Reviewer’s report
Title: 
Self-administered subcutaneous medroxyprogesterone acetate for
improving contraceptive outcomes: a systematic review and meta-analysis
Version: 
0 
Date: 
12 Jul 2021
Reviewer: 
Ines Velasco
Reviewer's report:
Dear Authors, 
I have had the opportunity to read your manuscript entitled: "Self-administered
subcutaneous medroxyprogesterone acetate for improving contraceptive
aoutcomes: a systematic review and meta-analysis" submitted to BMC Women's
Health in order to be considered for publication.
The role of self-administered contraceptives is particularly important in terms of
Public Health, as well as a valuable tool for female self-empowerment. In this
regard, this systematic review and meta-analysis is certainly interesting and
relevant. You have carried out an oustanding and updated meta-analysis,
following a rigorous methodological procedure, and providing us with
exhaustive explanations regarding your decissions. 
I have just a few comments to make: 
 The introduction may be improved, including a clear description of this
contraceptive method, adding information and references concerning:
o The effectiveness of this method in terms of: pharmacological effect, safety,
easiness to use, and so on.
o The comparison of benefits/disadventages with other similar methods
(intramuscular injection, or subcutaneous implant).
o The impact of self-administration in women's life, health care systems and
society. 
 Please review the writing style: it is difficult to catch the full meaning of
sentences like "It also providing (line 32, page 4) "Humanitarian crisis where
health infrastructure is disrupted or as part of preparedness" (lines 1-2, page 5).
"Little rigorous updated synthesized evidence" (line 13, page 5)
 Finally, try to avoid some judgments/opinions about other studies: It is a bit
shocking to find the word "rigor" in line 26, page 15. 
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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?
Yes
Are the methods sufficiently described to allow the study to be repeated?
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Yes
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No
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from apparent manipulation?
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