Title: Spatial distribution and associated factors of dropout from health facility delivery after
antenatal booking in Ethiopia: A multi-level analysis
Version: 0 Date: 28 Aug 2022
Reviewer:  Liknaw Bewket Zeleke
Reviewer's report:
Title
# It is too long better to rephrase
Abstract
# Better to avoid the abbreviations
# Better to describe the level of analysis in the methods section
# Report the individual and community level associated factors separately rather than focusing
on positively and negatively associated factors
# The conclusion states, “The prevalence of dropout from health facility delivery after ANC
booking was high as the government’s effort”. What do you mean by the government’s effort?
Is there a target set by the government?
# The conclusion's summary statement about the associated factors is similar to the result section
except for removing the odds ratios and confidence intervals. Hence, revise either.
Background
# The background contains fragmented ideas and paragraphs. For instance
Methods
# Better to specify the directions of the neighboring countries of Ethiopia
# Better to more description about the country in terms of administrative regions, the population
demography, the health care system status, and so on
# Line 128-129: grammatical error
# Line 131-135: A too long sentence that is hardly understandable
# Please explain more about the data collection procedure
#  In the variable measurement section
# Better to mention the individual and community level variables separately
# It looks good to use the median value for aggregating the community-level variables from
individual-level variables, but I don’t believe that you have operationalized them very well.
For instance, how did you consider women as educated? i.e., attaining primary education or
secondary education, or higher education?
# Better to use community-level media exposure and operationalize in terms of radio/tv
availability
# I recommend you add community-level women's autonomy
# Line 192: typing error (Model 3 duplicated)
Results
# Line 232: Typing error completed
# In the result section, better to avoid putting the count and percentage values at a time.
# In table 1, the age classification looks managed inappropriately. Please consider other
classification techniques considering the risk exposure of adolescents/youths and older women
# Present the community-level factors with a separate table
# In the “Factors associated with dropout from health facility delivery” section
# Please describe which model you selected to interpret and explain why
# I would like to advise you that present merging the text and tables of the fixed effect and random
effect findings. Accordingly, report the required parameters such as ICC, PCV, Loglikelihood,
AIC, and BIC of the null model (model I).
Discussion
# Better to add introductory statements focusing on the aim and scope of the study before directly
reporting the findings.
# Line 336: what do you mean by studies in Ethiopia? Other studies mentioned before were also
conducted in Ethiopia.
# For more clarification, I encourage you to use the terms/phrases like national level studies,
multi-country studies, and so on to distinguish them from studies involved in single area/setting
# I also advise mentioning specifically rather than stating different parts of Ethiopia
Conclusion
# Likewise, in my previous comments, what does the Ethiopian government's effort refers to?
# The statement “its spatial distribution in Ethiopia was clustered with positive Moran’s Index”
needs rephrasing by interpreting the implication of positive Moran’s Index.
# Some statements are directly taken to the abstract section without modification. Please make
amendments accordingly.