Reviewer ’s report  
 
Title: Pattern and correlates of out -of-pocket payment (OOP) on female ster ilization in India, 
1990 -2014.  
 
Version: 1 Date: 21 Oct 2019  
 
Reviewer: Karar Ahsan  
 
Reviewer's report:  
I congratulate the authors for preparing a manuscript on this important topic. OOPs and their 
effect on essentia l RH services are increasingly seen to be an important area for improving 
equity and health services delivery in the developing countries, and there is a severe knowledge 
gap. This paper attempts to fill that gap based on data from nationally representativ e cross -
sectional survey.  
Between the original and revised versions, writing improved considerably. The results of the 
analyses are explained well in the paper, and findings support the conclusions. I, however, would 
like to bring authors' attention to the  following issues to improve the manuscript.  
 
MAJOR COMMENTS  
1. Use of keyword: standard elaboration of OOP is out -of-pocket payment —the authors need to 
check and correct 'OOP payment' to 'OOP' throughout the text  
 
2. p.2, line 14 and p.19, line 46: words got lost from the earlier version —I suggest retaining 
those (see attached file for details)  
 
3. p.15‒17: Supplementary materials are for supporting main analyses/findings. Here two full 
paragraphs were used for describing results from supplementary tables which need to be 
revisited  
 
4. Methods: Two -part regression model is a correct choice for the analyses. However, I 
suggested LPM as an alternative to logit model for the first part regression for authors' 
consideration. In case the authors want to keep log it model, then the table on findings need to be 
revised (see attached file for details)  
 
5. Discussion section: At this moment, the discussion section only reiterates the findings. It 
needs comparison with other, similar studies from India and other countr ies to highlight 
agreement/difference in findings and explain the possible reasons. Two main findings of the 
study are a) Women belonging to OBS and other scheduled castes have higher OOP, and b) OOP 
varies substantially between public and private faciliti es. These two findings call for a discussion 
on equity implications and requirement for strengthening government's capacity to regulate the 
private sector.  
 
MINOR FORMATTING ISSUES  
1. Wrong use of 'dash': seen throughout the manuscript.  
 
2. Citations: use  range (e.g., 2‒7 in p.4, line 19) when using a series of successive sources; also 
sort the citations (e.g. 2,6,28‒31 in p.4, line 41)  
 
3. Use of currency symbol: a) check (and correct) the use of INR symbol throughout the 
document. What would be the correct use of ₹? I believe it would be either ₹*** or ***₹ instead 
of '*** ₹'; b) please use comma to separate digits in large numbers  
 
4. Capitalization: Unnecessary capitalization in table and section titles.  
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.  
 
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 manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require 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  
 
Decl aration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat 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, please give details below.  
 
I declare that I have no competing interests.  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my repo rt to the authors and, if the manuscript is accepted f or 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 Creati ve 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 in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to th e open peer review policy of the journal