Title: Financial burden faced by breastfeeding mothers caring for children diagnosed with
cancer in Ghana; An exploratory qualitative study
Version: 2 Date: 15 Aug 2023
Reviewer:  Waliu Jawula Salisu
Reviewer's report:
Childhood cancer is a prevalent issue that comes with significant financial burdens for mothers
caring for their children. This is an issue that cannot be overlooked.
Introduction:
The introduction of the study aims to shed light on the challenges faced by breastfeeding mothers
with a child diagnosed with cancer. Although the authors did address essential aspects of the
topic, there are still certain areas that need to be addressed more thoroughly, as highlighted
below.
Could the authors clarify these, ‘’291,319 (254,239 to 331,993) new cases and 98,834 (86,124
to 113,581) mortalities'' as the figures may appear confusing to readers?
Methods:
Methodology Clarity: To improve the methodology section, the authors should consider
providing additional detail and structure. Precisely, they should outline the study design,
participants, data collection methods, and data analysis procedures. While some information is
provided on these areas, the authors could enhance the section by including more specific details,
such as the source/reference of the interview guide, who designed the interview guide, and any
steps taken to ensure the quality of data collection.
Sampling: To better understand the research methodology, it would be helpful if the authors
could provide a brief explanation of why purposive sampling was chosen as the method for
participant selection, and how it aligns with the research objectives.
Data Collection and Consent: While the authors provided a comprehensive method for acquiring
informed consent, it would be beneficial to briefly clarify how they safeguarded the participants'
confidentiality and privacy throughout the interviews.
Data Saturation: The authors noted that they reached data saturation by the thirteenth participant.
It would be helpful if they could elaborate on the methodology used to determine saturation and
the reasons why no additional information was received.
Data analysis:
The analysis section, though it outlines a broad overview of the process, lacks details about
the process the authors used to generate the themes and subthemes, the coding process, and
intercoder reliability, which could altogether enhance the transparency and rigour of the study.
Discussion:
The discussion section provides an interpretation of the findings in the context of existing
literature. It's insightful, but here are a few suggestions:
Link to Research Questions: For better clarity and coherence, the authors should explicitly
connect their discussion to the research questions or objectives stated at the outset of the study.
This will ensure that there is a clear correlation between the study's findings and its intended
purpose.
Implications and Recommendations: The authors briefly mentioned that the findings "will bring
the attention of stakeholders to commit financial resources towards pediatric cancer care." To
fully achieve the goals of this study, I suggest the authors provide a more detailed explanation
of the potential impact of the findings on policy, practice, and future research. Additionally, it
is necessary to offer specific recommendations based on the study's results.
Strengths and Limitations: To aid readers in interpreting and generalizing the study, I suggest
that the authors provide a brief description of the study's strengths and limitations in a separate
section.
Conclusion:
The authors summarized the main findings and their implications, however, highlighting the
urgency of addressing the financial burden faced by mothers of children with cancer and
presenting a specific course of action based on the research findings would be highly impactful.
Also, the conclusion in the abstract does not seem to match that of the main manuscript. Could
the authors rectify this and maintain consistency?
Overall, the article provides valuable insights into the financial challenges faced by mothers
caring for children with cancer. While the manuscript is well-crafted, addressing the minor issues
highlighted could further enhance its clarity and impact.