Revi ewer’s report  
 
Title: Determinants of Family Planning Use among Ma rried Women in Bale Eco -Region, 
Southeast Et hiopia: A Community Based Study  
 
Version: 1 Date: 04 Feb 2018  
 
Reviewer: Morounfolu Thompson  
 
Reviewer's report:  
 
Abstract  
 
This is appropriate in the main, however there are far too many abbreviations which are only 
defined further along in the body of the study text. The abstract should be re -structured to retain 
adequate summarisation of the study while being brief enough to  remain within the word count 
limits. In essence it is a cohort study exploring modern contraception in the community base and 
reasons for acceptance or rejection. The authors may wish to clarify their statement that "Family 
Planning is a way of controllin g fertility by giving couples the ability to have desired family 
size" because their qualitative study results suggest that there may be spousal differences in 
desired family size.  
 
 
P2.Lines 2 -3. Abbreviatio ns should be avoided in the abstract except for u niversally accepted 
ones.  
 
 
P2 Lines 6 -7, EDHS and BER.  
 
 
It is noteworthy that the study objectives are clearly outlined on P2, Line 9 and the authors 
mention the use of previously validated questionnaires.  
 
 
 
Background  
 
This includes most of the consideratio ns for undertaking such a study but needs to be more 
focused as there are a few unnecessary references.   
 
 
Abbreviations used on P2, Line 16 should be avoided or explained , similarly , P4 Line 15, - 
HEWS  
 
 
P2, Line 25 and P10, Line2 - Grand Multiparity is no t defined by seven children but as more than 
five (pls refer to Solomons, B. The dangerous multipara. Lancet 1934; 2:8.).  
 
 
P3, Line 18 - It is commendable that the study authors acknowledge the fact that barriers to 
community family planning have previously  been studied and examine factors previously 
reported in other regions and countries.  
 
 
P5 Line 5 - conception, preconception or notion, (not commencement), because (not since)  
 
 
Methods - Study Setting, Study Population, Data Collection Tools and Procedures  
 
 
The study zones and sampling methods are very well described (P5 -7) for this descriptive cohort. 
The statistical analysis also appears to be well -rounded.  
 
 
There are however a few minor issues with grammatical tense and structure to improve;  
 
 
P6, Line 3. In tra-uterine contraceptive devices are (not is)  
 
 
P6, Line 12. The word "considering" should be deleted, being tautological  
 
 
P6, Line 15. Leaders (not leader), also Lines 7, 15 why married "males and women"? (Why not 
just "married couples")  
 
 
P6, Line 17. A mul tistage (not multistage)  
 
 
P7, Lines 4, 5. Is there a possibility that the FGD was subject to bias with its selection based on 
"who could give the most and best information about communities' contraceptive practice"  
unlike the extensive sampling methodology  described earlier in selecting the couples ?. Pleaese 
explain.  
 
 
P8, Lines 5 -6. Barriers to (not of)  
 
 
P9, Line 11. Wished, (not wish)  
 
P9, Line 14. "Giving" or "making", (not "which made")  
 
 
P9, Line 15, 16.  The whereabouts of the absent non -responders might b e related to socio -
economic or public health factors and could have been further explored  
 
 
P9, Line 19, 20. The different religions stated among responders could have been compared with 
the local or national background rates for interest  
 
 
 
Results  
 
There is a  good sample size of 567 women with a fairly good response rate reported.  
 
 
P9, Line21 -23 The $ per household income rates (58.9% earning above $440) stated for an 
agrarian region in the developing world appeared high, possibly at variance with the stated l ack 
of formal education in 64.6% of the women. However, in keeping with latter, the authors clearly 
described how the interviews were conducted in local languages by trained moderators. (One of 
the poorer areas in the world and a region where 86% of income  is derived from agriculture - 
World Bank Reports, 2015)  
 
 
 
Discussion  
 
There are a few more minor alterations here as in previous sections.  
 
 
P15, Line 17. "Supports" (not "agrees") the argument.  
 
 
Cogent reasons are proposed to explain why uptake of implants a nd oral family planning 
methods are half that of injectables, and LARCS usage is low.  
 
 
Referencing is good, with relevant comparisons in the study write up.  
 
 
The incidence of multiparity > 7 births being so high (24.6%) in a cohort with a mean age of 
30.5 ye ars, and with close to half of all the pregnancies being unplanned, underscores the prime 
importance of improving family planning in this region.  
 
 
P12, Line 3 -4. The reasons for the difference in percentage distribution of the women in the 
different altitu de zones and why they considered zoning may have been relevant to family 
planning in the area was not explained, and may have been of interest.  For example it is 
documented that the majority of the population here also live in the highland area where its good 
rainfall, moderate temperature and soil are favourable for crop and livestock production 
suggesting proportional representation in this study, however there could be other interesting 
reasons.  
 
 
A suggestion to the authors would have been to separate t he quantitative and qualitative aspects 
of this study prior to submission, applying a more extensive, possibly phenomenological 
approach to the qualitative aspects of their data.  
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does th e 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.  
 
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 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  
 
 
 
 
 
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, 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 receiv ed 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 i n 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 competing interests  
 
I agree to the open peer r eview policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publicat ion, 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://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included a s confidential comments 
to the editor s, which will not be published.  
 
I agree to the open peer review policy of the journal