Reviewer’s report
Title: 
Exploring how Syrian women manage their health after migration to
Germany: Results of a qualitative study
Version: 
0 
Date: 
19 Mar 2020
Reviewer: 
Esperanza Díaz
Reviewer's report:
Thank you for letting me review the manuscript "Exploring how Syrian women
manage their health after migration to Germany: Results of a qualitative study"
This is a well written, interesting paper addressing an important topic: the way
women from Syria who have lived in the country for some years perceive their
access to health care. I only have a few general comments.
In the introduction, most of the references are from German literature. Although
this is understandable because the study was in Germany, generally it would be
better if this matter could be lifted up to a more European context as well -also
adding references from other countries-, so that the reader can comprehend later
(and this should be discussed at the end of the paper) to which degree these
findings might be generalizable and for what type of countries. For example,
better information of the availability of professional interpreters would be
necessary to compare with other countries.
The women had been in Germany since 2011. Some place in the paper it says
"recently" arrived (page 7). I would no say so, an this indeed has implications for
the findings. These are women with some years of experience in Germany, not
recently arrived.
The methods are well described and the results seem well organised, but not new,
as far as I know. Was there anything especially surprising? Something you
would understand as your "new" finding? If so, lift it up in the discussion. I
would like to know more about the positive factors at the end, because from
those we can learn. You write that this has to be explored, but is there anything
more you can tell us? Were there more details about how the women "used"
these positive factors (laws, "German people"). Regarding this last one "German
people", it seems as this is not just "people", but some professionals. Is this
right? Following this, the importance of non-health laws, professionals and other
issues to improve health might be discussed in the discussion part.
In the implication part, I miss both more concrete suggestions and that solutions
are lifted up to a system level. In the text, it seems that the solutions are at the
health care professional level, but I might suggest that the system and societal
levels are key. Also the intersectional level might be relevant for some of these
solutions. Also, as the authors address, at the educational level is important, for
both patients and health professionals. In this sense, I would be careful to write
that we need more mental health care (which we probably do) without addressing
the causes of mental health problems: discrimination, lack of integration, lack of
interpreters an information, etc
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.
Unable to assess
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 manuscript or would you
recommend an additional statistical review?
If an additional statistical review is recommended, please specify 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:
Acceptable
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