PONE-D-23-00862Management of preterm birth using protocols in a low resource setting.PLOS ONE

Dear Dr. Jackline Akello

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Lumaan Sheikh, FRCOG

Academic Editor

PLOS ONE

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- https://www.ncbi.nlm.nih.gov/books/NBK321160/pdf/Bookshelf_NBK321160.pdf?

https://journals.lww.com/greenjournal/Fulltext/2019/10000/Clinical_Guidelines_and_Standardization_of.50.aspx?

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

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Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

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Reviewer #1: No

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 authors have chosen a very important topic which is specially pertinent to LMIC

The objective of the study is well defined

The methodology is overall well written but the numbers mentioned as numerator and denominator in Table no. 2 are not clear. This should be reworded for clarity.

It is not clear what is meant by the following sentence on page no. 8," Since there was no documented protocol on management of pre-term birth at Mulago Hospital labor ward, the baseline audit was conducted as per the components derived by the team of experts". This needs to reworded for clarity.

Although second audit showed improvement in quality of care in patients with preterm labour/delivery, the authors have also discussed in length the reasons for inability to meet all the parameters to the desired extent. It would be informative if authors could give suggestions on how to improve the deficiency.

There are several grammatical errors that need to be corrected.

Reviewer #2: The rationale in abstract and introduction should be similar. Certain grammatical mistakes are there. Page 4 4th paragraph instead of using word "basing" write "on the basis of" or use another word. Ideally referring to table write the number in numerical form, Table 2 rather than table two.

In the results the outcomes table, there is early neonatal death in 1st audit that is given 5.8% the second audit done after observing protocol ,the early neonatal death increased to 11% which is quite significant. What were the reasons please mention in discussion.

In methods you have mentioned in page 6 that participants were interviewed, was consent taken as its not mentioned how was the consent taken please mention. You have stated that staff were given information of the first audit outcome and in the second audit you mentioned the findings were discussed in another meeting .Mention who were the staff that received the information of both audit results? were they the same as in the first audit or a different group.Page 9 first paragraph rephrase the paragraph, long sentence used as well as structure of sentence is unclear.

Conclusion should reflect your study findings and not a general opinion or suggestion.

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Reviewer #1: Yes: Azra Amerjee

Reviewer #2: Yes: Ambareen Khan

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Management of preterm birth using protocols in a low resource setting.

PONE-D-23-00862R1

Dear Dr. Akello

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,

Lumaan Sheikh, FRCOG

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: