Reviewer's report
Title:Sexual and reproductive health services for women with disability: a
qualitative study with service providers in the Philippines
Version:2Date:7 August 2015
Reviewer: Janet McCabe
Reviewer's report:
Thank you for the opportunity to review this article. I find the topic extremely
compelling, the sexual health of individuals with disabilities is all too often
neglected and the national and regional variations in attempts to address sexual
health need to be further examined. I think that the authors have done an
excellent job presenting the findings from the participatory action research project
and I have outlined suggested revisions below. I would encourage the authors to
consider publishing a manuscript based on their methods used to develop
themes and the process of the workshop – this would be an excellent
contribution to the literature, especially considering that this workshop included
women with disabilities. I commend the authors on this. Also, there is mention
that this study spans both a rural and an urban area – do the authors feel that
this is a limitation of the study or a strength? Were there different issues raised?
Perhaps this is another paper as well?
Overall the authors draw on relevant literature and situate the study and their
findings within both global and regional findings.
Major Compulsory Revisions
1) Research Question. It is clear that this project is a piece of a larger project,
and that the objective was to contribute to the understanding of service providers
perceptions, however the exact research questions need to be clearly articulated.
I think that this research question is actually embedded in the methods section
on page 7 (lines 179-182)?
2) Methods. The authors clearly worked diligently to include and represent the
variety of service providers that interact with women with disabilities around
sexual health care. It would be extremely helpful to have a better understanding
of who the participants were. Perhaps a short demographic statement could be
added? Perhaps this was not included to provide anonymity due to smaller
number? Clarification on this would be greatly appreciated. The inclusion of a
breakdown based on percentages of male/female, age groups of participants and
number of different service providers (if possible) would help to paint a picture for
readers of those interviewed. In addition, the provision of inclusion and exclusion
criteria would help with this.
3) Methods. Additional information about interviews and the focus groups would
help the reader to understand the context that information was gathered in, how
long were the interviews and focus groups on average?
Minor Essential Revisions
4) Readability. The background information provided is very informative and
moves from a global to regional context, it would be beneficial to the reader to
explicate that the initial information is global and not specific to the Philippines. I
would suggest the inclusion of a heading “The Global Context” to situate the
reader, around line 87 on page 4.
5) Methods. Line 208 on page 9 – this sentence needs a grammatical change to
reflect that participants DID provide informed consent, not just that they were
able to do this.
6) Structure/Organization. Line 427-431 on page 17 seems to belong in the
“Capacity of service providers” section, as it is directly addressing the lack of
information and lack of funding impacting their capacity to provide care.
7) Title. The title and abstract communicate what the study is about, the title
could be changed to more accurately convey what has been found (e.g. Sexual
and reproductive health services for women with disabilities in the Philippines:
the need for support of service providers)
The article is well written, a quick proofread for passive language would be
helpful, as well as eliminating the use of contractions (e.g. don’t and won’t).
Discretionary Revisions
8) Results. The results section is thoroughly enjoying to read, the authors provide
concrete examples from their work to situate the themes. It may be helpful to the
reader to provide a brief summary at the end of each theme to recap and situate
the findings, often these sections end with a quote and leaves the reader wanting
more or at least a summary. In addition this would help clarify the instances
where ideas traverse across themes – such as societal beliefs/biases, the
influence of religious beliefs etc.
9) Impact of Findings. The authors may want to consider the impact of these
findings on the education of service providers in the Philippines, as well as
address the overwhelming social discourse regarding women with disabilities and
sexuality that is an undercurrent throughout the paper. There are certainly
signals here that an intersectoral approach may be needed to gather the
necessary statistical information to address violence against women with
disabilities, but also to support their care.
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare that I have no competing interests' below.