Reviewer ’s report  
 
Title:  A QUALITATIVE STUDY OF DEVELOPING BELIEFS ABOUT HEALTH, ILLNESS 
AND HEALTHCARE IN MIGRANT AFRICAN WOMEN WITH GESTATIONAL 
DIABETES LIVING IN SWEDEN  
 
Version: 0 Date: 16 Nov 2017 
 
Reviewer:  Teresa  Janevic  
 
Reviewer’s report:  
 
 
The manuscript "Gestational Diabetes: Prospective interview study of developing beliefs about 
health, illness and healthcare in migrant African women living in Sweden" is an important 
contribution to the growing body of literature on gestational diabetes a mong migrants. In many 
receiving countries, migrants have an increased risk of gestational diabetes, and there is a need to 
tailor antenatal and postnatal interventions to be implemented in migrant populations. 
Understanding the beliefs of migrant women wi th gestational diabetes is very informative and 
useful. Several minor changes may strengthen the manuscript, as outlined below.  
 
1) Contribution of the Paper. Lines 24 -34. The time period of the study is short, and any 
changes in beliefs are more likely to  be due to illness and interaction with health care 
providers, as opposed to due to acculturation, as this statement suggests. It may be more 
related to the research question to say "during and after pregnancy" or similar, so as to 
not set up a research qu estion the current study cannot answer.  
 
2) Contribution of the Paper. Line 38 -43. Please specify "among migrant women" in the 
first bullet point so that this section can stand alone, for those who only read the 
highlights.  
 
3) Theoretical Framework. Lines 3 3-50. My understanding based on the text is that these 
investigations were conducted solely in South Africa. African culture is diverse, and it is 
not clear the extent to which this research may be relevant to the origin countries of the 
women in the curre nt study. It doesn't seem to me that this paragraph contributes to the 
theoretical framework, at least in current form. I recommend removing it, or tying the 
literature cited more explicitly to the theoretical framework proposed.  
 
4) Aim. Line 45 -50. The au thors state 'over time' and this is a bit misleading, as the time 
period is short.  
 
5) Results. Line 48 -58. If possible, it would be helpful to know if the women were obese or 
not, as this has implications for treatment and outcomes of GDM, and it would pr ovide 
greater context for some of their later comments.  
 
6) Data analysis. Line 24. Please state which software was used for qualitative analysis.  
 
7) Beliefs about illness. Line 33. Please use an abbreviation other than 1,2,3 that is more 
description, so th e reader does not have to go to the footnote. I found this distracting. For 
example: Antenatal, 3 months, 12 months.  
 
8) Discussion Line 13. Here it states 14 months, whereas sometimes 12 months is used.  
 
9) Discussion Line 13. For optimal impact, the first paragraph of the discussion should 
review the most important findings of the study. The comparison to previous literature 
and uniqueness can be stressed in the second paragraph.  
 
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 manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manu script  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
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, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any  stocks or shares in an organisation that 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 competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no compe ting interests.  
 
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