-->PONE-D-26-22477-->-->Design and Validation of a Key Performance Indicator Dashboard for Equity in Community and Retail Pharmacy Services in Pakistan-->-->PLOS One

Dear Dr. Hammad,

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:  -->-->

The paper addresses an important and timely issue in pharmacy system strengthening in low- and middle-income countries (LMICs), particularly the lack of equity-focused monitoring tools for community and retail pharmacy services. The paper is well written but will require some minor improvement regarding methodological, analytical, and reporting limitations as described in my comments below and by the 2 reviewers.

Introduction:  The section provides good contextual background on pharmacy inequities in LMICs and Pakistan. However, it sounds more descriptive and may require some critical synthesis. Specifically, there are needs for critical comparison with existing pharmacy KPI frameworks and why current system fails in LMICs.  Also include more Pakistan-specific evidence on pharmacy infrastructure disparities.

Methods:  Multi-phase methodological structure and Delphi consensus are appropriate for dashboard development. The section will benefit from additional methodological rigor to qualitative analysis. Also include sample size rational and add technical description of the dashboard architecture.

Results:  The section is appropriate. However, it is unclear whether operational pharmacy data are real-world, pilot or hypothetical data.

Discussion:  It will be good to discuss implementation feasibility in low-resource rural settings including sustainability and governance considerations.

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We look forward to receiving your revised manuscript.

Kind regards,

Ibrahim Jahun, MD, MSC, PhD

Academic Editor

PLOS One

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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: Partly

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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 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

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-->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

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-->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: Introduction and Discussion

The author should add theory or model to explain the association between variables (Gustafson, 2023) – four domains (page 11).

Reference:

Gustafson, P., Abdul Aziz, Y., Lambert, M. et al. A scoping review of equity-focused implementation theories, models and frameworks in healthcare and their application in addressing ethnicity-related health inequities. Implementation Sci 18, 51 (2023). https://doi.org/10.1186/s13012-023-01304-0

Methods

How does the author determine or choose the respondents? What is the response rate? How does the author collect the data?

Results

What is the equity analysis between professions? Community Pharmacists, Pharmacy Technicians, Pharmacy Administrators have different roles and responsibilities.

Reviewer #2: Its a good initiative, much needed in LMIC. needs to be scaled up appropriately. One of the KPIs when you want to scale up is i believe should have been presence of registered pharmacist in community pharmacy.

My question this seems to be self reported data by pharmacists, staff and administrators. How was it verified? and validated? Or was it digitally monitored if pharmacies have full computerized system.

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Reviewer #1: No

Reviewer #2: No

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Design and Validation of a Key Performance Indicator Dashboard for Equity in Community and Retail Pharmacy Services in Pakistan

PONE-D-26-22477R1

Dear Dr. Hammad,

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,

Ibrahim Jahun, MD, MSC, PhD

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: (No Response)

Reviewer #2: (No Response)

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-->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: (No Response)

Reviewer #2: Yes

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

Reviewer #1: (No Response)

Reviewer #2: Yes

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-->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: (No Response)

Reviewer #2: Yes

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-->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: (No Response)

Reviewer #2: Yes

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-->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: (No Response)

Reviewer #2: (No Response)

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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

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