PONE-D-21-27069Knowledge, Attitude and Practice towards kangaroo mother care among postnatal women in Ethiopia: Systematic review and Meta-analysisPLOS ONE

Dear Dr. Natnael Atnafu

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.

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ACADEMIC EDITOR: 

There are several typological and grammar usage errors that need extensive proof reading for revisions. This would help you increase the readability of the manuscript.

Methods

Explain the reliability and validity of the data extraction tool. Explain if data transformation was required or undertaken when data were reported differently on the considered factors and/outcome of interest. 

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Wubet Alebachew Bayih, M.Sc.

Academic Editor

PLOS ONE

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Dawit , Aster /unpublished

Haftey Gebremedihn et,al /unpublished” which has currently not yet been accepted for publication. Please remove this from your References and amend this to state in the body of your manuscript: (ie ““Alelign, Zewuditu [unpublished]”) as detailed online in our guide for authors

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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: 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: This is an interesting study even though in Ethiopia the KMC was introduced in 1996. There are a lot of publication regarding KMC. So the author team has the opportunity to do systematic review and meta analysis on the issue.

Method:

I would like to suggest the time of data collection and range of yearly published on the articles to be reviewed.

The search strategy in the Pub Med : ((((( Knowledge, please check is it typo error?

Please in the keyword it included word: Ephysiotomy I could not find the relation with the subject to be studied.

Operational definition:

Practice was the study participants who responded more than 50% responded questions were categorized as having a good ATTITUDE (???). Please check.

Eligibility criteria:

I would like to recommend to add the time frame and also include grey materials (please explain what does it mean).

Data analysis:

Any ideal difference that happened due to extraction were also selected by the fourth articles. Please explain what you meant is by the four persons research team member?

Reviewer #2: Reviewer Comments to Authors:

Thank you for the opportunity to review your valuable research.

1. Abstract:

Since this is a Systematic Review (SR) article, it is advisable to follow the guideline in reporting a SR as listed in PRISMA Guideline. It seems that the abstract did not contain information about inclusion and exclusion criteria, methods to assess risk of bias, a brief summary of limitations, register name and registration number. It would be more complete if the abstract could contain the above information that are lacking.

2. Introduction:

The introduction was well-written.

3. Methods:

The methods section was, in general, written well. Some missing information could be added:

a. The search strategy was listed only for Pubmed, but not mentioned for the other databases. Could that be also provided in the article?

b. For Selection Process and Data Collection Process, if automation tool was not used, please add information as such.

c. The use of grey literature was not mentioned in the method section, however, it was mentioned in section on Strength and Limitation of the Study (third line) that one the strength of this study is …”the accessing of grey literature’s”. Could you explain this?

4. Results:

The results section was also well-written, however, there is some a question:

a. Sensitivity analysis, it is written as such: “A leave-out-one sensitivity analysis was done to identify the effect of each study on the pooled prevalence of good level of knowledge, positive level of attitude, and poor level of practice of kangaroo mother care of postnatal women by excluding each study step by step. The result showed that the excluded study brings significant change to the overall prevalence of a good level of knowledge, positive attitude, and poor practice.” Based on Table 1, Good Knowledge was supported by 5 studies, Good Attitude by 5 studies, and Good Practice by 16 studies, and from the Forest Plots (Fig. 2, Fig. 3, and Fig. 4), the number of studies listed in Table 1 and the corresponding figures of forest plot were exactly the same. There was no exclusion of any studies. The facts that there were only 5 studies for Good Knowledge and Good Attitude, is because the number of studies that provided information for the two outcomes were only five. There was no exclusion of any study as claimed above. Could the authors clarify this matter?

b. How to explain the connection between data estimates listed on Table 2 and those in figures of forest plot (Figs. 2, 3, and 4).

5. Discussion:

In the discussion section, the findings from this SR was compared to findings from national surveys done in developed countries (Denmark, America – meaning USA?, Taiwan, and Canada). Would the comparison be comparable? First, national survey data form the mentioned developed countries usually includes large sample sizes, whereas the studies included in this SR involved relatively small number of respondents. Secondly, eleven of 16 studies were from hospitals, whereas national surveys would include respondents from the community. Thirdly, would comparing KMC provided by mothers from Ethiopia to those from the above mentioned countries be a suitable comparisons? Especially if we consider the differences based on social, economic, cultural and daily needs/problems faced by the mothers. It would be more meaningful to compare the findings with those from countries in Africa or developing countries in Asia, as well as in Latin America.

Thank you. I hope that this Systematic Review will add significant knowledge about KMC implementation.

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Reviewer #1: Yes: Hadi Pratomo

Reviewer #2: No

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Submitted filename: SR_KAP_Ethiopia_reviewAA.docx

Knowledge, attitude and practice towards kangaroo mother care among postnatal women in Ethiopia: systematic review and meta-analysis

PONE-D-21-27069R1

Dear Dr. Atnafu,

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Kind regards,

Wubet Alebachew Bayih, M.Sc.

Academic Editor

PLOS ONE

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