Reviewer’ s report
Title: Spatial Distribution and Determinants of Early Marriage among Married Women in
Ethiopian: A spatial and Multilevel Analysis
Version: 0Date: 24 May 2020
Reviewer's report:
This paper is on an important topic and appropriately analyzes the nationally representative DHS
data. The authors have performed some rigorous analysis of DHS data, and added the novelaspect of analyzing the spatial patterns of early marriage which adds to the literature on the topic.
No results are presented on age specific early marriage rates, although one would expect that early
marriage would have declined over time and therefore would be higher in older age cohorts in the15 to 49 age group. That said, however, table 3 provides adjusted odds ratios from the multiplelogistic regression of all ever-married women, and both the 20 to 34 and 35 to 49 have the sameadjusted odds ratio. DHS data does not provide information on women over 49 and therefore it isnot possible to analyze that age group. In fact, however, the geographic analysis is appropriatelylimited to early marriages that took place in the last 5 years, although this is not mentioned in thetext (specifically in the methods section) while it should be (see Table 2). Obviously it is thegeographic clustering of recent marriages which are most important for policy and programpurposes.
The paper also does not discuss the limitations of DHS data on early marriage, particularly in
relation to the definition/goal within the SDGs. The SDG indicator is the percentage of women(NOT ever married women) aged 20 to 24 who married before the age of 18, but the DHS only can
provide that for ever-married women which is more limited.
The main findings of the paper are the identification of certain 'hot spots' where the risk of early
marriage is higher. This is an interesting finding, based on the analysis of data on recentmarriages. However, the discussion or conclusions sections do not adequately discuss what mightexplain this regional pattern. This would need to be addressed in the revision as it is critical interms of policy implications.
The conclusion specifies the need for education to prevent early marriage - but the paper does not
discuss in enough details the issues pertaining to education and early marriage, or how it relates tothe geographic distribution issue which is the main focus of the paper.
MINOR POINTS:Hypotheses are poorly worded; it is not clear why researchers would assume that early marriage is
randomly distributed. Why not have a hypothesis that it is not randomly distributed?
Background in abstract does not make very clear to reader why specifically a spatial analysis is
needed to inform policy
Title needs to be revised - too long and not appropriately worded
Writing needs editing for English - and especially for inappropriate use of punctuationThe P value is too minor a point to be included in the results presented in the abstract
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
YesDoes 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.
NoAre 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 reviewQuality of written English
Please indicate the quality of language in the manuscript:
Not suitable for publication unless extensively editedDeclaration of competing interests
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