Reviewer ’s report  
 
Title: Spousal discordance on reports of  contrac eptive communication, contraceptive use, and 
ideal family size in rural India: a cross -sectional study  
 
Version: 0 Date: 11 Jun 2018  
 
Reviewer: Paul Fleming  
 
Reviewer's report:  
 
Thank you for the opportunity to review the manuscript titled, 'The role of gender equity in 
spousal discordance on reports of contraceptive events and id eal family size in rural India: a 
cross -sectional study." I found the manuscript to be novel and provided new insights into 
research and programs focused on contraceptive use. The manuscript was nicely written and 
well-organized the methods used were appro priate for their aims. I only have a few minor 
recommendations to improve the quality and readability.  
- Consider editing the title. I found the term 'gender equity in spousal discordance' and 
'contraceptive events' confusing.  
 
- In paragraph 3 of the introduction, I would like to see a bit more specificity to what could be 
gained from the study of discordance. It was unclear from this paragraph, how interventions 
or programs might change based on findings based on discordance. I  might suggest that 
highlighting the correlates of discordance (or concordance) could help better target 
interventions (as the authors mention in the discussion). Also, this paragraph seems to 
assume that adding men's responses to women's would give a more  accurate depiction of 
prevalence of contraceptive use. Justify this or acknowledge that in the case of discordance, it 
is possible that men (or women's) responses are incorrect or misrepresent the truth.  
 
- In the methods section, add a note or reference to refer to more detail on what is meant by the 
'categorical measures of caste' that the authors used.  
 
- I would recommend adding AOR and 95% CIs to the results section  
 
- I was surprised that social desirability bias was not mentioned as a possible reason  for 
discordance (e.g. wife says she uses because she believes she should say that vs. the husband 
who doesn't feel that way, or vice versa). At the very least, I think this belongs in limitations. 
Or, I believe that this could fit into some of the discuss ion. The authors might consider noting 
that Husband + couples either means that the couple actually uses contraceptives or the 
husband at least thinks that he is supposed. Further supporting the argument that these men 
might be primed for interventions.  
Are the methods appropriate and well described?  
If not, please specify w hat 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 manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects requir e 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  
 
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 gain or lose financially from the publi cation 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 curr ently 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 that 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 rep ort 
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to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal