Dear Dr. Badri,

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.

We would like to be able to reconsider the manuscript and hope you can successfully address the concerns outlined below by the reviewers.

Reviewer #1

Lack of Novelty:

The study contributes little new knowledge to the existing literature. The influence of male dominance in family planning decisions, particularly in patriarchal societies, is well-documented in various studies across sub-Saharan Africa. This manuscript does not offer new insights or significant theoretical advancements in understanding these dynamics.

Methodological Flaws:

The qualitative methodology employed is insufficiently rigorous. The study’s sample size of 46 participants (23 couples) is small and lacks diversity, limiting the generalizability of the findings. Additionally, the recruitment process using a snowball sampling method introduces significant bias, as participants are likely to share similar sociocultural backgrounds, further reducing the representativeness of the sample.

The data collection and analysis methods are described in vague terms, with insufficient detail about how thematic coding was conducted. The use of NVivo software is mentioned, but without a clear explanation of the coding process, it is difficult to assess the reliability and validity of the results.

Overemphasis on Patriarchy without Critical Analysis:

The manuscript heavily emphasizes the role of patriarchy in shaping family planning decisions but fails to critically analyze this context. The discussion lacks depth and does not engage with alternative explanations or theoretical frameworks that could provide a more nuanced understanding of the findings. For instance, the role of economic factors, education levels, or healthcare access is not adequately explored.

Repetitiveness and Redundancy:

The manuscript is repetitive, particularly in the results and discussion sections. The same points about male dominance and decision-making power are reiterated multiple times without adding substantial new information or analysis. This repetition detracts from the manuscript's overall clarity and coherence.

Limited Practical Implications:

While the study aims to inform policymakers about the importance of male involvement in family planning, it does not provide actionable recommendations or innovative strategies to address the identified issues. The suggestions made are generic and lack specificity, reducing the potential impact of the research on policy and practice.

Ethical Considerations and Reflexivity:

The manuscript does not adequately address ethical considerations or the potential impact of the research on participants. Given the sensitive nature of the topic, more attention should have been given to ensuring confidentiality, especially considering the patriarchal context where discussing family planning can have serious social implications. Additionally, there is a lack of reflexivity regarding the researchers' positions and how this might have influenced the study.

Specific Comments:

Introduction:

The introduction provides a broad overview of the issue but lacks a clear statement of the research question. It would benefit from a more focused articulation of the study’s objectives and how it aims to fill specific gaps in the existing literature.

Research Methods:

The description of the qualitative approach is inadequate. The manuscript should provide more detail on the interview process, including how questions were structured and how interviews were conducted. The justification for the chosen sample size and the use of snowball sampling is weak, and these limitations should be acknowledged more transparently.

Results:

The results section is overly descriptive and lacks critical analysis. The themes identified from the interviews are not sufficiently supported by direct quotes or examples from the data, making it difficult to assess the validity of the interpretations.

Discussion:

The discussion fails to engage critically with the findings. It merely restates the results without offering deeper insights or considering alternative interpretations. The manuscript would benefit from a more critical engagement with the literature and a discussion of the broader implications of the findings.

Conclusion:

The conclusion does not effectively summarize the contributions of the study or suggest clear directions for future research. It should offer more specific recommendations for policy and practice, grounded in the study’s findings.

Recommendation:

Given the significant methodological weaknesses, lack of novelty, and inadequate analysis, I recommend rejection of the manuscript in its current form. The study does not make a substantial contribution to the field, and the identified flaws undermine the credibility and relevance of the findings.

Reviewer # 2

TITTLE

• Improve the title by unnecessary word.
• Title to be reversed

ABSTRACT

METHODS

• What is your study design? I comment mention the study design then approach
• You interview the husband or their wives make it clear

CONCLUSION

• Not well address
• Conclude based on the key findings

INTRODUCTION

• NOT well addressed with your title be specific. I comment to be reversed.
• Improve on writing much citation little voice of those researchers
• Should explained the role of husband and how will influence family planning
• You explain little modern family planning but natural family planning not well explain
• And how about 9% is prevalence of modern or natural be specific and improve

METHODS

• How do you perform the interview?
• What are the roles of researcher data collector?
• Use the researcher scientific words
• It’s thematic or content analysis makes it clear
• What is the procedure done?
• How trustworthiness was ensured?
• Ethical consideration should be well described to PLOS ONE guideline?

RESULT

• On part of result I comment to include the social demographic table.
• Also I comment using term majority on your result.
• I comment writing the number of respondent when you make the quotation.
• Also the tittle does not relate with the result especially in the quotations there is no husband role decision making explained its seem like you explain more perceptions and factors of decision making due to their wives. Make it reverse or change your title to write perceptions
• In the part of questions are too long and appeared to be like sentences. Improve the quotations

REFFERENCE

• Should be reversed are not clear in PLOS ONE guideline

DISCUSSION

• Should be reversed.
• I comment relate with the result

Please submit your revised manuscript by Dec 01 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,

Godwin Banafo Akrong, Ph.D.

Academic Editor

PLOS ONE

Journal Requirements:

1. When submitting your revision, we need you to address these additional requirements.

Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at

https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and

https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf

2. We note that this data set consists of interview transcripts. Can you please confirm that all participants gave consent for interview transcript to be published?

If they DID provide consent for these transcripts to be published, please also confirm that the transcripts do not contain any potentially identifying information (or let us know if the participants consented to having their personal details published and made publicly available). We consider the following details to be identifying information:

- Names, nicknames, and initials

- Age more specific than round numbers

- GPS coordinates, physical addresses, IP addresses, email addresses

- Information in small sample sizes (e.g. 40 students from X class in X year at X university)

- Specific dates (e.g. visit dates, interview dates)

- ID numbers

Or, if the participants DID NOT provide consent for these transcripts to be published:

- Provide a de-identified version of the data or excerpts of interview responses

- Provide information regarding how these transcripts can be accessed by researchers who meet the criteria for access to confidential data, including:

a) the grounds for restriction

b) the name of the ethics committee, Institutional Review Board, or third-party organization that is imposing sharing restrictions on the data

c) a non-author, institutional point of contact that is able to field data access queries, in the interest of maintaining long-term data accessibility.

d) Any relevant data set names, URLs, DOIs, etc. that an independent researcher would need in order to request your minimal data set.

For further information on sharing data that contains sensitive participant information, please see: https://journals.plos.org/plosone/s/data-availability#loc-human-research-participant-data-and-other-sensitive-data

If there are ethical, legal, or third-party restrictions upon your dataset, you must provide all of the following details (https://journals.plos.org/plosone/s/data-availability#loc-acceptable-data-access-restrictions):

a) A complete description of the dataset

b) The nature of the restrictions upon the data (ethical, legal, or owned by a third party) and the reasoning behind them

c) The full name of the body imposing the restrictions upon your dataset (ethics committee, institution, data access committee, etc)

d) If the data are owned by a third party, confirmation of whether the authors received any special privileges in accessing the data that other researchers would not have

e) Direct, non-author contact information (preferably email) for the body imposing the restrictions upon the data, to which data access requests can be sent.

3. Please amend either the title on the online submission form (via Edit Submission) or the title in the manuscript so that they are identical.

4. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information.

[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?

Reviewer #1: No

Reviewer #2: Yes

**********

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

Reviewer #1: No

Reviewer #2: Yes

**********

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

**********

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

Reviewer #1: Yes

Reviewer #2: Yes

**********

Reviewer #1: Overall Summary:

The manuscript explores the role of Sudanese husbands in the decision-making process related to their wives' family planning use in Khartoum and Omdurman. The study is grounded in qualitative research methods, involving interviews with 46 participants (23 married couples) to understand the sociocultural and gender norms influencing family planning decisions.

Major Concerns and Weaknesses:

Lack of Novelty:

The study contributes little new knowledge to the existing literature. The influence of male dominance in family planning decisions, particularly in patriarchal societies, is well-documented in various studies across sub-Saharan Africa. This manuscript does not offer new insights or significant theoretical advancements in understanding these dynamics.

Methodological Flaws:

The qualitative methodology employed is insufficiently rigorous. The study’s sample size of 46 participants (23 couples) is small and lacks diversity, limiting the generalizability of the findings. Additionally, the recruitment process using a snowball sampling method introduces significant bias, as participants are likely to share similar sociocultural backgrounds, further reducing the representativeness of the sample.

The data collection and analysis methods are described in vague terms, with insufficient detail about how thematic coding was conducted. The use of NVivo software is mentioned, but without a clear explanation of the coding process, it is difficult to assess the reliability and validity of the results.

Overemphasis on Patriarchy without Critical Analysis:

The manuscript heavily emphasizes the role of patriarchy in shaping family planning decisions but fails to critically analyze this context. The discussion lacks depth and does not engage with alternative explanations or theoretical frameworks that could provide a more nuanced understanding of the findings. For instance, the role of economic factors, education levels, or healthcare access is not adequately explored.

Repetitiveness and Redundancy:

The manuscript is repetitive, particularly in the results and discussion sections. The same points about male dominance and decision-making power are reiterated multiple times without adding substantial new information or analysis. This repetition detracts from the manuscript's overall clarity and coherence.

Limited Practical Implications:

While the study aims to inform policymakers about the importance of male involvement in family planning, it does not provide actionable recommendations or innovative strategies to address the identified issues. The suggestions made are generic and lack specificity, reducing the potential impact of the research on policy and practice.

Ethical Considerations and Reflexivity:

The manuscript does not adequately address ethical considerations or the potential impact of the research on participants. Given the sensitive nature of the topic, more attention should have been given to ensuring confidentiality, especially considering the patriarchal context where discussing family planning can have serious social implications. Additionally, there is a lack of reflexivity regarding the researchers' positions and how this might have influenced the study.

Specific Comments:

Introduction:

The introduction provides a broad overview of the issue but lacks a clear statement of the research question. It would benefit from a more focused articulation of the study’s objectives and how it aims to fill specific gaps in the existing literature.

Research Methods:

The description of the qualitative approach is inadequate. The manuscript should provide more detail on the interview process, including how questions were structured and how interviews were conducted. The justification for the chosen sample size and the use of snowball sampling is weak, and these limitations should be acknowledged more transparently.

Results:

The results section is overly descriptive and lacks critical analysis. The themes identified from the interviews are not sufficiently supported by direct quotes or examples from the data, making it difficult to assess the validity of the interpretations.

Discussion:

The discussion fails to engage critically with the findings. It merely restates the results without offering deeper insights or considering alternative interpretations. The manuscript would benefit from a more critical engagement with the literature and a discussion of the broader implications of the findings.

Conclusion:

The conclusion does not effectively summarize the contributions of the study or suggest clear directions for future research. It should offer more specific recommendations for policy and practice, grounded in the study’s findings.

Recommendation:

Given the significant methodological weaknesses, lack of novelty, and inadequate analysis, I recommend rejection of the manuscript in its current form. The study does not make a substantial contribution to the field, and the identified flaws undermine the credibility and relevance of the findings.

Reviewer #2: Generally the study appeared to be very important as it addressed the impact of quality of health care services and well-being of maternal and perinatal good outcome .HOWEVER many issues need to be addressed to make it more clear and scientific

Follow to the PLOS ONE in organizing your work

TITTLE

� Improve the title by unnecessary word.

� Title to be reversed

ABSTRACT

METHODS

� What is your study design? I comment mention the study design then approach

� You interview the husband or their wives make it clear

CONCLUSION

� Not well address

� Conclude based on the key findings

INTRODUCTION

� NOT well addressed with your title be specific. I comment to be reversed.

� Improve on writing much citation little voice of those researchers

� Should explained the role of husband and how will influence family planning

� You explain little modern family planning but natural family planning not well explain

� And how about 9% is prevalence of modern or natural be specific and improve

METHODS

� How do you perform the interview?

� What are the roles of researcher data collector?

� Use the researcher scientific words

� It’s thematic or content analysis makes it clear

� What is the procedure done?

� How trustworthiness was ensured?

� Ethical consideration should be well described to PLOS ONE guideline?

RESULT

� On part of result I comment to include the social demographic table.

� Also I comment using term majority on your result.

� I comment writing the number of respondent when you make the quotation.

� Also the tittle does not relate with the result especially in the quotations there is no husband role decision making explained its seem like you explain more perceptions and factors of decision making due to their wives. Make it reverse or change your title to write perceptions

� In the part of questions are too long and appeared to be like sentences. Improve the quotations

REFFERENCE

Should be reversed are not clear in PLOS ONE guideline

DISCUSSION

� Should be reversed.

� I comment relate with the result

N:B;

This is a very interesting paper, which is scientifically ground; the authors should work on those comments to improve the paper.

Thank You.

**********

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.

Dear Dr. Badri,

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.

==============================

ACADEMIC EDITOR:

1. Reviewer #2 requires you to add a table showing the social demographics of your respondents.
2. Try to indicate the study design and approach clearly. (Reviewer #2)
3. How did you ensure trustworthiness in your study? (Reviewer #2)
4. Indicate clearly whether you used thematic or content analysis. (Reviewer #2)
5. Kindly revise and improve upon your limitations. (Reviewer #2)
6. Kindly make sure to proofread your work and correct all grammatical and typographical errors. (Reviewer #2)
7. Introduction: This section needs revision. There are multiple short paragraphs, they lack continuity and do not establish facts in a coherent manner. (Reviewer #3)
8. Results: The quantitative information about respondents should be given as summary tables and not for each respondent. (Reviewer #3)
9. The qualitative results need further efforts by the authors. They are given in a very superfluous manner and lack an in-depth analysis. The themes and sub-themes emerging from the data need to be described in more detail. (Reviewer #3)
10. Discussion: I cannot comment on this section as the Results are not described comprehensively. (Reviewer #3)

==============================

Please submit your revised manuscript by Mar 15 2025 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.

• 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 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,

Godwin Banafo Akrong, Ph.D.

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

Reviewer #2: All comments have been addressed

Reviewer #3: (No Response)

**********

2. Is the manuscript technically sound, and do the data support the conclusions??>

Reviewer #2: Yes

Reviewer #3: Partly

**********

3. Has the statistical analysis been performed appropriately and rigorously? -->?>

Reviewer #2: Yes

Reviewer #3: No

**********

4. Have the authors made all data underlying the findings in their manuscript fully available??>

The PLOS Data policy

Reviewer #2: Yes

Reviewer #3: Yes

**********

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

Reviewer #2: Yes

Reviewer #3: No

**********

Reviewer #2: REVIEWER COMMENT AND SUGGESTIONS

Generally congratulation to the authors on putting much effort on improving this work however few issues should make it clear to the reader.

• Work extensively to be clear grammar and typographical errors throughout the document

• Also on top of your title authors should write the study design

• On part of result I comment to include the social demographic table it will be more better.

• What is your study design? I comment mention the study design then approach

• How trustworthiness was ensured

• It’s thematic or content analysis makes it clear

• On part of limitation the authors should revise and improve

NB:

Congratulation again to the authors the manuscript now It have improvement.

Reviewer #3: The research work addresses an important issue however, it needs to be written in a better manner for publication.

Introduction: This section needs revision. There are multiple short paragraphs, they lack continuity and do not establish facts in a coherent manner.

Results: The quantitative information about respondents should be given as summary tables and not for each respondent. The qualitative results need further efforts by the authors. They are given in a very superfluous manner and lack an in-depth analysis. The themes and sub-themes emerging from the data need to be described in more detail.

Discussion: I can not comment on this section as the Results are not described comprehensively.

**********

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 #2: Yes: rehema abdallah

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

Dear Dr. Badri,

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.

==============================

Key Areas for Improvement:

1. Kindly address the concerns raised regarding the research methods, results, and discussions.

In summary, I encourage you to address all the reviewers' comments and make the necessary revisions. I look forward to reviewing your revised manuscript.

Please submit your revised manuscript by May 11 2025 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.

• 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 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,

Godwin Banafo Akrong, Ph.D.

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

Reviewer #2: All comments have been addressed

Reviewer #3: (No Response)

**********

2. Is the manuscript technically sound, and do the data support the conclusions??>

Reviewer #2: Yes

Reviewer #3: Partly

**********

3. Has the statistical analysis been performed appropriately and rigorously? -->?>

Reviewer #2: Yes

Reviewer #3: N/A

**********

4. Have the authors made all data underlying the findings in their manuscript fully available??>

The PLOS Data policy

Reviewer #2: Yes

Reviewer #3: Yes

**********

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

Reviewer #2: Yes

Reviewer #3: Yes

**********

Reviewer #2: Reviewer Comment and suggestions

Abstract:

• The abstract is well-structured; however, consider summarizing the key findings in bold points for easier readability.

Introduction:

• Clearly define key terms early on, such as "family planning," "contraceptive use," and specific cultural terms related to fertility in Sudan.

• The authors could strengthen the rationale for the study by explicitly stating the gaps in existing research and the significance of addressing these in the Sudanese context.

Methodology:

• The authors should have provided strong details on methodology; however, clarify the rationale behind the sample size (46) and the decision to conduct interviews separately.

• Consider including additional information on any pilot testing done for interview guides or data collection methods to enhance credibility.

Results

• The four pathways are insightful. To enhance clarity, consider summarizing each pathway with a diagram or table that encapsulates the findings visually.

• When quoting participants, ensure a uniform presentation style to enhance readability.

• Tables (S1 and S2): Ensure that the tables are referenced consistently in the text. For instance, include contextual details before referencing a particular table.

Discussion

• Integrate relevant theoretical frameworks that support your findings. This could enhance the academic level and context of your analysis.

• Connect the findings to broader implications beyond Sudan, discussing how culturally influential decisions in family planning are a common issue in various regions globally.

Limitations:

• Your acknowledgment of limitations is good. It could be beneficial to offer suggestions for future research, highlighting how studies could be expanded or improved in method.

Conclusion

• The conclusion consolidates findings effectively. Reinforce the call to action for integrating men into family planning discussions, as it positions your research within a solution-focused frame.

NB

• While the tone is mostly formal and academic, consider refining some sentences for conciseness and impact.

• Ensure that all references are formatted consistently according to the selected citation style; this includes consistency in formatting year, volume, and pages in your references list.

• A thorough proofreading process could help catch minor typographical or grammatical errors that may have slipped through.

Reviewer #3: Research Methods:

The description of the qualitative approach is inadequate. The summary tables for the socio-demographic are not in the standard way. The justification for the chosen sample size and the use of snowball sampling is weak, and these limitations should be acknowledged more transparently.

Results:

The results section is still descriptive and lacks critical analysis. The themes identified from the interviews are supported by direct quotes or examples from the data, but the analytic approach for the results reported is weak.

Discussion:

The discussion does not critically engage with the findings. It merely restates the results without offering deeper insights or considering alternative interpretations. The manuscript would benefit from a more critical engagement with the literature and a discussion of the broader implications of the findings.

**********

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 #2: Yes: rehema abdallah

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

Decisions and Choices about Fertility and Family Planning: Perspectives from Husbands and Wives in Sudan.

Dear Dr. Badri,

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.

==============================

I encourage you to address the comments raised by Reviewer #4 and make the necessary revisions. I look forward to reviewing your revised manuscript.

==============================

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Kind regards,

Godwin Banafo Akrong, Ph.D.

Academic Editor

PLOS One

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

Reviewer #2: All comments have been addressed

Reviewer #4: (No Response)

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2. Is the manuscript technically sound, and do the data support the conclusions??>

Reviewer #2: Yes

Reviewer #4: Yes

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3. Has the statistical analysis been performed appropriately and rigorously? -->?>

Reviewer #2: Yes

Reviewer #4: Yes

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4. Have the authors made all data underlying the findings in their manuscript fully available??>

The PLOS Data policy

Reviewer #2: Yes

Reviewer #4: Yes

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

Reviewer #2: Yes

Reviewer #4: Yes

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Reviewer #2: This qualitative study offers valuable insights into the influence of husbands' fertility preferences on their wives' contraceptive use in Sudan, highlighting important societal and individual dynamics. However, there are several areas for improvement.

Strengths:

• The study addresses a critical reproductive health issue in Sudan, where low contraceptive use and high fertility remain challenges.

• Employing qualitative interviews provides depth and nuanced understanding of gender dynamics and personal beliefs.

• Including both husbands and wives in separate interviews allows for a comprehensive view of family planning decisions within relationships.

• The emphasis on policy and community engagement, including involving men in reproductive health discussions, is well-grounded.

Areas for Improvement:

• While 46 participants can provide rich qualitative data, the sample size and geographic focus on Khartoum and Omdurman may limit generalizability. Including rural areas or diverse socio-economic groups could enhance the comprehensiveness.

• Given the sensitive nature of family planning and gender roles, responses might be influenced by social desirability bias, especially when discussing male involvement and women’s agency. Strategies to mitigate this, such as ensuring confidentiality or triangulating data, should be explicitly discussed.

• The summary indicates common themes but lacks detail on how these themes emerged or how differences among participants were handled. A more detailed explanation of the coding process and thematic development would strengthen methodological transparency.

• Although some wives seek to assert their reproductive choices, the paper could delve deeper into the barriers they face when doing so, including cultural, social, or economic obstacles. This would provide a fuller picture of women’s agency.

• While recommendations are made for involving men and training health providers, specifics on how these strategies might be operationalized in the Sudanese context are limited. Including examples or frameworks could improve practical utility.

Reviewer #4: Comments

This topic is timely, given the increasing focus on how fertility preferences are shaped by demographic factors like education, economic status, and religious beliefs.

1. In the introduction, the author(s) should address the following:

a. Abbreviations should be provided in full before using them in the paper. E.g. ICPD

b. Also, perhaps it will be important for the author(s) to clearly define upfront some of the key terms they used in their study to ensure readers understand their specific meanings in the context of the study. E.g. family planning, contraceptive use, and fertility preferences.

2. The section title “aims” should be merged with the introduction.

3. The section titled “methodology” should be “methods.”

4. The colon placed in the subsections in the methodology section should be removed.

5. In using the snowballing approach, how did the author(s) address sample bias? This is because participants can be more inclined to recommend those who have similar traits or experiences, which could distort the sample.

6. What was the theoretical foundation of the study?

7. The author(s) make mention of data collectors; were these people trained? Who trained them?

8. S1 Table should be labelled Table 1.

9. In Table S1 Table, the column data collection methods should be deleted

10. In reporting the quotes made by participants, the author(s) should put them in this form “(Muslim- Wife, monogamous, three children)” rather than “(S1 Table. Couple: three children,

Khartoum).”

This is to help readers appreciate who is making the comments and the context in which they are being made.

11. The title states that the study will explore the perspective from husbands and wives, but the quotes reported as presented by the author(s) were only from the women. Can the author clarify why? Because it will be equally important to include the husbands' perspective?

12. The limitation section should be added to the discussion section.

13. Was the study shaped around any theoretical foundation?

14. Were the questions used for the interview guide adopted from a prior study?

15. With the interview guide design, were there any piloting? If yes, how was it carried out, and did it inform the final design of the interview guide?

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what does this mean? ). If published, this will include your full peer review and any attached files.

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Reviewer #2: Yes: rehema abdallah

Reviewer #4: No

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Decisions and Choices about Fertility and Family Planning: Perspectives from Husbands and Wives in Sudan.

PONE-D-24-10658R4

Dear Dr. Badri,

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.

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Kind regards,

Godwin Banafo Akrong, Ph.D.

Academic Editor

PLOS One

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

Reviewer #4: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions??>

Reviewer #4: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously? -->?>

Reviewer #4: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available??>

The PLOS Data policy

Reviewer #4: Yes

**********

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

Reviewer #4: Yes

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Reviewer #4: I don't have any additional comments. Authors have responded and worked on my suggested changes/comments

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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 #4: No

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