Reviewer's report
Title:Postpartum contraceptive use in Gondar town, Northwest Ethiopia: a
community based cross-sectional study
Version:2Date:6 June 2014
Reviewer: Yohannes Adama Melaku
Reviewer's report:
Title: Contraceptive use and associated factors among postpartum women in
Gondar town, Northwest Ethiopia: a cross-sectional study
The paper has improved greatly. The authors have addressed almost all of my
concerns and questions. However, the following issues should still be cleared.
General report
1. Is the question posed by the authors well defined? Yes
2. Are the methods appropriate and well described? Yes
3. Are the data sound? Yes
4. Does the manuscript adhere to the relevant standards for reporting and data
deposition? Yes
5. Are the discussion and conclusions well balanced and adequately supported
by the data? Yes
6. Are limitations of the work clearly stated? Partially, it is not well described and
all the limitations should be included; example-economic status was not
assessed, in this study attitude of women and their husband/sexual partner on
contraceptive was not assessed.
7. Do the authors clearly acknowledge any work upon which they are building,
both published and unpublished? Yes
8. Do the title and abstract accurately convey what has been found? Yes
9. Is the writing acceptable? Yes
10. Level of interest - An article of importance in its field
11. Statistical review- No, the manuscript does not need to be seen by a
statistician.
12. Declaration of competing interest-I confirm that I have no competing interests
13. What do you advise should be the next step? Unable to decide on
acceptance or rejection until the authors have responded to the major
compulsory revisions
Detail comments (all are major compulsory revisions)
A. Abstract
1. Methods- the sentence “……. was conducted in August 2013 among women
who gave birth one year prior to the study…..”—is it “within” or “before” a year?
Well, I understand, however for quick readers, this should be clear.
2. Result-the word “confidence interval” should appear first when CI appeared.
3. Recommendation-don’t the authors think counseling during postpartum,
especially the first six weeks of delivery important. I believe that counseling about
contraceptive methods during postpartum care is more appropriate than during
ANC.
B. Background
1. 4th paragraph, 4th sentences---“a women” should replaced by “a woman”.
C. Methods
1. Sample size calculation and sampling procedure-“confidence interval” should
be replaced by confidence level.
2. Sample size calculation and sampling procedure -their target population was
2.77% of all the population (5,734) which is <10000. And in this case, the authors
have to use a correction formula. However, they didn’t.
3. Sample size calculation and sampling procedure -Sampling technique needs
to be displayed diagrammatically, so that readers will be clear of their sampling
procedures and the number of study participants in each administrative areas
and clusters.
4. Data Collection and analysis-they have used P<0.2 for a variable to be
included in next step of analysis. Can they provide reference? Because some
recommend to use 0.05 in bivariate analysis for a variable to be modeled in
multivariate analysis.
D. Results
1. They have put that “Five hundred two (71.4%) of them had resumed sexual
intercourse. This means only 502 postpartum women started sexual intercourse
till time of data collection. The rest 201 didn’t. So for those who never had sexual
intercourse in their postpartum period, how can we ask about contraceptive
utilization as they didn’t have sexual intercourse? In this case, the authors did the
logistic regression considering all 703 women (sexually active+non-active), which
I thought it is wrong. They have to calculate contraceptive utilization and doo the
regression too, among sexually active postpartum women.
2. Contraceptive use in the postpartum period- “The prevalence of contraceptive
use was found to be 48.4% [95% CI: (44.5, 52.1)]. Injectable contraceptive
(68.5%) and oral contraceptive pills (16.8%) were the most frequently used
methods.” And “More than three fourth (76.4%) of the respondents made
contraceptive decisions jointly with their partners.”-----These sentences would be
benefited if they had incorporated the absolute numbers in addition to the
percentages. Similarly, figure 1 and the above first two sentences are not similar.
Please look and revise it.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I confirm that I have no competing interests