Authors’ response
Author list: Yohannes Adama Melaku1*(adamayohannes@gmail.com), Berhe Weldearegawi1
(berheph@gmail.com) , Fisaha Haile Tesfay1 (fisaha.1999@yahoo.com), Semaw Ferede Abera1
(semawfer@yahoo.com), Loko Abraham2 (lokab77@yahoo.com) , Alemseged Aregay3
(alex_aregay@yahoo.com) , Yemane Ashebir1 (yemaneph@gmail.com), Friehiwot Eshetu4
(ipk7@cdc.gov),
Ashenafi
Haile4
(hmx8@cdc.gov)
,
Yihunie
Lakew5
6
(yihunielakewt@gmail.com), John Kinsman (john.kinsman@epiph.umu.se)
Date: November 13, 2014
Previous title: Antenatal care and institutional delivery-unlinked maternal health care continuum:
evidence from community-based longitudinal study in Ethiopia
Corrected title: Poor linkages in maternal health care services—Evidence on antenatal care and
institutional delivery from a community-based longitudinal study in Tigray Region, Ethiopia
Journal: BMC pregnancy and childbirth
MS: 1121899263125482
We are really happy with the reviewers’ constructive comments. We would like to thank
them for their contribution to bring the paper in a better position. We can say that the new
version of the manuscript is much better than the previous ones. We have made also big
language editions with native speaker. We have made change on the topic to be “Poor
linkages in maternal health care services—Evidence on antenatal care and institutional delivery
from a community-based, longitudinal study in Tigray Region, Ethiopia”.
Below, we have addressed the questions and concerns point-by-point:
#-Reviewer’s concern
@-Responses/corrections made
Reviewer 1: Cheryl Moyer (1612305824140142)
Major Compulsory Revisions
#The introduction has been expanded to include new citations and a great deal more research
than the original version. However, now, it seems a bit disjointed and not particularly coherent.
As a reader, I want to see a story emerging about why ANC and facility based delivery are
important, why it matters if there is a gap between them, and what this study sought out to do to
demonstrate that. Instead I read a lot of statistics about how high or low it is in various countries.
I suggest the authors step back from the introduction and create an outline of the 'story' they are
trying to tell their reader. Create an outline to ensure that each paragraph only includes what it
needs to, and nothing else.
@All the comment is well taken and correction has been made based on the comments.
However, we have retained some of the evidences which we believe are important for
readers to get there in the background. Please look the new version of the manuscript.
#There are still a fair number of language issues. I am attaching a highlighted .pdf version that
shows various places where the verb doesn't match the noun in terms of plural vs. singular, etc.
These are only the ones I saw - I would encourage the authors to have a very detail-oriented
English speaker go through the manuscript very carefully.
@ The English is well edited by a detailed oriented English speaker in the current version.
All comments are also well taken.
#I still would have liked to have seen the authors address the implications more directly. From
Table 5, it looks like the women most likely to delivery in a facility were older, educated,
attended ANC, and yet had fewer children. What does this mean for programs and for policy?
Does it mean that special efforts ought to be developed to address younger, less educated women
with more children? Does it mean that perhaps we need to think about alternative strategies
beyond educating the women who DO come for ANC?
@In the current version of the manuscript, we have addressed this issue very well
considering practical point of view and implications.
Reviewer 2: Frédérique Vallières (1771036746134360)
Major Essential Revisions
# The manuscript still needs to be revised for grammar and language corrections.
@ The English is well edited by a detailed oriented English speaker in the current version.
All comments are also well taken.
Minor Essential Revisions
# The background section in particular needs to be revised for language and grammar.
@ The English is well edited by a detailed oriented English speaker in the current version.
All comments are also well taken.
# In addition to the stated study objectives it appears from reading the manuscript that the study
aimed to identify which factors predominantly determine greater ANC utilization and place of
delivery in this context. Though the authors refer to this objective in the discussion, it should be
made clearer from the onset that this is what the study aims to achieve.
@In the current version of the manuscript, we have included this point as “The objective of
the study was to assess ANC and institutional delivery service utilization and associated
factors in this part of northern Ethiopia, while also exploring the patterns and links
between ANC and institutional delivery.”
#The way the background section is organized makes it difficult to follow.
The authors may
want to consider including sub headings to (a) describe the current situation in Ethiopia in terms
of MNCH, identifying where the current gaps are and (b) compare this current situation to other
neighboring countries. In other words, what is the current situation in Ethiopia and how does this
compare to other countries?
@The issues that are mentioned in this concern are addressed very well in the current
version of the paper. In addition, some of the unnecessary statements are removed. Please
refer the current version of the paper. However, we didn’t include sub heading since it
doesn’t need as it stands in the current version.
Discretionary Revisions
Abstract
# Second sentence of Results section gives a percentage of 63927.1%
@ The comment is well taken. Correction made to be 27.1%.
#Conclusion
needs one sentence to summarise the implications for practice in this specific
context. “Clinicians practicing in Kilite-Awlaelo should be particularly vigilant to the additional
needs required for older, rural, less educated mothers”. Or something similar.
@The comment is well taken and we have made the correction based on the comment as
“Health service providers in Kilite-Awlaelo should be particularly vigilant regarding the
additional maternal health needs of rural and less educated women with high parity.”
Background Section
#First sentence requires a source.
@The comment is well accepted and the correction is made.
#Repetition of “of these deaths” in the second sentence
@The comment is well taken and we have made the correction accordingly.
#In
second sentence ‘didn’t’ should read ‘has not’ – in generally, avoid contractions in a
manuscript (see Predictor Variables paragraph)
@correction is made based on the comment.
#Last sentence of second paragraph needs rephrasing.
@ The comment is well taken and we have made correction accordingly.
Results
#The use of “terminated their pregnancy” in the first sentence may not be the best term to use
here.
@The comment is well taken. Changed to “Data were analyzed from 2,361 women who had
been pregnant and for whom there were records of the outcome.”