Reviewer’ s report
Title: Self-reported breast and cervical cancer screening practices among women in Ghana:
predictive factors and reproductive health policy implications from the WHO study on globalAGEing and adult health
Version: 0Date: 06 May 2020
Reviewer's report:
Manuscript Number: BMWH-D-20-00244
Health system readiness regarding adult women self-reports of breast and cervical cancerscreening practices in Ghana: analysis from the WHO study on global AGEing and adult health.BMC Women's HealthArticle type: Research articleReviewer reportName of the reviewer: Solomon WeldemariamThis is my first revisionDear EditorThank you for the opportunity to review this manuscript.This study addresses a critical component of reproductive health namely "breast and cervicalcancer screening practices". Dealing with breast and cervical cancer screening practice is crucial tohave intact reproductive health life among women. This is extremely helpful in countries withlimited resources like Ghana. Nowadays, the prevalence of non-communicable disease indeveloping countries has increased and the tool of this burden is high in these countries as a resultof in advanced technology and strategies in treating this problems. Therefore, it is important thatthe finding of the authors is worth publishing. However, the manuscript requires some clarification
and I am happy to share my concerns and comments with the authors.
The quality of the written English is acceptable. However, the manuscript lacks line number which
is important in the process of review.The area of research also timely and important to address reproductive health problems andachieve the goal of sustainable development goals (SDGs) among womenTitle: it is informative but I have a concern regarding the "Health system readiness". the methods,results and discussion part talks about breast and cervical cancer screening and its predictors. Didthe authors assess the health system's readiness for screening these cancers? It needs clarificationwhy the title named as "Health system readiness regarding adult women self-reports of breast andcervical cancer screening practices" as to me based on the document it has to be named as "self-reports of breast and cervical cancer screening practices among adult women in Ghana…….."Abstract part:
1.Well written
Introduction section1.Well writtenMethods section
Under the sub-heading dependant variable
1.The authors need more clarification about the second outcome variable (Cervical cancer
screening practice) measurement. How they measured this variable. As my understanding,depending on the countries health program, cervical cancer screening can be done using differentmethods like Visual inspection of cervix with acetic acid (VIA) or Pap smear test. But how can weable to measured cervical cancer screening using pelvic examination? It needs more explanation.Under the sub-heading Independent variables1.Lines number 53, page 7 correct the word sreening to screeningUnder the sub-heading Statistical analysis1.Why ordinal logistic regression analyses were performed? As to me there are two dichotomized
dependant variable (mammography and cervical cancer screening). Ordinal logistic regression is
appropriate when there is order among the categories of outcome variable (e.g pain =mild,moderate and sever). For this purpose, I think multivariable logistic regression analysis isappropriate.Result section1.A mean of a variable should be described in conjunction with standard deviation2.Line number 4, page 10, there is repetition of the word "associated" avoid one of them3.I recommend authors to avoid describing results of binary logistic regression in text rather theycan describe the odds ratio and CI of the binary regression in one column of the table as it isalready described in table 3. Table 3 is enough to describe the binary result. B/c after all we cannot declare significance Association OF V ARIABLES using CRUDE ODDS RATIODiscussion sectionIn general the discussion part is well discussed however the following errors should be corrected1.Line number 34, page 12 avoid the repeated word "were"2.Line number 39, page 12 avoid the repeated word "within the within"3.The authors should support their finding "education status" with similar findings from otherliteratures. Unless they have to give enough justification why it is significantly associated with theoutcome variable in this study.
4.Variables like ethnicity, mothers employment status, fathers educational status and chronic
diseases were associated with breast and cervical cancer screening practices in this study howeverthey are not justified in the discussion part(what could be the possible justification that thesevariables become associated with the outcome variable)5.Under the sub-heading "Policy relevance and health systems readiness in the context of studyfindings" line number 38, page number 17 change the word "disadvanged" to disadvantagedConclusion section1.Line number 41, page 18 avoid repetition of the word "should"
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
NoDoes 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.
YesAre you able to assess any statistics in the manuscript or would you recommend an
additional statistical review?If an additional statistical review is recommended, please specify what aspects require furtherassessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
AcceptableDeclaration of competing interests
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