Title: Female homicides and femicides in Ecuador: A nationwide ecological analysis from
2001-2017
Version: 5 Date: 15 Mar 2022
Reviewer's report:
Title and abstract
The title says "homicides in women" and "femicides" in Ecuador. I don´t find in the article an
explicit division between these two terms, both from a conceptual and methodological point of
view, and later in the analysis of the data. Although the difference in the terms is clear to the
researchers, along the article, it would seem that the two terms are being used as synonyms.
The figures show only homicides in women. I suggest a methodological explanation on how is
different “homicides in women” from “femicides”, including a separated analysis as much as
the date base allows it.
The title draws attention to an ecological study. However, I consider that the analysis of the data,
as it is proposed, is far from an ecological study in strict terms, and is rather related to a cross-
sectional study or a temporal trends. It hasn't been established a study unit on the ecological
design. I am concerned about the use of relative risk as a measure of association. I suggest
adjusting the study design and data analysis.
The objective of the study must be specified in the abstract.
Introduction
The authors inform in the last paragraph that the study is interested in identifying the economic
cost of femicide in Ecuador. Perhaps it should be made explicit that it is the economic cost per
years of life lost, since no other additional analysis of direct or indirect costs is carried out.
Methodology
In DataSource. If in 2014 the term femicide began to be used, how was this variable established
in the previous period of the study (2001-2013). How were the variables homicide in women
and femicide established?
Define type of study.
Results
Based on the foregoing, I seem to understand that the researchers took the variable homicide
in women for the period 2001-2013 and femicide from 2014. If my observation is correct, it is
necessary to consider that they are two completely different variables and that it would be It is
important to have separate results for the two variables.
Does Table 1 show results for homicides and Table 2 for femicides? Does that mean that Table
2 contains data only from 2014?
In Table 2, significant associations are missing, as they have been presented in Table 1.
In relation to the economic cost of homicide in women, does it should it be understood that it
would include the economic cost of femicide as well?
Tables 1 and 3 show relative risk results compared to homicides in men. This has not been
specified in the Methodology of the study, from where such information was obtained, with how
many cases in men the homicides in women were compared, how the calculation of mortality
in men was made. An analysis with adjustment of variables is not performed.
The results presented with relative risk are not consistent with an ecological study design in strict
terms. I have read a few ecological studies that use relative risk as a measure of association, but
start from a deeper analysis model.
Discussion
It is necessary to expand the limitations of the study, mainly the design of the study and the
findings found, as well as the limitations in the source of information on which the authors are
based (identification and notification of femicides, etc.).
Figures 1, 2 and 3. It is necessary to place a title and a footnote to explain the figure.