Effect of Covid-19 on maternal and child health services utilization in Ghana. Evidence from the National Health Insurance Scheme (NHIS)

Yaw Nyarko Opoku-Boateng; Emmanuel Opoku-Asante; Mylene Lagarde; Edward Nketiah-Amponsah

doi:10.1371/journal.pone.0311277

Peer Review History

Original SubmissionSeptember 5, 2023
6 Dec 2023 Decision Letter - Thales Philipe Rodrigues da Silva, Editor PONE-D-23-27704Effect of Covid-19 on Maternal and Child Health Services Utilization in Ghana. Evidence from the National Health Insurance Scheme (NHIS)PLOS ONE Dear Dr. Nketiah-Amponsah, 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 Jan 20 2024 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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Please remove them and upload them with the file type 'Supporting Information'. Please ensure that each Supporting Information file has a legend listed in the manuscript after the references list. Additional Editor Comments: Dear Editor. Thank you for the opportunity to evaluate the article in question. Thank you in advance. In view of the reviewers' assessments, I am sending the article for further revision by the authors and future resubmission. Sincerely, [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: Yes Reviewer #2: Yes ****** 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: Dear authors, The manuscript “Effect of COVID-19 on maternal and child health services utilization in Ghana. Evidence from the National Health Insurance Scheme (NHIS)” submitted to PLOS ONE, addresses current and relevant topics for maternal and child health, in addition to presenting implications for the health system in the context investigated. However, some points need to be reviewed as presented in the attached document. Thank you for the opportunity to read your manuscript. Reviewer #2: Dear Authors and Editors: Thanks for the invitation to revise this manuscript. This study was conducted to determine the effect of Covid-19 on healthcare utilization with specifics on ANC, PNC, Deliveries and OPD attendance in Ghana. I think this is an important article that should be published in PLOS One. ****** 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: 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: review_plosone.pdf https://doi.org/10.1371/journal.pone.0311277.r001
Revision 1
27 Jan 2024 Author Response Dear Editor, Thank you sincerely for your meticulous review and constructive feedback on our manuscript. Your insights have been invaluable in refining the quality of our work. In response to your comments, we have diligently implemented necessary corrections throughout the manuscript. It is important to note that these revisions may have resulted in changes to line numbers and page numbers. Our commitment to enhancing the clarity and precision of our submission has been paramount in making these adjustments. We genuinely appreciate your dedication to maintaining the academic rigor of our work, and your thoughtful suggestions have significantly contributed to its improvement. Please find below our responses to the reviewers’ comments; the comments are italicized while the responses are highlighted in read. Moreover, the ensuing corrections or changes in the manuscript are highlighted yellow for easy recognition. Comment 1: The summary is adequate, concise and presents the central information of the study clearly, but I suggest that acronyms are not presented in this part of the text, that the type of sampling is described in the method and that the main results are expressed numerically. Response 1: The acronyms in the summary have been expounded, with due consideration given to their comprehensive presentation. Additionally, the method section now explicitly outlines the type of sampling employed, further enhancing clarity and transparency. The key finding of the results have also been presented in numerical values. Comment 2: On page 5, the acronym OPD is mentioned without its prior description in the main text. I recommend review. Response 2: The acronym OPD has been judiciously introduced into the main text, ensuring a seamless and coherent narrative. Comment 3: The methodology appears to be adequate, however I recommend explaining the inclusion and exclusion criteria for the services that made up the study sample. Of the 37,468,336 consultations, what were the inclusion and exclusion criteria for those who made up the study sample? Response 3: A meticulous elucidation of the inclusion and exclusion criteria in the selection of services within the study sample has been incorporated into the methodology section, page 7, lines 145 - 155. This ensures a lucid understanding of the criteria shaping the dataset. Comment 4: In table 2 (page 10), why is the line referring to oct 2020 highlighted in bold? If the highlighting was intentional, it wasn't clear to me when reading why. I suggest review. Response 4: The formatting anomaly in Table 2, specifically the bold highlighting of the line referring to October 2020, has been rectified to uphold precision and consistency in presentation. Comment 5: In table 3, page 12, line 224, the total average value has the decimal point in the incorrect position (78,0590.30). I recommend this correction and the review of the sum (780,590.31). Response 5: The decimal point in Table 3 has been diligently rectified, addressing the highlighted discrepancy and ensuring numerical accuracy in the presentation. The total average now reads 780,590.31 Comment 6: I recommend deepening the discussion on the tendency for an increase in services from the middle of 2021. Vaccination is timidly mentioned as a possible interfering variable in this change in the profile of services. Response 6: The discussion on the discernible increase in services from mid-2021 has been substantially enriched (see page 12, lines 323 - 337. A comprehensive exploration of potential contributing factors, with a nuanced emphasis on the role of vaccination, has been incorporated, elevating the depth and scholarly discourse of the analysis. Comment 7: I recommend deepening the discussion, making the theoretical foundation used for comparison with the study findings more robust. Response 7: The discussion section has undergone a rigorous revision, bolstering its theoretical underpinnings, line 360 - 375, 385 - 404 and 421 - 429. A more robust integration of relevant theoretical frameworks has been undertaken to fortify the comparative analysis with the study's empirical findings. Comment 8: I identified an inconsistency between the number of citations 18 and 19, on page 20, respectively lines 352 and 357, with the references presented in the list of references. I recommend reviewing the numbering of references and citations. Response 8: A meticulous review and adjustment of reference and citation numbering have been conducted to align seamlessly, preserving scholarly precision and adherence to academic conventions. Specifically, the numbering of references and citations have been reviewed to 17 and 18 on pages 21 and 22, respectively lines 380 and 405. Additionally, three (3) new references have been introduced to augment the theoretical frameworks, numbering 19, 20 and 21. Comment 9: In the appendix, table 3, page 28, line 560, is the title correct? Ownership information appears in the title although this content is not covered in the table. I suggest review. Response 9: The title of Table 3 in the appendix has been aptly rectified to accurately reflect the table's content for clarity and precision. The revised title now appropriately denotes “Number of facility level per region, page 31, line 637. We hope our revision will meet your expectations. Yours faithfully Edward Nketiah-Amponsah (On behalf of authors) Attachments Attachment Submitted filename: Response to Reviewer Comments.docx https://doi.org/10.1371/journal.pone.0311277.r002
17 Sep 2024 Decision Letter - Essa Tawfiq, Editor Effect of Covid-19 on Maternal and Child Health Services Utilization in Ghana. Evidence from the National Health Insurance Scheme (NHIS) PONE-D-23-27704R1 Dear Dr. Edward Nketiah-Amponsah, 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 will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager® and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, 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, Essa Tawfiq Academic Editor PLOS ONE 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. 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. https://doi.org/10.1371/journal.pone.0311277.r003
Formally Accepted
9 Dec 2024 Acceptance Letter - Essa Tawfiq, Editor PONE-D-23-27704R1 PLOS ONE Dear Dr. Nketiah-Amponsah, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset If revisions are needed, the production department will contact you directly to resolve them. If no revisions are needed, you will receive an email when the publication date has been set. At this time, we do not offer pre-publication proofs to authors during production of the accepted work. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few weeks to review your paper and let you know the next and final steps. Lastly, 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 customercare@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. Essa Tawfiq Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0311277.r004

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