Reviewer ’s report  
 
Title: Barriers and facilitators to uptake of cervical cancer screening among women in Uga nda: a 
systematic review  
 
Version: 0 Date: 13 May 2019  
 
Reviewer: Maggie McConnell  
 
Reviewer's report:  
 
This paper offers a well -written systematic review on the literature surrounding barriers and 
facilitators of cervical cancer screening.  I have some specific suggestions for improvements and 
clarifications to the manuscript:  
 
 
1) It would be valuable to update the systematic review as the last search was done in 2017 
and this is an active area of research.  
 
2) On page 7 the manuscript report s that "Only studies of reported barriers and facilitators 
were chosen; studies that inferred correlations based on statistical associations with 
demographic features were excluded." However, in the results section the manuscript 
reports findings related t o socio -economic and demographic conditions. It would be 
helpful to clarify the scope of the review and whether the intention is to discuss findings 
which may shed light on barriers and facilitators that are related to differences in take -up 
across socioec onomic and demographic characteristics.  
 
3) I would in general be somewhat cautious about stating that anything can be concluded 
about the "most commonly reported barrier" -- does this mean reported by the greatest 
number of study participants? Reported in the greatest number of studies? Given the 
extraordinary range in methodologies, sample sizes and study scope it is bit difficult to 
support this kind of conclusion from the literature review at this point.  
 
4) The manuscript overall focuses on barriers and  facilitators from the point of view of 
interventions that could influence patients' behaviors, though some of the barriers at the 
health worker and facility level may be of more primary concern. For example, 
improving knowledge of screening will not impro ve screening rates if there are not 
trained health workers with adequate knowledge, materials and supplies to perform 
training.  
 
5) It is difficult to interpret the proportions of women screened in table 1 without also 
including the nature of stay recruitme nt (i.e. whether the sample is designed to be 
population representative).  This should be added.  
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary  controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, fund ing, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that  
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, w rite 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
 
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I agree to the open peer review policy of the journal