PGPH-D-22-01244

“Must you make an app?” A qualitative exploration of socio-technical challenges and opportunities for designing digital maternal and child health solutions in Soweto, South Africa

PLOS Global Public Health

Dear Dr. Klingberg,

Thank you for submitting your manuscript to PLOS Global Public Health. After careful consideration, we feel that it has great merit but does not fully meet PLOS Global Public Health’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. As you will see in the reviews, the reviewers were extremely positive about this work and raised only very minor suggested changes to provide additional context on the respondents.

Please submit your revised manuscript by Oct 21 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at globalpubhealth@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pgph/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

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• A rebuttal letter that responds to each point raised by the editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

We look forward to receiving your revised manuscript.

Kind regards,

Hannah Hogan Leslie, PhD

Academic Editor

PLOS Global Public Health

Journal Requirements:

1.Please provide separate figure files in .tif or .eps format.

For more information about figure files please see our guidelines:  LINK

https://journals.plos.org/globalpublichealth/s/figures 

https://journals.plos.org/globalpublichealth/s/figures#loc-file-requirements 

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

Additional Editor Comments (if provided):

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does this manuscript meet PLOS Global Public Health’s publication criteria? Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe methodologically and ethically rigorous research with conclusions that are appropriately drawn based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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

Reviewer #1: N/A

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 requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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

PLOS Global Public Health does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: I recommend that the article be accepted. It is a well written article which addresses current and relevant issues related to the use of digital health to improve access to health information and health care in low and middle income countries. Particularly important is that it explores these issues from the user's perspective.

A clear problem statement and rationale for the study is provided, and the methods are well described. However more could be said about the ethics of doing in-person interviews during the COVID-19 pandemic and precautions taken to protect participants and research staff.

The data analysis and results are well presented, and support the discussion and conclusions.

In reporting and discussing the study findings, it would have been useful to have more sociodemographic information on the participants e.g. education levels, employment. They also appeared to have been participants or community health workers in a related research project. Thus some discussion on how their perspectives may differ from women in other settings such as rural areas in South Africa, or may have been influenced by their proximity to ongoing research on these topic is needed.

A recent systematic review should on the use of digital health technologies in SA during COVID-19 would be good to refer to in the intro and discussion to reflect on whether this study confirms or differs in its findings:

Mbunge E, Batani J, Gaobotse G, Muchemwa B. Virtual healthcare services and digital health technologies deployed during coronavirus disease 2019 (COVID-19) pandemic in South Africa: a systematic review. Global Health Journal. 2022 Mar 5.

Reviewer #2: Congratulations to the authors on this very interesting manuscript that is timely and interesting. The methods, results and discussion flow logically and make sense. The work is important and I am happy to see the in-situ research on the intersection of maternal health and ICT. This is the first review manuscript that I have ever recommended be accepted without modifications.

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Reviewer #1: No

Reviewer #2: No

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“Must you make an app?” A qualitative exploration of socio-technical challenges and opportunities for designing digital maternal and child health solutions in Soweto, South Africa

PGPH-D-22-01244R1

Dear Dr Klingberg,

We are pleased to inform you that your manuscript '“Must you make an app?” A qualitative exploration of socio-technical challenges and opportunities for designing digital maternal and child health solutions in Soweto, South Africa' has been provisionally accepted for publication in PLOS Global Public Health. Thank you for the prompt and thorough response to the reviewers' comments, and congratulations on an excellent paper - this is certainly the smoothest review process I have had the pleasure of handling!

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

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

IMPORTANT: The editorial review process is now complete. PLOS will only permit corrections to spelling, formatting or significant scientific errors from this point onwards. Requests for major changes, or any which affect the scientific understanding of your work, will cause delays to the publication date of your manuscript.

If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they'll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact globalpubhealth@plos.org.

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

Best regards,

Hannah Hogan Leslie, PhD

Academic Editor

PLOS Global Public Health

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Reviewer Comments (if any, and for reference):