Reviewer's report
Title:Keeping silent about emergency contraceptives in Addis Ababa: a
qualitative study among young people, service providers, and key stakeholders
Version:1Date:13 July 2014
Reviewer: SEIFU GEBREYESUS
Reviewer's report:
General comments
The research question posed by authors on Emergency contraceptives is very
Important and timely. The introduction of EC as a public health measure to
combat unwanted pregnancy has brought a major challenge and the authors’
should be acknowledged for picking this topic and for their interesting work.
However, some major revisions are still required to improve the manuscript.
.
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1. Abstract
Use Background (not Introduction)
Methods: Stick to the study design, methods of data collection and it would be
useful to know the total number of people who participated in the study.
2. Introduction
a) There is a need to structure the introduction section (comment also applies to
other sections of your manuscript) for making it clear and suitable for readers.
b) Line 34-35: it is better to put the message than the quote,
c) Line 45-47: second paragraph (the last couple of lines): i am not quite sure
that this is how regular or repeat use is defined. Please put a reference
otherwise.
d) I did not see anywhere in this section a statement describing the research
gaps that the study is trying to address.
e) You may need to add specific objectives of your study at the end of this
section.
3. Methods
a) Structure: There is also a need to structure this section for making it clear and
suitable for readers. All what you need is there in the document. You may use
the following structure:
e.g Study are and period: The study is conducted in Addis Ababa city
administration. It is carried out from—to ---
Study design and methods of data collection: This study used qualitative design
and ethnographic method. The study employed prolonged observation, informal
interviews, key informant interviews, and a semi structure questionnaire.
Sampling…
Data collection process: how is the process of the data collection? What did you
do first, what follows? This will give a reader a good picture of the process.
Data analysis: how did you analyses the data? What methods did you use? Was
the data thematically analyzed? What software did you use? etc
b) Content
• You specified the age group 15-29 (line 98). How did you make sure that all
your observations and other data are only from this age group? Did you ask
about their age while observing? Please clarify.
• You indicated a snowball sampling method for recruiting 30 participants (line
101 and 135). When did you collect that data? It seems that you have been on
follow-up from September 2012 to January 2014. How did you select
participants? What was the criteria for selecting participants?
• The statements at line 102 and 103 should be taken to objective section.
• The statements at line 131 and 134 should be taken to the first part of the result
section
• I leant that you used covert observation at the beginning of the study. The issue
you are studying is sensitive (related to sex). How do you see that Interms of
privacy? Informed consent of study participants?
4. Results
• The results look more of a raw data and lacks interpretation and triangulation
with the different data sources.
o For example line 282-283: what do we learn from this observation notes? Good
themes/category that can come out form this and other data could be: Secrecy,
fear, shame. Why do these youngsters have a fear to buy EC? Why shameful to
buy? You need to put the data in this context and discus the results.
o A very good example of interpretation is found at line 284 to 287.
• It may not important to write who said a given statement unless you have a
good reason for it. E.g Line 190 (He also said…) line 194 (according to the
country director of ..)
• You discuss lack of improve access to and information about FP methods (line
191-193). Do you think that this is a sound conclusion? Can you think of other
reasons that EC is more popular than other FP methods from your data? This is
where data triangulation plays a role.
• On page 9 (line 220-224), When discussing results from your informal
discussion, you mentioned many reasons why the informants are using EC. This
section which I believe one of the main objectives of the study needs to be
discussed in detail. You gave more emphasis on results from stakeholders and
key informants interview.
• On page 13 (line 341-347): What kinds of questions were asked? What was the
objective of this semi quantitative part of your study?
• You indicated that (line 102-103) “ ..A deeper understanding of young people
experience with dating, relationship and fertility regulating methods was gained”
But I did not see result about dating, relationship etc anywhere in the document. I
think you need to clearly indicate the specific objectives of this paper and follow
them to display your results.
5. Discussion:
Line 424-426: you again listed a different set of objectives. Please be consistent
in your objectives.
Do you feel that this high and frequent use of ECs is due to lack of information of
other types of FP or other reasons? Please discuss more.
How do you see the transferability of this study for youngsters in the rural part
and other urban areas outside of Addis Ababa Ethiopia? I believe that there is a
different context, you may stick you discussion and other recommendations to
young people in Addis Ababa.
Line 498-503: Why did you mention sample size here as an issue ? This is a
qualitative study with a different theory than quantitative methods. We are here
interested in depth of information. We do not start out setting that I will interview
this # of informants. Then, when did you stop your data collection? What was you
base to decide stopping further data collection?
The conclusion should provide a strong message about the secrecy and shame
associated with accessing ECs.
Level of interest: An article of outstanding merit and interest 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 declare that I have no competing interests