Reviewer’ s report
Title: Patterns, trends, and factors associated with contraceptive use among adolescent girls in
Zambia (1996 to 2014): A multilevel analysis
Version: 0Date: 03 Nov 2019
Reviewer: Seema Vyas
Reviewer's report:
This study explores, descriptively and by using multilevel modelling methods, the relationship
between contraceptive use and sociodemographic characteristics among adolescent females inZambia. The study uses four rounds of Demographic and Health Surveys spanning over 16 years.
What lets this paper down is the lack of theoretical framing to contextualise the methodological
approach, interpretation of the findings and subsequent discussion. Rather the authors seem to relyon findings from a small number of studies to develop their conceptual framework which islimited to a handful of sociodemographic characteristics. For example, there is no exploration offertility intentions among this population or power dynamics between adolescent girls and theirpartners.
The methods section requires greater clarity. As a result it is difficult to assess the appropriateness
of the methodological approach. For example, the authors state current contraception method is abinary variable but do not describe whether this includes traditional or non-traditional methods orwhether this includes partner use of contraception.
It is not clear why the authors include all adolescent girls in their analytical sample given that
almost 80% have never been in a union of which a proportion have never had sex. Why wouldcontraceptive use be measure among these girls?
The authors do not explain why they use multilevel modelling especially as there is no mention of
the random effects in the Results section.
Table 2 is confusing. There are four columns for each survey round but no labelling to discern
what the data in each column reflects. The sample sizes should also be provided.ease include all comments for the authors in this box rather than uploading your report as anattachment. Please only upload as attachments annotated versions of manuscripts, graphs,supporting materials or other aspects of your report which cannot be included in a text format.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Unable to assess
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Unable to assessAre the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
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 furtherassessment in your comments to the editors.
I am able to assess the statisticsQuality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being publishedDeclaration of competing interests
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