Title: Factors associated with the practice of and intention to perform female genital mutilation
on a female child among married women in Abakaliki Nigeria
Version: 1 Date: 10 Apr 2023
Reviewer's report:
BMC REVIEWER’S COMMENTS
Title: I will suggest a change of title to : factors associated with the practice and intention to
perform FGM/C for female children. My reason is because we already know quite a lot about
the reasons for the practice  among  those who had it from previous studies
General: It is a very relevant topic of public health concerns that needs attention. The authors
have also address a gap in literature which has to do with the intention to practice FGM/C on
female children despite effort to abolish the practice.
Abstract:
Methods: was the level of significance set at exactly 0.05 or # 0.05?
Results: it is not clear if circumcision used here means the same as FGC and if the use of the
word mutilation for their children also means FGC?
kindly address this in the main text too
I will suggest that you are consistent with your terms if you have defined what you want to assess.
Key words: the key words are too many
Introduction:
You used female genital mutilation/cutting and female circumcision and one is not sure if they
mean the same thing or different procedures
The authors have not provided any evidence of the high incidence of FGM/C justifying this
study. How do you prove that it is not the prevalence based on the old cases that are still used?
We need to be sure that despite the enactment of the law, the practice has persisted.
I do agree that it is important to assess the intention to still practice FGM/C especially with their
female children and to find out reasons/factors associated with that.
Methods:
What was the estimated sample size that was calculated?
Any consideration for none response rate?
The sampling technique is also not clear. What is your reason for the purposive selection of this
LGA? The first selection of the communities is clear but what method/methods was used for
the selection of houses and household? Spinning of pen is not a sampling method. What is the
sampling frame for the household?
Also what sampling method was used for the selection of women at the household level?
Any inclusion and exclusion criteria used for the selection?
Which instrument did you use for the data collection?
How did you ensure the validity of the instrument?
There should be a separate section for the measurement of variable with clear description and
content of the questions on knowledge and practice including the scoring.
The cutoff point used for grading knowledge is the mean but I am wondering why? Do you
use the mean irrespective what the highest score is? Even if it is very low?  i amen lets assume
they all had a poor knowledge what happens? do you then use the mean of the poor level of
knowledge among them to determine the cutoff?
I am not clear how practice was assessed since the questions were not provided. I also do not
appreciate how any of the practice related to FGM/C can be good practice, kindly provide
explanation.
Kindly indicate the ethical approval and consent obtain for the study in your manuscript.
Results:
These results “Women who are circumcised are more likely to mutilate their daughters
(AOR=28.732, 95% CI=6.171–133.768), and those who have previously mutilated their
daughters have greater intention to mutilate future ones (AOR=141.786; 95% CI=9.584–
2097.592)” have very wide confidence interval and therefore needs explanations because it
undermines the precision.
The  titles for table 3 and 4 do not reflect the actual analysis. It should be factors associated with
conducting FGM/C with girl child and factors associated with the intention to perform FGM/
C on girl child.
Discussion:
The sequence for the discussion need some readjustment or restructuring, you cannot start with
the discussion about carrying out FGM/C or the intention to do so with their children. I suggest
you begin with the findings from the women themselves which includes the prevalence, the
reasons for the FGM/C, etc before those of the children.
Do you think that legal/ punitive measures for the practice of FGM/C could have affected the
responses and the findings of this study?
I suggest that you include a section on the strength and limitations of the study.