PONE-D-23-12847Health facility availability and readiness for family planning and maternity and neonatal care services in Nepal: Analysis of cross-sectional survey dataPLOS ONE

Dear Dr. Rai,

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 see my comments in comment section attached herewith. Requesting you to revise the paper based on reviewer's and my comments.

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Kanchan Thapa, MPH, MPhil

Academic Editor

PLOS ONE

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Additional Editor Comments:

Dear Authors,

I really enjoyed reading your paper. However, there are something which can improve your paper further. Please take care of all the comments from reviewers. Also, take care of these comments from my side.

In Abstract section, analytical perspectives of logistic regression is lacking. You have only used descriptive data to show the change over the time. There are limited information from logistic regression in the section.

Can you please review the Method section and especially in the data source section. Also in ethical section, there is special provision of DHS program to use the data set for analysis, have you followed the procedure for data use. Please also include the statement, how you downloaded data set from DHS program and when.

Results:

Table 1.

There can be better way of writing the table characteristics such as 2015 into NFHS 2015 or something better. Also, take care of N and n difference while reporting the research results.

Table 2. Same as above, but you have used n here. What is the difference between these two. What is MD 95(CI) mean?

Table 3. based on which data the results are reported? Also advised to see other results how to report the findings from logistic regression and reference.

Table 4. Same as previous comments

Also requesting you to review the whole paper once from all the 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?

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Reviewer #1: Yes

Reviewer #2: Partly

Reviewer #3: Yes

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

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: No

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Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: 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: Yes

Reviewer #2: Yes

Reviewer #3: 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 assessed Health facility availability and readiness for family planning and maternity and

neonatal care services in Nepal By relying on Nepal Health Facility Survey (NHFS)

data collected in 2015 and 2021. The authors further relied on WHO Service Availability and Readiness Assessment (SARA) Methods to determine the key variables necessary to attain the specific objectives of the study.

I took my time to go through the WHO SARA document while comparing same with what the authors did.

Per the WHO's SARA document, Availability is defined as the Physical presence of services while Readiness is referred to as the capacity of the facility to deliver those services.

Readiness and Availability were the two important dimensions in the study because they were the indicators the authors used to check family planning and maternity and neonatal care services being rendered in Nepal.

The WHO SARA document has highlighted that to generate reliable information on Service Availability then facility density, health worker density and service utilization should be assessed.

Also to generate reliable information on Service Readiness then Basic Amenities, Equipment & Supplies, Diagnostics, Essential medicines and commodities should all be assessed. Since such assessments will be the measurement scale to tell whether or not the there are Service Availability and Service Readiness.

Afterwards then the Specific Service Readiness Areas such as: Family Planning, Antenatal care, Obstetric care, Neonatal care and child health (curative and immunization), HIV, PMTCT, TB, Malaria, Chronic Diseases can be checked as to whether they are being rendered adequately or not.

Authors highlighted the facility types in table 1. However, the facility density was not captured. It is recommended that authors fuse in this data to enrich their findings. This is due to the fact that the facility density will enable us to see whether or not the listed facility types possess the requisite space and capability to render the key services of interest to the authors.

Also, health worker density across the listed facilities were not highlighted by the authors. It is again recommended that the authors include this important data in their results presentation. As the health worker density will enable us to know whether or not the listed facilities have the requisite numbers of health professionals to render the key services of interest.

Except the two important observations made above, authors rigorously complied with the methodology proferred in the WHO SARA guidelines.

Authors should modify their work to take cognizance of the recommendations made above.

In a nutshell, it is a very good work done by the authors.

Reviewer #2: I am very pleased to have the opportunity of reviewing the manuscript submitted to PLOS ONE Journal.

Thanks to the authors for carrying out this good study. The manuscript has enough potential to publish as a scientific work.

Best Regards,

Reviewer #3: 1. The manuscript was technically sound enough since the right methodology was used. WHO SARA tool was appropraite for the study

2. Analysis for objective one was good. However, the analysis for the secondary objective was unclear. You need to define your dependent and independent variables used fo the regression model clearly.

3. Findings supported study objectives

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Reviewer #1: Yes: ANTWI JOSEPH BARIMAH

Reviewer #2: No

Reviewer #3: No

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Health facility availability and readiness for family planning and maternity and neonatal care services in Nepal: Analysis of cross-sectional survey data

PONE-D-23-12847R1

Dear Dr. Rai,

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.

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Kind regards,

Kanchan Thapa, MPH, MPhil

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Dear Authors,

Thank you for revised version of the paper. I would like to thank you for your hard works. At the same time, requesting you to take care of use of N and n throughout the table. You have revised in the other section and included your sample size as n but still there are some N in tables.

Also, please format the table as per the guidelines of PLOS One.

Reviewers' comments: