Title: Determinants of Unmet Need for Family Planning Among Currently Married
Reproductive Age Women at Dewa Chefa District of Oromia Special Zone, Amhara Region,
Ethiopia, 2021; A Case-Control Study
Version: 1 Date: 28 Nov 2023
Reviewer's report:
General comments
Authors conducted very interesting research and please consider my comments to improve the
overall quality of the manuscript. I suggest publication of the manuscript should only be possible
after accommodation of the comments.
Specific comments
Abstract
• Please provide the rational of the study in short sentence line number 25 to 31
• Also I would recommend to use prevalence/proportion to indicate the magnitude than absolute
number (e.g ‘‘An estimated 23 million reproductive age women have an unmet need’’) line
number 27
• Since the study is case control, I was expecting to see the result (unmet need) between cases
and controls. Could you provide the proportion between the two group please? Were there a
significant difference?
• I don’t understand the difference between ‘‘using FP decided by husband’’ and ‘‘have no
support and disapproval of husband for FP use’’. Looks similar for me. Could you elaborate if
the categories are different? Line number 41 and 42
• Please re write the conclusion based on the result in relation with the outcome of the study. The
current version seems a bit confusing especially terms such as ‘‘positive significant association’’
and ‘‘negative significant association’’ line number 44 to 46.
Introduction
• Please provide/improve the rational of the study!
• Line number 79 to 83... Could you please add additional references to support your claim
‘‘different literatures’’? You provided only 1 reference for the whole paragraph. It would also
be great if you summarize what were reported by these literatures and how you relate with your
study as the studies were the base to formulate your research question. .
•  Line 85… ‘’This may not show the cause effect relation-ship well’’. I think you can omit the
word ‘may not’ and state the fact as it is. Obviously cross sectional study design has well known
limitation when it comes to cause and effect study.
• Line number 86…How about case control study? Is it not affected by confounders if not
designed and conducted well? Rather I suggest focusing on what differentiates your study from
those of the previously conducted studies?
• Line number 89 to 90 ‘‘On the other hand, women have less freedom and power to decide on
utilization FP methods’’ please provide reference for this statement.
Method
• Abbreviations must be explained if used for first time in the manuscript e.g ‘EFY’. This must
be consistent throughout the manuscript
• I wonder why you wouldn’t consider matching as it is a way to control confounding effect for
studies like case control. What method of conduct did you apply to avoid/minimize the effects
of confounding and bias in your study?
•
Result
• Would be great to present the proportion of unmet need for both case and control and see if
the difference were significant.
• Table 5, the study was case control and again I was expecting to see the distributions of unmet
need for cases and controls, and if the difference were significant across independent variables?
Please this needs a revision!
• Could you merge the categories in some of the variables on table 5? Some of the categories
had too small participants and difficult to compare. For example, ‘‘Occupation’’