Reviewer’s report
Title: 
Technology as the Key to Women’s Empowerment: A Scoping Review
Version: 
0 
Date: 
06 Jul 2020
Reviewer's report:
The authors conduct a scoping review to explore how information and
communications technology (ICT) impacts women's empowerment globally.
Below are comments for the authors to consider to improve the paper further.
1) Background:
a) Fourth paragraph, first statement (page 4, lines 24-26): This statement is
unnecessary repetition of what had already been stated earlier (see second last
statement of the first paragraph on page 3, lines 21-26).
b) There is still not a clear statement of the problem, which should have come at
the end of the fourth paragraph. The authors argue at the end of the paragraph
that ICTs have a plethora of opportunities for women. The question then that
comes to the reader's mind is, what gap(s) exist(s) in terms of what is already
known about these opportunities? Answering this question would then logically
ease the reader into the objectives of the paper stated in the subsequent
paragraph.
c) Last paragraph, first two statements (page 4, lines 48-58 & page 5, line 5):
Delete "Hence" from the first statement, and "As such" from the second
statement. The edits aside, the authors argue that part of the objective was to
explore the gaps in knowledge and research on the topic from a nursing lens.
However, the preceding discussion does not clearly bring out why exploring the
topic from such a lens is important and what insights we stand to gain from such
an approach. 
2) Methods:
a) First paragraph, first statement (page 5, lines 9-12): This statement appears
incomplete as it begs the question, "A rigorous synthesis of what?"
b) First paragraph, third statement (page 5, lines 17-39): It is not clear what the
authors mean by the phrase, "which is contingent upon feasibility" in point (f) as
it begs the question, "feasibility of what?"
c) Review protocol, team and expertise, first statement (page 5, lines 43-46): The
authors should rephrase this statement for better clarity as I struggled with what
it exactly means and I am sure some readers would as well, especially the second
part that reads: "a-priori protocols were developed for the inclusion criteria,
search protocols, and data characterization utility form."
d) Review question and scope (page 6, lines 7-9): It would be good if the authors
used active voice e.g. "We used scoping review methodology to address the
following research question …"
e) Search strategy: 
* First two paragraphs (page 6, lines 14-46): Again, it would be good if the
authors used active voice here since it is not clear who did what they are talking
about here given the use of passive voice.
* Third paragraph, first two statements (page 8, lines 15-20): The authors
mention initially searching two databases but they do not indicate which
databases these are and the rationale for selecting them over the others to start
with.
* Fourth paragraph, last statement (page 8, lines 49-52): The authors state that
they "evaluated" the journals for additional research. Perhaps it is a wrong choice
of word, "evaluated", as it is not clear what the "evaluation" criteria were.
f) Study selection:
* First paragraph, fourth statement (page 9, lines 26-34): The argument here is
not clear. How can initially choosing a time frame of 2012-2016 and later
expanding it to December 2017 "ensure feasibility of the search, specifically
related to the number of possible results"?
* Second paragraph, last statement (page 9, lines 38-46): It is not clear what the
authors mean by the phrase, "and secondly included how the social determinants
of health were present in each study". Is it whether the social determinants of
health were considered or how they were presented in each study? If the latter,
then the authors need to describe the criteria they used to determine the "how"
and the "presence". Also, what are these social determinants of health they were
looking for?
g) Scoping review management and analysis:
* Section heading (page 10, line 21): Perhaps the section heading could read:
"Scoping review management and data analysis". That aside, this section talks
about the "management" part but not the "analysis" part (i.e. there is no
description of analysis procedures, only reference to two reviewers managing the
analysis process).
* First statement (page 10, lines 24-34): The authors refer to some manual
removal of duplicates by "the masters candidate". Who was this candidate and
what was his/her role in the study?
* Second statement (page 10, lines 34-36): Again, it is not clear what the authors
mean here. Is it "screening for relevance" or "relevant screening"? Also change
the phrase, "within this software" to "using the software".
* Last statement (page 10, lines 36-41): This statement should be rephrased for
better clarity, especially in the active voice e.g. "Two reviewers conducted the
selection of articles and analysis of the data to ensure consistency in
exclusion/inclusion criteria …" 
3) Results:
a) First paragraph (page 10, lines 46-58): The authors should consider rephrasing
this paragraph using active voice to enhance clarity. Also, change the phrase,
"included within the analysis" in the last statement to "included in the analysis".
b) Second paragraph:
* First statement (page 11, lines 9-12): Change the phrase, "consistency in the
reporting" to "consistency in reporting".
* Third statement (page 11, lines 14-17): Change the phrase, "presentation
within" to "presentation in", and "populations" to "women" since the attributes
listed here pertain to women and not the general population.
* Fourth statement (page 11, lines 17-22): The authors refer to "disease specific
issues". Which issues are these?
* Last statement (page 11, lines 22-24): Delete "may" from the statement as it
connotes that the authors are not sure of what they are talking about.
c) Third paragraph:
* First statement (page 11, lines 26-29): Delete "study" before "design", and "of
the study" at the end of the statement.
* Last statement (page 11, lines 29-34): Rephrase the second part to read: "…
that utilized measurement of empowerment incorporated such measurement in
their design and outcomes".
d) Fourth paragraph, first statement (page 11, lines 36-41): It is not clear what
the authors mean by the phrase, "which future challenged achievement of a
uniform definition for the purposes of this research." What is this future when
the research being referred to is what is presented in this paper? Also, rather than
say, "challenged", "affected" would sound better.
e) Fifth paragraph, second statement (page 11, line 58 & page 12, line 5): Insert
"in" between "described" and "synonymous" for the statement to read well. Also,
delete "the" between "as well as" and "barriers" towards the end of the statement
because no barriers have been mentioned in the preceding text such that we can
be talking about the particular barriers.
f) ICT interventions to support women:
* Second statement (page 12, lines 19-22): Rephrase to read: "The frequency of
specific interventions in the 51 articles is presented in Figure 2." The edits aside,
the authors should summarize the key message(s) on the frequency of the
interventions for the reader. Simply stating the frequency is presented in the
figure does not help the reader in understanding what is going on.
* Last statement (page 12, lines 22-24): Again, simply stating that the
categorization of interventions is illustrated in Table 2 does not help the reader in
understanding what is going on. The authors should provide a summary of key
message(s) that a reader can take away from Table 2.
* Table 2 (pages 12-13): The last statement under "health challenges" does not
read well. Perhaps consider rephrasing to something like: "The health challenges
focused more on females than males."
g) Achieving empowerment:
* First paragraph, second and last statements (page 13, line 60 & page 14, lines
4-7 & 9-17): It is not clear why the authors are referring to the factors listed in
these statements as "perceptions" (see the last word in each statement). Does the
literature show that these factors were mere perceptions of the factors that
influence women's use of ICT or were they empirically determined? It would
also help the reader if the authors went a little bit further and summarized how
these factors influenced women's use of ICT based on the findings in the
literature that they reviewed.
* Second paragraph, last statement (page 14, lines 21-26): Again, it is not clear
why the authors are referring to the outcomes listed here as "perspectives". Were
they mere community and individual views regarding the outcomes or were they
empirically determined outcomes of use of ICT to empower women?
h) Attaining agency:
* First statement (page 14, lines 31-36): The authors should consider using
active voice here e.g. "Twenty of the 51 articles described …"
* Second statement (page 14, lines 36-39): The meaning of this statement is not
clear. First, which impacts are the authors talking about? The authors can only
talk about "these impacts" if they have listed what these impacts are following
from the first statement. Second, what are these "potential facilitators for future
research and programs", and what are the "described obstacles" that the authors
are referring to?
* Third statement (page 14, lines 39-41): Again, which "evidence" and "potential
research strategies" are the authors referring to here?
* Fourth statement (page 14, lines 41-44): This is another statement whose
meaning is not clear. How can "a consideration of the importance of generational
preference and knowing" improve uptake and use of ICTs? What is this
"generational preference" and "knowing"?
* Seventh statement (page 14, lines 51-58): Rephrase the last part to read: "…
and facilitators to developing behavioural change interventions."
* Last statement (page 14, line 58 & page 15, lines 4-7): What do the authors
mean by the phrase, "key to this being operationalized"? What is "this" that is
"being operationalized"? 
4) Discussion:
a) First paragraph:
* First statement (page 15, lines 12-14): The concepts summarized here
(accessibility, affordability and capability) are not clearly presented in the results
section. For the authors to discuss these concepts here, they should show in the
results sections the key findings and messages regarding the same from the
literature that they reviewed.
* Second statement (page 15, lines 14-17): This statement ought to have come in
the results section, especially where the authors were talking about the
description of women included in the studies that they reviewed. Encountering
this statement for the first time in the discussion ambushes the reader.
* Third statement (page 15, lines 19-22): It is not clear whether this was an
exclusion criterion for studies included in the review or for women who were
included in the studies. If the former, this statement ought to have come in the
methods section. If the latter, then it ought to have come in the results section
where the authors describe the attributes of women who were included in the
studies that they reviewed.
* Fourth statement (page 15, lines 22-24): It is not clear what the authors are
referring to here as "this finding". Which particular finding is this and whose
biased view does it reflect?
* Fifth statement (page 15, lines 24-29): This particular finding does not appear
in the results section, and therefore ambushes the reader. There is nowhere the
results section where the authors show that these categories of women were
excluded from existing studies. Also, delete the word "currently" from the
statement.
* Last two statements (page 15, lines 34-44): Whereas the arguments here are
generally true, the authors do not show in the results section that existing studies
excluded disadvantaged groups.
b) Second paragraph:
* First statement (page 15, line 46): Rephrase to read: "Empowerment was
defined through direct and indirect means in the evidence reviewed."
* Second statement (page 15, lines 46-51): Rephrase to read: "The definition was
… 12 articles having …"
c) Third paragraph, first statement (page 16, lines 12-14): How do the authors
reconcile this statement with an earlier assertion that although some studies used
measurements of empowerment, they did not incorporate it in their designs or
outcomes? Also, change the phrase, "cited within" to "cited in".
d) Fourth paragraph:
* First statement (page 16, lines 29-34): Rephrase to read: "While none of the
studies included in the review mentioned the broader …, the literature indicates
that …"
* Third statement (page 16, lines 36-39): Rephrase to read: "Evidence shows that
more often, cyber abuse …" so that it is clear that what the authors are talking
about here is not part of the results that they present.
* Fourth statement (page 16, lines 39-44): Rephrase to read: "Women expressed
concerns about the ability … their partners … technology and the potential for
social media settings to expose their activities online." 
e) Fifth paragraph:
* Second statement (page 16, lines 53-56): Change "support" to "suggests" since
it relates to "the complexity" alluded to at the beginning of the statement.
* Fourth statement (page 17, lines 4-7): Change "campaigns or workshops" to
"interventions".
* Fifth statement (page 17, lines 7-12): Change "These campaigns" to "The
interventions".
* Sixth statement (page 17, lines 12-17): Rephrase to read: "Governments
partnering with private telecommunications agencies through subsidization could
…"
* Seventh statement (page 17, lines 17-22): Rephrase the last part to read: "…
accessing interventions aimed at enhancing the use of ICT."
* Eighth statement (page 17, lines 22-27): Change the phrase, "transportation to
and from workshops" to "accessing services". The authors keep referring to
workshops but this is just one of the many channels for reaching beneficiaries
and it is not clear why they are singling out workshops only.
* Ninth statement (page 17, lines 31-34): Rephrase the last part to read: "…gap
in access to and use of ICT."
* Last statement (page 17, lines 36-39): Insert the words, "not only" between
"strategies" and "help" for the statement to read well. 
f) Last paragraph:
* First statement (page 17, lines 41-43): The argument here is not clear. What
are these "deficits in literacy" and how do they relate to "health and digital
literacy"? And what are these "gaps in delivery", and delivery of what?
* Fifth statement (page 17, lines 56-58 & page 18, line 5): Delete "must" from
the statement, and change "training for" to "training in".
* Sixth statement (page 18, lines 5-7): Again, the argument here is convoluted.
How do policies targeting women's empowerment "lead the way for programs",
which programs are these, which "specific populations of women" do such
programs benefit, and how different are these women from the general
population of women?
* Seventh statement (page 18, lines 7-12): This is another argument that lacks
clarity. Consider rephrasing to something like: "Programs informed by evidence
improve knowledge and skills of women to use ICT at local and national levels."
* Eighth statement (page 18, lines 12-17): The argument here does not make
sense. How would doing what the authors are proposing benefit stakeholders,
and which stakeholders are they talking about here? How would benefit to such
stakeholders translate to benefit for women who are the focus of the study?
* Ninth statement (page 18, lines 17-22): Who needs to provide the funding?
Why are the authors singling out libraries here and lumping other players as
"other agencies"? Who are these other agencies? And again, why are the authors
singling out workshops among the myriad channels for reaching intended
beneficiaries with interventions? Also, insert "related to" between "those" and
"using".
* Last statement (page 18, lines 22-27): What do the authors mean by "this
endeavour"? Which particular endeavour are they referring to? 
5) Limitations
a) Fourth statement (page 18, lines 48-51): Change "available data" to "available
evidence".
b) Fifth statement (page 18, lines 51-53): Change "resulting data" to "resulting
evidence".
c) Last statement (page 18, lines 55-58): What do the authors mean here by
"feasibility of the study"? What study are they referring to here and how does its
feasibility warrant a scoping review? What are the attainable timelines and what
is the publication timeframe that needs to be restricted? Or did the authors mean
to argue that to make the scoping review manageable and achievable within a
given timeframe, there is need to define the reference period for the articles to be
reviewed. If that is the case, they should go ahead and explain how this is a
limitation. 
6) Conclusions:
a) It is hard to decipher what the conclusion(s) is/are from the narrative here. The
authors should note that a conclusion is a concise summary of the message(s)
they would like the reader to take away from the paper based on the key findings
of the research and their implications for policy, programs or further research.
b) First paragraph:
* First statement (page 19, lines 7-14): This is not a conclusion but a mere
repetition of the objectives and the methods used in the paper.
* Second statement (page 19, lines 14-17): This statement is vague. What
importance does the issue of empowerment and ICT carry, and how does that
relate to women who are the key focus of the research? And does such
importance emanate from the review of the literature that was undertaken?
* Third statement (page 19, lines 17-22): What range of interventions are the
authors referring to here and do these also derive from the literature that was
reviewed? Also, change "implemented into" to "implemented in".
* Fourth statement (page 19, lines 22-24): Which particular findings and
discussion are the authors referring to here? If they mean the preceding
statements, then they are too vague to be considered findings (see the first three
bullets here).
* Last statement (page 19, lines 24-34): This is not a key message that a reader
can take away regarding the findings of the paper and their implications for
policy, programs or further research.
c) Second paragraph:
* First statement (page 19, lines 36-39): Is the argument here based on a key
finding of the review? If so, then it did not come out clearly in the results or in
the discussion of the findings i.e. the authors did not show in the results that the
goals for empowerment "at the international level lack a broader picture that is
told from a gender inclusive perspective."
* Second statement (page 19, lines 39-44): What do the authors mean by a
"partnering framework"? What does such a framework entail and how can it
support future research and analysis? And analysis of what?
* Third statement (page 19, lines 44-46): The argument here does not make
sense. How can empowerment and ICT be used to support the complexity of the
concepts within society?
* Fourth statement (page 19, lines 46-49): What are the "established categories
and sectors" that the authors are referring to here?
* Fifth statement (page 19, lines 49-54): What is "this goal" that the authors are
referring to here?
* Last statement (page 19, lines 54-58): What do the authors mean by "this
issue" and "the same broad scale" here? Also, "critically" is poor choice of word
here.
7) Future implications:
With a well-framed discussion that highlights the key findings of the review, the
gaps in what is already known based on the review, and their implications for
policy, programs or research, this section would be unnecessary. Moreover, since
it is not tied to the key findings of the review, it is hard for the reader to decipher
how they relate to the findings. The authors should consider incorporating some
of the text here in the discussion section, paying particular attention to how they
derive from the key findings of the review, and avoiding general statements that
are not substantiated. As the authors will note from the preceding comments, a
lot of statements need to be substantiated for clarity, and the same applies for
most statements in this section even if they are moved to the discussion section. 
8) Abstract
a) Background (page 2, lines 7-22): There is a lot of unnecessary text here while
important text is missing. The authors should state the gap(s) in what is already
known and the objective of the paper in the background section of the abstract. I
would, for instance, do away with the first two statements to give me space to
state the problem (knowledge gap) and the objective of the paper as the second
and third statements of the background section here.
b) Methods (page 2, lines 22-34): The authors should remove statements of the
research question and objective from the methods section of the abstract. These
are issues that should be summarized in the background section of the abstract.
The methods section should instead summarize the approach used, the databases
searched, the search criteria, the total number of articles identified, the number
of articles included in the final review, and the criteria used to identify this final
list of articles.
c) Results (page 2, lines 36-44): This is a poor summary of the findings of the
review. The authors should instead summarize the key findings regarding how
ICT impacts women's empowerment based on the review of the literature. In
other words, based on their review of the literature, how does ICT influence
women's empowerment?
d) Conclusion: Once the authors overhaul the results section of the abstract, the
conclusion here will just be a summary statement of the key take-home message
based on those findings e.g. whether the evidence generally shows that ICT
negatively or positively impacts women's empowerment and what that means for
policy or programs.
e) Keywords: Some of the keywords here do not make sense. For instance,
"Technology" and "ICTs" are all subsumed in "Information and Communications
Technology" and are therefore not distinct keywords. It is also not clear how
"Education" and "Nursing" come in. I would instead use words like "Scoping
review" and "Impact" besides "Information and Communications Technology",
"Women", and "Empowerment" to capture the key attributes of the paper e.g.
"Information and Communications Technology; Impact; Women;
Empowerment; Scoping review". 
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No
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
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authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
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require further assessment in your comments to the editors.
Not relevant to this manuscript
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