Title: A qualitative study on the adaptation of community programmes for the promotion of
early detection and health-seeking of perinatal depression in Nepal
Version: 0 Date: 02 Mar 2024
Reviewer's report:
Topic of study is well framed and important from the population and mental health problem
in the population perspectives. Literature review could have information where there is
involvement of cultural anthropologist or sociologist who have rich information about socio-
cultural perspective particularly patriarchal culture with little power to women regarding
conceiving the baby and family support system. Researcher has collected data through providers
but not from perinatal women, the key participant of the research, better to write the reason of not
using FGD. Usually women feel more easy to share among each others who experienced similar
problems that serves validation of the description provided for their psychosocial sufferings.
In step three information last sentence researcher stated that 'The workshop participants also
reviewed and revised the community sensitization manual content during the workshop', it would
be good if you can describe those changes there so that reader can understand easily about the
changes in the sensitization manual content.
Step has been written in two heading 'step 3-workshop' and next is again step-3 finalization'.
Are they both belonged to same process information or different, if same or if it is typo error
do correct.
Did you do validation of final adapted tool or program content with provider after the finalization
step. Such tools and information are often mainly guided by mental health expert at the end rather
than validating through the users' in the field. If it is followed user' validation it will helps to
strengthen the information of detection tool and sensitization program more useful for providers.
The last sentence of page 7 ' few reported having suicidal thoughts.....' need to articulate in the
discussion part or in result section that what the researcher do to address it as part of ethical
commitment.
In page 8 line 3 'the word 'jhingaleko'  is written as being caught up in problem'....is it a prototype
of depression symptoms or just used as concept of symptom of depression? The underlying
description in table 3 showed it is more feelings than thought and it needs to be discussed
in discussion section to increase strengths of this article. In paragraph three, the word 'single
minded' is used to refer 'ekohor huney' behavior. English translation source to be mentioned or
how the word is coined in English to explain. In endnote it says local phrase used to explain
the certain behavior that is considered as not daily occurring behavior or not normal………, but
single minded seems rather English translation of a particular way of reaction of subject. Please
explain how the translation derived for this particular one and whether there is cross validation
from field level service providers and sociologist or anthropologist.
Page 9 second paragraph information were collected from service providers at field level, it
would more stronger information (evidences) if researcher can provide cultural belief related
findings from FGD of pregnant or post natal women or FCHVs or IDI and support validation of
expert understanding with community people understanding (pregnant and post natal women).
I agree with the information of last paragraph of page 11 about information of tools. I found
they are really easy and clear to depict description of symptoms of mental health condition.
CIDT finalization process showed main influence of mental health expert (psychiatrist,
psychologist and psychosocial counselor) which is important from clinical perspective for the
diagnosis and treatment but in validation we need to think from the perspective of sociocultural
perspectives such as involvement of cultural anthropologist or sociologist to have more strengths
to claim tool validation otherwise it can be stated in the limitation section.
In table 1 occupation category showed house wife and farmer, I wonder whether there is
duplication of occupation as it is common trend mostly housewife have main person of working
agriculture. It would good if you can describe how occupational category is used in your study.
Please provide the reference of income sufficiency category you used in table 1 and write shortly
in result description as well. I also wonder the reason of showing sociodemographic result table
while there are interpretation of the findings both in result and discussion section.