Title: Home birth and its associated factors among mothers aged 15–49 years in Somalia: A
nationwide population-based cross-sectional study
Version: 0 Date: 22 Jun 2024
Reviewer:  Monica Ewomazino Akokuwebe
Reviewer's report:
Reviewer’s Observations
This study was replicated from this study below:
Lo, KM., Fulda, K.G. Impact of predisposing, enabling, and need factors in accessing preventive
medical care among U.S. children: results of the national survey of children's health. Osteopath
Med Prim Care 2, 12 (2008). https://doi.org/10.1186/1750-4732-2-12.
However, replication is one of the key ways scientists build confidence in the scientific merit
of results. When the result from one study is found to be consistent by another study, it is more
likely to represent a reliable claim to new knowledge. In statistics, replication is repetition of an
experiment or observation in the same or similar conditions. Replication is important because
it adds information about the reliability of the conclusions or estimates to be drawn from the
data. Replication in research is important because it allows for the verification and validation
of study findings, building confidence in their reliability and generalizability. It also fosters
scientific progress by promoting the discovery of new evidence, expanding understanding, and
challenging existing theories or claims.
It is often viewed as a cornerstone of science, replication builds confidence in the scientific merit
of a study’s results. The philosopher Karl Popper argued that, “we do not take even our own
observations quite seriously, or accept them as scientific observations, until we have repeated
and tested them.” As such, creating the potential for replication is a common goal for researchers.
The methods section of scientific manuscripts is vital to this process as it details exactly how
the study was conducted. From this information, other researchers can replicate the study and
evaluate its quality.
This study discusses engages in the replication of a study with the title mentioned above in
yellow ink (Lo, KM., Fulda, K.G. Impact of predisposing, enabling, and need factors in accessing
preventive medical care among U.S. children: results of the national survey of children's health.
Osteopath Med Prim Care 2, 12 (2008). https://doi.org/10.1186/1750-4732-2-12). As a rational
concept integral to the philosophy of science (other fields)/research and as a process in validating
continuous loop of the scientific methods, I will like the authors to consider both the ethical and
practical implications of replication studies, and it should be mentioned in the introduction and
in the method sections. Further, the authors should make their readers have better understanding
why replication is important in their research.
This my summation are very important to this study and the authors should not wave them away.
Notwithstanding, my comments which requires major revision are as follows:
MAJOR COMMENTS – Requires Major Revision
1. The introduction did not include much vital information on the subject matter. The
introduction is the place to review other conclusions on the topic. The introduction section should
introduce past findings to those who might not have that expertise. The introduction should have
steps such as: introduce the topic.
The first phase of the introduction is to tell the reader what the topic is and why it's interesting
or important by describing the background; establishing the research problem; specifying the
objective(s); and mapping out the paper. Also, remember that there are general phases that
are associated with writing an introduction: stating the intent of the study, outlining the key
characteristics of the study, describing important results, and giving a brief overview of the
structure of the paper.
Note that, the introduction of this study should follow the ‘Funnel Approach’ narrative method
to scope and review existing studies across the globe and the study setting. This will illustrate
the trends, pattens and prevalence rates of the outcome of interests of this study. Kindly revise.
In the introduction, the information on home births is very scanty. Also, kindly cite home births
in studies conducted in West Africa and kindly cite these works.
Recommended studies on home births for the Introduction and Discussion sections
# Akokuwebe, M. E., & Idemudia, E. S. (2023). Factors associated with choice of home birth
as place of delivery among women of reproductive age in South Africa on JSTOR. African
Journal of Reproductive Health / La Revue Africaine de la Santé Reproductive, 22. https://
doi.org/ 27231865
# Bado, A. R., Badolo, H., Johnson, E., Komboigo, E. B., Padonou, S. G. R., & Diawara,
F. (2022). Factors Associated With Home Births in Benin and Mali: Evidence From the
Recent Demographic and Health Surveys. Frontiers in reproductive health, 4, 808070. https://
doi.org/10.3389/ frph.2022.808070
# Weldegiorgis, S. K., & Feyisa, M. (2021). Why Women in Ethiopia Give Birth at Home?
A Systematic Review of Literature. International journal of women's health, 13, 1065–1079.
https://doi.org/10.2147/IJWH.S3 26293
# Budu, E. Predictors of home births among rural women in Ghana: analysis of data from
the 2014 Ghana Demographic and Health Survey. BMC Pregnancy Childbirth 20, 523 (2020).
https://doi.org/10.1186/s1 2884-020-03211-4
# Peter Adatara, Johanita Strumpher, Esmeralda Ricks & Prudence Portia Mwini-Nyaledzigbor
(2019) Cultural beliefs and practices of women influencing home births in rural Northern Ghana,
International Journal of Women's Health, , 353-361, DOI: 10.2147/IJWH.S190402. https://
doi.org/ 10.2147/IJWH.S190402
# Dayyabu, A., Murtala, Y., Grünebaum, A., McCullough, L., Arabin, B., Levene, M., Brent,
R., Monni, G., Sen, C., Makatsariya, A., Chervenak, F. & for the International Study Group
on Planned Home Birth, International Academy of Perinatal Medicine and World Association
of Perinatal Medicine (2019). Midwife-assisted planned home birth: an essential component of
improving the safety of childbirth in Sub-Saharan Africa. Journal of Perinatal Medicine, 47(1),
16-21. https:// doi.org/10.1515/jpm-2018-0066
# Adewale Olufemi Ashimi, Taiwo Gboluwaga Amole, Prevalence, reasons and predictors
for home births among pregnant women attending antenatal care in Birnin Kudu, North-west
Nigeria, Sexual & Reproductive Healthcare, Volume 6, Issue 3, 2015, Pages 119-125, ISSN
1877-5756, https://doi.org/ 10.1016/j.srhc.2015.01.004.
2. Where are the gaps identified in this study? What has the previous studies have mentioned as
regards the outcome(s) of this study? What is the current study saying on the current situation
of your study outcome(s)? Always remember that a gap in a research study is an unanswered
question or unresolved problem in a field, which reflects a lack of existing research in that
space or it can exist when there is a concept or new idea that hasn't been studied at all, when
the existing research is outdated or insufficient, or when there is a disagreement, contextual or
methodological issue among the researchers. A gap in a research study indicates an opportunity
for further investigation and contribution to the scientific knowledge. Kindly revise.
3. Where are the main objective of this study? Where are the specific objectives of this study?
Kindly state them clearly.
4. What is the significance of this study? A lot of studies on this title has been researched across
high-income and low-income countries. What are the rationale of this research you carried out?
5. The framework and the applicability of the theory should come immediately after the
introduction section. Discuss Andersen’s behavioral model and how it has been used in previous
studies. Tell us how you are going to apply this model in your studies and give justification for
using this model.
Methods
6. I suggest the methods for this study should follow this pattern –
o Study setting and design,
o Sampling methods,
o Study population and Sampling technique,
o Determining study sample size
o Variable measurements (Outcome variable or Dependent variable and Explanatory Variable
or Independent Variable),
o Definition of concepts used in this study,
o Statistical analysis and
o Ethical consideration.
7. Give us a geographical description of Somalia in your study
8. What is the study design of this study? You can get it from the DHS publication
9. The study variable section should be separated from the theoretical framework.
10. Statistical analysis is the process of collecting and analyzing large volumes of data in order
to identify trends and develop valuable insights. In research, statistical analysts take raw data
and find correlations between variables to reveal patterns and trends to relevant stakeholders.
Important types are descriptive analysis, inferential analysis, predictive analysis, prescriptive
analysis, exploratory data analysis (EDA), and causal analysis. The five basic methods are mean,
standard deviation, regression, hypothesis testing, and sample size determination. Therefore,
show us what type of statistics analysis you have employed and how each objectives was
measured and analyzed by the type of the statistical analysis you have employed. For instance,
o Objective one was analyzed using univariate analysis to show the respondents’ demographic
characteristics (Percentage and frequency including graphs and tables). Kindly revise.
o Objective two evaluated the associations between the outcome variable and explanatory
variables by using the bivariate analysis (Pearson correlation coefficient). Kindly revise.
o Objective three examined the relationship between the variables and predict the outcome
variable on the explanatory variables, when others are kept constant by using multivariate
regression (specify the type of regression you have employed in your statistical analysis) (For
instance, it can be Logistic regression if and only if the outcome variable is binary , Yes = 1 and
No = 0), otherwise, multiple régression analysis etc. Did you report Adjusted Odds Ratio (AOR)
or Unadjusted Odds Ratio (UAOR) on Table 3? This section must be revised. Kindly revise.
11. Missing values - Was there missing values? If yes, how did your account for missing
variables or non-responses from the respondents? Kindly look into this.
12. Ethical Consideration – What are the ethical principles you employed? The Ethical
considerations in research are a set of principles that guide your research designs and practices,
but these ethical principles include voluntary participation, informed consent, anonymity,
confidentiality, potential for harm, and results communication. Was informed consent forms
given to your respondents for their participation in the DHS data collection? All these
information you can get them from the DHS publication. Kindly revise.
Results
13. Interprete the Results and discuss the relevant and significant variables and make it precise
so that it doesn’t lose its meaning. Your readers will see the tables with the results. Kindy address
these concerns mentioned. Arrange the tables very well and put the results in a better table.
14. Look at Line 253 to Line 259 -  there was no calculation on prevalence rather it was a
percentage distribution of your outcome variable and the study population. The sub title of
“Prevalence of Home Delivery” should be written as “Percentage Distribution of Home Delivery
in Somalia” and “Percentage Distribution of Home Delivery by regions in Somalia”. So you
are going to have two sections under this aspect, and properly placed the figures according to
the sub-sections.
15. Look at Line 253 to Line 259 -  Figure 2 and 3 were not properly placed in the main
manuscript. Why should Figure 3 comes before Figure 2 in the write up
Conclusion
16.  The conclusion should stem from summing up your research paper (by the following steps
- restate your research topic, restate the thesis, summarize the main points, state the significance
or results, and conclude your thoughts). Always have it in mind that a conclusion is not merely a
summary of the main topic(s) covered or a re-statement of your research problem, but a synthesis
of key points and, if applicable, where you should recommend new areas for future research.
17.  This manuscript needs a Professional English Editor to edit and proofread the entire
manuscript. Thus, editing and proofreading services are not just correcting the content carefully
but also structuring it. These services are the two most important aspects of writing that ensure
the ultimate quality of the given content and make the written piece more appropriate, accurate,
authorized, engaging, and clear.
References
18. Remove the old references…there are new studies on home births across sub-Saharan Africa
that are published…kindly look for them and use them in your studies to boost the intellectual
efficacy of this study and remember to reference these recent studies.
Reviewer’s Decision: Major Revisions