Title: Barriers and facilitators of retention in care after cervical cancer screening: patients’ and
healthcare providers’ perspectives
Version: 0 Date: 20 Nov 2023
Reviewer:  Amos Deogratius Mwaka
Reviewer's report:
20th November 2023
Dear Authors,
This is an important contribution to the field of cervical screening and early detection. The aim
of the study is quite clear.
I have a few comments to contribute towards improving the quality of the manuscript.
1. The conclusion in the abstract comes out quite clearly on the role of male partners. But this
is coming unannounced as it does not appear explicitly in the results section of the abstract.
While this might be hidden in the expression “social support”, it is important to realize that
the conclusion ought to arise directly from the results of the study, not inferred indirectly or
otherwise. If you feel the issue of male partners is the gist of the matter, then make it explicit in
the result section first, then emphasize it in the conclusion.
2. The introduction is excellent and builds a clear rationale for the study.
3. Methods
3.1 Setting – requires some citation and perhaps a web link to the hospital so that a reader
not familiar with the study hospital gets a good glimpse of the institution in terms of services
provided and hence its suitability for this study.
3.2 Participant recruitment
(a) In lines 147 – 148 you say, “Patents were not . . . for the interview”. Please immediately
after this state, you need to tell how many were called up and of those called how many turned
up for the interviews.
(b) In lines 150 – 151, “Participants were recruited until saturation point . . . obtained”.
Please provide citations regarding this statement to validate it as the right thing to do in the
circumstance.
(c) You need to provide clarity on how you selected the healthcare providers included in the
study, and which category of providers were considered, and why those ones and not other
categories of healthcare providers.
3.3 Data collection
In lines 158 – 159; you need to provide citations for the social ecological model (SEM).
Elsewhere, I see citations 14 and 15 being referred to as though they are on the SEM.  When
I check them, they do not seem to be on the SEM but they too cited SEM. Please provide the
primary citations on the SEM.
3.4 data analysis
Lines 175 – 176, “The political level . . .  system”. Did you mean policy level or political”? The
component of the SEM you dissect in lines 171 – 173 does not have political aspects. Please
review and revise accordingly.
4. Results
4.1 The identification of quotes needs to be thought through carefully so that each quote is
distinct and the represent the multitude of the participants’ views. You identify some quotes as
(woman, 48 years) and then some as (Married woman, 48 years).
The identifiers of the quotes need to have relevance to the issue; Critical here are the sex, age
category, patient or healthcare provider, if patient whether or not they are active in care or lost
to follow up (those called on phone). If health providers, their cadres/roles.
Then for age, you need to use age category rather than the actual age; this is to minimize
possibilities of identification of the participants by readers. For example, if there are 4 nurses in
the unit, and you state that you recruited from the unit and you say (Nurse, Female, 48 years)
then someone can infer who this participant is.
4.2 In circumstances where there are pertinent quotes from both patients and providers, you
may want to include two quotes – one from patients and the other from healthcare providers. In
general, you may want to provide two quotes for each subtheme – from patients and healthcare
providers as maybe appropriate.
4.3 Revise line 224.
4.4 Lines 232 – 236; brings out a very important issue as far as screening and early detection is
concern – discrimination. Please follow this with suitable quotes to validate the same. You may
actually pick out discrimination and or stigma and present it as an independent subtheme.
4.5 Lines 383 – 385; please provide a quote or two to substantiate this important concept.
4.6 Lines 304 – 306 and 311 – 313; report marital as part of participant quote identifier. This
is not reported in the earlier quotes. Please refer to comment 4.1 above, and ensure that you
harmonize the quote identification style, and be consistent.
5.0 Discussion
5.1 Lines 469 – 470; the statement of aim here is not necessary. You may delete.
5.2 The various subheading, which serve as pointers are good but they do interfere with the
mental flow of ideas. Please remove them unless it is a strict journal requirement. Let the ideas
flow freely.
I hope these comments help you to improve on the manuscript.
Regards
AD Mwaka