PONE-D-21-11751

The interaction of health service quality and community-based health insurance in Ethiopia

PLOS ONE

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Professor Hafiz T.A. Khan, Ph.D, CStat

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

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: Partly

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?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). 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 ONE 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 have attached the manuscript with tracked comments. Key issues include;

1. A table with biographic data of participants is essential.

2. You refer to 'quotas of participants' in your sampling. How was this decided.

3. It is unclear if qualitative data was collected using local languages? If this is the case, clarity is needed on how translation was undertaken.

4. Interviews. Were these face to face interviews? Were they audio recorded? If so, were they recorded in different languages? If so, was data translated to English before analysis?

5. Clarity is needed on how many participants took part in; 1. exit interviews; 2. Survey; 3. Key informant interviews.

6. Data analysis - You state that thematic data analysis of qualitative data was undertaken, but no themes were presented. What framework was used for thematic analysis? Who undertook the thematic analysis?

7. The discussion need to be structured around the finds for each research question. The discussion reads like further reporting of results. This needs to focus on what the results mean for the participants and population under study.

8.The implications of the findings need a more rigorous critique. 1. What are the implications of people not renewing their insurance from a health point of view? 2. You report that there is no statistical difference between the quality of service in CBHI and non-CBHI areas. What are the implications of this on the USAID Transform: Primary Health Care project if the project is not making a measurable difference?

Reviewer #2: 1. The objectives are relevant to the study; however, they are broad and need to be revised to make them more specific. Try linking the objective to the overall aim and or the research title to avoid the possibility of answering yes or no.

2. Donabedian model used for the study seems appropriate but the reason for the model selection is not to justify. Make a little comment about other available potential models

3. The use of a mixed-method approach is critical for the study. The sampling technique for the 2 components of the study needs to be more refine and explicit.

4. The method used to recruit participants for the qualitative study should be clearly stated

5. The findings were very important and the conclusions were well written. However, the conclusion can be summary

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Reviewer #1: Yes: Professor K Mafuba, PhD

Reviewer #2: Yes: Abdulsalam Ahmed

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Attachments

Attachment

Submitted filename: PONE-D-21-11751_reviewer.pdf

The interaction of healthcare service quality and community-based health insurance in Ethiopia

PONE-D-21-11751R1

Dear Authors,

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.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Professor Hafiz T.A. Khan, Ph.D, CStat

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

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: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

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

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

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). 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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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE 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

**********

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 my questions. I have no further comments. I enjoyed reading your paper and wish all the best with the publication.

Reviewer #2: All the raised concerned are appropriately addressed and the article has been considered for publication without further review.

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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.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Professor Kay Mafuba

Reviewer #2: Yes: Abdulsalam Ahmed