Title: Inequality gaps in modern contraceptive use and associated factors among women of
reproductive age in Nigeria between 2003 and 2018
Version: 0 Date: 08 Feb 2024
Reviewer's report:
The second paragraph of the background talks about the proportion of women of reproductive
age who use modern contraceptives. The last sentence mentioned inequality but did not show an
example at the global level. The third paragraph focuses on SSA. In the second paragraph, the
author may show the inequalities across countries/continents and groups before coming down
to SSA. This will help provide some foundation for the third paragraph.
In the fourth paragraph, the author should show the proportion of women using contraceptives in
Nigeria and selected African countries. Is usage in Nigeria below or above the national average
in SSA? What are the figures in Rwanda and South Africa that you made reference to in the
paragraph?
In the fifth paragraph, you wrote, “Nevertheless, studies have noted unexplained inconsistency
distribution of modern contraceptive use among regions and some socioeconomic statuses in
Nigeria.” It appears there are missing words. Please fix this. In addition, the previous paragraph
claims that Nigeria has recorded progress in the acceptance and use of modern contraceptives.
So, the problem is not clearly articulated? Is it that the fertility rate is still high despite the
acceptance and use of modern contraceptives? The fifth paragraph focuses on family planning
and not specifically on contraceptives. The two are not the same?
Then boom! The last sentence of the fifth paragraph and the sixth paragraph go back to modern
contraceptives. To the best of my knowledge, the manuscript has not provided figures on the
proportion of women who use modern contraceptives in Nigeria. In fact, the claim that there is
a low use of modern contraceptives appears to contradict the progress mentioned in the fourth
paragraph. Again, the problem is not clearly articulated. The author needs to show that although
there has been progress in the proportion of women using modern contraceptives, the figures
are still undesirable or far from the set goals.
The penultimate paragraph in the background does not say much. Inequalities in what aspects?
Are you interested in inequalities across regions (north and south) or across the six geopolitical
zones or across states or across different socio-economic groups? Readers should not have to
get to methods or results before they understand your specific motivations/objectives.
I suggest that the last sentence of the last paragraph be reworded. I understand the interest in
stating the contribution of the research, but it is difficult to know with certainty that “…. no
study in Nigeria has used the Health Equality Assessment Toolkit (HEAT) developed by World
Health Organisation (WHO) to assess the variations in inequalities using complex summary
measures….” A systematic review of myriads of sources may be required to ascertain this.
Several research in Nigeria do not end up published as journal articles. And as the author may
know, lots of journals in Nigeria are not indexed in popular databases. So, you can’t be so sure.
The method and results appear well-written and well-articulated. However, the manuscript needs
to reiterate why the investigation of inequalities in Nigeria is important. As it stands, it looks
like a statistical exercise with no conceptual/theoretical importance. Why is the investigation
of inequalities between different geopolitical zones and socio-economic groups in Nigeria
important? Please discuss this. You may relate it to the SDG goals you mentioned earlier in the
background.
The reproductive age captured in DHS is 15-49, I am wondering why the manuscript adopted the
categories “15-19” and “20-49.” One class had a width of 5, the other has 25. Was this informed
by your analytical approach?