Dear Dr. Moshi,

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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

Reviewer #3: Yes

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

Reviewer #1: I Don't Know

Reviewer #2: Yes

Reviewer #3: 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

Reviewer #3: 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

Reviewer #3: No

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Reviewer #1: This is a interesting study, but in order to be accepted, it must take these comments and suggestions into account.

Manuscript Number: PONE-D-26-20044

Title: Contextual Barriers and Facilitators Influencing Implementation Fidelity of School-Based Preventive Chemotherapy for Schistosomiasis: A Qualitative Study in Two Endemic Districts in the Central Region, Ghana.

Page 11 ligne 62-64 : Scientific names should be in italics. Schistosoma mansoni and schistosoma haematobium

Page 11 line 73-80 : two long sentences, spit in 2 sentences

Page 11 ligne 79-80 Standardize the references (Kwabi et al., 2024 in number)

Page 12 line 97-98 : Standardize the references (Damschroder et al. (2022) in number)

Page 17 line 188 : Standardize the references (Carroll et al (2007 in number)

Page 18 line 228 : Table 1 should include “N” (sample size) in its columns and remove “Years” since that is already included in the table header.

Page 43 694 : The references need to be revised to conform to the journal's style.

Page 15, Line 152 : Inclusion and exclusion criteria are not clearly defined, please cite all of them

Please define program's implementation fidelity

Line 192 : Ethical Considerations

What language was the information sheet written in? Please explain how you handled participants who cannot read or write. How did you ensure that these individuals understood the information and were not influenced by the research team?

Line 206 : explain your triangulation procedures

Lines 205-209: the sentence is too long, please split in 2 or 3 short clear sentences.

Lines 218-219 : You mentioned that the sample of 219 people was nearly balanced in terms of gender (11 women and 10 men). Was this intentional, or just a coincidence that occurred during the study? If it was intentional, please include this information in the methodology section and explain how and why this was done.

Line 224-225 : Participants 225 were drawn from both districts, with slightly higher representation from Gomoa East. This sentence should go in the methodology section.

You mentioned that you used two frameworks to guide the study, but the components of these frameworks are not evident in either the results or the discussion. Please restructure the results and discussion based on these frameworks.This should clear.

I also highly recommend to use a qualitative reporting guideline to report your study.

Please provide the codebook

Reviewer #2: The paper is written well and attached are some minor comments:

Sentence on line 163-165 is hanging- please address.

The section on data collection techniques- line 158-175 describes 4 sections of the data collection tools i.e. KII to NTD coordinators and SHEP coordinators and IDI to the School Heads and SHEP teachers as 1) Background, 2) Perceived barriers and facilitators, 3) Fidelity components and 4) Recommended strategies for enhancing program implementation fidelity. However, in the results section, the results of section 4 on recommended strategies for enhancing program implementation results are not presented. Kindly present the results from the various study participants on the theme.

Reviewer #3: General comments: The study addressed the barriers and facilitators influencing implementation fidelity of school-based preventive chemotherapy for schistosomiasis in two endemic districts in Ghana. The findings showcased the interaction between sociocultural, organizational and health system factors in shaping implementation fidelity. Also, findings collaborated that from other studies and reported the factors hindering the implementation of school-based MDA programs.

Background: Appropriate

Methods

291: You mean schools that do not offer a feeding program? Why is it in a bracket?

293: Why is eating before taking praziquantel not always possible in the districts?

The NTD program coordinator 1 shared lots of experiences unlike others, is there a reason for this?

342: Who is in charge of releasing funds?

Results

384: what is the 1.5 for?

Was coordinator 3 not interviewed? Her views are not included.

Discussion: Appropriate

582-584 Recast sentences

597: Explain the meaning of temporal and structural dimensions?

597 and 602: Repetition here. Recast sentences

611: Elaborate on what temporal consistency means?

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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 #1: No

Reviewer #2: No

Reviewer #3: No

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Contextual Barriers and Facilitators Influencing Implementation Fidelity of School-Based Preventive Chemotherapy for Schistosomiasis: A Qualitative Study in Two Endemic Districts in the Central Region, Ghana.

PONE-D-26-20044R1

Dear Dr. Moshi,

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,

Hammed Oladeji Mogaji, Ph.D

Academic Editor

PLOS One

Additional Editor Comments (optional):

Please carefully review and revise all references to ensure they follow the journal's formatting guidelines. For example, references 18, 19, and 20 all use different citation styles, which should be standardized.

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

Reviewer #1: All comments have been addressed

Reviewer #3: All comments have been addressed

**********

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

Reviewer #1: Yes

Reviewer #3: Yes

**********

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

Reviewer #1: (No Response)

Reviewer #3: Yes

**********

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

The PLOS Data policy

Reviewer #1: Yes

Reviewer #3: Yes

**********

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

Reviewer #1: Yes

Reviewer #3: Yes

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Reviewer #1: My initial comments have been addressed. However, the references still need significant revision. They are not formatted according to the journal's reference style, and there are inconsistencies throughout the reference list.

Please carefully review and revise all references to ensure they follow the journal's formatting guidelines. For example, references 18, 19, and 20 all use different citation styles, which should be standardized.

Reviewer #3: General comments: The authors have addressed all corrections.

However, further information on how they concluded that taking praziquantel caused heavier bleeding during menstruation is needed. The authors should add this to the manuscript.

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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 #1: No

Reviewer #3: No

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