Reviewer ’s report  
Title: Postnatal Care Utilization among Urban Women in Nor thern Ethiopia: Cross -Sectional 
Surve y 
 
Version: 0 Date: 17 Jan 2017  
 
Reviewer: Robert Liston  
 
Reviewer's report:  
This paper reports on utilization of post natal care services in an area of Ethiopia, the aspects of 
preventive medicine covered, as perceived by the women, and the factors that are a ssociated with 
attendance for care. As such it provides  information that is useful for those planning and 
providing maternity care services and merits publication. The design is appropriate, the results 
clearly presented and logical conclusions are drawn.  There are a few errors of English but none 
that affect understanding of the paper. There are however a few errors that require correction 
prior to publication, which I will attempt to identify below:  
 
1. The Background provides a commentary on the state o f maternal and infant mortality in Sub 
Saharan Africa and in particular, Ethiopia, including noting some of the activities underway to 
address the problems. In my opinion the relevance of the study presented would be enhanced 
if the link between post natal  care , especially the coordinated activities of observation, care 
and response, and disease and death prevention was more clearly stated and stressed. This 
discussion could also focus on the "timing " of visits, to permit observation , care and 
response, as recommended by WHO, to enhance effectiveness.  
 
2. The background section makes reference to the level of utilization of post natal care in 
Mekelle Zone, but is it 45% , as quoted from reference 16, or is it 33% as stated (non 
referenced) in the paper?  
 
3. Method: The most important correction is in the method section, where it states the women 
subjects were recruited from among  women who attended health facilities for "PNC 
services". Clearly this was not the case! As stated in the discussion, women were  recruited 
from those who attended health facilities for MCH reasons. This has to be the true recruitment 
base, otherwise how could women who did not know about "PNC services " be included? The 
associations of attenders for PNC services and non attenders m akes no sense if the base for 
inclusion is women attending for "PNC services". Please correct the method section to clarify 
this. 
 
4. Results: There is a disconnect between the numbers presented in the "socio -demographic" 
section and the "obstetrical histor y " section. In the former it is stated that 37 of 367 
participants attended for care of a sick mother and 82 for care of a sick baby, but in the latter 
section it states that 21 of total had health problems during post natal period for mother or 
child or both. Please clarify this apparent dichotomy.  
 
    Also in the results section 170 women knew of PNC service availability, of which 73 knew of 
the timing of one visit but only 2 were aware of the recommended timing of the 4 visit schedule 
articulated by WHO . It would be interesting , and of importance , to know of which visit the 73 
were aware of the timing. The timing of observation in the post natal period has relevance in the 
prevention of maternal and infant mortality.  
 
    It is noted that only 23 women had visited within 3 days of birth. Further information on these 
women and their reasons for visiting would be relevant to disease prevention. Were they perhaps 
the only 3 who were aware of the importance of post natal observation 48 hrs after birth?  
 
    Continuing in the results section, considering the reasons for visiting the health facility, 43 did 
so for" Post Natal Care follow up". What does this mean? Is this a repeat visit or is it a visit 
initiated by a recommendation at the time of birth, prior to  discharge, (almost all the women gave 
birth in a health facility), perhaps as a result of a problem?  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
No 
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.  
Yes 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an addition al statistical review is recommended, please speci fy 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  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any  way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or i n the future?  
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give de tails below.  
 
I declare that I have no competing interests  
 
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