Reviewer’ s report
Title: Intimate partner violence against women and its association with pregnancy loss in
Ethiopia: Evidence from a national survey
Version: 1Date: 26 May 2020
Reviewer: Justice Moses K. Aheto
Reviewer's report:
Tiruye and colleagues examined the association between Intimate Partner Violence (IPV) and
pregnancy loss using data from the 2016 Ethiopian DHS. They carried out substantial revision tothe manuscript, especially the incorporation of the multilevel analysis, which showed substantialcluster-level variation in the outcome. Without accounting for this would have definitely biasedour model estimates.See more details below:
Abstract:
The authors did not report summary results (ICC/VPC) on the contribution of cluster-levelvariation obtained from the multilevel. It is important for the authors to state whether significantcluster-level residuals/effects were found (which is yes in their case).
Introduction:
a)The revision to this section is satisfactory. background to the study sounds good.Methods:
b)The authors now incorporated the multilevel analysis which is great, and the results from the
multilevel models confirmed the need to do so.c)The explanation of ICC reported at page 10 lines 222-225 is not clear. In this study, the ICC willmeasure similarity in the outcome measure considered in this study among women within thesame cluster other than they are to women in different clusters under study, NOT just similarityamong women from same cluster.d)Though the authors acknowledged the presence of sampling weights in the EDHS data, they didnot explain whether the model took this into account or not as I recommended in my first review.This can potentially bias their estimates and its resultant misleading conclusions/findings.However, I suggest the authors consider this in their future research work.
Results:
e)The revision to the results presented is satisfactory.f)The title for Table 4 should be revised to incorporate the 'multilevel model' analysis. It could read'Table 4 Associations between IPV and pregnancy loss among reproductive age women (15- 49years) in Ethiopia from the multilevel model.'Discussion and conclusion:g)The revision is satisfactory BUT the residual cluster-level variation must be adequately
discussed in the context of Ethiopia and relate that to policy and intervention strategies, and not
only to conduct further studies to search for left-out potential cluster/community-level variables
that might explain this. The conclusion section must also incorporate this.
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.
YesAre the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
YesAre 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 furtherassessment in your comments to the editors.
I am able to assess the statisticsQuality of written English
Please indicate the quality of language in the manuscript:
AcceptableDeclaration of competing 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 from the publication of thismanuscript, 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, please give details below.
I declare that I have no competing interests
Reviewer Publication Consent. 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) if this manu-script is accepted for publication. Any comments that I do not wish to be included in the publishedreport have been included as confidential comments to the editor, which will not be published.Ifyou are not happy for us to publish this report, please contact the editorial office before completingthe review.If you wish, you can include your name in your published report. Please note you mustdecide whether to include your name at the start of the process and confirm this decision wheneverprompted. If you change your decision later, we will not be able to publish your name.
I agree to the terms of the CC-BY 4.0 license; please publish my name with my report.