Reviewer ’s report  
 
Title: Predictors of contraceptive use among adolescent girls  and young women (AGYW) aged 
15 to 24 years in South Africa: results from the 2012 national population -based household survey  
 
Version: 0 Date: 31 Dec 2018  
 
Reviewer: Reynold Macrae  
 
Review er's report:  
 
Below  is my opinion about the manuscript and suggestions to the authors.  
 
 
Background  
 
The background makes a good case of highlighting the importance of contraceptive use in young 
(15-24 years) South African women and the need to address present challenges in im proving 
contraceptive use..  
 
 
Aim of study  
 
The aim of the study should be obvious in the initial part of the manuscript.  This highlights the 
main reason for performing the study. There is some reference to the aim of the study on page 5 : 
"To have improved  understanding of factors that influence contraceptive use among AGYW in 
order to strengthen current interventions."  
 
 
Objectives of study.  
 
The objectives are stated in the title but should also be explicitly described and obvious in the 
initial part of the   manuscript.  
 
 
Methods  
 
1. There is clear description of the target population.  
 
2. The National population based survey data is appropriate  as sampling frame, however the 
method of selecting the subsample of 3092 participants should be described. This sho uld include 
how the sample size was calculated. This will highlight attempts by the Authors to ensure that 
collected information is representative of the target population and limit sampling error.   
 
3. The survey instrument (questionnaire) relating to contraceptive use should be attached to the 
manuscript. This will help the reader determine if the questions addressed the objectives of the 
study. For example it will be useful to know if there are ques tions which determined  if married 
women who were not using contraception did so out of choice or lack of awareness.  
 
4. Appropriate use of multivariate logistic regression to explore the individual effects of a 
number of factors (socio -demographic and beh avioural) on contraceptive use in AGYW.  
 
 
Results  
 
1. There is need to mention the overall response rate of 47% (1460 women responded about 
contraceptive use out of 3092 participants).  
 
2. In Table 1 (Socio -demographic profile and contraceptive use), the n umbers and percentages in 
the study sample column seem to be swapped round and should be corrected.  
 
3. There is need for the authors to highlight the significant differences in response rates in the 
different sub -groups compared and the likely impact on r esults. Examples include:  
 
- 28% (454/1606) of 15 -19 year old women responded in comparison to 67.7%(1006/1486) of 
20-24year old women.  
 
-72% (101/140) of married women responded in comparison to 46% (1335/2874) of non -married 
women.  
 
-61% (489/801) of wom en with secondary education responded in comparison to 41% 
(764/1859) of women with primary or no education  
 
-50% (1074/2130) of black african women responded in comparison to 40%(384/955) of women 
from other races.  
 
 
Discussion  
 
Suggest the following:  
 
1. The authors should discuss their results in the context of the limitations of their study.  
 
2. There should be consideration of other possible explanations for their findings. Married 
women may not take up contraception due to choice rather than lack of awa reness.  
 
3. There should be a distinction between recommendations made from the findings of their study 
and other studies. While there may be an issue with access to contraceptive services in the rural 
areas, this study was not designed to investigate that factor.  
 
I will recommend a spell check.  
 
In summary, I accept for publication of the study if the recommendations are addressed. I am 
happy to consider alternative opinions from the authors.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported  by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
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 speci fy 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  
 
Decl aration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1.  Have you in the past five years received reimbursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation t hat 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 completing interests.  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is a ccepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecomm ons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal