Reviewer’s report
Title: 
Methods women use for induced abortion and sources of services: insights
from poor urban settlements of Accra, Ghana
Version: 
1 
Date: 
26 Sep 2020
Reviewer's report:
Full title : Methods women use for induced abortion and sources of service:
insights from poor urban settlements of Accra, Ghana
Manuscrit number: BMWH-D-20-00845R1
The study is quite relevant to understanding contextual issues relating to unsafe
abortion in Accra, Ghana. It also highlights the patterns of service use to induce
abortion in that country.
Comments:
1. Background:
Page 3 line 50-51: It is better to specify in which year this rate of 460 deaths per
100,000 abortions occured.
Page 4 line 62: Please replace [9) by [9]
Page 4 line 69: 
… leads to self-inducing abortions and the use of methods that
are unsafe. When are self-induced abortions considered safe abortions? Aren't
they already qualified as unsafe abortion according to the WHO definition of
unsafe abortion in the "less safe" sub-group? 
Page 5 line 96-97: Can the author develop how can it be possible that
unregistered products have become widely available at pharmacies?
It would be more appropriate to add some references about inequalities of access
to health care in poor urban communities and to compare with other countries in
Africa.
2. Methods 
2.1. Study setting and sampling process
Page 7 line 137-144. It would be appropriate to add a flowchart describing the
population approached and the final population analyzed to improve the
understanding of this part. 
2.2. Data collection
How did the enumerators do to ensure reliability of the information collected?
2.3. Measures 
Page 9 line 193. How was the classification into 5 sub-groups of the wealth
index obtained?
2.4. Analysis
Page 10 line 216. Explanatory variables… influence the response variable. How
did the authors manage the possible correlations between the variables?
3. Results 
The results have also been well presented. However, figure 2 needs to be
improved as some values are illegible.
4. Discussion 
Page 19 line 345 - 347. Nevertheless, this conflits … big of barrier. 
Isn't this
result related to the fact that the study took place in an poor urban settlements,
which might suggest that even if classified as rich, these women would not have
access to proper care in their environment? 
Page 19 line 350-353. This is also contrary … is largely obtained. Did the
authors analyze the correlations between the 2 variables (woman's marital status
& religion) to expect this statement?
Page 21 line 402-406. It would be more appropriate to move this last paragraph
to the limitations section 
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
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from apparent manipulation?
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