-->PONE-D-25-62035-->-->Lived experiences of postpartum women diagnosed with hypertension receiving care in a resource-constrained setting in Accra, Ghana-->-->PLOS One

Dear Dr. Konlan,

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.

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We look forward to receiving your revised manuscript.

Kind regards,

Joyce Jebet Cheptum

Academic Editor

PLOS One

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Additional Editor Comments:

Add "resource-constrained setting" in the keywords.

The conclusions need to be more succinct and be related to the study title and findings. The current conclusion is based on the management.

-->--> -->-->[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?

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 #1: Yes

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: No

**********

-->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: Manuscript Number: PONE-D-25-62035

This manuscript investigates the lived experiences of postpartum women diagnosed with hypertension receiving care in a resource-constrained setting in Accra, Ghana, using a qualitative descriptive phenomenological design based on the social cognitive theory. The author collected data from 16 women using semi-structured in-depth interviews. The manuscript content demonstrates scientific rigor for a qualitative study. The manuscript is written in English but there are minor grammatical errors. For example the drug 'Nifecard' is written as 'Nefecard'

Background

• The current background emphasizes the epidemiology and burden of postpartum hypertension but does not sufficiently address the lived experiences of affected women. Strengthening the background to reflect existing evidence on women’s experiences and clearly identifying the gap your study intends to fill will enhance the rationale.

• The theoretical framework is not described before its application in the study. Describe the constructs and how they informed the thematic analysis.

Methods

• The study design is appropriate, and the sampling is well described, including how data saturation was achieved.

• The study design description appears incomplete (check the paragraph under study design the last sentence is floating).

• In the inclusion criteria, describe how you will assess to confirm a cognitively stable mother. Did you have a cutoff for the age of the mother?

• The authors have not included the NVivo data codes or codebook used in the analysis. Without this information, the transparency of the analytic process is limited, and it is unclear which themes were most recurrent or how the relative weight of each theme was determined.

Results

• The results are well captured with participants' demographics clearly displayed in a table, and participants' excerpts are also indicated as appropriate for each subtheme/theme.

• A participant who was 7 months postpartum appears inconsistent with the rest of the sample, as the other mothers were 1 week to 1 month postpartum. Can this participant be considered postpartum at this time?

Discussion and Conclusions

• The comparison with other studies is noted, but the author’s independent scholarly contribution is not clear. The discussion should more explicitly articulate the significance of the findings and provide a clear response to the “so what” question.

• In the discussion, the study design changes to cross-sectional instead of descriptive phenomenology

• The discussion mentions that the study explored the expectations of the postpartum mothers instead of the experiences.

• The limitations are well articulated.

• The conclusion may need strengthening. Conclude based on the study findings

Ethical Considerations: The ethical consideration details are well captured and complete.

Reviewer #2:Title: I recommend rephrasing it for better clarity, propose "Lived experiences of postpartum hypertensive women in Accra, Ghana." Other waste words put in the title should be explained in the methodology and setting.

Abstract: It has almost the recommended word count- 305. It however, has some typo errors i.e. under method- purpose corrected to purposively; with the aid NVivo corrected to with the aid of NVivo.

On the main manuscript, under study design- last sentence ending "through" seems incomplete.

Selection of participants and data collection- paragraph 2, sentence 4: correct to "by the research team' instead of "researcher team". Sentence 7 (last sentence of paragraph 2): ? meaning of sentence i.e. "to grant the interviews". Suggest revision of the sentence.

Participants are 16 and researcher coded them using the alphabet and one would expect the coding to end at letter P but quotes from participants are given up to participant S. Need to correct this.

Intext citation seems to be mixing up various formats i.e. writing some author names as well as numbering them again.

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Reviewer #1: Yes:Dr. Serah Wanjiru Wachira

Reviewer #2: Yes:Dr Grace Danda

**********

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-->

Attachments

Attachment

Submitted filename: PONE-D-25-62035_reviewer comments.pdf

Attachment

Submitted filename: Reviewer Report 8.12.25.pdf

-->PONE-D-25-62035R1-->-->Lived experiences of postpartum hypertensive women in Accra, Ghana.-->-->PLOS One

Dear Dr. Konlan,

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 Mar 30 2026 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 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,

Joyce Jebet Cheptum

Academic Editor

PLOS One

Journal Requirements:

1. If the reviewer comments include a recommendation to cite specific previously published works, please review and evaluate these publications to determine whether they are relevant and should be cited. There is no requirement to cite these works unless the editor has indicated otherwise.

2. 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.]

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 #1: All comments have been addressed

Reviewer #2: All comments have been addressed

**********

-->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 #1: Yes

Reviewer #2: Yes

**********

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

Reviewer #1: Yes

Reviewer #2: 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 #1: Yes

Reviewer #2: 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 #1: Yes

Reviewer #2: 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 #1: Reviewer comments

The authors have adequately addressed all the concerns raised in my initial review. The revisions have strengthened the manuscript, particularly in terms of clarity and methodological description. I have no major concerns and support the publication of the manuscript, subject to the following minor revisions:

Minor edits:

1. The abstract exceeds the recommended word limit (approximately 362 words). Please revise the conclusion and recommendations to be more concise.

2. Please clearly specify the source of Figure 1 (the theoretical framework), indicating whether it was developed by the authors, adapted, or adopted from existing literature, and provide an appropriate reference where applicable.

Reviewer #2: The authors have attended to all recommendations and the article is up to standard. I recommend acceptance of the manuscript.

**********

-->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.

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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:Serah Wanjiru Wachira

Reviewer #2: Yes:Dr Grace Danda

**********

[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.]

To ensure your figures meet our technical requirements, please review our figure guidelines: https://journals.plos.org/plosone/s/figures

You may also use PLOS’s free figure tool, NAAS, to help you prepare publication quality figures: https://journals.plos.org/plosone/s/figures#loc-tools-for-figure-preparation.

NAAS will assess whether your figures meet our technical requirements by comparing each figure against our figure specifications.

-->

Attachments

Attachment

Submitted filename: Reviewer Report 28.1.26.docx

Lived experiences of postpartum hypertensive women in Accra, Ghana.

PONE-D-25-62035R2

Dear Dr. Konlan,

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. For questions related to billing, please contact billing support.

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,

Joyce Jebet Cheptum

Academic Editor

PLOS One

Additional Editor Comments (optional):

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 #1: All comments have been addressed

Reviewer #2: All comments have been addressed

**********

-->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 #1: Yes

Reviewer #2: (No Response)

**********

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

Reviewer #1: Yes

Reviewer #2: (No Response)

**********

-->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 #1: Yes

Reviewer #2: (No Response)

**********

-->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 #1: Yes

Reviewer #2: (No Response)

**********

-->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 #1: I have thoroughly reviewed the revised manuscript and the authors’ responses to the reviewers’ comments. I am confident that the authors have sufficiently addressed all the concerns raised in the previous review.

In its current form, the manuscript meets the standards for publication. I therefore recommend that it be accepted for publication in PLOS ONE.

Reviewer #2: (No Response)

**********

-->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 #1: Yes:Serah Wanjiru Wachira

Reviewer #2: Yes:Grace Danda

**********

Attachments

Attachment

Submitted filename: Reviewer report 8.4.26.pdf