Title: Period Poverty, Reuse Needs, and Depressive Symptoms among Refugee Menstruators
in Jordan’s Camps: A Cross-Sectional Study
Version: 1 Date: 26 May 2024
Reviewer's report:
The study is interesting, but I raise some comments that may improve the paper. These comments
aim to enhance the clarity, depth, and relevance of the study's findings and implications for
addressing period poverty and mental health challenges among refugee women in Jordan.
Major Comments:
1. Sample Size and Representation: The study included 386 refugee women, but it would be
beneficial to provide more information on how this sample size was determined and whether it
adequately represents the diverse refugee population in Jordan.
2. Data Collection Methods: While the study mentions informed consent and voluntary
participation, more details on how these were ensured, especially considering the vulnerable
nature of the participants, would strengthen the ethical considerations.
3. Statistical Analysis: The statistical methods used are comprehensive, but a more detailed
explanation of why specific tests were chosen for certain analyses would enhance the
transparency and reproducibility of the results.
4. Demographic Characteristics: The age range and mean age of participants are provided, but
additional demographic information such as nationality, length of stay in Jordan, and living
conditions could offer a more comprehensive understanding of the sample.
5. Period Poverty Assessment: The study mentions period poverty, but a clearer definition of
how it was assessed and measured in the context of refugee women in Jordan would provide a
better understanding of the challenges they face.
6. Mental Health Assessment: While the study used the PHQ-9 questionnaire to assess mental
health, more information on the prevalence of mental health issues among refugee women and
how they correlate with period poverty would strengthen the discussion.
7. Reuse Needs Assessment: The study includes a reuse needs score, but further details on what
this score represents and how it impacts menstrual hygiene practices among refugee women
would be valuable.
8. Recommendations and Implications: The study briefly mentions recommendations, but a
more in-depth discussion on practical interventions and policy implications to address period
poverty and improve mental health outcomes for refugee women would be beneficial.
Minor Comments:
1. Education Levels: The study reports education levels of participants, but a breakdown of
educational backgrounds by nationality or region of origin could provide additional insights.
2. Employment Status: While the employment status of participants is mentioned, further details
on the types of jobs held and their impact on access to menstrual hygiene products could be
insightful.
3. Health Insurance Coverage: The study touches on health insurance, but a discussion on how
insurance status affects access to healthcare, including menstrual health services, would be
relevant.
4. Income Disparities: The study highlights monthly income variations, but exploring how
income levels influence access to menstrual hygiene products and mental health outcomes would
add depth to the analysis.
5. Reuse Needs Score Interpretation: Providing a clear interpretation of the reuse needs score
and its implications for menstrual hygiene practices could enhance the understanding of the
study findings.
6. Cultural Considerations: Considering the cultural context of menstrual hygiene practices
among refugee women in Jordan and how it influences their experiences could provide valuable
insights.
7. Long-term Impact: Discussing the potential long-term consequences of period poverty and
poor mental health on the overall well-being and integration of refugee women in Jordan would
be a valuable addition to the study.