Reviewer's report
Title:Prevalence And Determinants Of Unintended Pregnancy Among Pregnant
Woman Attending ANC At Gelemso General Hospital, Oromiya Region, East
Ethiopia: A Facility Based Cross-Sectional Study
Version:4Date:12 January 2016
Reviewer: Melissa L Harris
Reviewer's report:
Abstract: There are still a number of grammatical errors in the abstract. These
need to be addressed. There are also structural, grammatical and spelling errors
throughout the entire document. The manuscript is unacceptable in its current
form and requires professional editing services for authors whose first language
is not English.
Introduction: Contextual information regarding the sexual and reproductive health
services available for Ethiopian women is still lacking.
Methods:
1. The definition of unintended pregnancy needs to be explicit in the methods
section when defining your variables. Also what is meant by final decision
maker?
2. Although the authors indicate that the variables were included in the analysis
as they show significant association with unintended pregnancy in the literature
in the response to reviewers’ document, there is no justification for the inclusion
of any of the variables in the manuscript. You need to explain out definitions for
each of the variables e.g. the issue about parity that you explain in 10a of the
response document. What is the significance of including availability of TV or
radio?
3. No reference has been made in text regarding the inclusion of the interview
questions as a supplementary file.
4. Clarification regarding the “pretesting sensitivity” analysis is required.
5. Detail about when the surveys were administered is needed to be included in
the manuscript and not just the response to reviewers’ document. The same
goes for information about the setting in which women completed the survey and
the time to complete the interviews/surveys.
Results:
1. The point being made regarding deleting the word “about” in your results
section is that you should just report the exact odds ratio. It is redundant to say
the odds were about 4 times greater when the AOR=4; it is 4 times greater.
2. Standard approach to explaining odds ratios is to include the p value in your
statement. At times you now have too many % signs
Discussion: I don’t think enough has been done to place the important findings of
your work within the context of existing literature, particularly with regard to
Ethiopia. You have to remember that many of your readers will not be aware of
the cultural implications surrounding sex and contraception. It is up to you to
provide this information.
1. Regarding citation for your comment about women who are divorced or
widowed being more likely to engage in sexual activities for reasons other than
child bearing, or that they are less likely to access contraceptives due to stigma,
there has to be some general literature surrounding pre-marital sex being taboo
etc.
2. Discussion surrounding the concept of unintended pregnancy occurring
because women do not see themselves as fertile was not well addressed. It
needs more of a discussion placing your findings in context with what is
happening in developed countries and what the implications may be.
Limitations: You need to add that the findings may not be representative of
unintended pregnancy in Ethiopia as it was a clinic-based study
Conclusion: The conclusion (as well as the discussion) could still be stronger. Is
it that simple in Ethiopia to make contraception accessible to all reproductive
aged women? In light of the cultural issues you mentioned, I believe this answer
to be far more complex and warrants discussion.
Level of interest: An article of limited interest
Quality of written English: Not suitable for publication unless extensively edited
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
Melissa Harris was previously employed as a Project Coordinator on a funded
Australian Research Council Linkage grant that received some cash and in-kind
support from Family Planning NSW and Bayer Australia Ltd.