Reviewer ’s report  
 
Title: ‘Leaving no one behind ’: A literature review on the provi sion of sexual and reproductive 
health care to nomadic populations  
 
Version: 0 Date: 09 Jul 2019  
 
Reviewer: Susan Igras  
 
Reviewer's report:  
It is nice to see more recent reproductive health literature identified in this scoping study on 
populations that are not well understood and who live on the edges of health care delivery 
systems.  The article is interesting to read, is written sensitively  by including perspectives of 
nomadic people, includes some level of gender analysis, and the analytical framework make it 
easy to follow conceptually.  A few suggestions follow that might make the article more salient.  
 
Problem statement.   
I think some f actors are missing in the opening argument.  1) How big is the issue from a 
population perspective, e.g., what proportion of the LMIC population is of nomadic people (or 
range of proportions, since this varies by country). Even if data are not available, i t is important 
to acknowledge.  2) These are populations who are, already, bearing the brunt of climate change 
yet it is not mentioned; does this add urgency to the health issues and SDG aims?   
 
External factors.  
I was surprised that there was no mention of health system costs to reach nomadic populations 
with quality services.  That has been a systems issue in many countries whose governments try to 
provide preventive services to nomadic populations.  I think some discussion of tradeoffs of 
existing servi ce delivery strategies would be important to include, assuming it is discussed in the 
reviewed literature.  
 
Likewise I was surprised that no mention of mHealth strategies surfaced in the literature review.  
This seems like a promising strategy for client c onsultations with providers and nomadic CHW 
consultations with providers. I believe mHealth strategies have been tested using mobile phones 
in some countries.   
 
Discussion and conclusion.  
The discussion is very descriptive, e,g, these are the strategies most commonly used and frankly, 
they don't seem very 'new.'  But the existing strategies are still not reaching many, so what new 
strategies/hybrids of older strategies are envisioned that could work more effectively?   
 
I think the article would be strong er if more specific research recommendations were made.  
Right now the recommendation is quite general.  Are the authors recommending operations 
research to test services outreach strategies, or formative research to understand sociocultural, 
structural, s elf-care and other factors from the nomadic client perspective?  Use of vendors in 
rural outposts for family planning method access? Or just better descriptive research on who is 
being reached and not reached?   
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
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:  
 
Acceptable  
 
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