Reviewer’s report
Title: 
Spatial distribution and associated factors’ of Early Marriage among
Reproductive age women in Ethiopia: A Secondary Data Analysis of Ethiopian
Demographic and Health Survey 2016.
Version: 
0 
Date: 
09 Jun 2020
Reviewer's report:
Review of manuscript for BMC Women's health on spatial patterns of early
marriage in Ethiopia - submitted May 24 2020 
This paper is on an important topic and appropriately analyzes the nationally
representative DHS data. 
The authors have performed some rigorous analysis of
DHS data, and added the novel aspect of analyzing the spatial patterns of early
marriage which adds to the literature on the topic.
No results are presented on age specific early marriage rates, although one would
expect that early marriage would have declined over time and therefore would be
higher in older age cohorts in the 15 to 49 age group. That said, however, table 3
provides adjusted odds ratios from the multiple logistic regression of all ever-
married women, and both the 20 to 34 and 35 to 49 have the same adjusted odds
ratio. 
DHS data does not provide information on women over 49 and therefore it
is not possible to analyze that age group. 
In fact, however, the geographic
analysis is appropriately limited to early marriages that took place in the last 5
years, although this is not mentioned in the text (specifically in the methods
section) while it should be (see Table 2). Obviously it is the geographic
clustering of recent marriages which are most important for policy and program
purposes. 
The paper also does not discuss the limitations of DHS data on early marriage,
particularly in relation to the definition/goal within the SDGs. 
The SDG
indicator is the percentage of women (NOT ever married women) aged 20 to 24
who married before the age of 18, but the DHS only can provide that for ever-
married women which is more limited. 
The main findings of the paper are the identification of certain 'hot spots' where
the risk of early marriage is higher. 
This is an interesting finding, based on the
analysis of data on recent marriages. 
However, the discussion or conclusions
sections do not adequately discuss what might explain this regional pattern. 
This
would need to be addressed in the revision as it is critical in terms of policy
implications. 
The conclusion specifies the need for education to prevent early marriage - but
the paper does not discuss in enough details the issues pertaining to education
and early marriage, or how it relates to the geographic distribution issue which is
the main focus of the paper. 
MINOR POINTS:
Hypotheses are poorly worded; it is not clear why researchers would assume that
early marriage is randomly distributed. 
Why not have a hypothesis that it is not
randomly distributed? 
Background in abstract does not make very clear to reader why specifically a
spatial analysis is needed to inform policy
Title needs to be revised - too long and not appropriately worded
Writing needs editing for English - and especially for inappropriate use of
punctuation
The P value is too minor a point to be included in the results presented in the
abstract
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.
No
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
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
require further assessment in your comments to the editors.
I recommend additional statistical review
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
Declaration of competing interests
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questions:
1
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or in the future?
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Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
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Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
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Do you have any other financial competing interests?
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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 I have no competing interests
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