Reviewer's report
Title:A Scoping Review on Determinants of Unmet Need for Family Planning
among Women of Reproductive Age in Low and Middle Income Countries
Version:1Date:24 September 2015
Reviewer: Mellissa Withers
Reviewer's report:
REVIEW OF “A SCOPING REVIEW ON DETERMINANTS….”
DISCRETIONARY:
The topic of the paper is an important one. Reducing unmet need for family
planning requires much more attention, especially in LMICs. Understanding the
determinants that are associated with unmet need is critical to meeting this need
and will have major implications in terms of women’s health. While not
completely innovative or surprising, I feel that this study does make an important
contribution to the literature and should be published with some revisions.
The title is good. The abstract makes sense. The objectives are well-described.
The writing is clear and concise. The rationale is clearly stated and is compelling.
Overall, I found it to be easy to follow and well-written.
The methodology was well-described and easy to follow. They also seemed
appropriate.
The associated chart is very detailed and informative. I think this will be useful for
the audience.
MINOR:
In the first sentence of the introduction, the authors say that unmet need is
related to not having “access to consistent use of family planning methods.” I am
not sure that this is true. There are plenty of examples where women do have
access but experience many other barriers that are more socio-cultural. So I
think this sentence needs to be changed.
I liked the explanation of the way in which the measurement of unmet need for
FP has changed over time. I also liked that the authors differentiate between
unmet need for spacing and for limiting. These categories are often just
combined but have very different policy considerations.
Also on pg 3, line 48 says that the original definition was (in use since about
2003) should probably read (in use between 2003-2008)
I found some grammatical errors- for example, line 60 should say “…..FP
programs HAD started already….”. Also on pg 16—(REFERENCE Hall) should
be fixed.
I think a map or chart or something would be very helpful in terms of geographic
distribution of the studies.
I thought the limitation section was good.
I was curious how you could study unmet need via participant observation. I think
this study could be deleted or at least explained more in the paper.
I liked the way that the results were presented. I found the difference between
qual and quant findings to be quite interesting. I also liked the findings in the next
ppg on age and # of living children. I think these are the most important findings
of this review. I liked the commentary of the authors with regard to policy
recommendations throughout the discussion, such as lines 445-450 and
463-470.
I think the conclusions should be expanded slightly to include more of a summary
of the key recommendations.
Major
I don’t think it is appropriate to include a literature review in this study. It seems
like it would skew the results. I feel like the authors should just incorporate
relevant empirical articles. I wonder if there was a rationale for this.
Also, I felt that in many instances, the information provided came from articles
that were REALLY old. These should be updated. For example, pg 4- examples
from Citations #1 and 3.
Another MAJOR limitation of this study is that articles going back all the way to
1980 were studied. I would argue that these have little relevance in terms of the
barriers that women face today. So much has changed that I don’t think these
articles provide any worthwhile information and should have been excluded. I
would have liked to see articles from the last 15 years, for example.
I think it would be helpful and important to include the total # of studies for each
category. For example, pg 14 lines 313 discussed the association between
religion and unmet need and that it was found in 3 studies. How many total
studies measured this? Also, pn pg 15- “partner level:- The authors say this was
examined in only a few studies. But this should be more exact….how many
studies included this and how many of them found a significant association? At
for “couple level”- the authors mentioned the studies found different associations.
I think it would be better to summarize how many found positive and how many
found negative and how many found no association upfront before giving
examples of the various studies.
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Declaration of competing interests:
I declare that I have no competing interests.