Title: Women leaders perceived barriers and consequences of safe abortion in Rwanda: A
qualitative Study
Version: 7 Date: 21 Nov 2022
Reviewer's report:
Thank you for this opportunity to review the manuscript, “Women leaders’ perceived barriers
and consequences of safe abortion in Rwanda: A qualitative study.” The work of the authors is
timely, relevant, and important – in Rwanda and on a global scale. The comments below intend
to strengthen the authors’ presentation of this dedicated work.
Suggestions for Revision
Abstract, Page 2 Lines 5-6: To say women often do not have the power to make informed
decisions requires more lead-in than implied poverty. Use of the word ‘power’ begs context
beyond poverty and age. The reader appreciates the word given the participant base. However,
so as not to disrupt the current flow, consider using “…often lack adequate insight to make
informed decisions…”
Abstract Lines 15-24: This reader prefers the use of italicized text to identify themes. Use of
quotation marks is distracting and, in this section, takes away from the text flow. Also, keep an
eye on consistency of theme presentation (capitalized at the front of first word).
Background, Page 3 Lines 20-21: Consider word flow “…unsafe abortion due to such barriers
as…”
Background, Page 3 Line 31 to page 4 Line 2: Sentence mix does not flow well. Divide the
two thoughts.
Background, Page 4 Lines 16-18: Citation is required at first sentence.
Background/Context, Page 5 Lines 24-26: This reader is missing a more direct statement of
purpose. What is the plan for this study’s findings (to be stated as primary objective[s] of
action following what you will learn from these participants)? Are the authors aiming to better
understand female leadership in order to glean whether their perspectives are aligned with
supporting and advocating the recent policy for safe abortion? What about the power these
women hold in relation to their expressed perspectives? What is the significance of the power
they hold? Given the previous background on impact among female representation, such an
objective is inferred but not directly made clear. Clarifying this aspect will help set the stage of
the important work reported here.
Methods, Page 6 Lines 4-5: Qualitative research is well understood and better appreciated these
days. A justification statement is not necessary.
Methods, Page 6 Line 7: Please qualify what is meant by “…interact with other women at the
local level.”
Methods, Page 7 Lines 1-3: Please have a look at the grammar in this section.
Methods, Page 7 Line 4: Please explain a bit more about how or with whom the interview guide
was tested.
Findings, Page 8 Lines 11-20: As from this reader’s comment about the Abstract, to make themes
clear and non-competitive with quoted excerpts, please consider use of italicized text to identify
themes, as in, Strong barriers and numerous consequences of safe abortion. Italicizing will also
help clarify the grammar.
Findings: Page 8 Line 23: Change to “…that illustrate participant views from…”
Findings: Page 9 Line 5: Please align the subheading with the subcategory described on Page
8 Lines 14-15.
Findings, overall: A general comment to indent quoted excerpts when longer than three lines
throughout the entire Findings section.
Findings, overall: A general comment is that the reader wonders whether the participants were
offered confidentiality because it would be fairly easy to discern the study participants given
how they are described in some sections, e.g., Page 11 Line 1.
Findings, Page 11 Lines 18-19: Please indent a conversation excerpt.
Findings, overall: Consider if asked to shorten the paper that some of the exemplar, non-
conversational quotes can be added to a restructured Table 2 so that the body of the paper only
requires the authors’ summary statements with a few major quotes.
Discussion, Page 16 Line 3: Reference to the themes in this section can also use italics instead
of quotation marks.
Discussion, Page 16 Lines 11-16: This reader is still looking for that “action objective.”
For example, what is the significance that barriers perceived and experienced by Ghanaian
adolescents are similar to those expressed by adult state and local leaders? This reader
welcomes a directionality statement ahead of the supporting evidence. Power is strongly inferred
throughout the manuscript but has not been clearly defined as the condition of inquiry. The early
Discussion might be a good place to frame power as a context supported by your findings.