Title: Patient Perspectives of Using Reproductive Autonomy to Measure Quality of Care: A
Qualitative Study
Version: 1 Date: 12 Oct 2023
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)?
No - there are minor issues
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?
N/A - there are no statistics in this study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
No - there are minor 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 interesting study on the patient-centered quality metrics
for reproductive health care. The manuscript is mostly written well, however, there are few major
issues especially in the methods part, that should be further clarified in the draft manuscript.
First of all, the authors studied patient-centered quality metrics using qualitative approach,
which I believe is somewhat misleading. The metrics are measure of quantitative assessment. By
reading the study title, I was expecting quantitative scale/metrics developed based on patient-
centered approach in reproductive health care, the same can be expected by the readers. I suggest
taking this into account in revising the study title as well as in the main texts in the discussion.
- Introduction is mostly clear except that some of the previously developed scales or metrics
need more detail explanation. The authors presented that earlier study developed ‘reproductive
autonomy scale’ but it is not clear whether the scale was quantitative scale and its validation.
- In Methods, there was no sample size mentioned.
- In page 5, the last sentence of the first paragraph “…..had seen a primary care provider…..”
must be primary care related to reproductive health.
- The procedure of the data collection and data analysis needs further details. Currently it is not
clear how many FGs were made and on what basis they were divided into different groups, etc.
- The perception of good care is also depending upon women’s socio-economic status including
age and parity. This should be taken into account while making FGs.
- The limitation of the studies is not sufficiently discussed. The authors should discuss how the
selection of these samples might have impacted their findings, etc.
- The conclusion part of the abstract, the authors concluded that “reproductive autonomy during
clinical encounters may be a useful metric for quality of reproductive health care” but it is not
clear from the methods and results that what metrics they have developed in this study.
REQUESTED REVISIONS:
Major revision required
ADDITIONAL REQUESTS/SUGGESTIONS:
No