Dear Dr. Girma, 

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Yibeltal Alemu Bekele, MpH

Academic Editor

PLOS ONE

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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?

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??>

The PLOS Data policy

Reviewer #1: Yes

Reviewer #2: Yes

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

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: This manuscript presents valuable original research on the spatial distribution of stunting in SSA. With some minor revisions and additional details, it has the potential to make a significant contribution to the field of public health and nutrition in Sub-Saharan Africa.

Reviewer #2: Summary

The paper addresses an important issue. However, some areas require clarification and revision. The following comments highlight specific aspects that need revision:

Abstract:

• Please specify the spatial interpolation technique.

Methods:

• Study setting and period: The first sentence mentions that the current study was carried out in 48 countries, while the last line mentions that, due to some technical reasons, the study was carried out in 31 SSA countries. This inconsistency may cause confusion. Consider rephrasing for clarity.

• Population and sample: In the first line of the first paragraph, mention that the study focuses on children under five years of age. In the second paragraph, the fourth line after the full stop is unclear. Breastfeed part and the questioning of mothers of reproductive age seem combined. Consider separating these aspects for better clarity. The last paragraph of this section would be more effective if placed at the beginning to provide context for the study.

• Variables and data sources: Correct the abbreviation for Global Administrative Areas, to GADM.

• Mention the software used to create Figure 1.

• Provide the formula for calculating Moran’s I value.

Results:

• The first sentence repeats information already provided in the Methods section. Consider removing it to avoid redundancy.

• Introduce a subheading for the section discussing socio-demographic characteristics and present the associated findings in a separate paragraph before moving on to other results.

• Spatial distribution of stunting in SSA: Cite the relevant figure or table wherever appropriate. For example, in the second paragraph, the fourth and eighth lines, indicate the corresponding figure number.

Discussion:

Strengthen the discussion by comparing and contrasting the findings with previous studies. If possible, include a comparison of current estimates and patterns of stunting in SSA with data from an earlier period.

Figures and Tables:

• In Figure 2, provide coordinates and scale, indicate the north line, and add a heading for proper interpretation and analysis of the map.

• In figure and table captions, the year 2024 is mentioned as the reference year. Although, in Table 1, it is mentioned that the recent DHS data vary by country.

• In Tables 2 and 3, replace ‘frequency’ with ‘percentage/proportion’ for numerical values (Table 2) and for stunting prevalence across eligible countries (Table 3).

Recommended course of action: Request Revision

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Reviewer #1: Yes:  Luqman Adewale Abass

Reviewer #2: No

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Attachments

Attachment

Submitted filename: Peer Review Report- Breast Feeding.docx

Spatial distribution of stunting among breast feeding children in Sub-Sahara Africa

PONE-D-25-03856R1

Dear Dr. Bekahegn Girma,

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,

Yibeltal Alemu Bekele, MpH

Academic Editor

PLOS ONE