Reviewer’s report
Title:  Effect  of  a  Postpartum  Family  Planning  Intervention  on  Postpartum  Intrauterine  Device
Counseling and Choice: Evidence from a Cluster-Randomized Trial in Tanzania
Version: 0 Date: 27 Jan 2020
Reviewer: Kelvin Nsanya
Reviewer's report:
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Title: Effect of a postpartum family planning intervention on postpartum intrauterine device counseling
and choice: evidence from a cluster randomized trial in Tanzania
This is a well designed and relevant study but has one major limitation as the authors correctly pointed
out. There is a potential for better findings with wider generalisability, had it been implemented in
lower facilities. 
I have the following comments: 
1.Under background, line 53, authors mentions that "the analysis focuses on the effect of the
intervention on this newly added service, including effects on PPIUD counseling and women's choice
of PPIUD (i.e having a PPIUD inserted) before being discharged from hospital after delivery.  Under
outcomes  of  interest  authors  mentioned  that  (line  39)  "Choice  of  PPIUD  was  measured  as  a
dichotomous variable based on both woman's report and the provider's report…..(line42) If either the
woman or the provider reported PPIUD insertion, the woman was considered to have chosen the
PPIUD"  .  It  appears  that   the  phrase  "PPIUD  choice"  and  "PPIUD  insertion"  are  being  used
interchangeably and bring confusion . A woman can choose PPIUD but not go for insertion.  In
addition, regarding line 42, was there a procedure to verify a woman's report of PPIUD insertion in the
provider's report/documents? If such procedure was not in place it would rather be better to strictly use
"PPIUD choice" and do away with "PPIUD insertion" as it was used under your conclusions.
2.The implementers of the intervention have been mentioned as FIGO/AGOTA and their roles
widely  described.  It  would  enlighten  the  reader  to  highlight  whether  data  collection  was  also
coordinated by FIGO/AGOTA or if there were any work related links with FIGO/AGOTA. 
3.Figure 1 Study Flow chart. The flow of numbers in group 2 is not correct and might need your
attention, (particularly for those who did not consent, n=648).
4.Under results, in page 7, line 29: authors refer to the trends in PPIUD choice…approximately
18% in Mbeya and 6% in Muhimbili, but when you turn to the figure it is less than 15% for Mbeya and
less  than 5% for Muhimbili. Again, as mentioned earlier, authors have used PPIUD choice in the text
and PPIUD insertion as the title of the figure which is confusing. 
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Unable to assess
Are 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 am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Acceptable
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