Reviewer ’s report  
 
Title: Family Planning Use and Associated Factors amon g Pastoralist Community of Afar 
region,  Eastern Ethiopia  
 
Version: 0 Date: 01 Jan 2016  
 
Reviewer: Tesfaye Regassa Feyi ssa 
 
Reviewer's report:  
 
Thank you for giving me a chance to review a manuscript entitled "Very Low Utilization of 
Family Planning Use in Pastoralist Community of Afar region, Eastern Ethiopia." The following 
are my comments:  
 
 
1. On the title  
 
The titles given on first and second page are not matching. I prefer the title to be "Family 
Planning Use and Associated factors among Pastoralist Community of Afar region, Eastern 
Ethiopia: A community based cross sectional study, January 2013."  
 
 
 
2. On the abstract Section  
 
The paragraph needs rewording and the use of symbols also needs reuse. E.g. in line 11 -12 no 
need of using comma between family planning and utilization. The background section of the 
abstract lacks strong justification behind t he study. Line 25 under planning methods where 
instead of were…. needs edition. The methods section of the abstract lacks study period. 
Conclusion needs rewriting and no recommendation is stated in the abstract session. In the result 
abstract State CI afte r the prevalence of Family planning utilization.  
 
 
The other issue related to family planning. is the family planning modern or traditional, short or 
long, natural or artificial? This needs clarification. Likewise, Is the study among married, single 
women or  both? When do we say Very Low Utilization of Family Planning Use in general and 
particularly in Ethiopia?  
 
 
3. On the Introduction Section  
 
Better to include  about national reproductive strategy of Ethiopia (2006 -2015) in this  section 
which aimed to improv e contraceptive use and designed to give special focus to  pastoralist 
communities not  only  in  Afar region  but  also  the other parts of the country. Need strong 
justification.  
4. On the Methods Section  
 
In the study setting, I recommend the title to 's tudy area and period' be the first sentence should 
begin as "Afar region is one of the nine regions of Ethiopia…". Here do Ethiopia has eleven 
regions? It is not. Ethiopia has nine regions and two administrative towns. Line 38 'In addition, 
the parameters of…" as to my suggestion it is better to say "with  the assumption of…". You 
didn't describe kebele as smallest administrative unit in Ethiopia.  
 
 
In the sample size and sampling technique if "used with the assumption of 9.1% FP utilization in 
the region fr om the preceding EDHS report [7]. In addition, the parameters of 95% confidence 
level and 3% degree of precision and design effect of 1.6, to decrease the variability that might 
be introduced because of the sample complex, were assumed to compute the sampl e size. To 
compensate the expected non -responses, we added 10% of the calculated sample size, amounting 
the total sample size to 615" might be incorrect. It gives 621. But it is not clear why you used 
design of effect of 1.6, how many stages were there, ho w you select the stages? Did you 
considers the factors to calculate sample size?  
 
What were the challenges not to translate to local language of the region? I doubt that all data 
collectors would able to use proper same language during data collection. If this is so  I doubt  
the quality of data as the primary  data collectors  were not native speakers of  the questionnaire 
language( Amharic) and as the questionnaire itself wasn't  translated  to Afarigna.  
 
 
5. On the Result Section  
 
In the reproductive charac teristics of women part of result section line 32 you better reword the 
resentence as "The mean age at marriage 15.72 years (SD=2.7) and first birth was 16.9 years  
(SD=2.8) respectively". In line 33" Experience of abortion was reported among 112 (18.6%) o f 
the respondents". My question here is what is Experience of abortion means? Is that once? 
twice?...or….?. Similarly, in line 35 -37 "history of child death, of which 8(25%) had two or 
more child deaths ".The same way my concern here is what is child death  means? Is neonate, 
infant, preschool children, school age children? ...or….?.  
 
Better to omit "A small number "way of describing in result section. In most of the results you 
fail to describe frequency and percentage e.g. 150 (40.2%). I want to remind you to thoroughly 
address the issue throughout the manuscript.  
 
In the attitudes of married women towards contraceptive utilization part of result section   you 
stated partner's knowledge, discussion and approval of contraceptive use. Nevertheless, you 
better h a other separate part to describe characters related to partner.  
 
In determinants of family planning, utilization parts of result section you better separate predictor 
variables associated in bivariate and multivariate logistic regression analysis.  
The second paragraph of "determinants of family planning, utilization" needs rewording 
correctly and I recommend not using the same word like "odds" repeatedly in one paragraph. 
Actually it is odds ratio rather odds. Please restate  
 
 
 
6. On the Discussion Sec tion 
 
The second line in the discussion section and the first paragraph of "determinants of family 
planning, utilization" are the same better not to mention the discussion section.  
 
The first paragraph of discussion has no discussion comparing with other fin dings. i.e. the 
proportion  of  FP  users  in  Afar  region  was  8.5%. Was not discussed why it is so. What is the 
importance of putting "Moreover,  this  study  was  conducted  in  a  rural,  remote,  pastoralist 
community where almost all (98.8%) were M uslims and 90% were unable to read and write" . 
Has no coherence with the previous sentence.  
 
The same paragraph you didn't compare and explain why early marriage is practiced in the area. 
What is your possible reason for practicing   early marriage in Afar ? 
 
 
 
7. On the Acknowledgements Section  
 
The support of AMREF Ethiopia should be clear is that financial?  
Thank You!!  
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work inc lude 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 t o 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 asse ss 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 qu estions:  
 
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 com peting 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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