Reviewer’s report
Title:  Effect  of  a  Postpartum  Family  Planning  Intervention  on  Postpartum  Intrauterine  Device
Counseling and Choice: Evidence from a Cluster-Randomized Trial in Tanzania
Version: 0 Date: 02 Dec 2019
Reviewer: Rebecca Callahan
Reviewer's report:
This is a well-written manuscript describing an important intervention and evaluation.  My main
question for the authors relates to the description of the primary analysis as a difference in difference
analysis when it appears that it is simply a comparison of pre vs post intervention or control vs.
intervention.  The paper could also be strengthened with a bit more context about the intervention in the
introduction.
Abstract
The second sentence is very long and somewhat hard to follow.
The results presented appear to be a difference between pre and post intervention rather than difference
in difference between two groups receiving an intervention.
Introduction
Page 3 Line 28: Are you referring to LMICs only or globally?
It would help to provide more context for the intervention.  Why was this implemented in Tanzania?
What was the origin?
Methods
Page 4 Line 21: More description is needed of the Groups: why the early intervention implementation
and late intervention implementation?  Why were the two Groups defined as they were, i.e., 3 months
and 9 months of baseline data collection?  What was the rationale?  What was the original goal in
comparing these two Groups?
Since the intervention data for Group 2 are not presented, why include them in this analysis?  Why not
just compare pre and post intervention in Group 1?
Should add mention of IRB approval(s)
Page 4 Line 45: How is the analysis difference in difference?  Seems like it is just difference between
pre and post intervention; treatment vs. control.  How this is a difference in difference analysis needs to
explained more clearly.
Page 5 Line 23: Who were the RAs?  Were they trained?
Page 5 Line 50: Main reasons for ineligibility?
Page 5 Line 54: Main reasons for missing outcomes/covariates?
Page 6 Line 7: As above, how is it difference in difference if you are just comparing intervention
exposed to not exposed?  
Page 6 Line 35: What are the "measured aspects of quality in counseling"? 
Results
Why not just show percentages in Tables 1 & 2?  
Table 3: Are these percentages or do they need to be multiplied by 100?  I would suggest showing
percentages in all tables.
What is the difference between Other Christian and Protestant?  
Page 7 Line 53: Again, how is  this difference in difference?   Seems  it is  just the effect of the
intervention compared to no intervention.  Please clarify.
Discussion
Page 9 Line 41: Why argue against post-admission counseling when your results  show that this
increased uptake significantly.  The literature is murky on how effective antenatal FP counseling is on
PPFP  uptake.   This  may  be  of  interest:  https://www.fphighimpactpractices.org/briefs/immediate-
postpartum-family-planning/
Page 9 Line 46: Need to define quality of counseling earlier.
Page 9 Line 52: Why is provision of a leaflet "emblematic of a provider who has a strong commitment
to high quality counseling"?
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 manuscript or would you recommend an additional
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further
assessment in your comments to the editors.
I recommend additional statistical review
Quality of written English
Please indicate the quality of language in the manuscript:
Acceptable
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