Reviewer ’s report  
 
Title: Magnitude, trends and causes of maternal mortality a mong reproductive aged women in 
Kersa Health and Demographic Surveillance System, Eastern Ethiopia  
 
Version: 2 Date: 18 Jul 2018  
 
Reviewer: Reviewer 2  
 
Reviewer's report:  
 
PEER REVIEWER COMMENTS: To view the full report from the academic peer reviewer,  
please see the attached file.  
 
REVIEWER COMMENTS FROM REPORT: GENERAL COMMENTS  
 
What is your overall impression of the study?  
 
This is a fairly well -written manuscript on Magnitude, trends and causes of maternal mortality 
among reproductive aged women i n Kersa Health and Demographic Surveillance System, 
Eastern Ethiopia  
 
 
What have the authors have done well?  
The Introduction, Methods and Results Sections of the paper are well -written, succinct and 
coherent. The authors reviewed the literature well, provided adequate justification for the study 
and had a clear study objective. The study design and data analysis   was clear, and the authors 
provided enough information for authors who may want to replicate the study findings.  
 
 
In what ways does it not meet best practice?  
 
The Discussion Section will require some minor revisions.  
 
 
SPECIFIC COMMENTS  
 
1)  Figure 6 : Maternal mortality ratio comparison with the national, regional, global and other 
sub-Saharan African countries average  
Comment: Please provide a reference for the data in Figure 6  
 
2) Page 11, line 15 -19: "Even though the maternal mortality ratio is bel ow the sub -Saharan 
Africa average, it is higher than the world average as is the case with other sub -Saharan African 
countries such as Sudan, Ghana, and Rwanda (Fig. 6)."  
Comment: Please provide a reference for the countries mentioned.  
 
3) Discuss the reas ons why maternal deaths were highest in 2011, and why specific causes of 
maternal deaths e.g., abortion, hypertensive disorders of pregnancy and "other direct causes" 
occurred in 2011. For example, was there a training programme in 2011 that specifically t argeted 
maternal death reporting or the identification of women with abortion or hypertensive disorders 
of pregnancy?  
 
4) Reference numbering should be cited after a comma or at the end of a sentence. Most of the 
references numbering in this paper were ind icated within phrases and sentences.  
 
5) Please, be consistent with the use of MMR as abbreviation for "maternal mortality ratio" in 
the manuscript text  
 
 
 
Other Minor Issues  
 
1) Please use a period (full stop) rather than a comma to separate decimal places   
 
2 In your list of abbreviations, you defined MMR as "Maternal Mortality". Please clarify  
 
3) There are a few grammatical errors in the text in general the authors needs to re -review and 
edit.  
 
 
REQUESTED REVISIONS:  
 
As indicated above Please  
 
ADDITIONAL REQUESTS/SUGGESTIONS:  
 
Please, see my comments above  
 
Are the methods appropriate and w ell 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.  
 
Yes 
 
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 rec ommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
 
 
Declaration of compet ing 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 fr om the publication 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 currently 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, plea se give details below.  
 
This reviewer has been recruited by a partner organization, Research Square. Reviewers with 
declared or  apparent competing interests are not utilized for these reviews. This reviewer has 
agreed to publication of their comments online under a Creative Commons Attribution License 
attributed to Research Square and was paid a small honorarium for completing the  review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer 
recommendation.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named  report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer revi ew policy of the journal