Reviewer’s report
Title: Women’s empowerment and fertility preferences in high fertility countries in Sub-Saharan Africa
Version: 0 Date: 17 Jul 2018
Reviewer: Eliud Wekesa
Reviewer's report:
Manuscript. No.: BMWH-D-18-00265
Title: Women's Empowerment and Fertility in Sub-Saharan Africa
 By Esso-Hanam ATAKE
General
I have reviewed the above manuscript. The paper has potential with several points of interest on a topic  
that is of interest to this journal, and the population and public health audience.  However, I have a  
number of concerns that should be addressed to improve the manuscript before it can be published. My  
verdict is Major Revision.
 Title: 
The title is too broad and unclear in the present form. There is need to be specific to desired fertility in  
high fertility countries in SSA. The use of the term fertility is problematic because it implies actual  
fertility (TFR) and yet yours is just fertility preferences (ideal number of children. You need to replace  
it with desired fertility throughout the text.  
Abstract 
You need to say something about high fertility countries or lagging fertility transition countries in SSA  
in the background. Your study countries fall in this category.
Background
The background is quite modest in respect to literature review and thus misses a number of important  
points.  First, What are the gaps in the literature that your study is addressing? There are several studies  
on this topic and the reader is also interested in the "catch" and value addition of the paper. The author  
should examine similar studies on the topic and their shortcomings, and hence justifying the study.
  Second, the author is interested in understanding how greater relative power ( empowerment) of  
women allows them to execute  their fertility preferences within the marriage irrespective of men's  
preferences. There is need for the author to place this study in the broader context of the female  
autonomy  and  fertility  literature.  The  study  would  thus  greatly  benefit  from  some  demographic  
literature on women and autonomy and fertility/reproductive health. There also the need to include the  
demographic literature on the measurement the ideal number of children and its shortcoming of being  
an abstract notion.
 
Third, the high fertility ( TFR) in the study countries should be placed in the broader context of fertility  
transition  in  Africa  and  elsewhere.  The  author,  should  therefore  average  TFRs  for  SSA,  other  
developing country regions and the world.
 
 What does the author mean by "taking into account the cultural, economic, social and demographic  
dimensions of gender" Are these control variables? Why not just say you are controlling for socio-
economic and demographic characteristics.
 I am not sure it is factually correct to say that "poverty" in Africa makes child control both individual  
and collective. The author should rephrase the appropriate sentence.
Methodology
 The author should start with a section on the data sources before going into variable descriptions.
The author should explain how his measurement of women empowerment is an improvement on the  
DHS indicator of women empowerment (autonomous decision making and acceptance of wife beating)
The author should move the first 2 paragraphs on explanatory variables to the background; they are  
more relevant for the literature review section. The same applies to most of the stuff on control  
variables. I expected to read such stuff in the lit review.
 The author should justify the focus on 35 and above year old women? Why not on all married women  
since you are controlling for the number of living children?
The author should define  Economic , social-cultural and familia empowerments here.
 
Results
 Rephrase this statement "According to Table 2, for all women aged 35 and over, the average ideal  
number  of  children  is  24  6.91,  6.72,  10.24  and  9.53  in  Burkina  Faso,  Mali,  Niger  and  Chad,  
respectively"
 
Who are these men that you are comparing with women? Are they husbands? Do we have couple data?
What does a positive and negative empowerment index mean to a lay reader?
 Table 4: are they beta coefficients or odds ratio? This should be reflected in the title.
Table 4: The title suggests linear regression while in the text you talk of logistic regression?
Table 5: The presentation of the results in the text is not clear. Please expound.
Table5: Is it possible to have negative odds ratios?
Discussion
 The question that remains unanswered is this: Is more empowerment of Burkina Faso and Chad  
women reflected in their ability to achieve their reproductive/ fertility preferences? Explain your  
answer to this question.
 
It is surprising that the reader only gets to understand the description of different components of  
empowerment in the discussion section.
Rephrase this statement "While fertility is under control in some countries, it is a factor that influences  
women in other countries where high fertility is regarded as particularly valuable"
Several statements in the discussion need to be supported by appropriate references.eg "societies give a  
higher social rank, greater privileges and greater authority to women with many children" and many  
more in the section.
 What do you mean by "This result suggests that one of the ways of significantly curtailing fertility in  
sub-Saharan Africa would be to promote social policies in education for married women and their  
spouses". Are you suggesting that married couples should go back to school or adult education or what?
Limitations
You also acknowledge the shortcoming of the measurement of ideal number of children. It has various  
biases. 
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.
Unable to assess
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 interests, 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  the  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.
I declare that I have no competing interests
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