Title: Factors associated with Female Genital Mutilation/Cutting in Tanzania: Insights from
Tanzania Demographic and Health Survey 2022
Version: 2 Date: 18 Sep 2024
Reviewer:  Fabiola Vincent Moshi
Reviewer's report:
Review Report
Abstract
1. Background
a. The objective should be placed as the final sentence of the background section. Please refer
to the author’s guide for proper placement.
b. Ensure consistency by using either "determinants" or "factors" throughout the text.
2. Method
a. The measurement of variables does not need detailed description here, as there is a dedicated
section for this information.
b. Clarify what is meant by "univariate model." Is this terminology synonymous with descriptive
analysis?
3. Conclusion
a. The first sentence of the conclusion needs revision, as it currently repeats the results. The
conclusion should emphasize the implications of the findings rather than reiterating them.
Background
1. Sub-heading Revision
a. The document currently uses "Introduction" as a sub-heading. According to the journal's
author guidelines, this should be "Background." Please make the necessary adjustments.
2. Opening Statement in Paragraph 4
a. The opening statement in paragraph 4 is unclear. Rephrase it to directly address the
consequences of FGM, making the impact and significance of the issue more evident.
3. Removal of First Sentence in Paragraph 5
a. The first sentence of paragraph 5 should be removed, as the severity of the act has already
been described in paragraph 4. Paragraph 5 should focus on highlighting the magnitude of the
problem.
4. Clarification of the Second Sentence in Paragraph 5
a. The second sentence in paragraph 5 lacks clarity. Re-write it to include specific variations
within Tanzania in a single, cohesive sentence. Instead of listing citations separately, integrate
the relevant variation and citation together to allow readers to easily refer to sources for more
information about specific regions.
5. Re-write Last Sentence
a. The last sentence contains language issues and needs re-writing for clarity and coherence
Method
1. Ethical Considerations Section Placement
a. The placement of the "Ethical Considerations" section is inappropriate. Please review the
author’s guide and reposition this section accordingly.
2. Study Population Spelling Correction
a. Correct the spelling under "Study Population" from "missings" to "missing."
3. Data Extraction Process
a. Include a section detailing the data extraction process. Describe how the data were extracted,
the original total sample size, the number and percentage of removed participants, and how
missing data were handled. Specifically, address if participants with missing data could have
been those who underwent circumcision and the approach taken to manage this missing data.
4. Dependent Variable Description
a. If the dependent variable is further described by the type of circumcision performed, ensure
that this explanation is included in this section for clarity.
5. Data Analysis Section
a. Remove the detailed description of variables and their categories from the data analysis
section, as these will be covered in the results section.
Results
1. Re-categorize Age Groups
a. Re-categorize the age groups into three broader categories to avoid small sample sizes in some
categories: "Adolescent," "20-34 years," and "Above 34 years."
2. Geographical Zones Categories
a. Explain the basis for the geographical zones categories you used. The TDHS dataset contains
more categories than those presented. Clarify how you selected and grouped these categories.
3. Variable Descriptions for "Distance to Health Facility" and "Permission for Healthcare"
a. Specify the variable from the dataset that provided the “Distance to health facility” and its
categories (e.g., “big problem” and “not a big problem”). Similarly, describe the variable related
to “Getting permission to access healthcare” and its categorization.
4. Dependent Variable Description
a. Since "respondent circumcised" is your dependent variable, it should have its own section
with a detailed description, including the type of circumcision performed.
5. Bivariate Analysis Results
a. The results for the bivariate analysis are missing. Please include and present these results.
6. Multivariable Logistic Regression Table
a. The multivariable logistic regression table needs improvement. Reformat the table to include
lines for the title and at the end of the table for better clarity and presentation.
Discussion
1. Discussion of Results
a. Avoid repeating the results in the discussion section. Instead, focus on interpreting each
finding. For each result, first describe its meaning and potential implications. Then, compare
these findings with other relevant studies. This approach will provide a more in-depth analysis
and contextualize your results.
2. Analysis of Factors and Odds
a. Discuss why certain categories show higher odds compared to others. For example, if elderly
women have higher odds of FGM compared to younger women, explore possible reasons behind
this trend. Provide a detailed discussion on why these differences exist before comparing your
findings with other studies. This will offer a more nuanced understanding of the results.
Study limitation
1. In addition to addressing the reported limitations, expand the discussion to include the
implications of self-reporting in data collection, particularly given the sensitive nature of the
topic. There is a risk of respondents concealing information, which could impact the accuracy
of the data. Provide a clearer explanation of this potential issue. Additionally, discuss the impact
of missing data on the study’s findings and how it might affect the overall results.