PONE-D-21-05981

Health Knowledge and Care Seeking Behaviour in Resource-Limited Settings amidst the COVID-19 Pandemic: A qualitative study in Ghana

PLOS ONE

Dear Dr. Saah,

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Kingston Rajiah

Academic Editor

PLOS ONE

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Reviewers' comments:

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Comments to the Author

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The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: N/A

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Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: 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: This manuscript present a novel results on the effect of COVID-19 on health knowledge and care seeking behaviours in Cape Coast Metropolis. However, there are few minor issues that need t be addressed to further improve the quality of the manuscript.

INTRODUCTION

The authors should consider revising the first sentence of the second paragraph that starts with “The increasing burden of COVID-19 has resulted in various international………………..”

The first sentence of the third paragraph needs a citation. This sentence reads “The emergence of COVID–19 has deepened the strain on health systems across the globe more

especially the already overburdened……………….

METHODS

The statement that reads “The study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guideline in reporting this study” needs to be cited.

At the study population and sampling, could the authors specify the age category for the adult they used in their study? Also, could the authors justify why they included only residents who lived for at least 6months in the study?

REFERENCES

The authors should work on the reference list. The numbers that need revision include 4, 12, 13, 15, 18, 20, 29, 34, 36, 46, and 48.

Reviewer #2: Review of “Health Knowledge and Care Seeking Behaviour in Resource-Limited Settings amidst the COVID-19 Pandemic: A qualitative study in Ghana”

Generally the entire manuscript requires some amount of editing, some of the phrases are poorly constructed, some of the sentences lack verbs, wrong phrases, wrong tenses, lack of parallel structure in a few of the sentences.

Ethics statement

• Metropolitan Health Directorate IRB (DHRCIRB/15/05/17): Is it the Dodowa Health and Research Centre IRB or the Metropolitan health directorate that approved the study? Correct this.

Abstract

Page 3: “COVID–19 associated conscious and unconscious reforms should systematically be harnessed”, need explanation or listing of exactly what authors are referring to.

Introduction

Page 5, second sentence in the last paragraph is missing “of”

Conceptual framework

• Paragraph 1: What are the three tenets? Mention them

• What are the few flaws of the model? List them and how this current study dealt or avoided them.

• What are these tenets and how are they in line with the study objectives, kindly explain

• Paragraph 1, the statement “This fit well with the study’s objective of assessing impact of the COVID-19 pandemic on the health knowledge of individuals.” Is that the entire objective of the study, I thought the model is more encompassing than making provision for only knowledge and the same with the study.

Methods and materials

• Last sentence on page 8 to first sentence on page 9: Check the sentence, the tense is not appropriate.

Study population and sampling

• Page 9, the following sentence “Only residents who had lived in the metropolis for at least six months within the period of COVID–19 pandemic in Ghana.” Says nothing, it is missing a verb. Check other paragraphs for such kinds of phrases as there are several in the entire manuscript.

• Page 9, kindly explain the following phrase “Recruitment was purposive and prospective.”

• How was saturation attained? Kindly explain.

Procedures

• Kindly complete title “procedure” does not mean anything.

• Consider improving the second sentence in the first paragraph, it is difficult to comprehend.

• Kindly explain what this means “the instrument was self-developed from literature”

• Please provide the following: age range of participants, any refusals, language that the study was carried in and how the research assistants were trained. Also, indicate how many other researchers were involved.

• Check the last sentence, I am not sure that “Collaborate” is the appropriate word, probably “corroborate”

Ethical issues

• I am not sure the study “took” approval from the Metropolitan Health Directorate following ethical approval (DHRCIRB/15/05/17) from the Dodowa Research Centre.

Correction: I think the study sought permission from the Metropolitan Health Directorate. Also, which Metropolitan Health Directorate are researchers referring to, kindly be specific. Also, correct the full name of the Dodowa Research Centre, it is not complete. Also correct it in the ethics statement and replace it with the Metropolitan Health Directorate.

Data analysis

• I don't understand how literature review is reported as a theme derived from your analysis

• Kindly explain “internal homogeneity” and “external heterogeneity”.

Results

Pages 13-19: The results section as it stands needs some improvement in analysis and write up. Researchers have resorted to putting most of the information in direct quotations, without critically analyzing the crucial messages that they contain. For instance several extensive quotes with very little explanation have been presented under all the themes. Authors should revise the results section by providing a deeper level of analysis with fewer quotes but more paraphrased and meaningful presentation.

• Opening sentence in results section: mention only main themes and link them to the framework and delete other irrelevant information that does not add anything to the introduction.

• Table 1. Structure the third major theme in the table into negative and positive effects and list the sub themes of each under is rightful theme

• Page 13, kindly explain or list “community public address systems”

• Delete “the” from sentence with the following phrase “due to their availability to majority of the Ghana’s population”

Discussion

• The authors do not refer to the conceptual framework in this section and the extent to which it helped them to answer their question or to achieve their study object. They also failed to indicate how they dealt with the flaws that were mentioned in the conceptual framework.

Reviewer #3: A couple of typographical errors and the use of articles have been noted and comments have been made in the attached document. The author(s) should be consistent in the language (Bristish or American English) choice.

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Reviewer #1: No

Reviewer #2: No

Reviewer #3: No

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Health Knowledge and Care Seeking Behaviour in Resource-Limited Settings amidst the COVID-19 Pandemic: A qualitative study in Ghana

PONE-D-21-05981R1

Dear Dr. Saah,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Kingston Rajiah

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: