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:14 July 2014
Reviewer: Sara S Randall
Reviewer's report:
1. This is an engaging and well-written article which reports on the findings of a
qualitative investigation of use of and attitudes to emergency Contraception (EC)
in Addis Ababa, Ethiopia. The work does not set out to address a specific
question, but aims to “discuss[es] the beliefs and practices concerning the use of
ECs among young people, service providers, and key stakeholders in Addis
Ababa, Ethiopia.”. This they achieve and in doing do address the diversity of
attitudes towards this contraceptive method and analyse the reasons particular
types of people hold their different attitudes and the logics behind this – along
with the implications for correct and appropriate use of the method.
2. One aspect which the article does not address is that of gender. Nearly half
their young respondents were male and the descriptions of encounters within
pharmacies often highlighted the gender of the pharmacy assistants. More
explicit awareness of gender issues (and decision making) in seeking EC and in
being informed / informing about EC would strengthen the paper.
3. The methods are clearly described and very appropriate for this type of study.
Although primarily qualitative they triangulate using a range of methods including
(extremely informative)observation, and interviews with people in very different
positions and relationships to the provision and use of EC. They have generated
interesting data from which they draw a number of quotations to illustrate their
claims.
4. It is not made clear who funded the study and whether the transcripts of the
interviews have been made available in a data archive. Given that the material
constitutes the data for the (as yet unfinished) PhD of one of the authors, it is
probably premature to expect the data to be deposited and available for
inspection.
5. The discussion and conclusions are well focused around the findings and
supported by the data. Again though, a greater reflection on gender roles in the
different ways of accessing EC and ways that information is transmitted would
have enhanced the conclusions.
6. The limitations of the work in terms of sample size are clearly stated. Given the
emphasis in the conclusions of the necessity for further written information it
would have been appropriate to have included some information in the table of
educational levels of respondents – and how representative these are of youth in
Addis Ababa. Is this a study which mainly focuses on educated middle class
youth or one which encompasses a wider cross section of urban Ethiopian
society?
Minor Essential Revisions not for publication
Table 2 has misleading categories for previous use of EC. It should be either 2-3,
4-5,6-10 or 2, 3-4,5-10 times. Each category needs to be exclusive.
Table 2 would benefit from a categorisation of the educational levels of
respondents if this is available.
Discretionary Revisions
Include a wider discussion of gender issues in terms of knowledge about and
access to EC and the relationships between clients and providers and both
partners in client couples (where appropriate)
Add details of educational levels of respondents into table 2 along with
comments on the educational / social class representativeness of a wide/ narrow
cross section of urban Ethiopian society
Level of interest: An article whose findings are important to those with closely
related research interests
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