Reviewer’s report
Title: 
Suicide and deliberate self-harm among women in Nepal: a scoping
review
Version: 
1 
Date: 
05 May 2021
Reviewer's report:
Manuscript: Suicide and deliberate self-harm among women in Nepal: a scoping
review
Dear editor,
I am very grateful for your consideration to review this article. The topic of
interest is very appreciable. It is known that suicide and deliberate self-harm
among women is one of the most devastating public health and social problem.
However, theoretical and empirical evidence addressing this issue rare,
particularly in Middle and Low income countries including Nepal. Having this
in mind;
Title: The title clearly depicts the scoping review, in addition to being
informative.
Abstract: The abstract reflects the content of the article clearly and precisely,
providing the reader with an exact understanding of the work done.
Background: The introduction part of this review is logical and addresses some
of the evidence published so far. However; the authors are rarely addressed what
is known and unknown evidence for this significant problem. What is the
nobility/originality of this scoping review? What is the major flaw of existing
scoping review conducted in Nepal in 2018 entitled with" Suicide and self-harm
in Nepal." Its main outcome is the same to current scoping review as portrayed
in: https://pubmed.ncbi.nlm.nih.gov/29202423/(Some of the key findings include
higher rate among women and younger age group, a rising trend among specific
groups such as marginalized, migrant workers and disaster affected population.
The studies also show role of mental illness, predominantly mood disorders and
psycho-social factors such as interpersonal or marital conflicts and socio-
economic issues in triggering suicide and self-harm behavior.). You have to
convince the scientific community in clear way and 'Avoid re-inventing the
wheel'.
Method and Materials
*The authors mentioned as they used PRISMA-ScR checklist. It is very
appreciable. However, authors not strictly followed the checklist; and simply
they attached the checklist. It is recommendable if they prepare scoping review
in the checklist format. That is easy to evaluate whether they used PRISMA-ScR
checklist strictly or not. 
For example, "present the full electronic search strategy
for at least 1 database, including any limits used, such that it could be repeated."
This is mandatory for many reviews like scoping, systematic review that portrays
how authors searching were genuine.
*The research question versus the search strategy:
"Does a socio-cultural, economic and environmental context influence
vulnerability of Nepalese women to suicide and deliberate self-harm
risks?"Versus "Suicide" AND "women" AND "Nepal"; "deliberate self-harm"
AND "women" AND "Nepal"; "suicide"AND "women" and "Nepal" OR
"deliberate self-harm" AND "women" AND "Nepal." 
Where is the socio-
cultural, economic and environmental factor you addressed or connected in
search strategy? It is also not indicated in the title.
In eligibility criteria: authors included papers from 2000-2019: What is your
tangible evidence for restriction to 2000-2019?
Authors used only two databases. According to Cochrane collaboration
recommendation, at least three databases would give you representative studies
(sensitivity vs specificity). What is your reflection in this point?
Results: The result part is clearly presented and in a logical sequence.
Discussion: The discussion session addressed in artistic way. The discussion part
should answer: Does the article support or contradict previous theories?
However, in this review authors used pocket studies to compare review results
which may not make discussion strong.
Conclusion: The conclusion is appropriate and derived from the data.
Thus, I believe that this scoping review does present reasons that justify its
publication in BMC Women's Health with major revision.
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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?
Yes
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?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes