Title: EXPLORING MENTAL HEALTH PROBLEMS AND SUPPORT NEEDS AMONG
PREGNANT AND PARENTING TEENAGERS IN RURAL AREAS OF LIMPOPO, SOUTH
AFRICA
Version: 3 Date: 28 Jul 2023
Reviewer's report:
Review of manuscript titled “Mental health problems and support needs among pregnant
teenagers in rural areas of Limpopo, South Africa”
This manuscript focuses on important mental health challenges among pregnant rural teenagers.
However, the following issues need to be addressed in order to enhance the quality of the article:
1. In order to enhance the flow of ideas, the document needs to be proofread and professionally
edited by a first language English speaker.
2. The Abstract – In the first sentence, the authors need to state that the 21 million teenagers
aged 15-19 is a global figure. My main concern with the abstract is that while the authors state
that their aim was to explore health associated challenges among pregnant teenage mothers,
they mention under Results, the factors causing these challenges. Such cause-effect relationships
cannot be established through qualitative research. Instead, they needed to refer to associations
between these factors.
3. Introduction – On p.2, second paragraph, they state that “Literature also revealed…”. Rather
cite the source as ‘literature’ is too broad. On p.4, 1st line, they refer to ‘others’ aged between
17 and 19’. Are these ‘others’ persons or studies?
4. Materials and methods – under Study site, what does “the administrations incorporate
regenerative wellbeing services” mean? Under Ethics approval, mention is made of telephonic
consent being obtained from parents. However, on p.14 they state that “written consent was
sought from the parents/guardians/caregivers”. Why did they not obtain written consent from
parents and written assent from the minors?
5. Results – In Table 1 the Themes are actually the research questions or objectives, while the
Sub-themes are actually the themes that emerged from an exploration of these objectives. Please
re-phrase ‘Community and friends’ stigmatization’ to read “Stigmatization by community and
friends”.  In the presentation of results, please change Theme 1 to Objective 1 and the sub-
themes to Themes 1.1, 1.2 and 1.3.  Similarly, change theme 2 to Objective 2 and theme 3 to
objective 3 with the sub-themes changed to themes. For the 2nd sentence under Objective 1,
change “The theme is explained by describing what is meant by mental health problems…” to
“This objective was explored by probing what is meant by mental health problems…”. Under
theme 1.1, what is meant by ‘which isolated the concept’? on p.9, 3rd sentence from the top,
please change “The theme is described in detail in the following sub-themes” to “This objective
elicited the following themes:” Similarly, on p.11, 3rd sentence from top, change “The following
sub-themes support the theme:” to “The following themes emerged:”
6. Discussion – On p.12, 3rd line from bottom, “Whereas stigmatisation…” is not a new sentence
but part of the previous sentence.  On p.13 and again on p.14, reference is made to ‘spouses’. As
one assumes that the couple was not married, were they not ‘partners’ rather than spouses? On
the same page in the middle paragraph, the authors write, “Contrary to the findings from (26)…”
It would be preferable to rather insert the name/s of the source. On p.13, bottom line, “Support
services…” is not the beginning of a new sentence but a continuation of the previous sentence.