Title: How Gender-Sensitive Disaster Management is Addressed in the Turkish Parliament: A
Qualitative Study from Feminist Bioethics Perspective
Version: 2 Date: 24 Jul 2024
Reviewer's report:
Feedback on the Manuscript Titled "Women’s Health and Health Ethics After Earthquakes in
Turkey"
Summary:
This study aims to identify key concepts and themes related to health ethics and rights by
analyzing discussions within the Turkish Grand National Assembly (GNAT) since February 7,
2023. It addresses a timely topic relevant to other natural disasters in Turkey and beyond.
Major Strengths:
1. The study sheds light on under-researched groups in contexts where the focus is primarily
on urgent humanitarian aid.
2. The methodology, centered around GNAT discussions, is generally appropriate for the study's
aims but contains several significant gaps, discussed below.
Major Issues:
1. The objective of assessing the earthquake's impact on women's health appears overly
ambitious given the study's focus on GNAT discourse. Consider narrowing the scope to focus
more closely on ethical principles and issues.
2. Provide detailed information on the content analysis process, including coding schemes,
inter-rater reliability, and analytical tools. The brief description in the 'Methods' section lacks
sufficient detail for replication or understanding.
3. Use a PRISMA flow diagram to visualize the document selection process, detailing how many
documents were found, screened, excluded, included, and analyzed at each phase.
4. Organize findings thematically by identified ethical principles with corresponding quotes for
clarity.
5. Incorporate concrete examples and quotations to support themes, linking each quote to its
relevant theme(s).
6. Ensure all conclusions are directly supported by evidence. For instance, the assertion that "the
presented themes underscore the complex intersection of health ethics and disaster intervention"
is valid only when results are aligned and organized along these themes.
Minor Issues Needing Attention by Subheading:
Abstract:
7. The list of ethical principles ("Gender Equality and Justice," "Benefitting and Preventing
Harm," etc.) in the abstract reads more like results than a methodological framework. Rephrase
to clarify they are potential themes for analysis.
Introduction:
8. Clearly define the specific research question to avoid confusion about the focus on women's
health impact versus the ethical analysis of GNAT discourse.
9. Consider removing references to women’s health to maintain the focus on ethical issues.
Examples of how disasters disproportionately affect women would be beneficial.
Methods:
10. Provide robust justification for selecting GNAT as the primary data source beyond
"authoritative and reliable public information."
11. Clarify the choice of the end date for data collection and describe the search strategy,
including keywords or terms used, the review process, and reviewer roles, especially concerning
the lack of ethics-related terms in keywords.
12. Define the nature of the study (research vs. review) and the need for ethical approval.
13. Provide examples of the search string and clarify statements regarding the ethics committee's
stance on the need for approval.
Results:
14. Avoid quantitative claims about the frequency of themes without appropriate data.
15. Ensure consistent terminology for ethical principles and address any inconsistencies
regarding women's health impact versus ethical analysis.
16. Consider merging similar principles under unified themes.
Discussion and Conclusion:
17. The statement that “issues concerning access to resources and justice were the most
commonly raised contexts” lacks empirical support from the presented results.
18. Further, the discussion surrounding the impact of disasters on women’s health should be
grounded in the study’s findings rather than existing literature.
19. Strengthen the connection between identified ethical principles and their implications for
disaster response.
20. Define each principle consistently throughout the manuscript, avoiding unsupported
generalizations about women's disaster-related impacts.
21. Develop concrete recommendations based on the findings to inform policy and practice.
Overall:
22. Maintain consistent focus on either assessing women's health impact or analyzing ethical
dimensions of GNAT responses.
23. Strengthen the theoretical framework and enhance clarity and coherence in the presentation.
Other Minor Issues:
24. Minimize the use of bullet points when unnecessary.
25. Revise style and tone for conciseness, avoiding repetition.
26. Use abbreviations consistently, ensuring they are defined at their first mention.
27.  Lastly, correct any incomplete or unclear sentences, such as “the Turkish Grand National
Assembly (GNAT) used content analysis...”