Reviewer ’s report  
 
Title: Factors influencing use of long -acting versus short -acting contraceptive methods among 
reproductive -age women in a resourc e-limited setting  
 
Version: 0 Date: 03 Nov 2015  
 
Reviewer: Kirsten Black  
 
Reviewer's report:  
 
This is an interesting article which is I believe is worthy of publication. However,  I consider that 
it requires attention to some issues before been published.  
One of the key issues that needs fixing is the definition of long term and s hort term contraceptive 
methods. Firstly the standard definition is long acting reversible contraceptive methods. In the 
text the long term methods are defined as IUDs or implants. In the qualitative interviews the 
injections is referred to as a long term method. In the table the long term methods listed include 
sterilization (which should be excluded as not reversible) but there is no mention of IUDs. This 
all needs clarification.  
 
ABSTRACT  
The abstract need to define what you mean by long and short term methods as above.  
 
BACKGROUND  
In the introduction again please define LARC methods and short term methods. Please note that 
the statement about short term methods in low resource settings is the same for all settings. The 
Contraceptive CHOICE study should be cited as evidence that long acting reversible methods 
(LARC) are better in all settings in terms of efficacy and cost effectiveness because they reduce 
unplanned pregnancies. Is contraceptive use low in all low resource settings? Some countries 
have mad e good in  
 
RESULTS  
The qualitative data is well presented with the exception of some confusion around method 
types.  
The quantitative data sample size is small and there were no significant findings with regression 
so I would not present the regression tab le.  
You may like to present Table 2 as figures (bar charts?).  
 
DISCUSSION AND CONCLUSION  
The discussion requires some refinement.  For example, the arguments in paragraph 2 on page 19 
do not make sense to me.  Use of long term methods does not mean no further children are 
desired, only that greater control over fertility and less dependence on  user compliance.  
Similarly the conclusion needs further consideration.  LARC methods are highly acceptable if 
good counseling is undertaken. User controlled LARC methods are difficult to conceive of 
because what makes them effective is that they are not user dependent. Thus there is no option 
for individual error in administration.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
 
Declaration of competing interests  
Please complete a declaration of competing i nterests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to t he content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
Nil 
 
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