Title: Perceived ideal number of children among adolescents in sub-Saharan Africa: does
exposure to family planning messages matter?
Version: 1 Date: 12 Apr 2023
Reviewer:  Michael Kunnuji
Reviewer's report:
This is an interesting analysis. You have used fertility preference, the desired number of children,
the ideal number of children, and the ideal family size interchangeably in your analysis. This
does not read well. Choose one and be consistent with its use. The problem may have come from
the DHS data, but the authors can clarify and operationalize their concept at the beginning. In
the very strict sense, the ideal number of children is not the same as fertility preference. While
the latter refers to what an individual considers perfect or recommended, preference is about
what an individual wants for themselves. One may consider three children ideal, but for health
reasons, choose to have one. Another may consider two as the ideal, but because he is the only
surviving son, he prefers to have 6 to make up for what was 'lost' in a generation. The authors,
therefore, need to make the most of the DHS data by carefully conceptualizing the variables
of interest based on how the questions were asked. See the question here: If you could choose
exactly the number of children to have in your whole life, how many would that be? This is
more about preference, not necessarily about the ideal.
Abstract
Adolescents from Lesotho had the lowest average desired family size at 2.1 (95%CI=2.0, 2.2)
while those Mali had the highest average ideal family size of 9.5 (95%CI=8.7, 10.4) ...
I don’t think this contributes to the results on exposure to FP message and desired family size.
Exposure to family planning communication has shown the potential to influence adolescents’
fertility behaviour in the region. ..
The study did not explore this, so there is no basis for this conclusion.
West and Central African countries, suggesting that high fertility remains a social concern in
these regions.
Introduction
on the decline trajectory ... The writing in many parts is superfluous. Make it more succinct.
Delete trajectory, for instance.
Using multivariate logistic regression models, the study also sought to establish sub-regional
and country level heterogeneity... Change heterogeneity to variation. Also, country-level ....
Measures
In second first... Meaning?
via visit a community health work )...  Recast.
SE version 16.0... Abstract reads 17.
Results
Results shows... show, not shows.
What results/test? Be specific
Adolescents who lived in rural areas of SSA were 18% less likely to desire large family size
compared to their counterparts living in urban areas.
Confirm that this is the result. Rural areas typically have higher fertility, and maybe, higher
fertility desire. In Nigeria and several other parts of SSA, it is the exact opposite. Check to see
how variables were coded. There may be a mix-up somewhere.
Furthermore, results in Table 3 show that, use of contraception and visiting the health facility in
the last 12 months were positively associated with reduced odds of desire for large family size
as 29% twenty-nine of adolescents who were using contraception and 14% who visited a health
facility were less likely to desired  a large family size.
The reporting of the results is very clumsy. Use 'positively' with care.
Table 3: Results of multivariate analyses examining the effect of individual level factors on
desired desire for a large family size among adolescents in sub-Saharan Africa
Indicate the reference categories.
Another notable finding from this study was the effect of contraceptive use on desired family
size. Contraception in adolescence was associated with a low chance of desiring large family
sizes. Twenty-nine percent of adolescents who used any form of contraception preferred a
small family size. This finding signifies the importance of family planning programmes in sub-
Saharan Africa’s agenda to reduce population growth rate through fertility reduction. Many
studies conducted in SSA (16,41,42,44) have found that contraception enables women in the
reproductive age to make an informed decision about planning their births and decide their
desirable number of children. Such decisions have far-important health benefits for couples and
their households at large.
... their desired number of children.
The argument here could be the exact opposite. People using contraceptives are doing so because
they prefer lower fertility. Your argument is that they desire fewer children because they use
contraceptives. That’s not likely.
References should be properly formatted.
The entire work should be thoroughly copy-edited.