Peer Review Process
The decision to publish a paper is based on an editorial assessment and peer review. Initially all papers are assessed by an editorial committee consisting of 2 or more members of the editorial team. The prime purpose is to decide whether to send a paper for peer review and to give a rapid decision on those that are not.
Editorials and Letters may be accepted at this stage but in all other cases the decision is to reject the paper or to send it for peer review. Papers which do not meet basic standards or are unlikely to be published irrespective of a positive peer review, for example because their novel contribution is insufficient or the relevance to the discipline is unclear, may be rejected at this point in order to avoid delays to authors who may wish to seek publication elsewhere. Occasionally a paper will be returned to the author with requests for revisions in order to assist the editors in deciding whether or not send it out for review. Authors can expect a decision from this stage of the review process within 2–3 weeks of submission.
Manuscripts going forward to the review process are reviewed by members of an international expert panel. All such papers will undergo a double-blind peer review by two or more reviewers, plus an Associate Editor. We take every reasonable step to ensure author identity is concealed during the review process but it is up to authors to ensure that their details of prior publications etc. do not reveal their identity. Authors who reveal their identity in the manuscript will be deemed to have declined anonymity and the review will be single blind (i.e. authors do not know reviewers' identities).
We aim to complete the review process within 4 weeks of the decision to review although occasionally delays do happen and authors should allow at least 6 weeks from submissions before contacting the journal. The Editor-in-Chief reserves the right to the final decision regarding acceptance. 

Reviewers Role
Reviewers are the main members contributing for the benefit of the journal being a peer reviewed (double-blind referee) journal they are insisted not to disclose their identity in any form.
A reviewer should immediately decline to review an article submitted if he/she feels that the article is technically unqualified or if the timely review cannot be done by him/her or if the article has a conflict of interest.
All submissions should be treated as confidential, editorial approval might be given for any outside person’s advice received.
No reviewer should pass on the article submitted to him/her for review to another reviewer in his own concern, it should be declined immediately.
Reviewers being the base of the whole quality process should ensure that the articles published should be of high quality and original work. He may inform the editor if he finds the article submitted to him for review is under consideration in any other publication to his/her knowledge.
There are no hard and fast rules to analysis an article, this can be done on case-to-case basis considering the worthiness, quality, and originality of the article submitted.
In general, cases the following may be checked in a review:

• Structure of the article submitted and its relevance to author guidelines
• Purpose and Objective of the article
• Method of using transitions in the article
• Introduction given and the conclusion/ suggestions provided
• References provided to substantiate the content
• Grammar, punctuation and spelling Plagiarism issues
• Suitability of the article to the need

A reviewer’s comment decides the acceptance or rejection of an article and they are one major element in a peer review process. All our reviewers are requested to go through the articles submitted to them for review in detail and give the review comments without any bias, which will increase the quality of our journal.

Guidance for Peer Reviewers
All manuscripts are double-blind reviewed. At Journal of Health System Research we believe that peer review is the foundation for safeguarding the quality and integrity of scientific and scholarly research.
As a reviewer you will be advising the editors, who make the final decision (aided by an editorial committee for all research articles and most analysis articles). We will let you know our decision. Even if we do not accept an article, we would like to pass on constructive comments that might help the author to improve it.
All unpublished manuscripts are confidential documents. If we invite you to review an article, please do not discuss it even with a colleague. When you receive an invitation to peer review, you should fill the journal’s reviewing form. You should try to respond to every peer review invitation you receive. If you feel the paper is outside your area of expertise or you are unable to devote the necessary time, please let the editorial office know as soon as possible so that they can invite an alternative reviewer – it as at this stage you may like to nominate an appropriately qualified colleague. And please remember, if an author's manuscript is sitting with reviewers who have not responded to the peer-review request, the author will not get a timely decision.
Please read the Aims and Scope and the Author Instruction with care. Consideration should be given to whether the paper is suitable for the journal it is submitted to. The journals' aims and scope is available on “Journal Information” menu and pages.
The essential feature of any review is that it is helpful and constructive and we urge reviewers to be robust but polite when making comments to authors. The Peer reviewers should provide an objective critical evaluation of the paper in the broadest terms practicable. Reviewers need to make a recommendation to the Editor-in-Chief on deciding the manuscript. Your report must contain your detailed answers on the journal questions in the reviewing form. If you believe the paper needs revisions to be made before it is acceptable, please make suggestions on how to improve the paper. Likewise, if you feel that a paper is not good enough and has no real prospects of being improved sufficiently to be published you should recommend rejection.
Reviewer Score Sheet is seen by the editors only and the comments will be shared with the authors. 
 
Article Reviewing Procedure
 
Privacy and Confidentiality

(Prepared Based on ICMJE's Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals)
In Journal of Health System research, manuscripts must be reviewed with due respect for authors’ confidentiality. In submitting their manuscripts for review, authors entrust editors with the results of their scientific work and creative effort, on which their reputation and career may depend. Authors’ rights may be violated by disclosure of the confidential details during review of their manuscript. Reviewers also have rights to confidentiality, which must be respected by the editor. Confidentiality may have to be breached if dishonesty or fraud is alleged but otherwise must be honored.
Editors must not disclose information about manuscripts (including their receipt, content, status in the reviewing process, criticism by reviewers, or ultimate fate) to anyone other than the authors and reviewers. This includes requests to use the materials for legal proceedings.
Editors must make clear to their reviewers that manuscripts sent for review are privileged communications and are the private property of the authors. Therefore, reviewers and members of the editorial staff must respect the authors’ rights by not publicly discussing the authors’ work or appropriating their ideas before the manuscript is published. Reviewers must not be allowed to make copies of the manuscript for their files and must be prohibited from sharing it with others, except with the editor’s permission. Reviewers should return or destroy copies of manuscripts after submitting reviews. Editors should not keep copies of rejected manuscripts. Reviewer comments should not be published or otherwise publicized without permission of the reviewer, author, and editor.

COPE’s Guidelines & Flowcharts
The Journal of Health System research is committed to follow and apply guidelines and flowcharts of Committee on Publication Ethics in its reviewing and publishing process and issues.

International Standards for Authors and Editors
Journal of Health System research is committed to follow and apply International Standards for Authors and Editors of Committee on Publication Ethics in designing and leading the Journal’s reviewing and publishing process and dealing with their issues. You may find the International Standards for Authors, here. 

Conflict of Interest in Reviewing Process
Although we are applying double bind peer review, research sphere can be a small world. It means many reviewers may know the author out of familiarity with their work. You can certainly give a fair assessment of an article that is written by a friend or competitor, but:

• If there’s a significant conflict of interest, you should reveal this to the editor
• If the conflict of interest causes a large positive or negative bias, then it is better to decline the review request.
• Avoid personal judgement and criticism at all times – judge the article. This is more likely to be well received by the author and lead to better work by them.
• Every editor will appreciate honesty about conflicts of interest, even if they then have to look for a replacement reviewer.

Please email the Editorial Office at the journal formal email, if you have any concerns about conflict of interest or ethical issues with the paper.