Key drivers of fertility levels and differentials in India, at the national, state and population subgroup levels, 2015–2016: An application of Bongaarts’ proximate determinants model

Susheela Singh; Chander Shekhar; Akinrinola Bankole; Rajib Acharya; Suzette Audam; Temitope Akinade

doi:10.1371/journal.pone.0263532

Peer Review History

Original SubmissionSeptember 23, 2021
16 Nov 2021 Decision Letter - Akanni Ibukun Akinyemi, Editor PONE-D-21-30800Key drivers of fertility levels and differentials in India, at the national, state and population subgroup levels, 2015-2016: An application of Bongaarts’ proximate determinants modelPLOS ONE Dear Dr. Singh, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has sufficient merit but requires minor correction to fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. ============================== Kindly attend to the comments from the reviewer. Also, There are few issues to be attended to: Delete the details about MA, the details add any value to the paragraph unless it has any influence on the abortion estimate used. it is more appropriate to show the sub-national variations of abortion incidence in similar way the other proximate factors were described. (An 141 estimated 73 percent of the 15.6 million abortions that took place in 2015 were induced through 142 use of MA obtained outside of health facilities (13). However, studies have found that the 143 information provided to clients purchasing MA drugs is generally inadequate and inaccurate, 144 including essential information on timing of administration of the medication and what side 145 effects to expect while experiencing the normal process of the abortion (20,21). Moreover, 146 pharmacists themselves have very poor knowledge about the correct regimen of the drugs to 147 safely induce an abortion (21,22)): ============================== Please submit your revised manuscript by December 31, 2021. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. 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Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Akanni Ibukun Akinyemi, PhD Academic Editor PLOS ONE Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf. 2. We note that you have included the phrase “data not shown” in your manuscript. Unfortunately, this does not meet our data sharing requirements. PLOS does not permit references to inaccessible data. We require that authors provide all relevant data within the paper, Supporting Information files, or in an acceptable, public repository. Please add a citation to support this phrase or upload the data that corresponds with these findings to a stable repository (such as Figshare or Dryad) and provide and URLs, DOIs, or accession numbers that may be used to access these data. Or, if the data are not a core part of the research being presented in your study, we ask that you remove the phrase that refers to these data. 3. Please include a new copy of Tables 1-3, S1 and S2 in your manuscript; the current table is difficult to read. Please follow the link for more information: https://blogs.plos.org/plos/2019/06/looking-good-tips-for-creating-your-plos-figures-graphics/ 4. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Additional Editor Comments : It is a well written manuscript. There are few issues to be attended to: Delete the details about MA, the details add any value to the paragraph unless it has any influence on the abortion estimate used. it is more appropriate to show the sub-national variations of abortion incidence in similar way the other proximate factors were described. (An 141 estimated 73 percent of the 15.6 million abortions that took place in 2015 were induced through 142 use of MA obtained outside of health facilities (13). However, studies have found that the 143 information provided to clients purchasing MA drugs is generally inadequate and inaccurate, 144 including essential information on timing of administration of the medication and what side 145 effects to expect while experiencing the normal process of the abortion (20,21). Moreover, 146 pharmacists themselves have very poor knowledge about the correct regimen of the drugs to 147 safely induce an abortion (21,22)): Part of tables 1 & 2 (last column) was cut off. Please, check the tables. Table 3 is long. You may consider it as part of the appendix. [Note: HTML markup is below. Please do not edit.] 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: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 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: Yes ****** 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: Yes ****** 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: A well written paper. The focus is of high public health relevance. The paper would be useful in providing evidences that can inform policies and programs that address gaps in access to sexual and reproductive health (SRH) services among Indian states and key population subgroups, through providing evidence on the role of the key determinants of fertility level across states and population groups. This study was nationally representative, hence its generalizability. The four contributors to fertility levels were explored. Methods were appropriate, results were adequate and well presented. The study limitations were identified and well stated but it appears to have overshadowed the strength of the paper. Can the authors “strengthen” the strength of their studies? L31: delete: possible because abortion incidence estimates were available for 2015; The aims and objectives of the paper should have been stated at the end of the introduction. This should be supplied. The aims and objectives is different from the usefulness of the study as currently stated in L97. The sampling methodology is missing. You should describe it briefly and refer the readers to where it could be found L304: How reliable/consistent is it to choose the longest duration of any of the four factors—breastfeeding, amenorrhea, postpartum abstinence, and non-contraceptive hysterectomy for each of the women? Rather than choosing a particular one for all the women? Marriage was explored as one of the determinants, but the actual measurement on marriage was not stated……age at marriage? Type of family? Etc which was considered? L357 – 361 - 371: Move to methods Table 1 : The last columns were cut off Table 2, 3 : The last columns were cut off Table 3 is too long…could it be presented as for example Table 3a for a specific state/region….else…Table 3 may go for a supplementary material There are no specific recommendations for policymakers and population programmers in India. This must be provided. ****** 6. 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: Yes:** Adeniyi Francis Fagbamigbe [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0263532.r001
Revision 1
17 Dec 2021 Author Response Manuscript Content • Delete the details about MA, the details add any value to the paragraph unless it has any influence on the abortion estimate used. it is more appropriate to show the sub-national variations of abortion incidence in similar way the other proximate factors were described. (An 141 estimated 73 percent of the 15.6 million abortions that took place in 2015 were induced through 142 use of MA obtained outside of health facilities (13). However, studies have found that the 143 information provided to clients purchasing MA drugs is generally inadequate and inaccurate, 144 including essential information on timing of administration of the medication and what side 145 effects to expect while experiencing the normal process of the abortion (20,21). Moreover, 146 pharmacists themselves have very poor knowledge about the correct regimen of the drugs to 147 safely induce an abortion (21,22)) Response: We agree that specifics on MA are not relevant for this analysis and have deleted those details. We have added information on what data on abortion incidence is available, and therefore used for the current analysis. • The study limitations were identified and well stated but it appears to have overshadowed the strength of the paper. Can the authors “strengthen” the strength of their studies? Response: We agree and have re-organized parts of the Discussion and edited the text to highlight the contributions of the study, while reducing the over-emphasis on limitations (by reducing repetition, focusing on study limitations as opposed to data limitations, and referencing future research needs to recognize areas where data are inadequate). • L31: delete: possible because abortion incidence estimates were available for 2015; Response: Agree and deletion made. • The aims and objectives of the paper should have been stated at the end of the introduction. This should be supplied. The aims and objectives is different from the usefulness of the study as currently stated in L97. Response: Agree and added to the text to address this suggestion. • The sampling methodology is missing. You should describe it briefly and refer the readers to where it could be found. Response: We have added a sentence on sampling methodology and study design for the two main secondary data sources used in this analysis (NFHS4 and a study on abortion incidence), and also provided references to published documentation on the methodology underlying these data sources. • L304: How reliable/consistent is it to choose the longest duration of any of the four factors—breastfeeding, amenorrhea, postpartum abstinence, and non-contraceptive hysterectomy for each of the women? Rather than choosing a particular one for all the women? Response: This is a standard demographic approach to integrating the impact of two or more behaviors that contribute to an outcome. This is logical because each behavior contributes to reduction in exposure to pregnancy and because individual women vary in practice of each behavior. In the Demographic and Health Surveys, for which most countries collect data on the first three of these four behaviors, the standard measure of infecundability is based on the behavior with the longest duration. Our adaptation to the standard measure is to add in one more behavior that is especially relevant in India, that is non-contraceptive hysterectomy. • Marriage was explored as one of the determinants, but the actual measurement on marriage was not stated……age at marriage? Type of family? Etc which was considered? Response: The index of marriage is based on proportions currently married for five-year age groups; it is a proxy for sexual activity and likelihood of pregnancy. We have added this information to the text in the methods section. This index does not incorporate type of relationship or family structure. • L357 – 361 - 371: Move to methods Response: We agree with the Reviewer that this paragraph fits better in the Methods section and have moved it to be the last paragraph of the methods section. This has the advantage that the reader will see it just before moving into Results, where those points are relevant and necessary for understanding the results that are reported. • Table 3 is too long…could it be presented as for example Table 3a for a specific state/region….else…Table 3 may go for a supplementary material. Response: We agree and have responded by dividing Table 3 into four segments, numbered Tables 3a, 3b, 3c and 3d. Each of these tables presents results for one socio-economic characteristic at the national level and for each state, and the four socioeconomic characteristics are: place of residence, educational attainment, wealth status, and caste. This approach has two important advantages -- in addition to having tables that are easier to digest, it facilitates comparisons across states for each characteristic. Our focus in interpretation of results is comparisons across states for each characteristic and not on within state comparisons across characteristics: Therefore, this change in presentation of results better serves interpretation of the results. We prefer to keep these tables within the body of the paper (rather than presenting them as an Appendix Table) because results from the subgroup analysis are a key contribution of the paper. • There are no specific recommendations for policymakers and population programmers in India. This must be provided. Response: We agree that more specific recommendations are needed. We have added a section on recommendations for policymakers and providers, particularly with respect to improvements needed in contraceptive services and abortion services. We also offer some recommendation for improving key relevant data. Formatting and Submission 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf. 2. We note that you have included the phrase “data not shown” in your manuscript. Unfortunately, this does not meet our data sharing requirements. PLOS does not permit references to inaccessible data. We require that authors provide all relevant data within the paper, Supporting Information files, or in an acceptable, public repository. Please add a citation to support this phrase or upload the data that corresponds with these findings to a stable repository (such as Figshare or Dryad) and provide and URLs, DOIs, or accession numbers that may be used to access these data. Or, if the data are not a core part of the research being presented in your study, we ask that you remove the phrase that refers to these data. Authors Response regarding “Data not Shown” : We have added Appendix Table 5 that presents findings according to groups of states by TFR level, and we reference this appendix table in the text. 3. Please include a new copy of Tables 1-3, S1 and S2 in your manuscript; the current table is difficult to read. Please follow the link for more information: https://blogs.plos.org/plos/2019/06/looking-good-tips-for-creating-your-plos-figures-graphics/ Authors Response: We have uploaded new copies of all tables, figures and supplementary Appendix Tables. 4. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Authors Response: We have checked references; we do not cite any retracted articles or other retracted sources. Attachments Attachment Submitted filename: Responses to Reviewers 12-17-21.docx https://doi.org/10.1371/journal.pone.0263532.r002
21 Jan 2022 Decision Letter - Akanni Ibukun Akinyemi, Editor Key drivers of fertility levels and differentials in India, at the national, state and population subgroup levels, 2015-2016: An application of Bongaarts’ proximate determinants model PONE-D-21-30800R1 Dear Dr. Singh, 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. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Akanni Ibukun Akinyemi, PhD Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0263532.r003
Formally Accepted
28 Jan 2022 Acceptance Letter - Akanni Ibukun Akinyemi, Editor PONE-D-21-30800R1 Key drivers of fertility levels and differentials in India, at the national, state and population subgroup levels, 2015-2016: An application of Bongaarts’ proximate determinants model Dear Dr. Singh: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Akanni Ibukun Akinyemi Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0263532.r004

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