Reviewer ’s report  
 
Title: Pattern and correlates of out -of-pocket payment (OOP) on female ster ilization in India, 
1990 -2014.  
 
Version: 2 Date: 02 Dec 2019  
 
Reviewer: Antoinette D.I. Van Asselt  
 
Reviewer's report:  
The manuscript has improved substantially since the las t version. In the results section there still 
seem to be some minor language issues, in the sense that how these are presented on p15, they 
are quite confusing. On p15 it is stated that over 90 percent of the female sterilizations were 
carried out in publi c health centers in Chandigarh etc. Next sentence then goes on to state that on 
the other hand, more than 25 percent of female sterilizations were conducted in private centers in 
Kerrela etc. When phrased  alternatively it would be more clear what is seen from figure 3, for 
instance like this: In Chandigarh, .... and Pondicherry, over 90% of the female sterilizations were 
carried out in public healthcare centers. On the other hand, in Kerala, ... and Daman and Diu, 
over 25% of female sterilizations were car ried out in private health care centers.  
A question that came to mind while reading the results: is there any information on the absolute 
number of female sterilizations in India over the years and per state? It seems (but maybe I 
overlooked) that all is relative and percentages only. Could in so me way this information be 
added to the figures that are already there?  
 
minor edits:  
- p13 line 41: one of the preferred method - should be methods  
- p14 line 29 (header): India and the States - the States is not self -explanatory. Should change 
this int o something like 'States of India'  
p14- also, would it be a good choice to call the different types of centers a 'source' ? I would 
prefer to make this something like; Female sterilization per type of facility in India  
And then after, in lines 30 -40 it wou ld be 'trends in female sterilization by type of facility in 
India' (line 30) etcetc.  
- p17 line 14: Majority of - 'The majority of'  
- p17 Appendix  and 2 - would it make sense to discuss extensively the contents of an appendix 
in the main text of the pap er? 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
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.  
 
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:  
 
Acceptable  
 
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 
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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?  
 
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below. If your reply is yes to any, please give details below.  
 
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