Reviewer’ s report
Title: Overview and factors associated with pregnancies and abortions occurring in sex workers in
Benin
Version: 0Date: 30 Dec 2019
Reviewer: Katrina Frances Ortblad
Reviewer's report:
OVERALL: An overall interesting paper. The methods section could be edited to improve flow
and clarity (brevity is better). The discussion section of this paper was strong - the authors shouldconsider moving some of this to the introduction section to better motivate the paper. Many of thefindings are not that surprising - they are factors associated with pregnancy - so be sure to motivatewhy this matters and the policy ramifications of these specific findings. The authors compare theFSW outcomes with those of individuals in the general population in the discussion section, butcould take this further - potentially adding a graph with these comparisons in the methods section.
MINOR:
Abstract*(Intro): Higher MMM relative to where?*(Methods): Consider revising to improve flow of these 3 sentences. How many were in eachsurvey? What were the inclusion criteria to be included in the survey or analyses? (e.g., was therean age cut off?)*(Results): Mean age of who? How many participants were included in the analyses? Considerrevising for clarity - for example, pregnancies during sex work is confusing. Was anything else
besides living with a boyfriend and not consistently using condoms (with clients?) associated with
pregnancy? Did you have any information on childhood outcomes? (e.g., childhood mortality?).
Introduction
*(Page 2, Line 59): Is the 13% for both of these causes, or just unsafe abortion. Would be good toclarify.*(Page 3, Lines 6-14): Consider here listing the motivations for multiple sexual partners and theprovision of condomless sex - e.g., lack of empowerment/ability to negotiate condom use, strongeconomic incentives for multiple partners, the provision of condomless sex, etc.*(Page 3, Line 49): How do you know they have a high rate of unmet SRH needs if this is whatyou are seeking to explore/answer in this paper?
Methods
*(Page 4, Line 15): Divisions or districts vs. departments?*(Page 4, Pine 29): Consider replacing "prostitution" with a more neutral word.*(Database merging): Does this need a whole section? It is not clear to me what you did after youidentified these duplicates? Did you drop one of the observations? If so, which one?
Results
*(Page 7, Lines 26-48): For continuous variables, consider reporting medians and IQR vs. means
and SD - these are less skewed by outliers and give a better sense of the spread of the data.*(Page 8, Lines 12-26): In the surveys, was there a way to identify if these pregnancies werewanted or unwanted?
Discussion
*Really nice discussion that addressed many of the questions I had when reading the paper. Wouldbe great if you could add more details to the comparison you are making with these outcomes inthe general population so that it becomes more clear how these outcomes differ among FSWs.
Could even consider adding a figure comparing key outcomes in the FSW population with the
general populations in similar years and ages (using DHS data or something).
Table/figures
*(Table 1): Consider turning this into an appendix table.*(Table 2): Don't need to present both means and categories for continuous variables. Considerjust reporting medians and IQRs for these variables. This will make the table smaller, and thusmake it easier to take in the key information.*(Table 3): Consider just presenting the combined numbers in a bar graph.*(Table 4 & 5): Consider just presenting the multivariable analyses, and putting the univariateanalyses in appendix tables.
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.
YesAre the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
YesAre 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 require furtherassessment in your comments to the editors.
I am able to assess the statisticsQuality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
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