Title: Reasons for Early Marriage of Women in Zahedan, Iran: A qualitative study
Version: 4 Date: 05 Oct 2022
Reviewer:  Emmanuel Biracyaza
Reviewer's report:
Report
Thank you very much for this opportunity to review this valuable piece of research exploring
a topic that we know little about. Although I recognize that this study has the potential of an
interesting paper and I recommend that the manuscript should be carefully reviewed, particularly
with respect to aspects related to soundness of background, methods, results or critical discussion
of the results, consistency between objectives and analysis as well as paper's structure. So, I do
believe that this topic is relevant and the paper is interesting for this journal. However, I suggest
to the authors to perform a major revision addressing all the points raised.
Overall comments
The English language still needs to be improved for making this study be strengthened and
increased its reputation.
References need to be revised and if possible the authors can use the software to write the
references correctly (some software such as Mendeley software desktop are freely accessible
on Google). Indeed, authors must pay attention to the available publications because not all
journals publish the studies of good quality (please, I recommend to remove the papers published
in predatory journals and replace them by good papers). Some of the predatory journals can
be checked using this link (https://www.immunofrontiers.com/list-of-predatory-journals-and-
trusted-resources-2022).
Please explain clearly how the authors identify/measured the results. Indeed, the citations are
too long and results/interpretations too shorts. Further, please revise the manuscript, because the
conclusions seems to be too subjective and not having their roots into the results analysis.
Declaration part also has to be restructured using the guidelines of the BMC Women’s Health.
Background
There is lack of focus, structure, and clarity in the introduction. I suggest the authors skip the
first paragraph and instead organise the introduction by for instance providing evidence on
accessibility of mental heath services, barriers to the accessibility, evidence from around the
world, evidence from African countries and description of mental health services and evidence
on accessibility and barriers in the Rwandan context.
More literature about the early marriage at world level, in HICs and LMICs is more important
to clarify the reason why this study is important.
Please, add a specific paragraph entiled as "Rationale and objectives" at the end of background
section where you should report what this study adds to the current literature, why it is relevant
for the field, its originality and finally the objectives
Methods
This section lacks some important subheading including study design, study settings (you
can include the administrative map), study participants (the inclusion and exclusion criteria
should be stated clearly, in this part of participants, more information regarding the participants
‘characteristics), data collection, sampling techniques (it remains unclear, in this study),  data
analysis (please, provide the themes and sub-themes in appropriate manners) and ethics (in
ethics indicate who reviewed and approved the study, as the study was conducted in human-
beings were all methods conducted in accordance with the standards and regulations of Helsinki
Declaration; if yes, provide the reference, what is about consent or assent form, confidentiality
and anonymity). Please, I have serious concerns about the method used for data analyzes.  Were
categories the themes and sub-categories the sub-themes. If themes, was inductive or deductive
method applied. Please clarify the translation/transcription procedures. Did you take audio and
notes...
Thanks for the details about participants. However, I suggest you to review some aspects of
the method section: recall the number of participants in the sample section, then add ust mean
age (median is not necessary); add references to content analysis; avoid repetitions of analysis
methods;
-It is not clear whether the participants signed written informed consent. Please, clarify
-Are there any additional socio-demographic regarding participants? This would greatly improve
the manuscript's strengths and help the reader to understand the context of your research
Results
The themes and subthemes should be clearly defined. I suggest the authors provide a table
exposing those and perhaps providing some of the examples. Participants should be coded; each
subtheme could be followed by several quotes to support its content.
When introducing interviews quotations; gender and age of participants could be included after
the quotation, in brackets as a label, for example: (Male, 33 years);. quotations should be reported
in the same form along the paper; maybe quotations could be indented, in italics and ending with
the label. Some quotations are already written as such. The interview questions or the macro
areas of the interview are not included in appendix.
Discussion
Discussion lacks flow and you need to restructure based on the major results you find. A
clear structure for discussing the results should be followed, starting with a summary, followed
by comparison with previous literature, limitations and strengths, and providing specific
implications for research and practice.  Among the limitations the authors can provide limitations
to the study design which cannot  determine the causal relationship and the study design could
not explore the factors such as socio-demographic etc. which may play a role of confounders
of the early marriage. Thus, the first step would be to re-organise the results and then discuss
each of the findings.
Conclusion
As the analysis of the content also raises doubts in the context of providing individual examples
of statements in a given category - it requires supplementing, more careful consideration of
statements presented in such a way, meticulousness and due diligence; also, the conclusions can
raise serious doubts. At the end, the recommendations to the policy makers should be reduced
and provide relevant recommendation to the future researchers based on the results findings.