Title: Partner support and women contraceptive use: Insight from urban poor communities in
Accra, Ghana.
Version: 4 Date: 05 Jan 2022
Reviewer's report:
Overall
- Thank you for the opportunity to review this work. The authors’ research question is a
useful addition to the field regarding men’s participation in family planning, particularly in an
understudied geography.
- The paper would benefit from editorial review for grammar and spelling to help make the
writing as concise as possible.
- I suggest reviewing with STROBE guidelines in mind to ensure enough detail is provided
to allow the work to be reproduced by an independent researcher. See: https://www.strobe-
statement.org/checklists/
-  The analytic sample needs justification. (See point #2)
See below for point-by-point suggestions to help strengthen this paper. I look forward to
eventually seeing this in print!
Abstract
1. Please include the size of the analytic sample
Methods
2. Line 169-170 The authors state their analytic sample includes women 16-44 years old
who have ever used any contraceptive method and are in union; however, since the outcomes
of interest include current contraceptive use, the denominator should be women *in need of
contraception*. This includes women in union who are not currently pregnant and do not want to
have a child now or soon. Have women who are currently pregnant or trying to become pregnant
been excluded from the analytic sample? Not excluding these women will bias your results.
3. Line 127-130 Please include a citation for economic description of the study sites.
4. Line 138 Please provide a citation for GSS census
5. Line 144 were enumerators all women?
6. Line 146 “consenting” should be “consented”
7. Line 166 suggested slighting tweaking wording to make clear which inclusion criteria refers
to the parent study and which refers to this analysis. For example, could change line 166 to “The
inclusion criteria for the larger study … (line 168) For the purpose of this analysis, we further
restricted the sample to women …”
8. Line 167 which local languages?
9. Line 180 were these the only methods asked about? What about female/male sterilization or
female condoms?
10. Line 186 please use a consistent citation style
11. Line 187-188 LARC should be “long acting reversible contraception”
12.  Line 190-192 Be explicit about how covert use is defined and measured. What question
was asked? Include in the methods. Include a discussion of the limitations of this measure in the
discussion section. (See e.g. Choiriyyah, I., & Becker, S. (2018). Measuring Women's Covert
Use of Modern Contraception in Cross-Sectional Surveys. Stud Fam Plann, 49(2), 143-157.
doi:10.1111/sifp.12053)
9. Line 195 should read “Independent variable”
10. Cite literature referred to for determination of control variables (Line 205)
10. Line 224 please include a citation for the stata version; also, the correct spelling is “Stata”
Results
11. Line 237-239 nearly 11% of women not knowing whether their partner supports their
contraceptive choice is important. Authors later (Line 286-288) report, “. In addition, women
who indicated that they do not know if their partners support them in their contraceptive use were
less likely (AOR=0.26; CI 95% 0.10-0.72) to use a modern contraceptive method compared to
those with no support from their partners.”  Discuss in the interpretation of results. This has
programmatic implications for partner communication.
12. Line 259 “using any modern contraceptive method to prevent pregnancy”… how was the
question asked? Include in the methods so it is clear. (written this way it seems like women could
have responded they were using contraceptives for other reasons; e.g. menstrual regulation)
13. Table 2: how many of these women were pregnant? You need to exclude pregnant women
from the analysis. A non-user because she is pregnant is different from a non-user with unmet
need. The analysis should be current users of contraceptive methods among those in need of
contraception.
Discussion
14. Please include further contextualize of your results. How do they relate to literature in
the field? Again, suggest referring to the STROBE guidelines here. See: https://www.strobe-
statement.org/checklists/
15. Include a further discussion of study limitations. E.g. discussion of the cross-sectional nature
of the study, limitations of the covert use measure, how did you account for women who were
pregnant at the time of the survey? Were these excluded? Justify
16. Line 344 Not sure what you mean by "stepwise process"? Can you clarify?