Reviewer's report
Title:The silent cry: Women's status and violence against Young Married
Women by Husbands in Rural Nepal
Version: 1Date:3 February 2011
Reviewer: Katarina Swahnberg
Reviewer's report:
I welcome this paper since it deal with a very important topic and I declare that I
have no competing interests. I appreciate the inclusion of several kinds of
violence, and the gender perspective, even if it could have been a little more
pronounced. Methodologically I find the study sound, using available procedures
to ensure good quality.
I recommend the manuscript for publication after revision according to the
following points.
Title: If the gender perspective is developed a little further with references to the
literature women status could be exchanged for e.g. gender perspective. I would
omit “The silence cry” since it does not refer to the study. The word “husband” is
not necessary in the title either.
Rural Nepal is important and you have to make that very clear also in the main
text. Sometimes you refer to just Nepal but the study is not about the whole of
Nepal but rural Nepal, as I have understood it. Se e.g. background in abstract
and conclusion pp20 and inbetween.
Abstract: conclusion, last sentence – more research in Nepal?
Background: need to be condensed and rewritten. I also think you need to
contact a native English speaker or professional language editor.
- First paragraph presents prevalence rates. These figures make no sense
without definitions. If you like to illustrate the statement in the first sentence you
have to find a better way.
- Line 10. There is a growing literature in developing countries too, please be
more specific.
- pp5 you mention two studies from Bangladesh but only give one reference. Is it
possible that the second one is by Koustuv Dalal?
- pp5 last paragraph; what neglect? What social indicators?
- The context could also be described a little e.g. arranged marriage, possibility to
live with more than one wife, married young women as the husband and his
family’s property etc. (Is is a culturally conservative area as you claim in the
discussion?)
Methods: this section need to be shortened and much more to the point. Maybe it
could also be more structured to avoid repetition such as e.g. pp 7 line 8 and 21.
It should also include information about translation procedures for using the
WHO questionnaire and explain what “necessary modifications” means. I also
think that you can clarify that the WHO questionnaire separates different degrees
of violence.
What does “removing personal identification” mean? Why was it there in the first
place? Did you not use codes and lists of participants that were destroyed when
data collection was completed?
pp9 Omit the expression “self-explanatory” it is not to any help for the reader.
You have to present all variables that are essential to your analysis, but not
twice. Now e.g. the abuse questions are presented at pp 8-9 and pp 28. It should
also be made clear why you choose the variables that you are using e.g. type of
marriage, sex composition of children, media exposure. You must have a theory
or hypothesis for including these variables.
pp9 what does feeling/love mean, was it one question or two?
pp10 were the WHO attitude questions used? Or were you just inspired by them?
I think it is good that you did not just dichotomise the accepting violence scale but
used at least these three degrees.
The second paragraph pp 10-11 can preferably be made more clear and
shortened.
In the last paragraph of the method section you mention “risk factors” (you use
this terminology later too). As you say yourself, this study can only point out
associated factors and this is the case with many, many studies. Are you sure
that there are evidence that the factors you call risk factors are not associated
factors?
Results: Results are presented in text and tables, one place will do e.g. that
results are presented in tables and only main findings are summarised in the text.
Overall I think you should present prevalence rates and results from the
multivariate analysis. The bivariate results (long text) is not interesting once you
have the multivariate results with one exception - table 4.
I find it difficult to follow who is the respondent. Is head of the family synonym
with husband?
Pp 15 line 2 “Regarding attitudes of women on men…” please clarify.
Pp 15 line 11 was stronger than what? This kind of expression is often used
thought out the manuscript without explaining what you are comparing with.
Another example is pp 18 line 1-2.
Pp 16 line 4 clearify that you are talking about lifetime violence in the first
sentence.
If you declare in the method section that you refer to differences only at the level
of p=….. you do not have to repeat the word significant all the time in the text.
Discussion: I expected a more thorough methodological discussion about the
cluster sampling, head of the household identifying eligible respondents, the use
of a Questionnaire developed in another context, translation of the questionnaire,
all the variables you adjusted for in table 5 etc – implications for your sample?
The results?
Ethical discussion? Why do you think that non of the eligible women refused an
interview?
Are there any safety matters that other researchers in the field might have
something to learn from?
When you talk about unemployment do you mean male or female
unemployment? Pp 18 line 9.
pp18 Correlations should first be mentioned in the results
Conclusion: should be more to the point and more related to your own most
important results.
Tables: 1 and 2 could preferably present women without and women with lifetime
experiences of violence (with p-values), and a column for the total.
Table 3, add the question (operationalization) for emotional abuse like you have
done for the other kinds.
Table 5. You do not have to present both CI and p-values. I prefer CI since I find
them more informative.
I appreciate your work and wish you luck in the future.