Reviewer ’s report  
 
Title: Unintended Pregnancy and Subsequent Postpartum Long -acting Reversible Contraceptive 
Use in Zimbabwe  
 
Version: 0 Date: 07 Mar 2018  
 
Reviewer: Gretchen S Stuart  
 
Reviewer's report:  
 
The authors present a descriptive study of women in 5 areas of Zimbabwe.   
Ethical approval wa s obtained and is reported.  
 
There are some major weaknesses in the paper:  
1. The background needs to be more clear regarding the population of interest in the study.  was 
it HIV positive women?  All women?  
 
2. Lines 47 -50 - too many broad objectives are sta ted here.  Please focus on one objective - 
overall this will make the paper much more impactful and readable.  
 
3. Overall the methods could be written more clearly.  Please clearly state if this study was 
designed as a substudy of the primary study?  Or was  this a secondary data analysis of data 
already collected?  Was this a planned sub -analysis of the primary study?  
 
4. The authors state that surveys were collected of mother -infant pairs.  yet none of the data 
reported are from the infant.  It seems the imp ortant defining characteristic of the women in 
the study was that they were postpartum.  
 
5. The paper would be much stronger if the authors used the STROBE guidelines when 
designing the study, or when writing the paper.  
STROBE Statement:  von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting 
of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting 
observational studies. Int J Surg 2014;12:1495 -9. 
6. Lines 50 -59 in the results section.  The high proportion of wome n who were using LARC at 
the time of their conception of the unintended pregnancy suggests that this population had 
easily available reproductive health care.  Please check the statements here because the 
authors write that a disproportionate number of wom en were using contraception at the time 
they got pregnant.  This suggests either oversampling women using contraception, or 
oversampling diagnosed pregnancies.  
 
7. Overall this is a localized population.  the authors should include information in the 
discus sion that compares or contrasts this population with overall population.  What is the 
generalizability of the major findings?  
 
8. There should be more comparing and contrasting of the findings in this paper with published 
literature on contraceptive switchi ng and use of postpartum contraception.  
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 manuscript 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 recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Not suitable for publication unless extensively edit ed 
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way g ain 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 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 I have no competing interests  
 
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on my report to the authors and, if the manuscript is accepted for publication, my named report  
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