Reviewer ’s report  
 
Title: Shifts in FGM/C Practice in Sudan: Communities' Perspectives and Drivers  
 
Version: 1 Date: 12 May 2019  
 
Reviewer: Nazar Shabila  
 
Reviewer's report:  
 
This int eresting study tries to understand the drivers for the shift in FGM/C practice in Sudan 
from the community's perspective.  
 
The manuscript is well structured and written and includes a good literature review. It is also 
based on a relevant theoretical framework.  
 
The study employed a qualitative approach using focus groups and individual in -depth 
interviews, which I think is hel pful in exploring these drivers.  
 
The main concern that I have is about the Methods section as more detailed description of the 
methods used is needed.  
 
 
Sample size and sampling:  
 
It is not clear to the reader how many participants from each group were inclu ded. It is also 
helpful to provide the basic socio -demographic characteristics of the participants, preferably 
in a table.  
 
Please provide more details about the sampling strategy, e.g. how snow balling was applied 
for selecting the families and what approa ch was used to recruit the trained midwives and 
TBAs.  
 
It is not clear whether each focus group was for one family (mother, father, an older sibling, 
the girl,  and grandmother) or several families together. In average, how many participants 
were included in  each focus group?  
 
Did you involve different categories together in one focus groups (e.g. (mother, father, an 
older sibling, the girl, and grandmother together in one focus group), or each focus group was 
for one category (e.g. fathers alone)? How the app roach might have affected the findings of 
this socially sensitive topic?  
 
What determined the number of in -depth interviews and focus groups?  
 
 
Procedure:  
 
What was the venue of focus groups and interviews mainly (home or other setting)?  
 
Please provide more de tails about the contents of the semi -structured interview guides. You 
might provide them as an additional file.  
 
As the discussion and interviews were in Arabic language, at which stage translation to 
English language was made and how such translation was v alidated?  
 
Please provide more details about the qualitative analysis of the data and provide some 
examples of the codes you employed.  
 
 
Ethical considerations:  
 
Was the informed consent verbal or written and how did you did this for the illiterate 
participant s, if any.  
 
Abstract: I think this study needs a more detailed abstract. More information is needed in the 
methods section and more detailed results need to be provided in terms of the change drivers.  
 
 
Results  
 
It would have been useful to show the effect o f having a law banning FGM/C in one of the 
settings on this shift particularly in terms of the medicalization of the practice. I am not sure 
if this questions has been asked or such issue was raised during the discussions or interviews.  
 
Are the methods appropriate and well described?  
If not, please  specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1.  Have you in the past five years received reimbursements, f ees, funding, or 
salary from an organisation that may in any way gain  or lose financial ly from 
the publication of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation t hat may in any way gain 
or lose financially from the publication of this manuscript, either now or in the 
future? 
 
3.  Do you hold or are you currently applying for any patents  relating to the 
content of the manuscript?  
 
4.  Have you received reimbursements, fees, funding, or salary from an 
organization that holds or has applied for patents relating to the content of  the 
manuscript?  
 
5.  Do you have any other financial competing interests?  
 
6.  Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no compet ing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understan d that my name will be 
included on my report to the authors and, if the manuscript is acce pted f or publication, my 
named report including any attachments I upload will be posted on the website along with the 
authors' responses. I agree for my report to be made available under an Open Access Creative 
Commons CC-BY license ( http://creativecommons .org/licenses/by/4.0/ ). I understand that 
any comments which I do not wish to be included in my named report can be in cluded as 
confidential comments to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal