PGPH-D-24-00274

Seasonal variations in household food insecurity and consumption affect women’s nutritional status in rural South Ethiopia.

PLOS Global Public Health

Dear Dr. Mezgebe,

Thank you for submitting your manuscript to PLOS Global Public Health. After careful consideration, we feel that it has 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.

==============================

EDITOR: Please insert comments here and delete this placeholder text when finished. Be sure to:

• Please ensure that your decision is justified on PLOS Global Public Health’s publication criteria and not, for example, on novelty or perceived impact.
  ==============================
  Please submit your revised manuscript by 22/04/2024. 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.
  Please include the following items when submitting your revised manuscript:

• 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,

Dickson Abanimi Amugsi, PhD

Academic Editor

PLOS Global Public Health

Journal Requirements:

1. Please amend your detailed Financial Disclosure statement. This is published with the article. It must therefore be completed in full sentences and contain the exact wording you wish to be published.

a. State the initials, alongside each funding source, of each author to receive each grant.

b. State what role the funders took in the study. If the funders had no role in your study, please state: “The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.”

c. If any authors received a salary from any of your funders, please state which authors and which funders.

If you did not receive any funding for this study, please simply state: “The authors received no specific funding for this work.

Additional Editor Comments (if provided):

[Note: HTML markup is below. Please do not edit.]

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

Reviewer #3: Yes

**********

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

Reviewer #1: Yes

Reviewer #2: No

Reviewer #3: Yes

**********

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

Reviewer #3: Yes

**********

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

Reviewer #3: No

**********

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: Thank you for preparing the article. I have a few comments which I hope would help with improving the manuscript.

Title

I suggest the authors consider rewriting the objective of the study for clarity. “Food insecurity,” which has a negative connotation, is not consistent with “dietary diversity” and “food consumption” and makes the objective hard to read. The objective can be refined to: “To assess the effect of seasonal variation in household food security, adequate dietary diversity and food consumption, and household income on the nutritional status of women of reproductive age in a rural community in South Ethiopia. Further, the study aimed at identifying associated factors to women's nutritional status”.

Introduction

It would be helpful to the reader if the authors specified in the introduction what information is from Ethiopia and what is from other countries.

Study setting and context

What was the reason for using “live birth rate” instead of “birth rate”? “Live birth rate is usually used in fertility reporting and not at the population level.

Selection of study population and sample size

Could you add the total number of women included at the end of the section and specify the reason for including all eligible women?

Wealth index

Line 217: typo. “Cooking”

Meal frequency

I couldn’t find the description of calculating “meal frequency” in the methods. Further, if data is available, including the meal frequency finding in Table 2 would be informative.

Discussion

I suggest the authors discuss the significance of the findings; the discussion primarily compares the findings of the study with other studies. However, the validity and significance of the findings could have been discussed further. I also would like authors to discuss the implications of funding, not only for future research but also in designing development projects.

Reviewer #2: Dear author,

Thank you for interesting in this area, which needs great attention all sectors to overcome the problem of malnutrition. However, a lots of researches have been conducted and published on this title. So, the followings are the main questions raised on your work. I have included the comments also.

1. what a new thing your research findings contribute to the science?

2. the recommendation needs to be revised and inline with the study findings.

3. Use the journal guidelines as all contents of the paper has poor write up.

4. Use the scientific tables for the study results

5. Your discussion is weak and recommendations also need revision.

Reviewer #3: The manuscript entitled "Seasonal variation in household food insecurity and consumption affect women's nutritional status in rural South Ethiopia" is important as it deals with with household food security and its impact to women's health. The study findings will be useful to Policymakers, farmers, health officials, extension officers, government, researchers, students, other readers, etc. I suggest the following to improve the quality of the manuscript.

1. The Author must include the hypothesis towards the end of Introduction section.

2. The Methods and Materials section is not organised properly and needs to be rearranged. The first subsection must be "Study area description, food production and food availability". The current subsections "Study design" in Line 107 and Study setting and context in Line 110 must be deleted. This means that the content under these deleted subsection will be under new subsection.

3. The subsection "Ethical consideration must be second subsection following Study area description, food production and availability

4. The subsection "Variables" in Line 159 must be deleted and be replaced with subsection "Data collection procedures". All the content before Data processing and analysis will be under new subsection of "Data collection procedures"

5. It will be interesting for the Author to make recommendation(s) to Policymakers based on this study findings to ensure sustainable nutritious food availability throughout the year including food scarcity seasons.

6. There are some minor gramatical errors and the Author needs to go through the manuscript, reading it carefully and correct these.

**********

6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

Do you want your identity to be public for this peer review? If you choose “no”, your identity will remain anonymous but your review may still be made public.

For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Behnoush Ahranjani

Reviewer #2: Yes: Tamiru Yazew

Reviewer #3: No

**********

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

PGPH-D-24-00274R1

Seasonal variations in household food security and consumption affect women’s nutritional status in rural South Ethiopia.

PLOS Global Public Health

Dear Bethelhem,

Thank you for submitting your manuscript to PLOS Global Public Health. After careful consideration, we feel that it has 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.

Please submit your revised manuscript by 18/06/2024. 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.

Please include the following items when submitting your revised manuscript:

• 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,

Dickson Abanimi Amugsi, PhD

Academic Editor

PLOS Global Public Health

Journal Requirements:

1. 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.

2. Please amend your detailed Financial Disclosure statement. This is published with the article. It must therefore be completed in full sentences and contain the exact wording you wish to be published.

a. State the initials, alongside each funding source, of each author to receive each grant.

b. State what role the funders took in the study. If the funders had no role in your study, please state: “The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.”

c. If any authors received a salary from any of your funders, please state which authors and which funders.

If you did not receive any funding for this study, please simply state: “The authors received no specific funding for this work.”

3. We have noticed that you have uploaded Supporting Information files, but you have not included a list of legends. Please add a full list of legends for your Supporting Information files after the references list.

Additional Editor Comments (if provided):

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: (No Response)

Reviewer #3: All comments have been addressed

**********

2. 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: Partly

Reviewer #3: Yes

**********

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

Reviewer #1: I don't know

Reviewer #3: Yes

**********

4. 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 #3: Yes

**********

5. 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: No

Reviewer #3: Yes

**********

6. 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: Thank you for addressing the comments and updating the manuscript. Based on the updated manuscript, I have some recommendations.

The updated introduction section is long and can be rewritten to be more concise. Further, some detailed information about other studies can be used in writing the discussion and not being included in the introduction.

Could you please check that "paid activities" L88 refers to paid and not unpaid?

L285, I believe taking height measures in adults for two times addresses reliability or accuracy of measures and not validity.

Did you use dietary recall to assess food consumption? If so and you haven't mentioned it somewhere, could you add it?

Table 3: numbers don't add up. Please check and if this is because of missing data, note that.

Discussion:

-Generally, before comparing the findings of the study to other studies, the importance and significance of the findings should be discussed. How accurate and relevant are the findings? I recommend re-writing the discussion.

- What does "weighted" food consumption mean?

- Regarding PSNP, when was the BMI of beneficiaries were lower than their peers? I wonder if the recipients of PSNP had lower BMI than others and that's the reason they were part of the program.

- Please check L481: is there any evidence to suggest the impact of changes in seasonal wealth on women's nutrition status?

-L503: What does information bias include?

Recommendation:

What is the difference between year-round access and sustainable access? I recommend merge these two categories and group the recommendations under different stakeholders such as policy makers, local government, etc.

I recommend a final edit of the document for English language to prepare a concise version.

Reviewer #3: (No Response)

**********

7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

Do you want your identity to be public for this peer review? If you choose “no”, your identity will remain anonymous but your review may still be made public.

For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Behnoush Ahranjani

Reviewer #3: No

**********

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

Seasonal variations in household food security and consumption affect women’s nutritional status in rural South Ethiopia.

PGPH-D-24-00274R2

Dear Dr Mezgebe,

We are pleased to inform you that your manuscript 'Seasonal variations in household food security and consumption affect women’s nutritional status in rural South Ethiopia.' has been provisionally accepted for publication in PLOS Global Public Health.

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,

Dickson Abanimi Amugsi, PhD

Academic Editor

PLOS Global Public Health

***********************************************************

Please work with the editorial office to address this very minor issues from reviewer 2:

Thank you for addressing the comments.

Please check L91: it seems it should be association and not impact, and L455: incomplete sentence.

The manuscript needs editing for English.

Thank you

Reviewer Comments (if any, and for reference):

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

**********

2. 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: Partly

**********

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

Reviewer #1: I don't know

**********

4. 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: (No Response)

**********

5. 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: No

**********

6. 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: Thank you for addressing the comments.

Please check L91: it seems it should be association and not impact, and L455: incomplete sentence.

The manuscript needs editing for English.

**********

7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

Do you want your identity to be public for this peer review? If you choose “no”, your identity will remain anonymous but your review may still be made public.

For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Behnoush Ahranjani

**********