PONE-D-21-30029Prevalence of Child Malnutrition and Household Socioeconomic Deprivation: An Empirical Analysis in rural Southern Punjab, PakistanPLOS ONE

Dear Dr. Waqar Ameer,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’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. Your are requested to submit the revised version of the article keeping the points raised by reviewers 1 and 2 provided with the email.

In addition to comments by reviewers, The following points may also be addressed in the revised version.

1- Why Rahim Yar Khan was chosen for this study? Is there any particular reason?

2- How you can you justify that Only One district (i.e. Rahim Yar Khan) is representative of the entire Sothern Punjab area of Pakistan. It needs to be justified because the title is about southern Punjab. You may revise the title as

"Prevalence of Child Malnutrition and Household Socioeconomic Deprivation: A case study"

3- In Abstract you have written "The results indicate that the prevalence of malnutrition in the Rahimyar Khan is higher than those in other regions of Punjab". Please justify this result as nothing is provided in analysis section that compares situation of Rahim Yar Khan with other areas of Punjab. If you have compared with other area of Punjab than that comparison may added as appendix.

4- Line 45: remove extra space after "[9]"

5- Add some suitable reference to support the text from line 46- line 48: "In Rahim Yar Khan..........their ends."

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Sajjad Haider Bhatti, Ph.D.

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

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

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: No

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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 paper uses reasonable empirical design and analysis method to prove the correlation between household social-economic status and children's malnutrition condition. Three commonly-used and widely-acknowledged measurements of malnutrition are used in the paper, which are standardiezed z-score of weight-for-age (WAZ), weight-for-height(WHZ) and height-for-age (HAZ). The data used in the article is collected via rigorous stratified sampling method in the most deprived area in rural Pakistan, which matches the academic question the paper aims to address. Therefore, I recommend this article for acceptance. The research could be extended in the following areas.

1. The empirical analysis could be exteneded to childeren within other aging range. Malnutrition occurs at all age levels of teenagers of the developing world.

2. The channel and mechanism of the impact of socialeconomic gradients on the children's health outcomes could be another question of interest.

3. More heterogeneity could be added to the research if possible in the future. For example, results of children of different birth orders could be tested. Other measurements of socialeconomic status like projected lifetime income, or consumption, or occupation could be also used in the empirical study.

Reviewer #2: The article titled “Prevalence of Child Malnutrition and Household Socioeconomic Deprivation: An Empirical Analysis in rural Southern Punjab, Pakistan” has studied the hypothesis that household poverty is responsible for the child malnutrition.

The study is quite interesting in the purview of deprived rural area from Pakistan. It is the source to increase the literature from African countries to South Asia. In my view, the article is well-written and interesting especially for low- and middle-income counties context. After the following corrections/reviews, the article can add value to the journal and for the researchers in South Asian countries.

The author is using the word ‘under five years’ age of children unnecessarily many a times in the article. However, it is repeated multiple times in the Methods section, too (Page 3, line 75, 80; Page 4, line 87, 102-103). By studying the sample characteristics, it is understood. Author should eliminate it wherever it irritates the reader (e.g. Page 6, line 147).

Page 4, line 110: null hypothesis assumes that a child comes from a healthy population. The hypothesis does not clearly show the relation with study objectives, research question, or study hypothesis. Author needs to clearly write this hypothesis according to the study objectives.

Page 15, In Table S1, the sum of last column numbers is not correct.

In the analysis, p-values can add some stronger evidence of significance, if added in Tables 2, 3, and 4.

What is the importance of results disaggregated by sex. What are the relevant recommendations in the article?

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Reviewer #1: No

Reviewer #2: No

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Prevalence of Child Malnutrition and Household Socioeconomic Deprivation: A Case Study of Marginalized District in Punjab, Pakistan

PONE-D-21-30029R1

Dear Dr. Ameer,

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,

Sajjad Haider Bhatti, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

In my opinion, the authors have addressed all concerns raised by me (as academic editor) and reviewers.

So, now I am in a position to recommend acceptance of the manuscript for publication in PLOS ONE.

Thanks and Regards

Reviewers' comments: