Title: Factors associated with delay in seeking treatment among women with pelvic organ
prolapse at selected General and Referral Hospitals of Southern Ethiopia, 2020
Version: 1 Date: 16 Dec 2020
Reviewer's report:
Comments
1. The title should be modified. I think the outcome variable for the study is the time of treatment
that was dichotomized as Delayed and Early.  Therefore, would be better to say ‘Factors
associated with time of treatments of POP among women with pelvic organ prolapse at selected
General and Referral Hospitals of Southern Ethiopia’, 2020.
2. Abstract: Recommendation should be in line with the findings and specific enough. For
instance, health education are ambiguous terms. better to specify the area of health education
should be cover
On the other hand, I could not come across with the finding that triggers you to recommend
screening and health education. Better to check the finding versus recommendation.
3. Methods: Generally, method section is okay. However, I have some concerns. The study
main aim is to identify the factors for delayed treatments. The proportion of clients delayed for
treatment was obviously known, then the study interested to identify the factors. If this was the
case, does the study design used in this study was appropriate?
In addition, the outcome variable of the study is not clear; was it delayed treatment or time for
treatment? In table 3 and 4, if I am not mistaken it was dichotomized as Delay and early. Better
to check and be consistent throughout the document. In addition, when we say women were
delayed for treatments? This must be clearly operationalized. Some of the variables are not self-
explanatory.  I think these variables also needs operational definition. For instance, low income,
lack of support, culture, busy etc.
Page 6, paragraph I, you stated that the questionnaire was developed by the investigators
by reviewing different related literature. Better to cite for resources used for developing the
questionnaire. Page 6, Paragraph I, about pretesting, where you did the pretest? Specify the site.
Better if the value of Hosmer and Lemeshow goodness test was included in your report.
Do you think doing analysis for factors is appropriate in this study?  How do you see the sampling
adequacy to run logistic regression?
What was the difference between ‘ethical consideration’ you have jotted under method section
on page 7, paragraph 1 and ‘Ethical approval and consent to participate’ on page 11 under
declaration section? It was repetition. Where is the appropriate place to put concerns related to
ethics? Better to check it and follow journal guideline.
4. Result section: I feel that the organization of the result section needs revision. For instance,
it would be better if the first glance paragraph will to come next to socio-demographic
characteristics.
Table 2. for some variables, such as Ethnicity and Religion it would be better if the frequency
was written based on descending order.  In addition, you should have clearly specified ‘other’
category.
In table 3 there was the variable called culture, then dichotomized to Yes/No. What do you mean?
Be consistent across your document while using words. You used reason and factors
interchangeable. Are they the same?
5. Discussion: This is quite important section where you focus on discussing the key findings
from the result part. however, it is not well articulated. it does not include the possible
justification about mean length of delay for POP treatments differences across countries. Also,
justify about your associated factors.