Reviewer’s report
Title: 
Association between intimate partner violence and the use of maternal
health care services among married Malawian women
Version: 
0 
Date: 
20 Feb 2021
Reviewer: 
BEATRIZ AYALA
Reviewer's report:
Thank you for let me review this interesting manuscript. Please see below my
comments:
1. In the abstract:
a. IPV should be written in full the first time.
b. The authors should consider to show the results as: "Women who reported
experiencing any form of IPV had 35% reduced likelihood of delivering at a
health facility [aOR: 0.65; 95% CI: 0.45 - 0.94] or were 37% less likely [aOR:
0.63; 95% CI: 0.46 - 0.88] to have had skilled assistance during delivery
compared to those who never experienced IPV", instead of " IPV was negatively
associated with institutional deliveries [adjusted odds ratio (aOR): 0.65; 95%
confidence interval (CI): 0.45 - 0.94], and use of skilled assistants at birth [aOR:
0.63; 95% CI: 0.46 - 0.88]..
c. The conclusion of the abstract should also be related to the main findings of
the study.
2. In Methods:
a. Base on the Malawi Demographic and Health Survey 2015-16
(file:///D:/BMC_R/Jan%202021/DHS%20Largo.pdf), there was "In total, 6,379
women received the domestic violence questions. About 4% of women eligible
for the domestic violence module could not be successfully interviewed because
of privacy or other reasons". It would be important to know why the sample size
was 2712 participants, and this explanation may added or considered as a
limitation of the study.
b. According to the WHO, it has been recommended at least eight ANC
(antenatal care) contacts during pregnancy to improve perinatal outcomes
(https://apps.who.int/iris/bitstream/handle/10665/259947/WHO-RHR-18.02-
eng.pdf;jsessionid=8113365FD531F62F7E18F3585CC01880?sequence=1).
Then, the authors should consider this recommendation to establish the definition
of adequate or inadequate antenatal care, and this should be changed throughout
the manuscript accordingly (Methods, Results, Discussion and so on), including
in the models. 
c. Why about parity? Parity should be a variable included in the study and then 
it
should be part of the models?
d. For the variable "Skilled assistance during delivery", does this include any
type of deliveries?. It would be interesting to show the type of deliveries in the
manuscript.
e. Is it possible to know how many institutional deliveries were skilled assistance
during delivery? It is likely that all institutional deliveries were under the
category of skilled assistance during delivery so that I wonder how it would be
possible to differentiate those variables among this population of women.
f. Was it not possible to create one model with all the variables? However, this
should require testing for interactions.
g. Could the authors clarify if the IPV (Composite) means women who reported
experiencing of domestic violence in at least one type of domestic violence?
3. In discussion:
It should be considered that there are other negative repercussions of IPV during
and after pregnancy, which should be considered when further policy/program
would be implemented in Malawi 
4. In the parts written as "insignificant", it should be described as "no
significant".
5. What does it mean "TBAs"?
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
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