Reviewer’ s report
Title: PREV ALENCE AND DETERMINANTS OF UNMET NEED FOR CONTRACEPTION
IN NORTH GONJA DISTRICT, GHANA
Version: 0Date: 13 Dec 2019
Reviewer: Margareta Larsson
Reviewer's report:
Comments
In general a well written paper, but could benefit from some revision.
Background:
I question the statement that pregnancy and childbirth are the leading causes of mortality,morbidity and disability among women of reproductive age. The reference is almost 10 years oldand the statistics it builds on even older. I think newer data about causes of death show anotherpicture. Please check and correct. It could simply be solved by stating that; pregnancy andchildbirth are important causes of…
You use the terminology developing country, which is often questioned, since all countries are
developing in different ways. More correct would be low-income countries.Please explain better the health system organization and especially the access to FP services in thecountry as a whole and in the study setting. Which FP methods are available where and by whathealth care providers. Costs for accessing services and for the different methods?
Methods:
Not necessary to state that it is an analytical study.I miss a rationale for choosing this particular setting for the study. Please also describe somenational health statistics compared with those from this particular setting.Your power calculation was based on 50% assumed prevalence of unmet need for contraceptionbut the DHS had lower numbers. How come? Describe your reasoning.I also miss some information about how many women were approached, how many could not bereached and how many declined. Were there any drop-outs or excluded cases based on incompletedata?Under study variables: The proportion of fecund… How could you determine that they were
fecund?
Results:
I do not understand the folllowing sentence and i do not see it refelcted in the table. Please clarify:"62.8% of those who gave method related reasons attribute non-use to fear of side effects, and55.9% of those who cited opposition to use reason attributed non-use to fear of side effects ofcontraceptives."
Discussion
The results are not surprising but the fact that education plays a vital role could be more expanded
on. Ensuring access to education for all girls in a country is probably the very best intervention forimproving maternal and child health. How is this ensured in Ghana and in this region in particular?What about public/private schools? School fees? Can more be done to get all girls to school?Since there is no information about current access to services and methods it is difficult to asseswhether any improvements in FP services could be suggested. In the conclusion you state that FPmessages should be strengthened. But what about services?Limitations? I do not see that the authors have discussed any limitation? Discuss issues ofsampling procedure, instruments, data collection and data collectors etc. Are results possible to
generalize to other settings? Discuss also strengths with the study.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
YesDoes the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Unable to assessAre 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 furtherassessment in your comments to the editors.
I am able to assess the statisticsQuality of written English
Please indicate the quality of language in the manuscript:
AcceptableDeclaration of competing interests
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