Title: Predictors of contraceptive method discontinuation among adolescent and young women
in three West African countries (Burkina Faso, Mali, and Niger)
Version: 1 Date: 27 Dec 2020
Reviewer's report:
It was a wonderful experience to read your manuscript. The manuscript is entitled “Factors
predictive of contraceptive discontinuation among adolescent and young women in three
West African countries (Burkina Faso, Mali, Niger)” and aims to “estimate the magnitude
of contraceptive discontinuation and analyze the factors associated with the contraceptive
discontinuation among adolescents and young women using DHS data from 2010 to 2013 from
three West African countries, Burkina Faso, Mali, and Niger.”
When the word “magnitude” is used in health study, it is expected a more in-depth understanding
of the phenomenon (contraceptive discontinuation). Data about the entire problem dimension
should be presented as: 1) prevalence and/or incidence of contraception use, pregnancy,
abortion, and sexual infection; 2) which contraceptive method is being used; 3) vulnerability
data; and others. Another thing expected is to present recommendations for health action.  This
study has the honorable purpose of “to estimate the contraceptive discontinuation (…)”.
In the objective of the study, the “data from 2010 to 2013”  is mentioned but in two different
locations a “five-year period” is also mentioned. This information was a little confusing to
understand. Was data collected from 2010 to 2013 requesting information of the previous 5 years
(retrospectively)? Or was data collection completed between 2010 and 2013?
I am not sure if the “background” really introduces the studied phenomenon. There is
information on “study setting” that would be better in “background”. Why were data from
these three countries chosen to be presented together? Are there cultural, social or religious
similarities?
A link is presented in methods to access collection methodology, but it is a link to the
website itself. Is there a more direct link to data collection methodology used to this specific
study? I would like to make a similar suggestion regarding the questionnaire. The website
presents different versions of the questionnaire according to “phases”. Which was used, core
questionnaire phase 5 or 6 or other? Which section was data extracted from? If it comes from
section 3 of the core questionnaire 6, there is valuable information that could also be presented.
For example, specific information of each contraception method used. Were women excluded
if they answered in the first interview that they were pregnant? Were they also excluded from
follow-up? Was it a face-to-face or an online survey? If it were online, how was data collected
from those 4.9% without media access? Or is “media access” referring only to television and
other media?
Table 1 does not present the meaning of “###” and “####”. Is the p-value column set incorrectly?
The term “uneducated” is a synonym for “rude”, “unschooled” or “without formal education”  or
“without schooling” would be more appropriate. Table 1 (continued 2) – Is columm “(n=2264)
%” missing?
I really missed reading about the meaning of the results considering the culture of these countries
and how it could influence clinical practice. It is said “First, women may not want to report
their experience of contraception discontinuation due to social reasons.” but experience is
a subjective phenomenon best studied through a qualitative study. If you had performed a
mixed methods study, you could say so. The suggestion of a qualitative study to better and
deeply understand the experience of these young women while using contraception methods is
important. It is difficult to take “into account some factors when developing youth reproductive
health programs” without understanding why the ideal family size in Niger is 6 or more children
and the meaning of having more children for both men and wife.
Finally, English proofreading is always welcome.