JerMa88/BMC_Womens_Health_Peer_Reviews huggingface dataset:
Title: Factors associated with respectful maternity care reported by patients in selected health
facilities in Musanze District, Rwanda: A facility-based cross-sectional study
Version: 4 Date: 03 Apr 2025
Reviewer:  Chinedu U. Obioha
Reviewer's report:
ABSTRACT:
1.
You compare the level of  respectful maternity care in Musanze to similar settings in East Africa,
without providing numbers for the reader to draw conclusions from. Please provide the figures
for some of these other settings in East Africa that you speak of.
BACKGROUND:
2.
You mention that "Mistreatment poses a threat to women’s human rights globally ." Which
human right are you talking about? Please provide some more context here.
METHODS:
3.
Since "The study's target population was postpartum women waiting to be discharged from
selected health facilities and women returning for vaccination at six weeks postpartum.",  yould
you findings only apply to these women in these randomly seected hospitals/health facilities?
I would have thought that your target population would include postpartum women from more
than the specific hospitals you selected. I would  revisit this to make the target population clearer.
4.
In the operationalisation of your RMC variable, you mention that "...if a woman responded "0=
No, never” or “1= yes, a few times," for at least one of the 30 items, RMC was considered to not
have been received." Please provide justification for why those coded as 1 would be classified as
never receiving respectful care. Why have you not grouped those coded as 1, under the received
respectful care category?
RESULTS
5.
Please, remove the second colum for categories, and apply the categories to the variables column.
Compare to published studies to see the right way to present your variables and results.
6.
See comments aove for table 2
7.
Please revisit your results section and correctly report your findings for the odds ratios you have
found in your multilogistic regressions. Your reported likelihood estimates  are not suitable for
odds ratios. e.g., "...health centers were 3.7 times more likely to receive RMC ...".
DISCUSSION
8.
The confidence interval for some of your results are very wide. e.g., unemployed mothers
[AOR=17.75, 95% CI: 8.06-39.06, p<0.001]. Please procide more information to help us
understand why there is such a big gap, and how these can influence the interpretation of your
findings.
9.
Overall, the paper could benefit from proofreading. In  order to catch any gramatical and
typographic errors
Title: Factors associated with respectful maternity care reported by patients in selected health
facilities in Musanze District, Rwanda: A facility-based cross-sectional study
Version: 4 Date: 04 Apr 2025
Reviewer:  Mary Grace Nakate
Reviewer's report:
I commend you for addressing the important topic of Respectful Maternity Care. Firstly, review
the title to pick out a specific area to contextualise the study. Additionally, the sampling
methods will be analyzed for clarity on how the final sample size ensures adequate power
to detect differences in RMC.  Furthermore, it aims to identify and interpret the association
between cesarean sections and RMC. Lastly, the specific objectives should be followed to make
recommendations that will inform policy.
Title: Factors associated with respectful maternity care reported by patients in selected health
facilities in Musanze District, Rwanda: A facility-based cross-sectional study
Version: 4 Date: 07 Apr 2025
Reviewer's report:
This article is well written after adding the inputs from the previous reviewers were well
incorporated.
Comment 1: Factors associated with respectful maternity care in selected health facilities in
Rwanda: A facility-based cross-sectional study
I still think that the title should be reviewed to say that this study only focused on patients’ RMC
perspectives and did not include healthcare providers. Also, say where the study was conducted,
in Musanze since it did not look at the entire country’s data and there are other studies that in
other parts of the country.
Comment 2: This research aims to determine the prevalence of RMC and identify factors
associated with its provision in healthcare settings, in Musanze District, Northern Province of
Rwanda. Where prevalence is mentioned, I believe the first author is talking about the proportion
of women who received RMC during delivery rather than the prevalence of RMC in a real sense.
Change the word prevalence to proportion.
Comment 3: Observations were that components of RMC were not comprehensively provided
due to shortage of staff and limited supervision. Where did this finding come from, remove it.
Title: Factors associated with respectful maternity care reported by patients in selected health
facilities in Musanze District, Rwanda: A facility-based cross-sectional study
Version: 4 Date: 11 Apr 2025
Reviewer's report:
I appreciated reading about your study on an important theme (RMC). I wonder about your
statement" With implementation of the RMC interventions, Rwanda has substantially reduced
maternal mortality from 1,007 to 203 deaths per 100,000 live births from 2000 to 2021" (page 5).
I would not attribute the reduction of MMR to implementation of RMC interventions without
further proof. Can the reduction also be due to more facility-based births and better training and
management of obstetrical emergencies?
Respectful maternity care varies according to culture, settings, and interventions implemented
to improve it; however, limited literature exploring the implementation and effectiveness of
interventions to enhance RMC in Rwanda. (this is not a proper sentence. Page 5).
When you discuss Study population, should you discuss on your Discussion part of the paper,
the fact that there might be different responses  (from the same woman) if interviewed at 24
hours as compared to at 6 weeks? Maybe there is no way of knowing but worth noting.
I appreciate your mentioning you computed 0.72 on Cronach's Alpha Coefficient for reliability
for your 30 question questionnaire in your pre-test but is data from 20 women only sufficient
for this test? Please look into that.
On [age 11 you say 69.3% of women were delivered during the daytime. Language is important.
Did they not give birth during the daytime?
Also on page 11 you said there were no interventions during vaginal delivery - no drips? no
episiotomies? In my mind there must have been some. These two things at least have to be
counted as interventions. If interventions unknown, it would be best to remove those lines.
Page 12 - please review grammar to clarify your meaning.
When you say that mothers who received cesarean sections were more likely to receive RMC,
could you mention whether or not they paid for this surgery? If the health care team will receive
more money, for a surgical birth it might be that they treat the women nicely... so please clarify
if all care was free care or payments were given.
On page 15 I wonder why you commented, in relation to why Nepal and Nigeria had low rates
of RMC: This might be because the study was conducted in a setting with different cultural
perceptions. I cannot understand this idea. Please elaborate. But if surveys or interviews were
done, women do know of they are treated well or not. On page 16 you say that primips  might
perceive that they received respectful care, when they didn't... but you said that you used a 30
question survey. So they either answered that they had been respected according to the question
or they had not. So I wonder if your comment  is a correct assumption. I would like the 30 survey
questionnaire to be included  as part of your paper.
On page 18 you suggest that the personnel in charge of admissions should reduce delays to care
- this seems like a new concept to me. Maybe mention it earlier if that was the fact?
Title: A Pilot Investigation of the Impact of Acute Mental and Physical Fatigue Exposure on
Inflammatory Cytokines and State Fatigue Level in Breast Cancer Survivors
Version: 0 Date: 03 Nov 2024
Reviewer's report:
this is interesting and important data and the dynamic responses are great to record
I do wonder if the paper needs to draw out the positive findings alone - the trends which are
not significant despite ANOVA are distracting in the text and dont add to the findings or future
mechanisms or possible treatment
I think overall there is data that should go in a supplemental file so that the paper can focus on
the plausible mechanisms and future research
Title: Resilience and renewal: the personal impact of physical activity in breast cancer survivors
Version: 2 Date: 26 Mar 2025
Reviewer's report:
Overall, this is an interesting topic, and your findings appear to support the current literature.
More information is needed in a few areas (see detailed comments). One of the biggest
opportunities for improvement is to provide more detail about interviewing the instructors and
the insights gained from including them in this study. It was an innovative idea to include them
in this study, yet you missed the opportunity to discuss findings from the group interview. Doing
so would add more depth to your findings. I would be excited to hear more about what you
learned from the instructors as well and if it supported or echoed what the participants stated.
Title: Resilience and renewal: the personal impact of physical activity in breast cancer survivors
Version: 3 Date: 15 Apr 2025
Reviewer's report:
I am grateful for the opportunity to review your resubmission. You addressed all the comments
with thoughtful responses and updates. Your updated description of the thematic analysis
approach based on the phases presented by Strauss and Corbin seems to accurately describe the
analysis based on the information provided.
I appreciate your addition of the section with interpretations and quotes from the instructor
interviews. This section is novel and enhances the findings from your study. The updated
description of how reflexivity was operationalized adds rigor and helps the reader understand
the processes that strengthened the analysis. Great work!
Title: Cervical and breast cancer screening outcomes among Métis people in Alberta, Canada
Version: 2 Date: 25 Mar 2025
Reviewer's report:
Lines 56-59, suggest including study years and "current" population numbers in this statement.
Data timeframe not referenced until methods section, understanding that this work includes data
from 2008-onward. Is this statement referencing a population of 63,000 in 2008 or some other
timeframe?
Limitations: suggest including a limitation of use of retrospective study design, some data used
in analysis is ~15 years old and may not be relevant or reflective of changes and implementation
efforts.
Title: Cervical and breast cancer screening outcomes among Métis people in Alberta, Canada
Version: 2 Date: 28 Mar 2025
Reviewer's report:
This is a unique and interesting descriptive analysis comparing Canadian Partnership Against
Cancer breast and cervical cancer screening program metrics between Métis and non-Métis
persons in Alberta, Canada.
Comments:
1. In the abstract, beginning on line 17, the sentence should read: “However, the time between
abnormal cancer screening results and follow-up tests was longer for Métis people compared
to non-Métis people.”
2. In the abstract, beginning on line 18, the sentence should read: “Métis people had higher
proportions of abnormal cytology test results…”
3. Background, line 49, should be “bison-rich,” not “buffalo-rich.”
4. Background, beginning on line 75, should be: “Participation in organized cancer screening
programs is one important strategy to reduce cancer burden…” Breast cancer screening
programs do not decrease incidence.
5. Throughout the document, “rates” are being confused with proportions in several places in
the manuscript, such as participation and retention rates. However, this language is in the CPAC
documentation and does not originate with the authors. The authors could consider using the
language - rate, proportion - appropriate for each outcome, but this would not match CPAC
guidelines.
6. Results. For Figures 1 a and b, can the Group labels be Métis and non-Métis? There seems
no need to footnote MN=Métis when there should be room to label Métis completely. This
same comment applies to the other figures. For Figure 1, why is the x-axis labeled as 19-20 and
20-21, etc., instead of whole calendar years? Are these combinations of years to avoid small cell
suppression? It is not clear if the Joinpoint analysis was run on individual year data or grouped
data.
7. Results. For Figure 2a, please show additional years for the x-axis, not just 2010 and 2015.
8. Results. In Table 1, label the Median and 90th percentile as number of weeks. Why are you
including medians if the CPAC targets pertain to the 90th percentile?
9. Results. For Figure 3, the same comment regarding labeling groups as Métis and non-Métis
and omitting the footnote. Note that the footnote says non-MN, but the figure shows NMN.
Title: Cervical and breast cancer screening outcomes among Métis people in Alberta, Canada
Version: 2 Date: 31 Mar 2025
Reviewer's report:
Could the authors review the description and legend of Figure 4? The description describes the
blue and orange bars as high and low risk test results, but the legend of the chart defines the blue
and orange bars as Metis and non-Metis outcomes.
Lines 421-429. I would recommend redrafting this paragraph to emphasise that it is abnormal
call rates (ACR) above the national standard that results in "unnecessary" additional testing and
psychological stress. It is inevitable, in the absence of a perfect test, that the ACR will be above
the cancer detection rate and some of the tests in positive screens with no cancer diagnosis are
necessary however the ACRs for Initial Screeners are 70% above the national target and for
subsequent screeners more than 30% above the target.
Very low (<50%) Colposcopy attendance rates are mentioned in the discussion (line 440) but
the results are not presented in the results section.
In the strengths and limitations section is it possible for the authors to comment on any
differences in the non-registered Metis population and the registered Metis population? Does
the fact that there is a significant proportion of the Metis population not registered mean that the
differences between the Metis and Non-Metis population are under-estimated?
Title: Clinical features of bonding disorders in Japanese mothers derived from the Stafford
Interview
Version: 0 Date: 18 Jul 2024
Reviewer's report:
Although the MIBQ and MIBS are widely used, studies examining their cutoff values are scarce,
making this research extremely valuable. I appreciate the opportunity to review this manuscript.
L95 “This study applied the mother-infant relationship section of the Japanese version of the
Stafford Interview (6th edition) to diagnose bonding disorders.”
Regarding this statement, I have a question. Is it possible to describe the diagnostic criteria?
Are the diagnoses based on "MOTHER’S EMOTIONAL RESPONSE TO HER INFANT" and
"ANGER AND ABUSE"?
L97 “We also explored the following sections on pregnancy: Psychological and Obstetric
Background to Pregnancy, Response to Conception, and Wellbeing of the Unborn Child.”
I have a question regarding this statement. Why were these three parts chosen?
L121 “Test 1: G1 × (G1+G2): mothers with severe mother-child relationship disorder vs others”
Is this statement correct?
Regarding Table 1, I have a question. If classified under “Normal bonding,” but with
“severe infant-focused anxiety” would the mother be categorized as G1? Could you explain
the relationship between the diagnostic criteria for bonding disorders and the G1/G2/G3
classifications more clearly?
It might be better to describe the rationale for setting the EPDS cutoff score at 8 points.
Is there a reason why only the EPDS score was not used in the analysis?
In supplemental table 4, there is no score for “Timing of positive feelings for baby.” Is this an
item without a score originally?
Title: Rural-urban variations in cervical cancer screening uptake among women in Ghana:
Evidence from the 2022 Ghana Demographic and Health Survey
Version: 1 Date: 06 Jun 2024
Reviewer:  Ragini Mehrotra
Reviewer's report:
The Work is good. In my opinion a multicentric longitudinal study is required to get more values
about the possible reasons for low uptake of the cervical cancer screening in a specific population
in an underdeveloped country.
The present study has shown the results with proper statistical analysis and it will definitely give
a trigger to further research in this particular field.
Title: Rural-urban variations in cervical cancer screening uptake among women in Ghana:
Evidence from the 2022 Ghana Demographic and Health Survey
Version: 1 Date: 19 Jul 2024
Reviewer:  Boniface Ago
Reviewer's report:
Please reconcile the statements on the Epidemiology of cervical cancer.
1. In the background of the abstract,  you stated that " cervical cancer is the third most common
cancer affecting women world"
2. In the opening of the Introduction,  you stated " cervical cancer is a leading Public Health
problem and the fourth most common cancer affecting women globally "
Title: Rural-urban variations in cervical cancer screening uptake among women in Ghana:
Evidence from the 2022 Ghana Demographic and Health Survey
Version: 2 Date: 31 Jul 2024
Reviewer:  Hallie Dau
Reviewer's report:
1. Please provide the urban and rural total for Table 1
2. When comparing the urban vs rural population, it would be beneficial to include the p-value
to understand the differences between the two areas and whether they are significant. They can
be included for descriptive statistics.
3. In the third paragraph of the discussion the authors note that screening is low in India. However
the paragraph is focused on urban-rural variations. Please clarify what area of India the authors
are referring to (urban or rural)
4. The third paragraph repeats several reasons why there is a low screening rate in Ghana, similar
to the 2nd paragraph. The authors should discuss why they suspect variations urban vs rural areas
and how that impacts screening. The authors may also want to consider solutions to improve
screening rates in rural areas.
5. Paragraph four should be combined with the third. Please see the previous comment
6. In paragraph five, could it also be possible that they are more likely to interact with the health
system if they have had children?
7. Many of the discussion paragraphs start the same way “the study revealed….” Please revise.
8. I would urge the authors to focus the discussion on actionable points that could be made to
increase screening in Ghana. For example, while significant that urban widowed women have
higher screening uptake, it is a very specific population to focus on in terms of future research
and policy given the already low rates of screening among the population in the country.
Title: Rural-urban variations in cervical cancer screening uptake among women in Ghana:
Evidence from the 2022 Ghana Demographic and Health Survey
Version: 2 Date: 03 Aug 2024
Reviewer:  Ragini Mehrotra
Reviewer's report:
The study on the rural urban difference in cervical cancer screening uptake becomes important
to enhance the uptake in rural set up also to upscale early diagnosis and management of cervical
cancer specifically in underpriviledge area of the society to correct the overall incidence and
prevailence of cervical cancer. in my opinion the study should include a larger group, may be
a multicentric study, to conclude and to act towards a more inclusive  data in this regards. this
will help the societies for study to make a more authentic and validated guidelines. As such the
present study is a step towards the right direction for a good authentication.
Title: Surgical Care Bundle: Effect on Post-Caesarean Wound Infection
Version: 1 Date: 22 Feb 2025
Reviewer's report:
This manuscript needs some more work with formatting so that it reads more like a manuscript
than a copy and paste from a thesis. this would require a complete rewrite of many of the sections
so that the authors story is communicated to their target audience.
It would be nice to also describe the standard of care in detail for the control group so that the
addition  that comes as part of the intervention is clear.  For example Scrubbing  is a must for
all patients. withholding this from the control group would be unethical in many ways. once this
is clear then we can tell what we are comparing. for now it is not clear at all and would border
on unethical to publish work where the controls were given a known inferior standard of care
in the name of experimentation.
You could also follow the consort guidelines.
Title: Surgical Care Bundle: Effect on Post-Caesarean Wound Infection
Version: 5 Date: 09 Apr 2025
Reviewer's report:
Dear Authors,
thanks for this revised version of the manuscript.
The revised manuscript is well-structured, comprehensive, and demonstrates a rigorous
approach to evaluating the surgical care bundle.
- However, here are several areas for further refinement and improvement, including the
suggestion to cite and discuss the article https://doi.org/10.1089/gyn.2023.0038
- . Improve Clarity on Timeframe of Infection Detection
The 48-hour follow-up window is short and may miss later-developing SSIs. The manuscript
acknowledges this in the Limitations section, but it would strengthen the Discussion to include
a sentence about why this timeframe was chosen and whether this early result is predictive of
later outcomes (supported by literature if available).
- Since the bundle involves low-cost and accessible interventions, consider adding brief
commentary in the Discussion or Conclusion about the cost-effectiveness or scalability,
particularly for low-resource settings.
- There are inconsistencies in terminology—e.g., "care bundle" vs. "surgical care bundle" vs.
"evidence-based bundle"—which could be streamlined.
Ensure consistent tense (some of the Discussion shifts into present tense).
Title: Surgical Care Bundle: Effect on Post-Caesarean Wound Infection
Version: 5 Date: 22 Apr 2025
Reviewer:  Gourisankar Kamilya
Reviewer's report:
1. In page 3. It is being written as In the control and intervention groups, the incidence of SSIs
was 14 (9.8%) and 28 (19.4%) (P = 0.02), respectively. - How it is possible?
2. Compared o standard publication, the introduction part is too long, should be more precise.
3. Page 7. 10 procedure were practised in the intervention group and the standard hospital
practice is only scrubbing and antibiotic? But some of the practise like hair trimming, proper
hand washing, slow placental delivery by controlled cord traction are routone acce[pted
procedure and if not practised in any institution mean lack of evidence based procedure.
Povidone iodine solution painting in the vagina before CS is beneficial only performed in
intranatal CS not in the antepartum CS.
4. The results are expressed in multiple tables , like dissertation not like any research publication.
Base line characteristics like age, education, economic status, gestational age, associated medical
complications, types and indication of CS can be expressed in one or two tables.Table 5, is of
no significance, can be omitted.