Title: Role of husband’s attitude towards the usage of contraceptives for unmet need of family
planning among married women of reproductive age in Pakistan
Version: 0 Date: 04 Dec 2020
Reviewer's report:
The authors have written about an important topic and have a worthwhile intervention by
examining the role of social norms in influencing reported unmet family planning needs among
women in Pakistan.
One concern is that the article does not engage at all with the construct validity of the measures
it uses or the concepts it discusses. There is no discussion of social norms, what they are, why
we would expect them to shape unmet family needs, and, importantly, why husbands opinions
are a valid measure of them.
In my opinion, a stronger approach is to stick to exactly what the data represent. Instead of
measuring social norms, they are measuring husbands attitudes. Social norms, in my opinion, are
contextual features of cultural environments. They may be reflected in husbands' attitudes; but
to focus so much on social norms, as the paper does, requires a much broader engagement with
culture that I don't think is necessary or useful in this case. And, most importantly, it gets away
from what the primary independent variable is directly measuring. Generally, when scholars
measure social norms they use some type of latent variable analysis combining several measures
to make inferences on a context. Since the authors have only the one measure, I suggest they
stick to what it most clearly represents. An alternative framing focusing on husbands views
toward family planning and motivated more firmly on why those may be consequential would
be a much clearer and stronger contribution.
In addition, much more attention needs to be devoted to the methods. I suggest extending the
discussion of the data and measures. How was the survey collected? How were respondents
selected? More importantly, details should be given as to how, exactly, key constructs were
asked in the survey, such as UMNFP, WSH, and social norms. Question wording and response
options should be included to show the validity of these measures.
I am unfamiliar with the functional form model given in the methods. In my field, these are
almost always done in the form of an equation showing the model used in analysis. In this case,
that would be a logistic regression model. If using a functional form model is common in this
field, then stick with it. Otherwise, I believe using a logistic regression equation with annotation
for each variable included would improve clarity.
The presentation of results appears more as a list of items associated with unmet family
planning needs rather than a hypothesis-driven study. I suggest devoting less attention to the
controls and more attention to the focal independent variable of husbands' views toward family
planning. Focus on the coefficients, elaborate on their effects, perhaps consider providing a data
visualization of the predicted probabilities of the outcome across levels of the main independent
variable. The authors may consider discussing further on why husbands opinions matter so
much.
To the same end, the framing could be improved by motivating the study's particular focus on
husbands opinions. Engaging with literature that may suggest that these factors matter would be
a great start to motivate the hypotheses explored.
Lastly, I suggest the authors examine previous articles in the journal and model their presentation
of results in a similar fashion.