues at international level today. The tools used for the analysis are very interesting and easy to apply. I have only one doubt, namely whether the authors took into account possible biases or the direct interests of the respondents during the interviews. If they did not take this into account, perhaps it is an aspect that could be highlighted in the “Limitations” chapter.

Apart from a few typos and the above question, I believe it is publishable and worthwhile.

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Reviewer #1: Yes: HUMPHREY AGEVI

Reviewer #2: No

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Translating national climate policies to resilience actions at the subnational level in low resource settings: Lessons from Ghana’s health systems.

PCLM-D-25-00430R1

Dear Dr. Abugnaba-Abanga,

We are pleased to inform you that your manuscript 'Translating national climate policies to resilience actions at the subnational level in low resource settings: Lessons from Ghana’s health systems.' has been provisionally accepted for publication in PLOS Climate.

Before your manuscript can be formally accepted you will need to complete some formatting changes, which you will receive in a follow-up email from a member of our team.

Please note that your manuscript will not be scheduled for publication until you have made the required changes, so a swift response is appreciated.

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Thank you again for supporting Open Access publishing; we are looking forward to publishing your work in PLOS Climate.

Best regards,

Teodoro Georgiadis

Academic Editor

PLOS Climate