Does previous circumcision and wealth index influence women’s attitude to discontinue the practice of female genital mutilation and cutting (FGM/C) in Ethiopia?

Mohammed Ahmed; Abdu Seid; Seada Seid; Ali Yimer

doi:10.1371/journal.pone.0272934

Peer Review History

Original SubmissionMarch 10, 2021
18 Apr 2022 Decision Letter - Sebastian Shepherd, Editor PONE-D-21-07908 Does previous circumcision and wealth index influencing women’s attitude to discontinue the practice of female genital mutilation and cutting (FGM/C) in Ethiopia? PLOS ONE Dear Dr. Ahmed, 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. The manuscript has been evaluated by three reviewers, and their comments are available below. The reviewers have raised a number of concerns that need attention. They request additional information on methodological aspects of the study, comments on the discussion/introduction and other queries/revisions regarding this manuscript. Could you please revise the manuscript to carefully address the concerns raised? Please submit your revised manuscript by May 29 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Sebastian Shepherd Associate Editor PLOS ONE Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. During your revisions, please note that a simple title correction is required: The grammar choice of 'influencing' in the title is not correct, one suggested edit to the title could be - 'Does previous circumcision and wealth index influence women’s attitude to discontinue the practice of female genital mutilation and cutting (FGM/C) in Ethiopia?'. Please ensure this is updated in the manuscript file and the online submission information. 3. In your Data Availability statement, you have not specified where the minimal data set underlying the results described in your manuscript can be found. PLOS defines a study's minimal data set as the underlying data used to reach the conclusions drawn in the manuscript and any additional data required to replicate the reported study findings in their entirety. All PLOS journals require that the minimal data set be made fully available. For more information about our data policy, please see http://journals.plos.org/plosone/s/data-availability. Upon re-submitting your revised manuscript, please upload your study’s minimal underlying data set as either Supporting Information files or to a stable, public repository and include the relevant URLs, DOIs, or accession numbers within your revised cover letter. For a list of acceptable repositories, please see http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories. Any potentially identifying patient information must be fully anonymized. Important: If there are ethical or legal restrictions to sharing your data publicly, please explain these restrictions in detail. Please see our guidelines for more information on what we consider unacceptable restrictions to publicly sharing data: http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions. Note that it is not acceptable for the authors to be the sole named individuals responsible for ensuring data access. We will update your Data Availability statement to reflect the information you provide in your cover letter. 4. We noticed you have some minor occurrence of overlapping text with the following previous publication, which needs to be addressed: - https://obgyn.pericles-prod.literatumonline.com/doi/10.1016/j.ijgo.2009.07.022 The text that needs to be addressed involves the Discussion section. In your revision ensure you cite all your sources (including your own works), and quote or rephrase any duplicated text outside the methods section. Further consideration is dependent on these concerns being addressed. Additional Editor Comments (if provided): Not up to the mark for sending out for review. [Note: HTML markup is below. Please do not edit.] 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 Reviewer #3: No ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: No ****** 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 Reviewer #3: Yes ****** 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: No Reviewer #2: Yes Reviewer #3: Yes ****** 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: Thank you so much for submitting this manuscript to PLOS ONE. The manuscript focused on a very important women’s health issue of global relevance for which health providers are in the forefront for care provision and advocacy. It was indeed a great delight to reviewing this manuscript which has been well conceived and written. Well-done to the team. To further improve on the quality of the manuscript and make it publishable for international audience, below are my suggestions: General comment on the manuscript. FGM/C and FGM acronyms and circumcision were inconsistently used in the manuscript. Please make up your mind on the one you want to use and be consistent with its use throughout the manuscript. You also need to clarify that female genital mutilation/cutting is also known as female circumcision so that this becomes clearer for lay global audience. The manuscript will benefit from editing from primary speakers of English language. Title: This looks clumsy and unclear. I suggest that you write it out in a clear statement. If you insist on presenting it as a question, kindly revise to ensure clarity. Abstract Conclusion: The 1st sentence is not complete. Kindly revise Background As previously indicated, you need clearly clarify female genital mutilation/cutting is also known as female circumcision so that this becomes clearer for lay global audience. For example, in paragraph 4, 1st sentence and the entire paragraph you used circumcision for the first time despite previous use of female genital mutilation/cutting. Be consistent throughout the manuscript. Methodology Data source: 3rd sentence “A detailed description… were founded elsewhere (2)” Do you mean were reported somewhere? How did you arrive at your sample size? Any statistical power analysis? Study variables: You stated that the wealth index were five, however, you mentioned 4- poorest, poorer, middle richer, and richest. Please check and amend. Ethics Analysis How did you contact and obtain consent from 6984 women of reproductive age whose data you used? This needs to be clearly presented. Results Well presented, thank you. Discussion You stated in your findings that “Also, circumcised women compared to non-circumcised women lower the odds of the attitude towards the discontinuation of female genital mutilation by 78%” suggesting that women with FGM/C are more likely to want to continue the practice. However, in the 2nd paragraph of your discussion, you included previous FGM/C as a predictor for discontinuing the practice. Please check and amend. Your conflicting discussion of your finding is further depicted in the 3rd paragraph where the content here is different to that of paragraph 2 with reference previous FGM/C and attitude to continue or discontinue FGM/C. Please check and amend. In general, thank you for this manuscript. Best wishes. Reviewer #2: Corrections about References (See revised Manuscript) Reviewer #3: The topic of what explains the persistence of FGC, and attitudes in support of FGC, is an important one. The authors use one survey in one country to examine the correlation between FGC attitudes and wealth and education. Unfortunately I do not see how this piece adds to our knowledge of the perpetuation of FGC above and beyond works that have already been published. The authors note that there are some mixed results regarding socioeconomic status and the practice of FGC. However this study does not help us resolve or make sense of these conflicting results but rather adds another case, which has also been included in past studies. It does not attempt to help us theoretically understand the reason for these conflicting results or present results that help in this regard either. As such, I cannot recommend the article for publication as I do not see it contributing new knowledge to the study of FGC, however I commend the authors for their effort. Perhaps including more countries and over a longer period of time, both of which are possible with the DHS data, could help. Note however that a number of scholars have also already done this. ****** 6. 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:** Dr Olayide Ogunsiji Reviewer #2: No Reviewer #3: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. Attachments Attachment Submitted filename: Filled Review Form for PONE-D-21-07908 BALDE Mamadou Dioulde 10.02.2022 (2).docx https://doi.org/10.1371/journal.pone.0272934.r001
Revision 1
26 Apr 2022 Author Response Thank you very much for PLOS one editorial office, academic editors, as well as reviewers of this manuscript entitled Does previous circumcision and wealth index influence women’s attitude to discontinue the practice of female genital mutilation in Ethiopia? For their astonished effort. The written documents below explained point by point response for respective editor and reviewer’s comment. Editor comments and author response During your revisions, please note that a simple title correction is required: The grammar choice of 'influencing' in the title is not correct, one suggested edit to the title could be - 'Does previous circumcision and wealth index influence women’s attitude to discontinue the practice of female genital mutilation and cutting (FGM/C) in Ethiopia?'. Author response: Thank you so much. The authors amended the manuscript based on the reviewer comments and included in the revised manuscript. Reviewer 1 comments and authors response: Reviewer #1: General comment on the manuscript. FGM/C and FGM acronyms and circumcision were inconsistently used in the manuscript. Please make up your mind on the one you want to use and be consistent with its use throughout the manuscript. You also need to clarify that female genital mutilation/cutting is also known as female circumcision so that this becomes clearer for lay global audience. The manuscript will benefit from editing from primary speakers of English language. Author response: Thank you so much. The authors amended the manuscript based on the reviewer comments and included in the revised manuscript. Title: This looks clumsy and unclear. I suggest that you write it out in a clear statement. If you insist on presenting it as a question, kindly revise to ensure clarity. Author response: The authors amended the manuscript based on the reviewer comments and included in the revised manuscript. Abstract Conclusion: The 1st sentence is not complete. Kindly revise Author response: The authors amended the manuscript based on the reviewer comments and included in the revised manuscript. Background As previously indicated, you need clearly clarify female genital mutilation/cutting is also known as female circumcision so that this becomes clearer for lay global audience. For example, in paragraph 4, 1st sentence and the entire paragraph you used circumcision for the first time despite previous use of female genital mutilation/cutting. Be consistent throughout the manuscript. Author response: The authors amended the manuscript based on the reviewer comments and included in the revised manuscript. Methodology Data source: 3rd sentence “A detailed description… were founded elsewhere (2)” Do you mean were reported somewhere? How did you arrive at your sample size? Any statistical power analysis? Study variables: You stated that the wealth index were five, however, you mentioned 4- poorest, poorer, middle, richer, and richest. Please check and amend. Author response: The authors amended the manuscript based on the reviewer comments and included in the revised manuscript. In the 2016 EDHS, 15,683 women (15–49 years) were interviewed, For studying FGM, after excluding cases with missing values on the variables of interests, the analytic sample in this study consisted of 6984 reproductive age women (15- 49 years). Ethics Analysis How did you contact and obtain consent from 6984 women of reproductive age whose data you used? This needs to be clearly presented. Author response: The authors amended the manuscript based on the reviewer comments and included in the revised manuscript. Results Well presented, thank you. Discussion You stated in your findings that “Also, circumcised women compared to non-circumcised women lower the odds of the attitude towards the discontinuation of female genital mutilation by 78%” suggesting that women with FGM/C are more likely to want to continue the practice. However, in the 2nd paragraph of your discussion, you included previous FGM/C as a predictor for discontinuing the practice. Please check and amend. Author response: The authors amended the manuscript based on the reviewer comments and included in the revised manuscript. Your conflicting discussion of your finding is further depicted in the 3rd paragraph where the content here is different to that of paragraph 2 with reference previous FGM/C and attitude to continue or discontinue FGM/C. Please check and amend. In general, thank you for this manuscript. Best wishes. Author response: The authors amended the manuscript based on the reviewer comments and included in the revised manuscript. Reviewer 2 comments and author response Reviewer #2: Corrections about References (See revised Manuscript) Author response: The authors amended the manuscript based on the reviewer comments and included in the revised manuscript. Reviewer #3: The topic of what explains the persistence of FGC, and attitudes in support of FGC, is an important one. The authors use one survey in one country to examine the correlation between FGC attitudes and wealth and education. Unfortunately I do not see how this piece adds to our knowledge of the perpetuation of FGC above and beyond works that have already been published. The authors note that there are some mixed results regarding socioeconomic status and the practice of FGC. However this study does not help us resolve or make sense of these conflicting results but rather adds another case, which has also been included in past studies. It does not attempt to help us theoretically understand the reason for these conflicting results or present results that help in this regard either. As such, I cannot recommend the article for publication as I do not see it contributing new knowledge to the study of FGC, however I commend the authors for their effort. Perhaps including more countries and over a longer period of time, both of which are possible with the DHS data, could help. Note however that a number of scholars have also already done this Author response: There was no study conducted so far in relation to wealth index and attitude to discontinue FGM in Ethiopia. That is why we eager to undertake this study. Thank you Attachments Attachment Submitted filename: Response to reviewers.docx https://doi.org/10.1371/journal.pone.0272934.r002
8 Jul 2022 Decision Letter - Sebastian Shepherd, Editor PONE-D-21-07908R1Does previous circumcision and wealth index influence women’s attitude to discontinue the practice of female genital mutilation and cutting (FGM/C) in Ethiopia?PLOS ONE Dear Dr. Ahmed, 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. The manuscript has been evaluated by one reviewer and their comments are available below. The reviewer has raised a concern that the manuscript still requires extensive copyediting. We suggest you thoroughly copyedit your manuscript for language usage, spelling, and grammar. If you do not know anyone who can help you do this, you may wish to consider employing a professional scientific editing service. Could you please revise the manuscript to carefully address the concerns raised? Whilst you may use any professional scientific editing service of your choice, PLOS has partnered with both American Journal Experts (AJE) and Editage to provide discounted services to PLOS authors. Both organizations have experience helping authors meet PLOS guidelines and can provide language editing, translation, manuscript formatting, and figure formatting to ensure your manuscript meets our submission guidelines. To take advantage of our partnership with AJE, visit the AJE website (http://learn.aje.com/plos/) for a 15% discount off AJE services. To take advantage of our partnership with Editage, visit the Editage website (www.editage.com) and enter referral code PLOSEDIT for a 15% discount off Editage services. If the PLOS editorial team finds any language issues in text that either AJE or Editage has edited, the service provider will re-edit the text for free. Please submit your revised manuscript by Aug 22 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: The name of the colleague or the details of the professional service that edited your manuscript A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Sebastian Shepherd Staff Editor PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. [Note: HTML markup is below. Please do not edit.] 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 ******** 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 ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: 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 ****** 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 ****** 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 responding to majority of my comments in the previous version of this manuscript. However, the manuscript will still benefit from editing done by a primary speaker of English language. This is important for the international audience that this journal targets. ****** 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: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0272934.r003
Revision 2
11 Jul 2022 Author Response Thank you very much for PLOS one editorial office, academic editors, as well as reviewers of this manuscript entitled Does previous circumcision and wealth index influence women’s attitude to discontinue the practice of female genital mutilation and cutting (FGM/C) in Ethiopia?. The written documents below explained point by point response for respective reviewer and editor comments. Reviewer 1 comments and authors response: Comment 1: the reviewer raised a concern that the manuscript still requires extensive copyediting. We suggest you thoroughly copyedit your manuscript for language usage, spelling, and grammar. Author response: the authors addressed all of the issue raised by the reviewer in the revised manuscript. The copy-editing was done by the authors. Editor comments and author response Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Author response: I have reviewed the references in the manuscript and I did not found retracted articles. Thank you for reviewers and editors (staff as well as academic editors) for their extensive and constructive comments throughout the process Attachments Attachment Submitted filename: Response to reviewers.docx https://doi.org/10.1371/journal.pone.0272934.r004
1 Aug 2022 Decision Letter - Sebastian Shepherd, Editor Does previous circumcision and wealth index influence women’s attitude to discontinue the practice of female genital mutilation and cutting (FGM/C) in Ethiopia? PONE-D-21-07908R2 Dear Dr. Ahmed, 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. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Sebastian Shepherd Staff Editor PLOS ONE Additional Editor Comments (optional): Please note, we have edited your abstract for clarity and style (the edited version is below - and we have also attached a copy of the edited abstract as a word file). Please review these changes and incorporate those that you agree with for the final version of the manuscript. * Abstract Edit * Introduction: Understanding women’s attitudes towards female genital mutilation is an important step towards eliminating this practice. We used the 2016 Ethiopia Demographic and Health Survey (EDHS) data set to examine the relationship between wealth index and previous history of circumcision on women's opinions whether female genital mutilation (FGM) should be continued or stopped in Ethiopia. Methods: Data from 6984 women aged 15-49 years were extracted from the 2016 EDHS data set. Multivariable logistic regression analysis was performed to analyse the data. Result: In this study, women with a higher level of education and wealth index were more likely to support the cessation of FGM. However, circumcised women (AOR: 0.22; 95% CI: 0.15-0.32), women from the Afar region (AOR: 0.34; 95% CI: 0.22-0.50), Somali region (AOR: 0.42; 95% CI: 0.27-0.65), and Dire Dawa region (AOR: 0.51; 95% CI: 0.32-0.83) were less likely to support discontinuation of FGM. Conclusion: The present study revealed that wealth index, education level, history of circumcision, and regional variation are associated with women’s attitude towards discontinuation of the practice of FGM in Ethiopia. Empowering women in terms of socioeconomic status and education can change attitudes and might help prevent female genital mutilation in the future. Furthermore, interventions targeting FGM practices should focus on regional variance in order to have a meaningful impact on reducing this harmful cultural practice in Ethiopia. Reviewers' comments: Attachments Attachment Submitted filename: Abstract - ONE Edit.docx https://doi.org/10.1371/journal.pone.0272934.r005
Formally Accepted
11 Aug 2022 Acceptance Letter - Sebastian Shepherd, Editor PONE-D-21-07908R2 Does previous circumcision and wealth index influence women’s attitude to discontinue the practice of female genital mutilation and cutting (FGM/C) in Ethiopia? Dear Dr. Ahmed: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr Sebastian Shepherd Staff Editor PLOS ONE https://doi.org/10.1371/journal.pone.0272934.r006

Open letter on the publication of peer review reports

PLOS recognizes the benefits of transparency in the peer review process. Therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. Reviewers remain anonymous, unless they choose to reveal their names.

We encourage other journals to join us in this initiative. We hope that our action inspires the community, including researchers, research funders, and research institutions, to recognize the benefits of published peer review reports for all parts of the research system.

Learn more at ASAPbio .