Title: Factors Associated with Mental Health of Internal Migrants (Kayayei) in Agbogbloshie-
Ghana
Version: 3 Date: 07 Feb 2023
Reviewer:  Williams Agyemang-duah
Reviewer's report:
Thanks for the opportunity to review the manuscript to review the manuscript titled: “Factors
Impacting Mental Health of Internal Migrants (Kayayei) in Agbogbloshie-Ghana”. The
manuscript is of interest and falls within the scope of the journal. I however have the following
comments to improve the current version of the manuscript.
Title
1. The current title of the manuscript should be modified as: “Factors Associated with Mental
Health of Internal Migrants (Kayayei) in Agbogbloshie-Ghana”.
Abstract
2. The research gap driving the study is not clearly indicated in the abstract. Also, the purpose
of the study has not been clearly included in the abstract. These issues should be fixed. You also
indicate that you used a stepwise logistic regression…I think you have to be specific here….
Is it binary logistic regression?
Introduction
3. “Furthermore, physical and mental health issues have not been given the necessary attention
they deserve in Ghana”, Why do you think it is necessary to have a study in these areas? What
implications would such study have on the achievement of the United Nations health-related
Sustainable Development Goals? What implications will it have on the development of local
health policy and programme for migrants?
4. “This study, therefore, sought to plug a literature gap by determining factors impacting mental
health of internal migrants (Kayayei) in Agbogbloshie-Ghana, which is one of the largest and
busiest markets in the country’. Plug a literature gap is not the right phrase to use in this context?
Please, modify…
5. In the introduction, kindly include a key hypothesis driving the study.
Methods
6. “First, convenient sampling was used to select Agbogbloshie market because it is one of
the largest and busiest markets in the country, with a lot of Kayayei activities (27)”.. Why did
you use convenient sampling to select the study participants? Readers will be interested in this
information..
7. “Three hundred and fifty-two (352) participants were purposely selected to take part in the
study”. Why did you use purposive sampling to recruit the participants? A detailed justification
will do.
8. “The process of the data collection should be extensively explained. What was the procedure
of data collection? What were the inclusion and exclusion criteria applied? And why? What was
the estimated time for the administration of each questionnaire? Did you provide any incentives
(such as cash or soap or any other item) to the participants? Did you recruit any research
assistants? If yes, did you organize any training for them? What issues did the training cover?
How did you ensure confidentiality and privacy of the information provided? How did you check
for validity and reliability? How did you check for multicollinearity? What was the Variance
Inflation Factor (VIF)?
9. “Three Stepwise Logistic Regression models were fitted by using the Backwards Selection
method to predict the mental health challenges of the Kayayei (Depression, Anxiety, and Stress)
at p=0.2”. What is the specific logistic regression used? Why is p=0.2? Why not 0.05. This is
because in social science and health, we used p-value of 0.05 or below. Any theoretical and
empirical justification?
10. “The DASS 21 is rated on a 4-point Likert scale (Did not apply to me, applied to me to some
degree, or some of the time, applied to me to a considerable degree or a good part of time, and
applied to me very much or most of the time). The total score for each sub-scale is multiplied by
2 to get the final score. Scores for depression, anxiety and stress were calculated by summing
the scores for the relevant items. The score for depression ranged from (0-9 for normal; 10-13
for mild; 14-20 for moderate; 21-27 for severe and 28+ for extremely severe depression.  The
score for anxiety ranged from (0-7 normal, 8-9 mild, 10-14 moderate, 15-19 severe, and 20+
extremely severe, finally the score for stress also ranged from (0-14 normal, 15-18 mild, 19-25
moderate, 26-33 severe, and 34+ extremely severe) (29)”. What was the Cronbach alpha value
for each of the scale or the overall scale used?
11. “Independent variables that were fitted include background characteristics’, This is reason
why I asked you to check for multicollinearity?
Results
12. “The median age of the study participants was 25 (IQR=18-65)”. Why median age but not
mean age?
13. Table 1, add years to the age variable…
14. “The results further indicated that the odds of being stressed is 67 percent lower in
participants with accommodations as compared to those without accommodation (95% CI=0.21,
0.52, p=0.001)”. This shows that it is not 67% lower. I should be 79% lower… check it again…
Discussion
15. Start the discussion with a brief introduction outlining the purpose of the study and the key
hypothesis driving the study.
16. The discussion should be strengthened. Authors should be able to comment on the new
findings as this will form the core contribution of the study. Again, you have to establish why
these findings are important? The implications for policy, practice and future research should
be strengthened. Strength of the study should be added.