Reviewer ’s report  
 
Title: Feasibility and acceptability of using Medical and Nursing Students to provide Implanon  
NXT at the community level in Kinshasa, Democratic Republic of Congo  
 
Version: 0 Date: 20 Sep 2018  
 
Reviewer: Finn Egil Skjeldestad  
 
Reviewer's report:  
 
This prospective caseserie of 541 women, large sample size, undertaken in Kinshasa, Democratic 
Repbulic of Congo, provides data for community based distribution of an implant by medical 
and nursing school students. The study is well organized and well written. The study documents 
that medical and nursing students can do an excellent job as family planning providers.  Included 
were women who choose Nexplanon as their contraceptive method, and were willing to complete 
follow -up at 6 and 12 months.  
 
The abstract needs a clear aim of th e study.  The second sentence in Background is more a 
conclusion and can be replaced by a Clear aim.  
 
The inclusion period was November 2016, 6 months follow -up in May 2017, so when was 12 
month follow -up done?  Where there any data at baseline on "menstrua l history"?  
Where any pregnancy tests offered at baseline?  The 6 pregnancies during first 6 months needs 
some additional information.  The group of "frequent/Heavy bleeding" need a defintion?  
Is this information just "face value" or is it recorded through  use of knowledge truse postings, 
binds, diapers?  The number of women With "frequent/Heavy bleeding" is considered high on 
implants!(?). As bleeding may be a risk factor for STD, or will have an impact on sexual 
pleasure/frequencey is not discussed.  
 
Table 1 is very illustrative for informatioin on the women lost -to-follow -up.  It will add 
valueable information to the readers to see the same information in Table 2.  
 
A follow -up rate above 80% at 12 -months is acceptable.  The continuation rate at 12 -month o ver 
93% is good.   This reflects that the women accept the contraceptive method despite all side 
effects.  
 
The refernece list is rather short - there are more updated publications on implants.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the a uthors.  
 
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 manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects req uire 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:  
 
Acceptable  
 
Declaration of competing interests  
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