Title: Sexual and reproductive health and gender-based violence among female migrants in
Morocco: a cross sectional survey
Version: 1 Date: 14 Dec 2022
Reviewer's report:
General Comments: This manuscript presents descriptive data on a sample of migrants living
in Morocco. While the study includes an important, and understudied population, the paper is
descriptive and results are largely superficial. There needs to be a lot more information provided
on the methods used for this study. Many of the definitions are unclear, for example, how do
the authors define and measure SGBV? Finally, the discussion section would need substantial
revision, especially with regard to focus. In its current form, the discussion section focuses on
issues that are not central to the paper's aims, and also is primarily focused on summarizing the
results. The paper would require significant revision in order to be suitable for publication.
Introduction
The structure of the introduction is somewhat difficult to follow. There is poor delineation
between paragraphs. The first paragraph, for example, should be divided into several paragraphs,
each on a specific topic.
Make it more clear in the first sentence that the third paragraph in the introduction relates to
Morcocco specifically.
It would be helpful to revise the information on the Moroccan government’s response, currently
in the second paragraph, to be more clear in terms of what these different initiatives and treatise
are meant to do.
The authors say that the majority of the migrants in Morocco come from countries in Sub-
Saharan Africa. Is there any additional data on the origin of the migrants that the authors can
provide?
Methods
How were the facilities selected into the study? Why was the maternity hospital and the two
health centers selected? Is there any context that is specific to Rabat that the readers would find
helpful?
Much more information should be provided on how the sample was obtained. Was there a sample
size calculation performed? If not, how was the sample size determined?
Were participants sampled by convenience? Were they randomly selected?
Authors may want to give some thought in the discussion section for how their sample of
women recruited from SRH services may have affected the prevalence estimtes that they see in
comparison to other studies.
Can the authors provide more information on the specific questions used to assess exposure to
SGBV in the questionnaire? How does this questionnaire compare to other modules (such as
WHO’s module) on exposure to SGBV? Did the questionnaire cover different types of SGBV?
If so, how were they defined?
Were there ethical considerations that were taken into account given the sensitivity of the
questions?
Results
What does it mean that that the participants “had previous birth experience?”
How were obstetric morbidities defined? Is the percentage calculated among all women -- not
just currently pregnant women in the study? It seems pre-natal care is only among pregnant
women.
Again, it would be very helpful for the authors to discuss more about the types of SGBV
experienced and how SGBV was defined in the questionnaire, especially given the very high
prevalence. For example, did the authors include emotional abuse? Physical abuse?
Table 3: In the table, it appears that the forms of SGBV are detailed, but I’m not sure that they
make sense. For example, what is “aggression for theft?” Also, Being threatened with physical
violence is different from actually being the victim of physical violence. One is mental and the
other is physical. Authors may want to provide support for grouping these forms of violence
together, or consider disaggregating them. Further, how do the authors define blackmail and
intimidation (if different than threat of violence)?
Table 4: What does “disruption of sexuality” mean?
Discussion
The discussion section seems to miss the mark and fails to go into depth in synthesizing the
findings of the study within the local and global context. It needs substantial revision. The
authors should avoid summarizing the results that are of peripheral importance to the study and
stay focused on the study aims. For example, describing the percentage of the study population
who received vocational training does not seem to be aligned with the aims of the study. What
does this study contribute that has not been known before?
Further, there is much more background information on SRH and SGBV among migrants in
Morocco presented than was provided in the introduction. Some of this context should be
included in the introduction to frame this study.
Further the discussion makes claims that aren’t supported in the study results. For example,
“Verbal violence and use of physical force were the most common forms of SGBV in this
study which match” however, this is not clear from the results presented in the study, given that
physical violence is combined with threats of violence in the results.
The authors describe this as a quantitative study, but there are no statistical inferences drawn. It
should be emphasized that this was a descriptive study.