Reviewer’s report
Title: 
Changes in the prevalence and trends of female genital mutilation in Iraqi
Kurdistan Region between 2011 and 2018
Version: 
0 
Date: 
18 Jan 2021
Reviewer: 
Research Square Reviewer 1
Reviewer's report:
PEER REVIEWER ASSESSMENTS: 
OBJECTIVE - Full research articles: is there a clear objective that addresses a
testable research question(s) (brief or other article types: is there a clear
objective)?
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols)
appropriate for the objective?
No - there are major issues
EXECUTION - Are the experiments and analyses performed with technical rigor
to allow confidence in the results?
No - there are major issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
No - there are issues with the statistics in the study
INTERPRETATION - Is the current interpretation/discussion of the results
reasonable and not overstated?
No - there are major issues
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work
technically sound? If not, can revisions be made to make the work technically
sound?
Maybe - with major revisions
PEER REVIEWER COMMENTS: 
GENERAL COMMENTS: 
This is an important study that should contribute to the fight against FGM and
authors have done well to come up with it. The study however needs a lot of
work before it can be considered for publication as follows: Topic needs to
capture the essence of the study - trends and determinants of FGM
Sentence 1 under introduction: Give full definition of FGM as per WHO. A
genital alteration procedure qualifies as FGM if done for non-medical reasons.
Methodology
Needs to be redone. Authors should not present methodology of the two multiple
indicator cluster surveys (MICS). There could be a section in the introduction to
discuss how the MICS were done then a substantive section for methodology of
this study. As it is now methodology section for the study is missing and authors
have instead discussed methodology of the MICS.
Data analysis
Authors will need to analyze trends in the determinants of FGM - age, education,
etc. over the period of study to show how these have changed; show if there has
been a significant difference in the two periods of the MICS in these factors; and
deduce how these changes could have affected prevalence of FGM. Example:
how has education changed in the two MICS? How has FGM rates changed for
each of the categories - no education, primary education, secondary, etc.? What
should we conclude on how FGM is changing based on education? This analysis
should be done for all variables. 
Under discussion/recommendations section - Explain the implications of the
findings on FGM control in Iraq.
REQUESTED REVISIONS: 
Revise the topic to capture trends and determinants of FGM; Define FGM as per
WHO definition; Develop a methodology for your study; do analysis of
determinants of FGM; discuss implications of the study on FGM control.
ADDITIONAL REQUESTS/SUGGESTIONS: 
None
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Declaration of competing interests
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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?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes