Title: KNOWLEDGE AND ATTITUDE TOWARDS PRECONCEPTION CARE AND
ASSOCIATED FACTORS AMONG WOMEN OF REPRODUCTIVE AGE WITH CHRONIC
DISEASE IN AMHARA REGION REFERRAL HOSPITALS, ETHIOPIA, 2022
Version: 4 Date: 16 Jan 2024
Reviewer:  Desire Habonimana
Reviewer's report:
Thanks for sharing a revised manuscript and sorry for taking too long to give feedback - end of
and new year weeks are always busy and family focus proves inevitable.
This revised manuscript continues to demonstrate downsides, both English grammatical and
methodological, with lack of conciseness and clear conveying on the message.
For instance, a sentence in the introduction of the abstract reads: “However, little was known
…” the use of “was known” is likely inaccurate to justify the study as it sounds that lack of this
knowledge has past, historical.
Also, the title seems to be wordy with commas and semi-colon at the same time, looks like a
sentence. I would suggest something like (without being immune from criticism): Determinants
of preconception care among women of reproductive age with chronic diseases in Amhara,
Ethiopia: A multicenter cross-sectional study
Methods section (abstract) remains scant: e.g., no mention of how many centers, whether
these 828 women had chronic conditions, etc. A proposed restructuring would look like: “We
interviewed 828 women of reproductive age living with chronic conditions (which ones?) from
x health centres in Amhara region selected using a stratified and systematic random sampling
technique. Etc.
In the results section, we read that “This study found that 55.6% of respondents had a good
knowledge of preconception care, and about half of the women (50.2%) had a good attitude
towards PCC” but cannot understand what “good knowledge” means as not define a priori in
the methods. And the remaining results section is heavily packed with numbers rather than
conveying a message. In order words, what did your study find? Tell readers what you found
in English and only support your claims with numbers. In this manuscript, it looks like “the
message” supports the numbers, which is the other way around.
In the conclusion, authors argue that “The finding of this study showed that women’s knowledge
and attitude towards preconception care were relatively low”. This has no clear meaning and
isn’t backed by any previous definition, so quite vague conclusion. Authors recommend that
“The government would promote women's education and utilization of family planning and
health professionals in the study area shall counsel women to improve knowledge and attitude
towards preconception care”. These are general recommendation we often find in global health
meetings, which are vague and with little implications. For instance, did you study investigate
whether the government actually does not do so already? You cannot recommend something
“good intention” in an academic paper.
Introduction: I find lack of important elements:
i) Acronyms (e.g., WHO, LMICs, etc.) which would be used thereafter
ii) Sentence grammatical problems e.g., “Most of these complications occur during pregnancy,
exist prior to pregnancy, and worsen during pregnancy, particularly if not managed as part of
preconception care, and maternal and fetal health are jeopardized primarily due to a lack of
knowledge about preconception health care”. “Occur” should be “occurring”, long sentence
with so many ideas some of which arguable e.g., “maternal and fetal health are jeopardized
primarily due to a lack of knowledge about preconception health” this argument is arguable true
particularly the emphasis on “primarily”.
Already, this paper requires much more work to be published.