Reviewer ’s report  
 
Title: Couple's concordance and discordance in househ old decision -making and married 
women's  use of modern contraceptives i n Bangladesh  
 
Version: 0 Date: 15 Dec 2015  
 
Reviewer: Mai Do  
 
Reviewer's report:  
 
Major comments  
None  
 
 
 
Minor comments  
 
1. The selection of the three measures of decision making in the household should be better 
explained. The authors ment ioned that they were the "most relevant ones". What is the 
basis of this statement?  
 
 
 
2. The authors alluded in the Discussion that the use of limited measures of decision -
making may be an issue of content validity. I agree with it. Is it possible for the au thors to 
elaborate a bit, maybe discussing what the results may look like if they had more 
measures, or if they used the measures that were available in the data set but they decided 
to exclude?  
 
 
 
3. Related to the previous comment, the findings that only de cision making in women's 
mobility had some influence on contraceptive use warrants some discussions. This is 
particularly interesting in the context of Bangladesh. Could the authors offer some 
explanations - perhaps because this is a more sensitive measure  of women's decision -
making power in Bangladesh than the other two measures?  
 
 
 
a. In the Discussion, the authors mentioned that couples who reported joint decision -making 
may be more likely to engage in spousal consultation and negotiation, which could be a 
reason for increased contraceptive use among them. Wouldn't some of this already be 
captured by the variable on couple's FP communication? Could the authors address some 
limitations of these measures?  
 
4. I have a minor concern with grouping all (modern and  traditional) contraceptive use as 
one outcome variable (yes/no). Couple power dynamics may have different influences on 
different methods of contraception, depending on whether a method only involves men, 
or women or both. For example, a decision to use w ithdrawal or condoms may be 
completely different from a decision to use implants. The authors may want to add some 
discussion to this effect.  
 
 
 
5. Some discrepancies in wives' and husbands' reports of decision -making are interesting. 
For example, women were  less likely to report joint decision -making than men did. From 
Table 2, it seems that among men who reported joint decision -making, a large proportion 
of their wives actually reported "husband only". What did it say about actual or perceived 
women's decis ion-making power?  
 
 
 
6. In the last paragraph, the authors stated that more work was needed to explore couple's 
attitudes towards and use of contraceptives, not just women's use of contraceptives. I am 
not sure the differences between couples and women's use of contraception here. Does it 
mean that the outcome of this analysis was limited to women's methods only and 
methods like withdrawal and condoms were excluded?  
 
 
 
7. The data is quite dated; Bangladesh since then has had two more rounds of DHS in 2011 
and 20 14, although the 2014 data is not yet available.  
 
 
 
8. The authors should discuss the results within the current context of Bangladesh. Were 
there significant changes to women's decision making power? Does the government aim 
to promote some methods of contra ception more than others?  
 
 
 
 
 
 
 
 
 
 
 
 
 
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 t he authors.  
 
No 
 
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  
additi onal 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 l anguage in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the follow ing questions:  
 
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3. Do you hold or are you currently applying for any patents relating to the content of the  
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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?  
 
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