Reviewer ’s report  
 
Title: Reasons for delay in decision making and reaching health facility among obstetric fistula 
and pelvic organ prolapse patients in Gondar University Hospital, Northwest Ethiopia  
 
Version: 0 Date: 04 Mar 2017  
 
Reviewer: Mehmet Baki Şentürk  
 
Reviewer's report:  
 
Introduction is large can be more small.  
The variable affect delaying are explained age, religions, ethnicity, marital status, educational 
status, income, number of children, failure to recognize signs of complication  failure to perceive 
severity of illness, decision making power, distance from a health  facility, health care cost and 
means of transportation. Thus factors of course very important but in urogynecologic practice , it 
is well known prolapse is not life threatening condition  hence many patients don’t  desire to seek 
treatment even symp tomatic patients. Authors should consider this factor and explained in 
methods and discussion . 
Authors explained that '' delay in deciding to seek health  facility care among fistula cases were 
classified as individuals who decided to seek health care with in 3 months were good, while 
above 3 months were considered as poor or delayed. For POP cases women who stayed for 12 
months and above to get treatment is considered as delayed to get treatment'' how is determined 
this cut of?  
Authors indicated that divorced and experience stigma from husbands were associated factors to 
delay to seek treat.   I wonder how is their sexual life? does it affect especially women with 
fistula life by their husbands? Are there any information?  
In divorce, widowed and separated  women, were thus women abandoned by their husbands ? or 
husbands of thus women get married again?  
If so could thus pr oblems affect the social stigma ? 
In both fistula  and prolapse patients; sexual life should be questioned.  
Table 2 and 3 re arranged. Please  indicate in both table value of both delayed and non delayed 
patients.  
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.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are y ou 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.  
 
I am abl e to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
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