Title: Behaviors and practices of incarcerated women towards menstrual hygiene in a large
urban prison in Uganda: a phenomenological qualitative study
Version: 2 Date: 20 Mar 2023
Reviewer:  Emmanuel Ochola
Reviewer's report:
This is a highly motivated study in a neglected area of big importance. i congratulate the authors.
1. Please state the qualitative design that the authors use, e.g. phenomenology [probably the
case], ethnography, grounded theory, etc. Also clarify the framework used if any.
2. Please justify the use of random sampling in this study that required a very small sample size.
State how it was implemented
3. Generally, there seems to be only one quote from a warder- please ensure that their opinions
were not grossly disregarded
4. abstract-methods and results have disagreeing age groups of inclusion.
5. abstract concept- doesn't seem to probe personal factors, or overlook desirability bias.
6. abstract conclusions- nothing is practical- make it more specific. what should IGP do?
7. line 74: this study may not give the current numbers correctly- or you should state the period
quoted.
8. 74 vs 76: the numbers of female prisoners are conflicting- please harmonise.
9. lines 78-79- the statement starting "however, with the overwhelming...' seems to be a
repetition of the previous.
10. 83-84; the concept of RUMPS have been encouraged... are you discouraging them as only
second best, or are you paragonising them against some standards?
11. line 92; the phrase 'cannot be achieved' is rather overtoned since it makes your study
seemingly 'sine qua non'... you may want to tone it down.
12. line 101- inclusion age is 20-59 yet you expect menses in the last 1 month [line 102]- why
is the age past menopause. Please harmonise or justify inclusion.
13. Line 100 cs 115- why are there two different numbers reported
14. line 140; add on to this statement 'but relied saturation principle'
15. Even with the concept of saturation, there should be an apriori sample size. Why did you
prefer a qualitative study and not quant or mixed.
16. ethics; how was privacy and confidentiality assured in this population, and how were they
compensated for their time
17. The duration of interview seem to be misplaced in line 166 and 170. You had already talked
about it under methods. You can delete
18. Table 1- use 'less or equal to 5' instead of the stated 'greater or equal to 5'
19. themes; what is the difference between behaviour and practice, or why you use the two
together under one theme and title.
20. none of the quotes under the recycling of sanitary products seems to reflect the stated
subtheme- they talk about soap supply, and contradict the subtheme about frequent bathing with
soap and water...[there you state that there is unlimited supply of water and soap- line 230]-233.
What do you mean by sanitary products- is it only soap
21. Again, even under frequent bathing with soap and water, there is no quote that justifies
having soap.
22. it is difficult to find evidence of 'inadequacies in menstrual hygiene facilities', line 209-10,
since the theme is about privacy.
23. 217- consider removing 'alternative' since you seem to insinuate that its the only option
24. 248 on unreliable access to clean water contradicts 232 where there is adequate quantities
of water. Could there be a bias in the statement
25. 250- it would be good to corroborate 'most' from the authorities side.
26. i see a lot of quotes under 261-271. it seems some are more appropriate for behaviors, e.g.
263-5.
DISCUSSION
27. The stated 'behaviours' don't seem to come out clearly.
28. you seem to mix referencing styles especially 283-7, please stick to the recommended.
29. 317-319 contradicts your recommendation in 308ff
30. 328-330 check sentence for comprehension and repetitions like 'setting'
31. limitations; do you sense some biased exaggeration just because most respondents are
incarcerated?
32. 357 seems a repetition of earlier ethics section
33. references 1 and 2 should be improved to be standard