Demand–supply-side barriers affecting maternal health service utilization among rural women of West Shoa Zone, Oromia, Ethiopia: A qualitative study

Seifadin Ahmed Shallo; Deresa Bekele Daba; Abuzumeran Abubekar

doi:10.1371/journal.pone.0274018

Peer Review History

Original SubmissionJuly 1, 2022
4 Aug 2022 Decision Letter - Dylan A Mordaunt, Editor PONE-D-22-18718Title: Demand –supply-side barriers affecting maternal health service utilization among rural women of West Shoa Zone: A qualitative studyPLOS ONE Dear Dr. Shallo, 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. Please submit your revised manuscript by Sep 18 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. 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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. Please upload a copy of Figure 1, to which you refer in your text on page 7. If the figure is no longer to be included as part of the submission please remove all reference to it within the text. Additional Editor Comments: Thank you for your submission. The main feedback was for additional detail with overall minor suggestions. With regards to the criteria for publication: 1. The study appears to present the results of original research. 2. Results reported do not appear to have been published elsewhere. 3. Experiments, statistics, and other analyses require further detail as described by the reviewers. I would also suggest that given the general readership of this journal that the epistemology and methodology are outlined in a bit more detail. 4. Conclusions are presented in an appropriate fashion and are supported by the data. 5. The article is presented in an intelligible fashion and is written in standard English. 6. The research meets all applicable standards for the ethics of experimentation and research integrity. 7. I would suggest the authors use a guideline or checklist for qualitative research such as the SRQR (https://www.equator-network.org/reporting-guidelines/srqr/) or COREQ (https://www.equator-network.org/reporting-guidelines/coreq/). [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 ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: N/A Reviewer #2: N/A ****** 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 ****** 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 ****** 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: Very interesting work on demand and supply side barriers. Please see the comments inserted in the paper. Please add some more global references to demand and supply side barrier analysis in the earlier section. The conclusion section needs to be strengthened. suggest the authors make some recommendations on easily addressable barriers and those that require more long term systemic changes Reviewer #2: This manuscript explored an important topic of public health importance. Overall, the manuscript is well written. The authors made reasonable arguments why exploring demand-side barriers for maternal health care seeking is important in Ethiopia. Below are comments which may improve the manuscript; 1. Please describe how the authors decide upon the sample sizes for interviews and what sampling procedure was used. 2. Did the authors achieve data saturation? If yes, which type of data saturation was achieved? 3. Did the authors pretest the interview guidelines and made any modifications? If yes, how did they incorporate the feedback? 4. How did the authors ensure data quality? 5. Please include the reflexivity of the researchers included in data collection, analysis, and writing. ****** 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: No Reviewer #2: Yes: Nazia Binte Ali ******** [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: PONE-D-22-18718_reviewer_KA.pdf https://doi.org/10.1371/journal.pone.0274018.r001
Revision 1
13 Aug 2022 Author Response Responses to reviewers/academic editor’s comments First of all we appreciate and would like to thank the academic Editor and reviewers for their constructive comments which we believe will strengthen the quality of our work. With this, we have addressed the comments and suggestions forwarded from reviewers and editorial offices as follows. Responses to Comments raised from academic editor: 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. Response: we have already addressed the points as per the PLOS One template guide at first submission of the manuscript. We have also named the file accordingly 2. Please upload a copy of Figure 1, to which you refer in your text on page 7. If the figure is no longer to be included as part of the submission please remove all reference to it within the text. Response: the Figure is included (already there) on page 16 of the manuscript. Now, we have put as separate document and uploaded it with the revised manuscript. 3. I would suggest the authors use a guideline or checklist for qualitative research such as the SRQR Responses: we have included the COREQ checklist as supplementary document and uploaded it. Responses to the Comments raised from Reviewers Reviewer #1: Very interesting work on demand and supply side barriers. Please see the comments inserted in the paper. Please add some more global references to demand and supply side barrier analysis in the earlier section. The conclusion section needs to be strengthened. Suggest the authors make some recommendations on easily addressable barriers and those that require more long term systemic changes. Response: we have tried to add the global status of demand-supply barriers to maternal health service utilization in introduction part and indicated with track changes. We have also addressed the recommendations in terms of short term and long term intervention as per recommended. Reviewer #2: This manuscript explored an important topic of public health importance. Overall, the manuscript is well written. The authors made reasonable arguments why exploring demand-side barriers for maternal health care seeking is important in Ethiopia. Below are comments which may improve the manuscript; 1. Please describe how the authors decide upon the sample sizes for interviews and what sampling procedure was used. Response: as we have tried to explain in the method sections of the manuscript, the key informant interview participants for the study were selected purposively based on the direct connection (coordinating the MCH service, giving leadership, delivering the service) they have with the maternal health service issues. (Mentioned under the study population and sampling techniques subsection of part of the method section). There are 4 government structures which are in charge of maternal health issue at district level i.e. District health office, PHC director, MCH head at each health center and HEWs at community level. Since we have conducted our study in three districts, we finally decided to conduct KII with 12 personnel i.e. four each districts. (3 district 4 structures=12 participants). In both KII and IDI, we have used purposive sampling technique. ((Mentioned under the study population and sampling techniques subsection of part of the method section). 2. Did the authors achieve data saturation? If yes, which type of data saturation was achieved? Response: yes. The type of data saturation the authors used for FGD and IDI was the “redundancy of idea”. We have conducted both FGD and IDI to the level where no new idea comes out of the participants (the idea is repeated). 3. Did the authors pretest the interview guidelines and made any modifications? If yes, how did they incorporate the feedback? Response: thank you for this question. Actually e have pre tested our tools ahead of data collection. We have adjusted a lot. E.g. order of probing questions, time it take to complete, we have avoided some unrelated questions, and we also able to add some questions based on feed bac from the pre-test participants. Why we didn’t include in the manuscript is because of there is no subheading which invite us to include issue about data quality control as per the PLOS one journal manuscript preparation guideline. Now, we have included new subheadings (data quality control subtopic) 4. How did the authors ensure data quality? Response: yes. See the “data quality control” sub topics. (Newly added sub topics). 5. Please include the reflexivity of the researchers included in data collection, analysis, and writing. Response: we have included in the main document Attachments Attachment Submitted filename: Responses to reviewers.docx* https://doi.org/10.1371/journal.pone.0274018.r002
22 Aug 2022 Decision Letter - Dylan A Mordaunt, Editor Title: Demand –supply-side barriers affecting maternal health service utilization among rural women of West Shoa Zone, Oromia, Ethiopia: A qualitative study PONE-D-22-18718R1 Dear Dr. Shallo, 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, Dylan A Mordaunt, MD, MPH, FRACP Academic Editor PLOS ONE Additional Editor Comments (optional): Thank you for your resubmission. This now meets the criteria for publication. Reviewers' comments: https://doi.org/10.1371/journal.pone.0274018.r003
Formally Accepted
25 Aug 2022 Acceptance Letter - Dylan A Mordaunt, Editor PONE-D-22-18718R1 Title: Demand –supply-side barriers affecting maternal health service utilization among rural women of West Shoa Zone, Oromia, Ethiopia: A qualitative study Dear Dr. Shallo: 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 Associate Professor Dylan A Mordaunt Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0274018.r004

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