PONE-D-20-15843

Prevalence and Factors which Influence Early Antenatal Booking Among Women of Reproductive Age in Tanzania: An Analysis of Data from the 2015-16 Tanzania HIV and Malaria Indicators Survey

PLOS ONE

Dear Dr. Moshi,

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: No

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: No

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: No

Reviewer #2: No

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The article contains some interesting information regarding factors related to antenatal care visits in underserved settings, but the reviewer would like to make some comments before it should be considered for publication.

Major comments

1. In the Introduction, the author needs to fully and thoroughly review previous research regarding antenatal care (ANC) visits. There are several review articles related to positive and negative factors of ANC participation. In both high and low-middle income countries, low maternal education, non-marital status, and high parity are associated with inadequate use of ANC (Simkhada, 2008; Feijen-de Jong, 2012). Then, the author needs to describe why the study on Tanzania is required at this time.

2. The reviewer does not clearly make the connection between the last sentence “little is known …”, in the last paragraph and the second to last paragraph in the Introduction. Also, there is no statement of the objectives of the study.

3. The author stated that the WHO recommended antenatal model including numbers of ANC visit in 2016. However, the author uses data collected in 2015-2016. The reviewer assumes that ANC provision may have followed the previous WHO recommendation at the time of data collection in Tanzania. It may be reasonable to evaluate data in 2015-2016 according to the previous WHO recommendation and the national guideline of ANC at the time of data collection. In addition, more detail of ANC related conditions in Tanzania, which are distribution of healthcare personnel and healthcare facilities, and quantity and quality of ANC provision, will be informative for readers of this manuscript, if the author adds them in the Introduction section.

4. If the author provided an association between religion and ANC visits, it would be informative, because early ANC visits were less likely to be observed in Zanzibar than mainland, where there are more Muslims.

5. If the author considered confounders and/or mediators among independent variables, it would be informative to the interpretation of the findings.

6. The author mentioned that teenage pregnant women are less likely to initiate ANC visit than the older pregnant women. Is there a possibility of unplanned teenage pregnancy without marriage? How about conditions for and provision of youth friendly services in Tanzania? How about cultural and/or social norms regarding teenage pregnancy? The reviewer considers marital status, cultural and/or social norms, and access to and quality of youth friendly services provision are important factors when evaluating maternity services including ANC and consequences/outcomes among teenage pregnancy.

7. In the last paragraph of the Discussion section, the author should discuss in-depth the Zanzibar conditions from the perspective of religious, cultural and/or social norms, distribution of healthcare personnel, and quantity and quality of ANC service provision.

8. It would be better to describe the limitations of this study in the Discussion section.

Minor comments

1. Abstract: In the Results section, AOR and CI should be spelled out when used for the first time.

2. Results section: In the “Factors which influence early antenatal booking”, AOR and CI should be spelled out when used at the first time.

3. Discussion section: The last sentence of the third to the last paragraph needs referencing. ‘Previous studies have reported that pregnant women ….. if compared with those without complication.’

4. Overall, the reviewer recommends basic editing of the article, such as adjusting spacing between word and word, word and brackets, and after comma, because there are unnecessary spaces and/or no spaces.

Reviewer #2: REVIEWER COMMENTS

Abstract: Minor grammatical errors to be corrected

Introduction: Requires cleaning up. The literature review in the introduction section needs to be summarized especially the area on WHO 2016 report. It is more of copy and paste.

Methods

Study population: Conflicting figures from the previous statement

Sampling technique: The sampling technique is faulty. What you did is a multi-stage sampling and not two stages. Tanzania was divided into 8 zones. This should have formed your clusters or strata from where you will select the households. How did you arrive at 608 clusters?

How you reached your study participants after selecting the households was not stated

Data collection tool: Was the translated questionnaire to Kiswahili Tanzania’s national language validated? If not it is a flaw in this study

How you administered the questionnaire to the study participants was not expla9ined

Data analysis: Recast the first sentence

Results: What happened to 117 of the study participants?

Discussions: Requires cleaning up for grammatical errors

Conclusion: What you did is not an interventional study so delete

Declarations: The questionnaire was used as interview guide to interview your study participants.

References : Revisit to be consistent,

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Reviewer #1: No

Reviewer #2: No

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Prevalence and Factors which Influence Early Antenatal Booking Among Women of Reproductive Age in Tanzania: An Analysis of Data from the 2015-16 Tanzania HIV and Malaria Indicators Survey

PONE-D-20-15843R1

Dear Dr. Fabiola V. Moshi,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Claudia Marotta

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

dear authors congratulations

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: There are still inappropriate editing of the article, such as adjusting spacing between word and word, word and brackets, and after comma.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No