Reviewer’s report
Title: 
Perpetuation of Gender Discrimination in Pakistani Society: Results from
a Qualitative Study conducted in three provinces of Pakistan
Version: 
1 
Date: 
28 Mar 2022
Reviewer's report:
General comment: Thank you for the opportunity to review this paper. This is a
highly emotive issue and one I believe is an important contribution to the
scholarly literature. I encourage the authors to consider separating this paper into
two discreet papers or look at reformatting to ensure there is a more cohesive
flow throughout the paper. As the reader I was invested in wanting to know more
however I did feel the paper could have flowed more easily both in structure but
also in terms of adding clarity to sentences. 
Page 2 Line 8 My suggestion is to reconsider the term contempt or add some
clarifying information.
Page 2 Line 10 I suggest rephrasing to: Gender discrimination occurs in every
country…..
Page 2 Line 12 My suggestion is that a clarifier is added to: It affects the
provision of…you could consider It adversely affects the provision of women's
rights and …..
Page 2 Line 23 Clarification on who community leaders, workers and families
are recommended. Clarification is also required as to the gender of the
participants.
Page 2 Line 24 I am unsure of what is meant by "data analysis was manually
done" - adding in detail to outline this for the reader would assist in providing
clarity
Page 2 Line 26 I suggest that in the methods section of the abstract there is
clarification that rather than stating "data were then compiled" a statement which
highlights "themes were developed and verified by the research team" provides
more clarity. 
Page 2 Line 30 I suggest removing "The focus of the collected data…." My
suggestion is rephrasing to: Three themes were identified from the data.
Page 2 Line 30 I recommend the themes stated in the abstract results align
clearly with what is stated in the findings section of the paper.
General comment: It took me a while to understand that this was a mixed
methods approach using the literature review and the qualitative data collected. I
encourage the authors to make this explicate earlier in the methods section of the
abstract. Although I do wonder if separating the literature review to stand on it's
own would assist with the readability and flow of ideas. It seems the results
section of the abstract are only presenting the themes from the qualitative study
and the themes from the literature review are not mentioned. Both the literature
review and the results from the study I believe would add to the scholarly
literature so separating these into discreet papers may be useful.
Page 3 Summary: This is where I became confused. Earlier in the abstract 3
themes are mentioned however in this summary section of the manuscript 6
themes from the literature and then 4 themes from the qualitative interviews are
mentioned and then three themes are presented. 
I encourage the authors to refer to the author guidelines - I have not identified
that this subheading of summary is required.
Page 3 - Line 35: The authors refer to the "emerged themes". Do the writers
mean "merged themes" from the literature review and the qualitative findings?
Adding clarity around this I believe is critical to the flow of the paper if the
authors decide they wish to present both the literature review and qualitative
findings together.
Page 4 Line 37 The background is illuminating however I suggest adding clarity
to the statement "other familial aspects". Providing clarity to what the authors
refer to as mundane tasks is recommended. I would also suggest reconsidering
the term "mundane" as this could be considered a loaded term. 
Page 4 Line 39 I suggest reconsidering the term "clasps women". Could the
authors consider: Withdrawal of basic human rights for women reinforces a
perception that a woman's position is inferior to that of men. This perpetuates a
position of powerlessness for women.
Page 4 Line 43 I wonder if the authors would consider removing the term
empowerment. For me this perpetuates the suggestion that the power remains
with the male and is to be bestowed to women. 
Page 4 Line 46 I wonder if the authors need to clarify what they mean by the
term the real world. For me as a reader at times I am left feeling that some of the
terms perpetuate the home tasks as being less important. 
Page 4 Line 54 - 59
Page 5 - Line 4 - 14 I found this paragraph confusing as it is highlighting the
limitations of the literature. I suggest that this statement is more suitable when
discussing the literature which is included in the literature review rather than
being included in the background. 
Page 5 Line 26 Rather than using the term" To solve this" - I suggest using the
term "To address this" as the authors have previously highlighted that gender
discrimination continues to exist globally
Page 5 - General comment This section has begun to read like a literature review
rather than the background to a paper.
Page 6 - Line 10 See previous comment that the mixed methods design is not
include in the abstract earlier in the manuscript
Page 6 -Line 13 It is not clear if the aim of the systematic literature review is the
same as the qualitative interviews. As a reader I found the switch between the
literature review search strategy on page 6 to participant selection on Page 7 too
disjointed. This impacts on the flow of the paper.
Page 6 - Line 43 Suggest removing the reference to ethics for the literature
review - as highlighted by the authors this is not relevant to the review.
Page 6 - Line 45 I am wondering why the literature search was only between
2008 - 2018? Why are the past few years not included? 
Page 6 - Line 59 I am unclear what the authors mean by "….and have been used
nationally or internationally" - suggest rephrasing to add clarity
Page 7 - Line 23 What do the authors mean "the quality of the articles was
questionable" - clarity and inclusion of an evidence based rational is
recommended 
Page 7 - Line 43 There is a jump from discussing the literature review to
describing the qualitative study. Including a subheading is needed to add flow
and clarity for the reader. However please see general comments about the flow
of the paper. 
Page 8- line 6 The terms Lady Health Visitors and Lady Health workers needs to
be clarified. 
Page 8 - Line 15 I think there may be a typographical error where the authors
state "I was conducted"
Page 9 Data analysis The type of analysis using an evidence base is not
provided. Themes were mentioned however no reference to thematic analysis is
evident in the manuscript.
Page 9 Data Integrity The discussion regarding data integrity has not been
supported by literature. Adding references to this section would add credibility.
Page 10 - Literature review findings My suggestion is to present the literature
review in one section - jumping between the literature review and the qualitive
study feels disjointed for the reader.
Page 10 and Page 11 There is a bit of repetition where the themes from the
literature review are mentioned on both pages in consecutive paragraphs. 
Title As I am reading through the manuscript, it is evident that the focus is on
gender discrimination for women - I recommend that this is more explicate in the
title.
Literature review General comment Given the literature review is a presentation
of what has previously been published - it is advised that the authors revise the
tense used. One example of this is Page 11 - line 9. Women are seen as…I
suggest restating to the literature identified that women were seen as…. 
I suggest that there is consistency of the term women used rather than moving
between women and female.
At times the term she is used which indicates singular. I suggest removing this
and using the term women.
Page 12 - line 14 Women can not a decision on her health…. This requires
rephrasing to ensure clarity
Page 12 - Line 17 - 21 Suggest rephrasing to ensure clarity for the reader.
Page 12 - Line 41 I encourage the authors to consider the language in this line.
"less obedient, become evil" As I reader I feel this is prejudicial language. If this
is a quote from the paper then quotation marks are required. If this is not a quote
then I encourage the authors to rephrase.
Page 12 - Line 43 The term Maulvis needs to be explained for the reader
Page 12 - line 48 - 50 Suggest the authors look at rephrasing to: Additional
barriers that contribute to lower rates of education for girls are related to….
Page 13 - Line 14 Suggest that this sentence is rephrased to ensure clarity, the
meaning is not explicate for the reader.
Page 22 - Line 39 I encourage the authors to use the term women rather than
woman when writing the discussion. 
Page 22 - Line 48 Consider the use pf past tense when stating women seek…the
findings are past tense
Discussion - General comments Consider clarifying if you are referring to the
literature generally or if you are referring to the findings from this study. This is
often not clear in the discussion section of the paper.
Page 23 - Line10 Clarifying what is meant by "sincerer in society" is
recommended
Page 23 - Line 23 Reconsider the term "set in stone"
Page 23 - Line 28 Reconsider the term bolstered to reinforced
Page 24 - Challenges This section may bot be required for this manuscript
Page 24 - Strengths / Limitations: It is not clear if the groups were single sex or
mixed gendered groups. If these were mixed groups this may have added to
hesitation from participants to speak. Clarifying this in the design section is
recommended.
Page 34 - Figure 2 I am wondering why there is only one figure when there are 6
themes identified from the literature review; 4 themes from the qualitative
interviews and 3 themes from the merged themes from the literature review and
the qualitative interviews. If the paper remains a combined literature review and
qualitative study paper, I recommend presenting all 3 diagrammatic
representations of the themes OR having one diagram which presents the three
themes which came from the merged findings.
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
No
Are the methods sufficiently described to allow the study to be repeated?
No
Is the use of statistics and treatment of uncertainties appropriate?
No
Is the presentation of the work clear?
No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes