Title: Rural-urban correlates of modern contraceptives utilization among adolescents in Zambia:
a national cross-sectional survey
Version: 0 Date: 05 Jun 2022
Reviewer:  James Mulenga
Reviewer's report:
TITLE: Rural-urban correlates of modern contraceptives utilization among adolescents in
Zambia: a national cross-sectional survey
GENERAL COMMENT
This is a goods study trying to use the most recent Zambia Demographic and Health Survey
of 2018 to analyse the factors related to modern contraceptives utilization among adolescents
in Zambia.
Generally, the article is well written and follows the recommended format. However, the authors
can consider the various suggestions I have offered below.
ABSTRACT
BACKGROUND
The background is tilted towards the Subsaharan African situation. It would be good to present
more background information relating to Zambia because the focus of the study is on Zambia.
Present the trends, policies and programmes around the issue in Zambia.
LITERATURE
The article has limited literature review. It would be nice to add more related empirical literature
as various studies on the topic both in Zambia and elsewhere.
DATA AND METHODS
Line 93 - Under the heading: Study Sampling and Participants
There is need to mention the sampling frame and the fact that 2018 ZDHS sample is a two-stage
stratified cluster sample.
Line 120: It would be nice to recode “Level of education” into (no education, primary, secondary
and tertiary)
Line 121: Change “having a child” to “has a child or children”
Line 126: It is not clear why the authors decided to recode the variable “number of household
members” into less than 6 and 6 and above.  I am also wondering the rationale behind the
inclusion of this variable into the model.
The authors can also consider adding more independent variables such as religion, desired for
children. “Exposure to media messages on family planning” is another nice variable. Perceptions
and knowledge of contraceptives are also important variables that might influence ultilisation.
Lines 141-143: “All variables in the model were assessed for collinearity, which was considered
present if the variables had a variance inflation factor (VIF) greater than 10”. The authors should
take note that multicollinearity is not an issues of presence or absence, rather it is about the
degree. Thus VIF of 5 to 10 is high multicolllinearity and above 10 is severe multicollinearity.
RESULTS
Lines 176 – 185: It would be nice to interpret the Adjusted Odds Ratios in terms of their
magnitudes.  Rather than in terms of whether the effect is positive or negative. The AORs should
be interpreted relative to their respective benchmark categories.
DISCUSSION
Line 195: “nulliparous”, the discussion should relate as much as possible to the way variables
are coded. Changing the labels of the categories might confuse the reader.
Lines 197-198: “Married adolescents and those who have ever had a child are more likely to
utilize modern contraceptives”. Is this statement based on the odds ratio or percentages?
Lines 198-201: It is always nice to compare countries with similar characteristics
Lines 207-209: This can marry well with information in the first paragraph of the Discussion
section
Lines 207-230: The narrative here is quite confusing. What exactly are the authors discussing
here? The authors should as much as possible discuss the findings of the study. Most of the
statements here are long and confusing. I recommend revision.
The discussion section requires some more reflection and reorganization.
POLICY
Add the policy implications of this study