PGPH-D-22-00810

Are midwives ready to provide quality evidence-based care after pre-service training? Curricula assessment in four countries - Benin, Malawi, Tanzania, and Uganda

PLOS Global Public Health

Dear Dr. Moller,

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.

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Kind regards,

Hannah Tappis, DrPH, MPH

Academic Editor

PLOS Global Public Health

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Reviewers' comments:

Reviewer's Responses to Questions

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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: N/A

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Reviewer #1: Yes

Reviewer #2: Yes

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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: The authors have used a mapping exercise to identify evidence-based care after services training for midwives across 4 countries, Benin, Malawi, Tanzania, and Uganda. The methodology is sound, and the manuscript is well-written. The article is acceptable in the current form.

Reviewer #2: In this manuscript authors have reported on the findings of the mapping of the curricula for the training of midwives in four African countries. The manuscript makes important contributions to the literature and identify gaps that should be worked on to improve the curricula.

However, I have a few observations I will like to make known to the authors, that I believe will help improve the readability of the manuscript.

1. The abstract and the background are well written and have situated the topic in a relevant context. The problem statement is well articulated and the significance of the study is well defined

2. The methods are well written except that there is lack of clarity on how authors requested for the midwifery curricula of the various schools. How was the request done? Was it sent to all training schools in the respective countries or they were selected? If they were selected, was it a random process or non-random?

3. Another issue that appears unclear to me has to do with how authors determined if a curriculum met the ICM framework? Was it that a curriculum was deemed to have met the ICM framework if they had objectives or content that are similar with the ICM?

4. In the results section authors indicated that they conducted four interviews with lead country midwives. In my opinion, four seems too small to get rich information for this kind of review. Authors could have invited midwives from other schools within the project countries that were not part of the project.

5. In the discussion section, it is commendable that authors noted that assessment of the curricula is an important necessary step but it is not enough to bring about improvement in quality of training given that there are several facets that should be considered in the assessment process. One of such facets which was not noted by the authors, is the beneficiaries of the curriculum i.e., midwifery trainees. Their perspectives will have illuminated further the findings presented in this study if authors had also interviewed them. This should be noted as limitation of the study.

6. It is also worthwhile for authors to discuss at least one positive finding in the current curriculum that they will encourage the institutions to maintain in the curriculum. Notwithstanding the fact that the review was intended to identify gaps it will enrich the report if they also report on the positive aspects of the curriculum.

7. Authors should also note that health curricula are designed to meet the local health needs of the country or community. I am wondering if they reflected their findings in relation to this key component of health curricula design.

8. Authors should also offer a few solutions or recommendations that could be adopted to help improve the curricula.

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Reviewer #1: Yes: Denny John

Reviewer #2: Yes: A/Prof. Victor Mogre

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Are midwives ready to provide quality evidence-based care after pre-service training? Curricula assessment in four countries - Benin, Malawi, Tanzania, and Uganda

PGPH-D-22-00810R1

Dear PhD student Moller,

We are pleased to inform you that your manuscript 'Are midwives ready to provide quality evidence-based care after pre-service training? Curricula assessment in four countries - Benin, Malawi, Tanzania, and Uganda' 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.

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

Best regards,

Hannah Tappis, DrPH, MPH

Academic Editor

PLOS Global Public Health

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Reviewer Comments (if any, and for reference):