PONE-D-24-53694End users’ perception and challenges to adopt the WHONET/BacLink system in clinical microbiology laboratories in NepalPLOS ONE

Dear Dr. Gautam,

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Reviewer #1: Partly

Reviewer #2: Yes

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

Reviewer #1: I Don't Know

Reviewer #2: Yes

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Reviewer #1: No

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1: This manuscript, "End users’ perception and challenges to adopt the WHONET/BacLink system in clinical microbiology laboratories in Nepal," has potential for publication particularly in the context of global health, antimicrobial resistance (AMR) surveillance, and digital health interventions.

Although it presents a real-world evaluation of WHONET/BacLink and provides actionable insights into barriers to software adoption, however this manuscript has some key gaps that need to be addressed. Fo example,

• The title and abstract should be more explicit about the study's qualitative nature. Consider modifying the title to:

"Barriers and Perceptions of WHONET/BacLink Adoption in Nepal: A Qualitative Study of Clinical Microbiology Laboratories."

• The introduction should explicitly state the research question(s).

• The discussion section should have a more structured approach, aligning findings with solutions.

In methodology,

• the sample size (10 hospitals out of 19) is small, which limits generalizability. A discussion of this limitation and possible biases (e.g., response bias in phone interviews) is needed.

• The inductive coding approach used for qualitative analysis should be described more transparently (e.g., how themes were validated).

Data utilization & interoperability solutions

• Line 15-18: Despite given extensive training on uses of WHONET/BacLink, why do you think lack of knowledge is the barrier?

• The paper extensively discusses barriers but does not explore technical solutions to WHONET/BacLink's interoperability issues. Are there existing case studies or proposed solutions in other countries?

• The manuscript does not sufficiently compare hospitals that adopted the system vs. those that did not—are there contextual factors that influenced successful implementation?

• The study is valuable but lacks a broader policy or global perspective—how do these findings compare to other low-resource settings?

• Some findings (e.g., hospital-specific WHONET usage patterns) would be better presented in tables or figures for clarity.

Reviewer #2: The authors have put together a clear and well-written manuscript that adds to the narrative in the use of WHONET; an End users’ perception and challenges to adopting the WHONET/BacLink system in clinical microbiology laboratories in Nepal

find below a few suggestions.

The background in the abstract did not really capture the aim of the work/study if you could be modified to bring out the aim.

In the method section, was the translation done manually or was software used for the translation

Line 24 “IVI’ kindly gives the full meaning of this acronym as it is the first time appearing in the writeup

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Reviewer #1: Yes: Md Hafizur Rahman

Reviewer #2: No

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Attachment

Submitted filename: Review feedback-PONE-D-24-53694.docx

Barriers and perceptions of WHONET/BacLink adoption in Nepal: A qualitative study of clinical microbiology laboratories

PONE-D-24-53694R1

Dear Dr. Gautam,

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,

Cornelius Cecil Dodoo, PhD

Academic Editor

PLOS ONE

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