Title: Partner support and women contraceptive use: Insight from urban poor communities in
Accra, Ghana.
Version: 5 Date: 24 Apr 2022
Reviewer:  Daniel Yaw Fiaveh
Reviewer's report:
Dear Colleague,
I wish to congratulate you for revising the topic to fit the content of the paper and for providing
further details about the methodology and the theorization. I am also pleased to read your point-
by-point responses to the reviewers’ comments and detailing how issues have been addressed.
Thank you for this.
The title now reads better.
The abstract is now clearer except to say that the recommendation for educating men on modern
contraceptive methods looks vague. It will be useful to be very specific about what needs to be
done. That said, the abstract is now well written and I have to congratulate the authors.
In addition, a clearer justification has now been offered why this study is relevant. According
to the researchers, we already know a lot about the impact of so-called poverty on sexuality.
The missing link, however, is how male partners from the so-called poor areas impact on their
female partners' modern contraceptive decision making. This looks interesting though not very
controversial. The responses are imbedded in curiosity. Perhaps a very controversial question
here following from the problem of low prevalence of contraceptive use across sub-Saharan
Africa with specific reference to Ghana could be a “wow” question.
Further details about the inclusion and exclusion criteria have been provided. This reviewer is
particularly pleased with the clarity offered in relation to the point of informing the readers that
“women who were pregnant and those trying to be pregnant were excluded from the analysis”
because the absence of this could have led to the potential confounding of the results. This is an
extremely important intervention. Thank you for this addition. My only concern is how it was
possible to identify women who were trying to get pregnant. Was it done through some series
of questions from the data set? If so, please make reference to those for clarity and acknowledge
the potential limitations as such.
I also see some revisions to the structure of the independent variables for clarity’s sake. This
is commendable.
However, there are still some few problems and I wish to list them below:
While the introduction looks much more improved, especially with the introduction of a theory,
Gender Power, some sections, especially 2,3,4, appear repetitive. I think it would be good if
the authors could synchronize those sections to make reading more appropriate and/or suitable
in the circumstances. Alternatively, a subsection that focuses on Gendered contraceptive use in
Ghana OR Women and contraceptives in Ghana.
The discussion section is now well organised. My only issue is that the discussion is under
theorized. Although the paper purports to have been guided by a theory, it doesn't look like the
Gender Power theory has been well engaged in the discussion. The contribution of this paper
would be better appreciated if the discussion section focused a bit on integrating Gender Power
theory more closely.
It is surprising that in their response to the claim about the value-laden nature of the
discussion in relation to ethnicity and contraception use, the authors responded that because
previous researchers attempted to establish a relationship between contraceptive use and culture
(ethnicity), the current research also does the same and but reported contrary findings. What
kind of rationale is that? How does a person’s cultural (ethnic) upbringing/ training/socialization
influence/translate to contraceptive use or non-use? It is important that as researchers, we
interrogate issues very cautiously and not create problems as a result of producing science.
I still maintain that the conclusion of the study is skewed. The authors only dealt with women and
not men. Therefore, the attempt to use what women think/say to generalize for understanding
men is not only problematic but gender insensitive. The study is claiming more than expected
and should focus on what was done. It is surprising that a paper that seeks to engage in gender
analysis based on the theoretical paradigm is not sensitive to gender.
Many thanks for sharing a much more improved paper with me. It has been a great pleasure
reading your ideas.