Mapping the prevalence and covariates associated with home delivery in Bangladesh: A multilevel regression analysis

Rakhi Dey; Susmita Rani Dey; Meem Haque; Anushuya Binta Rahman; Satyajit Kundu; Sarmistha Paul Setu; U. K. Majumder

doi:10.1371/journal.pone.0313606

Peer Review History

Original SubmissionNovember 8, 2023
3 Apr 2024 Decision Letter - Mohammad Nayeem Hasan, Editor PONE-D-23-36533Mapping the prevalence and Covariates Associated with Home Delivery in Bangladesh: A Multilevel Regression AnalysisPLOS ONE Dear Dr. Majumder, 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 May 18 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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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: Yes 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, I hope this email finds you well. I wanted to let you know that I found your article to be well-written, covering an interesting and helpful topic that could prove valuable for future recommendations and actions. I strongly recommend that the article be published with no significant changes. However, I would like to suggest updating the reference list, as approximately 40% of the sources listed are dated before 2015. Thank you for taking the time to consider my feedback. Best regards, Reviewer #2: (Line 100 : skilled “attendance” is it a typo error of attendant. Line 132 : ever-married : what is the meaning of it ? Line 131 : and study procedure can be found elsewhere , it should be replaced with proper place as author is given reference for it . Link 148 : wealth status (poorest, poorer, middle, richer, richest)… Representation doesn’t look here , it can be replaced with income range , like low income (0 – 100 USD per week/month ,100 – 500 USD ) so on. 149 : exposure to media .What is the role of exposure of media in this study? Classification should be modify or add reference where from it was adopted words like “Poorest” and “Richest”, in my concern it should be replaced with the range of income. Line 189 : Result section Define this line “9,166 (weighted) women who had at least one live delivery in the two years before to 190 the survey were part of this investigation.” while shading some light of the data given in the table 1 section Age at first marriage/union , ≤ 18 years , number of correspondents is 6632 . As 7069 correspondents were of 20 – 34 year range. As well as 6632 were less than 18 year. Please explain it , I am confused now . Line 292 and line 295 is seems the repetition of the same statement in a different way . Rewrite it please. Line 286 and line 300 also looks similar, better this sentence should be used in the later part of discussions to make it general statement with combining the effect of education and wealth status. Check the spellings and reference throughout use correct format , As ref 14, 16 and 22 . Rest if possible to support study some recent references also can be added. ) ****** 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: Beisan A. Mohammad,PhD, MSc Pharm Sci, BPharm, MSc MEd 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. https://doi.org/10.1371/journal.pone.0313606.r001
Revision 1
27 Apr 2024 Author Response Response to the Reviewers' comments: Reviewer #1: Comment: Dear Authors, I hope this email finds you well. I wanted to let you know that I found your article to be well-written, covering an interesting and helpful topic that could prove valuable for future recommendations and actions. I strongly recommend that the article be published with no significant changes. However, I would like to suggest updating the reference list, as approximately 40% of the sources listed are dated before 2015. Thank you for taking the time to consider my feedback. Author’s Response: Dear reviewer, thank you for your appreciation and time to review our paper. We agree with your argument that almost 40% of references are dated before 2015. For your kind information, we found a few references that are available on the home delivery, rather most of the recent works focused mainly on the institutional delivery. However, we have updated some references this time according to your suggestion and also incorporated some recent references that worked on home delivery. Please check the reference section. Besides that, we had to keep some references dated even before 2010 due to supporting some arguments in our problem statement and discuss some results of our study. We found those references are crucial to rationalize our statements. So, we hope you will also agree with us; however, if you suggest some references that are strongly required to improve our paper, we will be happy to include them. Reviewer #2: Comment: Line 100: skilled “attendance” is it a typo error of attendant. Author’s Response: Dear reviewer, thank you for your time to review our paper. We corrected the typo you pointed out. Comment: Line 132: ever-married: what is the meaning of it? Author’s Response: We have defined the term “ever-married” with reference as follows: “The ever-married women were those who had been married at least once in their lives though they may not be currently married [26]” Comment: Line 131: and study procedure can be found elsewhere, it should be replaced with proper place as author is given reference for it. Author’s Response: We have replaced it with the report of MICS 2019. Now it reads: “The detailed information on sampling technique, questionnaire, and study procedure can be found in the MICS 2019 report [25]” Comment: Line 148: wealth status (poorest, poorer, middle, richer, richest). Representation doesn’t look here, it can be replaced with income range, like low income (0–100 USD per week/month, 100–500 USD ) so on. Author’s Response: Thank you for your comment. MICS measures the household wealth status based on ownership of different household assets. In Bangladesh MICS 2019, 25 (groups of) variables that were used for the construction of the Bangladesh Wealth Index. The wealth index is assumed to capture the underlying long-term wealth through information on the household assets and is intended to produce a ranking of households by wealth, from poorest to richest. The wealth index does not provide information on absolute poverty, current income or expenditure levels. Each household in the total sample is then assigned a wealth score based on the assets owned by that household and on the final factor scores obtained as described above. The survey household population is then ranked according to the wealth score of the household they are living in and is finally divided into 5 equal parts (quintiles) from lowest (poorest) to highest (richest). In MICS report, there is a separate variable for wealth status that we used where the quintiles of wealth status were named as poorest, second, middle, fourth, and richest. We also replaced “poorer” with “second”, and “richer” with “fourth” in this study (please see in the method section). The aforementioned description are taken from the MICS 2019 report. There is no estimation of the income amount (like in USD) available in the MICS data sets. Previous studies also used this variable as wealth quintile. Please see a previous study and MICS report 2019 below: Bangladesh Bureau of Statistics (BBS) and UNICEF Bangladesh. Progotir Pathey, Bangladesh Multiple Indicator Cluster Survey 2019, Survey Findings Report. Dhaka, Bangladesh: Bangladesh Bureau of Statistics (BBS); 2019. Chowdhury TR, Chakrabarty S, Rakib M, Winn S, Bennie J. Risk factors for child stunting in Bangladesh: an analysis using MICS 2019 data. Arch Public Heal. 2022;80:1–12. We also added a statement with reference in the method section in this study as follows: “The household wealth status was calculated based on the ownership of different household assets using principal component analysis (PCA) [28].” Comment: Line 149: exposure to media . What is the role of exposure of media in this study? Author’s Response: The Bangladesh MICS, 2019 collected information on exposure to mass media, where the information was collected on exposure to newspapers / magazines, radio and television among women 15-49 years. We categorized women having exposure to media if they had access to either reading newspapers / magazines, or listening radio or watching television following the guidelines of MICS and previous literature (please see ref below). Saleheen AAS, Afrin S, Kabir S, Habib MJ, Zinnia MA, Hossain MI, et al. Sociodemographic factors and early marriage among women in Bangladesh, Ghana and Iraq: An illustration from Multiple Indicator Cluster Survey. Heliyon. 2021;7. We added the following statement in the method section now: “We classified women as having exposure to media if they had access to read newspapers or magazines, listen to the radio, or watch television.” In response to your question- “what is the role of exposure of media in this study”, we included this variable based on the previous studies where media exposure was found to be associated with the place of delivery. Though we didn’t find any significant association for the individual level exposure to media, a significant association of community level media exposure was significantly associated with the home delivery in this study, and we discussed this finding. Comment: Classification should be modified or add reference where from it was adopted words like “Poorest” and “Richest”, in my concern it should be replaced with the range of income. Author’s Response: We have provided the references of MICS 2019 report, where the wealth status also categorized as quintile (poorest, second, middle, fourth, richest). Please see ref 25. Comment: Line 189: Define this line “9,166 (weighted) women who had at least one live delivery in the two years before to 190 the survey was part of this investigation.” Author’s Response: We have rewritten the line as follows: “A total of 9,166 (weighted) women who had at least one live delivery in the two years preceding the survey were included in this study.” Comment: While shading some light of the data given in the Table 1 section Age at first marriage/union, ≤18 years, and number of correspondents is 6632. As 7069 correspondents were of 20–34 -year range. As well as 6632 were less than 18 year. Please explain it, I am confused now. Author’s Response: These are two distinct variables. The variable “Age of women” represents the current age of women at the time of survey, where we found 7069 women were from 20-34 years age group. On the contrary, the variable “Age at first marriage/union” provides the information on about how old the woman was at the time of first marriage / union? Hence, the variable “Age at first marriage/union” provides the prior information, not current, and consequently, it shows that 7069 respondents were of 20–34 -year range, but 6632 were less than 18 year at their first marriage / union. Comment: Line 292 and line 295 is seems the repetition of the same statement in a different way. Rewrite it please. Author’s Response: Thank you for pointing this out. We have removed the 2nd line. Comment: Line 286 and line 300 also looks similar, better this sentence should be used in the later part of discussions to make it general statement with combining the effect of education and wealth status. Author’s Response: Thank you for this comment. We have placed this sentence at the end of the paragraph discussing association between socioeconomic status and home delivery in a single statement with combining the effect of education and wealth status. Now it reads: “Additionally, women from higher socioeconomic group with higher education and wealth status may be more empowered to make decisions for themselves, obtain information, and be financially independent enough to support themselves, travel to a medical facility and pay for services when needed, as well as to easily absorb health-related messages from the media and from medical professionals [46,47]” Comment: Check the spellings and reference throughout use correct format, as ref 14, 16 and 22. Rest if possible to support study some recent references also can be added. Author’s Response: We followed the PLOS style for referencing. We have added some recent references also. Please see refs 18 to 24. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0313606.r002
25 Jun 2024 Decision Letter - Mohammad Nayeem Hasan, Editor PONE-D-23-36533R1Mapping the prevalence and Covariates Associated with Home Delivery in Bangladesh: A Multilevel Regression AnalysisPLOS ONE Dear Dr. Majumder, 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 Aug 09 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. Please include the following items when submitting your revised 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, Mohammad Nayeem Hasan Academic Editor PLOS ONE [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 #3: (No Response) ******** 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 #3: Partly ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #3: 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 #3: 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 #3: 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 #3: Comments Generally, this paper is essential to maternal and child health. The authors dealt with the phenomenon with a clear methodological step. I congratulate them on that. It’s great work, congratulations to the authors. However, they should pay attention to these comments and work on them to improve the paper. Lines 1 and 2, the title reads: “Mapping the prevalence and Covariates Associated with Home Delivery in Bangladesh: A Multilevel Regression Analysis”. For consistency’s sake, they could consider capitalizing “prevalence” as the major keywords started with capital letters. Line 41 to 43, they started the sentence with “though”. Technically, Abstract should be written in abstracting terms. As such, authors could consider removing “though”, and “however” from the abstract. In line 43, the authors stated that “However, reasons behind this need to be explored in community-level”. the use of “reasons” appears as if the authors are going to present real reasons. Meanwhile, the work is quantitative. Quantitative language should be used here instead of qualitative terms/words. Preferably, they can use terms such as “predictors”, “plausible factors”, “determinants” and others. “Reasons” sounds more in a qualitative sense. Line 51, the authors stated that “The overall weighted prevalence of home delivery was 46.41%”. it is appropriate to add the confidence intervals for this overall prevalence. Line 51-58, the authors only presented fixed effects results, it will be appropriate if they capture the random effects results as well here, briefly. In line 68, the authors included “delivery care” as a keyword and I wonder how that can be a keyword in this study. In lines 76-77, the authors stated that “In most, but not all, nations during the past few decades, there has been a marked decline in home births”. This is a good point though; however, I was expecting a recent citation to align with this statement. However, the authors cited 1985, 1997. This is several decades ago as we are in 2024. Lines 78-80, Reference 11 and 12 are citations in 2006 and 2012 on Maternal mortality trends. This is less acceptable as recent estimates of maternal mortality are available for use. Authors should consider revising references that are too old in the entire background section. In line 108, the authors stated “Bangladesh has implemented several initiatives to address maternal health……..”. However, they didn’t elaborate on these initiatives. The section will read better and scientifically good if the authors narrate/synthesize the strategies/initiatives, adopted in Bangladesh, the success made by such strategies, and the failures if any. They have to do such a comparative analysis. In lines 108 to 111, the authors presented “Issues such as inadequate healthcare infrastructure, geographical barriers, limited access to skilled birth attendants, and socioeconomic disparities continue to affect maternal health outcomes”. These are probable factors that might have been identified by earlier studies so to avoid plagiarism, authors have to reference this statement accordingly. Lines 111 to 113, reads “Our study’s findings help in identifying the obstacles to health facility delivery and the variables influencing maternal fatalities during in-home birth in Bangladesh”. Is this a justification or statement of the problem? Authors should come clearly and state the problem and the justification for the study separately. They should not combine the problem statement and justification. Authors should present the study design first before talking about the data source in the methods section. In lines 136 to 142, the authors didn’t talk about “others” in the responses. Were there “others” in the responses given by the respondents and yes, how are “others” managed in this study? Line 148, ANC visits were classified as no visits, 1-3 visits, and 4 or above visits. What informs this classification? Currently, the practice is less than 8 visits as poor and 8 or more as desirable. It could be appropriate if they reclassify ANC according to current standards. A similar thing applies to the community ANC variable. Here, authors classified them into less than 50% having 4 or more ANC visits which is even not consistent with their earlier ANC classification at the individual level. they should reconcile this. Line 149, the authors should consider explaining how they generated exposure to mass media as the dataset used does not have a variable called mass media, to the best of my knowledge. Line 249, the authors should check this grammar “was to mapping” and correct it appropriately, “The main objective of this study was to mapping the prevalence of home delivery practice”. In the policy implication section, authors have to be specific. Who or which agency or ministry should implement what? They should direct their policy implications to specific agencies or ministries/departments of Bangladesh. For instance, targeted efforts by the Ministry of Health, Reproductive Unit or Public Health Division of Bangladesh should focus on…… Authors should consider discussing policy implications after the conclusion. So, they should shift policy implication to the last section after the conclusion. Finally, authors should check for grammatical errors and if any exist, correct them. Thank you. ****** 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 #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: Comments PLOS ARTICLE.docx https://doi.org/10.1371/journal.pone.0313606.r003
Revision 2
3 Aug 2024 Author Response Response to the Reviewers' comments: Comment: Generally, this paper is essential to maternal and child health. The authors dealt with the phenomenon with a clear methodological step. I congratulate them on that. It’s great work, congratulations to the authors. However, they should pay attention to these comments and work on them to improve the paper. Author’s response: Dear Reviewer, Thank you for the time and for considering our paper for reviewing. We appreciate your effort and are thankful for your appreciation and valuable feedback. Comment: Lines 1 and 2, the title reads: “Mapping the prevalence and Covariates Associated with Home Delivery in Bangladesh: A Multilevel Regression Analysis”. For consistency’s sake, they could consider capitalizing “prevalence” as the major keywords started with capital letters. Author’s response: Thank you for pointing this out. We have capitalized it in the title. Comment: Line 41 to 43, they started the sentence with “though”. Technically, Abstract should be written in abstracting terms. As such, authors could consider removing “though”, and “however” from the abstract. Author’s response: We have revised the introduction section of the abstract and removed ‘though’ and ‘however’ from the abstract. Now it reads: Bangladesh has made an intense effort to improve maternal healthcare facilities including facility delivery, but the number of home deliveries is still very high Therefore, this study aims to find out district-wise prevalence and determine the individual and community-level covariates related to home delivery among women in Bangladesh. Comment: In line 43, the authors stated that “However, reasons behind this need to be explored in community-level”. the use of “reasons” appears as if the authors are going to present real reasons. Meanwhile, the work is quantitative. Quantitative language should be used here instead of qualitative terms/words. Preferably, they can use terms such as “predictors”, “plausible factors”, “determinants” and others. “Reasons” sounds more in a qualitative sense. Author’s response: Thank you for this insightful comment. We have changed the sentence and revised the section. Please see the previous response. Comment: Line 51, the authors stated that “The overall weighted prevalence of home delivery was 46.41%”. it is appropriate to add the confidence intervals for this overall prevalence. Author’s response: Thank you for your suggestion. We have added the confidence intervals for the prevalence in the abstract. Comment: Line 51-58, the authors only presented fixed effects results, it will be appropriate if they capture the random effects results as well here, briefly. Author’s response: We have added a statement from the random effects results in the abstract. Please see the statement below: The intercept-only regression model demonstrates that the likelihood of women from various clusters having home delivery varied significantly (variance: 1.47, standard error [SE]: 0.117), indicating the applicability of multilevel regression modeling. Comment: In line 68, the authors included “delivery care” as a keyword and I wonder how that can be a keyword in this study. Author’s response: We have removed ‘delivery care’ from the keywords. Comment: In lines 76-77, the authors stated that “In most, but not all, nations during the past few decades, there has been a marked decline in home births”. This is a good point though; however, I was expecting a recent citation to align with this statement. However, the authors cited 1985, 1997. This is several decades ago as we are in 2024. Author’s response: We have updated these with some recent references (Please check refs 6-8). Comment: Lines 78-80, Reference 11 and 12 are citations in 2006 and 2012 on Maternal mortality trends. This is less acceptable as recent estimates of maternal mortality are available for use. Authors should consider revising references that are too old in the entire background section. Author’s response: Dear reviewer, Thank you for your observation. We have tried to update the references for the entire background section. The references you are referring to, was to support the following statement “The expansion of institutional delivery coverage and the use of skilled birth attendants during deliveries are only a couple of the measures that have been put forth to lower this maternal, fetal, and newborn mortality.” To support the maternal mortality rate and trends, we used several recent references those are mostly after 2019. Please check the refs 11-14. Comment: In line 108, the authors stated “Bangladesh has implemented several initiatives to address maternal health……..”. However, they didn’t elaborate on these initiatives. The section will read better and scientifically good if the authors narrate/synthesize the strategies/initiatives, adopted in Bangladesh, the success made by such strategies, and the failures if any. They have to do such a comparative analysis. Author’s response: We have added some statements demonstrating the available health services and initiatives of Bangladesh with references. Now it reads: Bangladesh has implemented several initiatives related to maternal health services to address maternal health. The key maternal health services available in Bangladesh include antennal care, post-abortion care, basic essential obstetric care (EOC), comprehensive EOC, postnatal care for mothers, intensive care unit for mothers, introduction of health vouchers scheme for poor women, deployment of community-based skilled birth attendants, and introduction of the midwifery programme [28–30]. But not all health facilities, particularly those in rural regions in Bangladesh, offer all kinds of maternity and newborn health services [29]. Consequently, despite progress, Bangladesh still faces challenges in reducing maternal mortality [31]. Comment: In lines 108 to 111, the authors presented “Issues such as inadequate healthcare infrastructure, geographical barriers, limited access to skilled birth attendants, and socioeconomic disparities continue to affect maternal health outcomes”. These are probable factors that might have been identified by earlier studies so to avoid plagiarism, authors have to reference this statement accordingly. Author’s response: We already added the references for this statement. Please see refs 31 & 32. Comment: Lines 111 to 113, reads “Our study’s findings help in identifying the obstacles to health facility delivery and the variables influencing maternal fatalities during in-home birth in Bangladesh”. Is this a justification or statement of the problem? Authors should come clearly and state the problem and the justification for the study separately. They should not combine the problem statement and justification. Author’s response: We have revised the sentence now and focused on the objective of the study. We have separated the problem statement and justification of the study now. Comment: Authors should present the study design first before talking about the data source in the methods section. Author’s response: We have re-organized the section, keeping study design before the data source in the method section as per reviewers comment. Comment: In lines 136 to 142, the authors didn’t talk about “others” in the responses. Were there “others” in the responses given by the respondents and yes, how are “others” managed in this study? Author’s response: We have clarified about the other’s home now. In the question, there were two options for home delivery along with the name of some other institutions. The two options for home delivery were “respondent’s home” and “other’s home”, where the other’s home meant the home of neighbours, friends, relatives or any birth attendants, and we have clarified this in the method section now as follows: The other’s home referred to the home of neighbors, friends or relatives of the respondents, or any birth attendant’s home. Comment: Line 148, ANC visits were classified as no visits, 1-3 visits, and 4 or above visits. What informs this classification? Currently, the practice is less than 8 visits as poor and 8 or more as desirable. It could be appropriate if they reclassify ANC according to current standards. A similar thing applies to the community ANC variable. Here, authors classified them into less than 50% having 4 or more ANC visits which is even not consistent with their earlier ANC classification at the individual level. they should reconcile this. Author’s response: Thank you for your insightful comment. In response, we have recategorized the individual-level ANC visits into four categories: no visits, 1-3 visits, 4-7 visits, and 8 or more visits. This reclassification aligns with the current WHO recommendations for antenatal care (ANC) visits. Following this adjustment, we have reanalyzed the data accordingly. Regarding the community-level ANC visit variable, we encountered a significant limitation. When we attempted to create a separate community-level variable based on the criterion of 8 or more visits as indicative of high community-level ANC, we observed that less than 1% of participants fell into this category. This extremely low prevalence rendered the variable ineffective for meaningful analysis and interpretation. Consequently, we have excluded the community-level ANC visit variable from our study because of low percentage (less than 1%) in one category of two. We appreciate your feedback, which has been instrumental in refining our analysis. Please refer to the revised tables for the updated results. Comment: Line 149, the authors should consider explaining how they generated exposure to mass media as the dataset used does not have a variable called mass media, to the best of my knowledge. Author’s response: We have clarified how we generated the media exposure variable. Now it reads: Media exposure was created as a dichotomous variable. Women were categorized as having media exposure if they reported access to at least one of the following information sources like reading newspapers/magazines, listening radio, or watching television. Those with access to any of these sources were classified as ‘yes’ for media exposure, while those without access to any were classified as ‘no’ [38]. Comment: Line 249, the authors should check the grammar “was to mapping” and correct it appropriately, “The main objective of this study was to mapping the prevalence of home delivery practice”. Author’s response: Thank you for pointing this out. We have corrected this and fixed the grammatical errors throughout the manuscript. Comment: In the policy implication section, authors have to be specific. Who or which agency or ministry should implement what? They should direct their policy implications to specific agencies or ministries/departments of Bangladesh. For instance, targeted efforts by the Ministry of Health, Reproductive Unit or Public Health Division of Bangladesh should focus on…… Author’s response: Thank you for this insightful comment. We have revised the recommendations and now it reads: The study's conclusions may have a significant impact on interventions and policy decisions that are proposed for specific agencies and ministries in Bangladesh to lower the prevalence of home birth in Bangladesh. The Directorate General of Health Services (DGHS) under the Ministry of Health and Family Welfare along with different non-government organizations should spearhead awareness campaigns on the benefits of skilled birth attendance and the risks of home delivery. Concurrently, the Ministry of Women and Children Affairs, in collaboration with the Ministry of Education, should focus on improving education and awareness among women regarding the benefits of skilled birth attendance and the potential risks associated with home delivery. Additionally, interventions should address socioeconomic barriers by providing financial support for transportation and improving the affordability of maternal health services. The DGHS, Bangladesh should also enhance the availability and quality of healthcare facilities in rural areas in order to curve the reliance on home delivery in these regions. Comment: Authors should consider discussing policy implications after the conclusion. So they should shift policy implication to the last section after the conclusion. Author’s response: We have shifted the policy implication to the last section after the conclusion. Comment: Finally, authors should check for grammatical errors and if any exist, correct them. Thank you. Author’s response: We have thoroughly checked and fixed the grammatical errors throughout the manuscript this time. Attachments Attachment Submitted filename: Response to reviewers.docx https://doi.org/10.1371/journal.pone.0313606.r004
29 Oct 2024 Decision Letter - Md Hasinur Rahaman Khan, Editor Mapping the prevalence and Covariates Associated with Home Delivery in Bangladesh: A Multilevel Regression Analysis PONE-D-23-36533R2 Dear Dr. Majumder, 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, Md Hasinur Rahaman Khan, Ph.D. Academic Editor PLOS ONE Additional Editor Comments (optional): I have reviewed the response letter and happy with the responses. The authors need to refer the following multilevel modelling implemented to Bangladesh data in the text of the manuscript. Multilevel Logistic Regression Analysis Applied to Binary Contraceptive Prevalence Data Journal of Data Science, Vol. 9, pp. 93-110, 2011 Reviewers' comments: https://doi.org/10.1371/journal.pone.0313606.r005
Formally Accepted
1 Nov 2024 Acceptance Letter - Md Hasinur Rahaman Khan, Editor PONE-D-23-36533R2 PLOS ONE Dear Dr. Majumder, 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. Md Hasinur Rahaman Khan Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0313606.r006

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