Peer Review History

Original SubmissionApril 18, 2021
Decision Letter - Paola Viganò, Editor

PONE-D-21-12824

ASSESSING DETERMINANTS OF FAMILY PLANNING USE AMONG WOMEN OF REPRODUCTIVE AGE IN RURAL AREAS, MOROGORO, TANZANIA. MIXED CROSS-SECTIONAL  PROTOCOL STUDY.

PLOS ONE

Dear Dr. machange,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not 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.

Please submit your revised manuscript by Dec 02 2021 11:59PM. 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'.
  • An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. 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,

Paola Viganò

Academic Editor

PLOS ONE

Additional Editor Comments (if provided):

The Authors need to address the issues raised by the two Reviewers. More details on the study design, sampling procedure and data collection are required. Moreover, limitations should be described.

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 

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https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf

2. Please include additional information regarding the survey or questionnaire used in the study and ensure that you have provided sufficient details that others could replicate the analyses. For instance, if you developed a questionnaire as part of this study and it is not under a copyright more restrictive than CC-BY, please include a copy, in both the original language and English, as Supporting Information. If the original language is written in non-Latin characters, for example Amharic, Chinese, or Korean, please use a file format that ensures these characters are visible.

3. Please state whether you validated the questionnaire. Please provide details regarding the validation group within the methods section.

4. Please include a copy of the interview guide to be used in the study, in both the original language and English, as Supporting Information, or include a citation if it has been published previously.

5. In your Data Availability statement, you have not specified where the minimal data set underlying the results described in your manuscript can be found. PLOS defines a study's minimal data set as the underlying data used to reach the conclusions drawn in the manuscript and any additional data required to replicate the reported study findings in their entirety. All PLOS journals require that the minimal data set be made fully available. For more information about our data policy, please see http://journals.plos.org/plosone/s/data-availability.

Upon re-submitting your revised manuscript, please upload your study’s minimal underlying data set as either Supporting Information files or to a stable, public repository and include the relevant URLs, DOIs, or accession numbers within your revised cover letter. For a list of acceptable repositories, please see http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories. Any potentially identifying patient information must be fully anonymized.

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We will update your Data Availability statement to reflect the information you provide in your cover letter.

6. PLOS requires an ORCID iD for the corresponding author in Editorial Manager on papers submitted after December 6th, 2016. Please ensure that you have an ORCID iD and that it is validated in Editorial Manager. To do this, go to ‘Update my Information’ (in the upper left-hand corner of the main menu), and click on the Fetch/Validate link next to the ORCID field. This will take you to the ORCID site and allow you to create a new iD or authenticate a pre-existing iD in Editorial Manager. Please see the following video for instructions on linking an ORCID iD to your Editorial Manager account: https://www.youtube.com/watch?v=_xcclfuvtxQ

7. Your ethics statement should only appear in the Methods section of your manuscript. If your ethics statement is written in any section besides the Methods, please delete it from any other section. 

8. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information. 

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #1: Yes

Reviewer #2: Partly

**********

2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory.

Reviewer #1: Yes

Reviewer #2: Partly

**********

3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible.

Reviewer #1: Yes

Reviewer #2: No

**********

4. Have the authors described where all data underlying the findings will be made available when the study is complete?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. 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

Reviewer #2: Yes

**********

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

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

(Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Comments to the authors

I enjoyed reading the study protocol, and it is an important topic and well presented. This protocol manuscript is also well written. However, I do have some points that require the authors' attention.

� The discussion section must be added. This section should include the any issues involved in performing the study that are not covered in other sections. These can include: limitations of the study design & dissemination plans.

Sincerely,

Tesfalem Tilahun

Reviewer #2: The reviewer believes additional work would improve the quality of the manuscript before its publication.

ABSTRACT: Methodology

Authors indicate Objectives 1 through 3. However, readers do not know which objective you refer to 1, 2, or 3. Adding these numbers in the "Objective of the study" is recommended. Also, there is only one objective in the main text. Authors may consider including three specific objectives in the main text.

Keywords: "Women of Reproductive Age" would be more suitable than "Reproductive age."

Citation: Please be thorough on the citation format. Sometimes authors use (author, reference number), which is not consistent.

Introduction:

Women of Reproductive Age (WRA) appears first on this page. Please add an acronym where it first appears and be consistent in using it in subsequent text.

Authors define WRA are those aged 18-49. WHO and other UN agencies use the definition of WRA (15-49 years). Please provide annotation or explanation.

TDHS: where it first appears on page 4; please spell it out.

CycleBeads® is one word.

Literature review: it is suggested that authors add a review of more literature on contraceptive use among WRA in Tanzania (esp. Morogoro or neighboring regions) as many studies have already been conducted. By doing this, the authors will have a much more vigorous justification for conducting this study (including highlighting why this study has to be conducted among WRA in Morogoro and those residing in rural areas).

METHODS

Study Area: More description on Morogoro Region (the number of Districts within the Region, among which how many Districts are considered "rural," and how authors define "rural" in this study.

Research design: Do authors consider this study as a mixed-methods study? If so, please describe which design of a mixed-methods study the authors employ with its justification.

Sampling Procedure for Qualitative Approach

Please describe in more detail which approach of purposive sampling the authors adopt for this study.

How do authors determine key informants from the results of the quantitative study?

Data Collection Methods for Quantitative Approach

What kind of questionnaire do the authors plan to use for this study? Has it been validated?

Data Collection Methods for Qualitative Data

No details are known, but the authors' interview method in this manuscript would be key informant interviews rather than in-depth interviews.

Please also indicate whether recording and transcriptions are made, how long does each interview would take, and if the authors plan to interview the informants only once or iteratively.

Definition and Measurement of Variables

Would the dependent variables any FP use, rather than modern methods use?

During the qualitative interviews, authors should highlight on positive aspects of FP use rather than just focusing on the challenges.

**********

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: Yes: Tesfalem Tilahun Yemane

Reviewer #2: No

[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.

Attachments
Attachment
Submitted filename: PLOS ONE Review.docx
Revision 1

POINT-BY-POINT RESPONSES TO REVIEWERS’ COMMENTS

We would like to take this opportunity to thank you all, editors and reviewers from PLOS ONE We have appreciated all the comments given in order to improve the manuscripts. We have thoroughly responded to all reviewers’ comments. The table below is a summary of responses for the reviewers.

Comments to the authors Authors’ Response

Authors had revised the whole document for grammar check and clarity

1 Please include additional information regarding the survey or questionnaire used in the study and ensure that you have provided sufficient details that others could replicate the analyses. For instance, if you developed a questionnaire as part of this study and it is not under a copyright more restrictive than CC-BY, please include a copy, in both the original language and English, as Supporting Information. If the original language is written in non-Latin characters, for example Amharic, Chinese, or Korean, please use a file format that ensures these characters are visible. The questionnaire description has been revised. The questionnaire has been adapted from the Demographic Health Surveys questionnaire. We only selected the questions related to family planning for this particular study. Minor modification has been done.

The questionnaire has been uploaded as additional file (Appendix 1) (Page 6)

2 Please state whether you validated the questionnaire. Please provide details regarding the validation group within the methods section. The questionnaire was not validated because it was extracted from a standard questionnaire that is normally used for country wide survey.

However minor modifications has been made

3 Please include a copy of the interview guide to be used in the study, in both the original language and English, as Supporting Information, or include a citation if it has been published previously. A copy of interview guide has been added and uploaded as additional file

Attachments
Attachment
Submitted filename: PROTOCOL REVIEWERS RESPONSE Plos.doc
Decision Letter - Paola Viganò, Editor

PONE-D-21-12824R1To assess the determinants of family planning uptake among women of reproductive age in rural settings, Morogoro Region, Tanzania. Protocol for a cross-sectional studyPLOS ONE

Dear Dr. machange,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not 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.

==============================

ACADEMIC EDITOR: From the authors' response, it is unclear whether the Authors have addressed all the Reviewers' comments. One of the reviewer was not satisfied. The Authors should present a rebuttal letter with responses to all the issues raised and not only to some of them. The presentation of the manuscript completely highlighted did not help. It would have been much more useful to highlight only changes. All the Reviewers and Editorial issues need to be addressed.

==============================

Please submit your revised manuscript by Feb 27 2022 11:59PM. 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'.
  • An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. 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,

Paola Viganò

Academic Editor

PLOS ONE

Additional Editor Comments:

From the authors' response, it is unclear whether the Authors have addressed all the Reviewers' comments. One of the reviewer was not satisfied. The Authors should present a rebuttal letter with responses to all the issues raised and not only to some of them. The presentation of the manuscript completely highlighted did not help. It would have been much more useful to highlight only changes. All the Reviewers and Editorial issues need to be addressed.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #1: Yes

Reviewer #2: Yes

**********

2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory.

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible.

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors described where all data underlying the findings will be made available when the study is complete?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. 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

Reviewer #2: Yes

**********

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

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

(Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: In general, the author has made a good revision. I enjoyed reading the revised study protocol, and the comments what we give also addressed and well presented.

Reviewer #2: I understand that my comments have been shared with the authors. However, I do not think the authors have seen my previous comments as I do not see any changes in the manuscript. If authors have seen my comments, and if they do not agree with them, I would appreciate it if they state why they do not agree with my comments/suggestions in the next "author's response" in a "point-by-point" manner.

**********

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: Yes: Tesfalem Tilahun Yemane

Reviewer #2: No

[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.

Revision 2

POINT-BY-POINT RESPONSES TO REVIEWERS’ AND EDITOR’S COMMENTS

We would like to take this opportunity to thank you all, editors and reviewers from PLOS ONE We have appreciated all the comments given in order to improve the manuscripts. We have thoroughly responded to all reviewers’ comments. The table below is a summary of responses for the reviewers.

Comments to the authors Authors’ Response

General Authors had revised the whole document for grammar check and clarity

1.0 Second Round Reviewer’s comments

Reviewer #1

1.1 In general, the author has made a good revision. I enjoyed reading the revised study protocol, and the comments what we give also addressed and well presented. Noted, Thank you

Reviewer #2

1.2 I understand that my comments have been shared with the authors. However, I do not think the authors have seen my previous comments as I do not see any changes in the manuscript. If authors have seen my comments, and if they do not agree with them, I would appreciate it if they state why they do not agree with my comments/suggestions in the next "author's response" in a "point-by-point" manner. The comments were received. Authors worked on all the comments and the responses are given below serial number 3 of this document

The corresponding revisions are highlighted in respective sections of the document

2.0 Editor’s comments

2.1 Please include additional information regarding the survey or questionnaire used in the study and ensure that you have provided sufficient details that others could replicate the analyses. For instance, if you developed a questionnaire as part of this study and it is not under a copyright more restrictive than CC-BY, please include a copy, in both the original language and English, as Supporting Information. If the original language is written in non-Latin characters, for example Amharic, Chinese, or Korean, please use a file format that ensures these characters are visible. The questionnaire description has been revised. The questionnaire has been adapted from the Demographic Health Surveys questionnaire. We only selected the questions related to family planning for this particular study. Minor modification has been done.

The questionnaire has been uploaded as additional file (Appendix 1) (Page 6)

2.2 Please state whether you validated the questionnaire. Please provide details regarding the validation group within the methods section. The questionnaire was not validated because it was extracted from a standard questionnaire that is normally used for country wide health and demographic survey.

However minor modifications has been made to match with the current study

2.3 Please include a copy of the interview guide to be used in the study, in both the original language and English, as Supporting Information, or include a citation if it has been published previously. A copy of interview guide has been added and uploaded as additional file (Page 7)

3.0 First Reviewer’s comments

Reviewer #1

3.1 The discussion section must be added.

This section should include the any issues involved in performing the study that are not covered in other sections. These can include: limitations of the study design & dissemination plans • The discussion part has been added (Page 10 - 12)

• Limitation of the study design and dissemination plans added page 12

• Dissemination plan has been added on page 9

Reviewer # 2

3.2 ABSTRACT:

Methodology

Authors indicate Objectives 1 through 3. However, readers do not know which objective you refer to 1, 2, or 3. Adding these numbers in the "Objective of the study" is recommended. Also, there is only one objective in the main text. Authors may consider including three specific objectives in the main text. The section has been revised accordingly to accommodate the comments.

The broad objective has been maintained at the abstract section Page 2 and at the end of the introduction section page 4

The specific objective have been stated in numbers on page 4

3.3 Keywords: "Women of Reproductive Age" would be more suitable than "Reproductive age." The keyword has been revised. Page 2 and the word has been revised throughout the document

3.4 Citation: Please be thorough on the citation format. Sometimes authors use (author, reference number), which is not consistent. The citation format has been revised. Numbering style (Vancouver style) has been used throughout the document

3.5 Introduction:

Women of Reproductive Age (WRA) appears first on this page. Please add an acronym where it first appears and be consistent in using it in subsequent text.. • We have agreed to maintain the long form of the term women of reproductive age because the abbreviation is not standard and we are trying to reduce the abbreviations

Authors define WRA are those aged 18-49. WHO and other UN agencies use the definition of WRA (15-49 years)? Please provide annotation or explanation • We have revised the section and agreed to use the standard definition of Women of reproduction age as per WHO, UN i.e 15 – 49 years Page 5

3.6 TDHS: where it first appears on page 4; please spell it out. It has been revised and the acronym has been written in long from first before the acronym Page 1

3.7 CycleBeads® is one word. This word has been removed

3.8 Literature review:

It is suggested that authors add a review of more literature on contraceptive use among WRA in Tanzania (esp. Morogoro or neighboring regions) as many studies have already been conducted. By doing this, the authors will have a much more vigorous justification for conducting this study (including highlighting why this study has to be conducted among WRA in Morogoro and those residing in rural areas). The literature review has been added in the introduction section. – Introduction section page 2 - 4

3.9 METHODS

Study Area:

More description on Morogoro Region (the number of Districts within the Region, among which how many Districts are considered "rural," and how authors define "rural" in this study. Revised accordingly pages 3 – 4

The definition of rural is based on the current classification of these districts as per Report of Basic Demographic and Socio-Economic Profile of 2014

3.10 Research design: Do authors consider this study as a mixed-methods study? If so, please describe which design of a mixed-methods study the authors employ with its justification. Revised accordingly pages 5. This study will be cross-sectional with mixed approaches namely qualitative and quantitative

3.11 Sampling Procedure for Qualitative Approach

Please describe in more detail which approach of purposive sampling the authors adopt for this study.

How do authors determine key informants from the results of the quantitative study?

Data Collection Methods for Quantitative Approach Described accordingly Methods section pages 5 - 6

3.12 What kind of questionnaire do the authors plan to use for this study? Has it been validated? The questionnaire has been adapted from the Demographic Health Surveys questionnaire. We only selected the questions related to family planning for this particular study. Minor modification has been done.

The questionnaire has been uploaded as additional file (Appendix 1) (Page 6)

3.13 Data Collection Methods for Qualitative Data

No details are known, but the authors' interview method in this manuscript would be key informant interviews rather than in-depth interviews.

Please also indicate whether recording and transcriptions are made, how long does each interview would take, and if the authors plan to interview the informants only once or iteratively. Revised on page 7

3.14 Definition and Measurement of Variables

Would the dependent variables any FP use, rather than modern methods use? Definition of variables are provided on page 8

3.15 During the qualitative interviews, authors should highlight on positive aspects of FP use rather than just focusing on the challenges. The qualitative part is meant to explore both positives and negative aspects for broad understanding. Page 7

Attachments
Attachment
Submitted filename: PROTOCOL REVIEWERS RESPONSE.doc
Decision Letter - Paola Viganò, Editor

To assess the determinants of family planning uptake among women of reproductive age in rural settings, Morogoro Region, Tanzania. Protocol for a cross-sectional study

PONE-D-21-12824R2

Dear Dr. Machange,

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,

Paola Viganò

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #2: Yes

**********

2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory.

Reviewer #2: Yes

**********

3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible.

Reviewer #2: Yes

**********

4. Have the authors described where all data underlying the findings will be made available when the study is complete?

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Reviewer #2: 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 #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

(Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: Thank you very much for responding to the previous questions in a point-by-point manner, which is well reflected in the improved quality of the manuscript. The reviewer wishes the best to the authors for implementing this study.

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Reviewer #2: No

Formally Accepted
Acceptance Letter - Paola Viganò, Editor

PONE-D-21-12824R2

To assess the determinants of family planning uptake among women of reproductive age in rural settings, Morogoro Region, Tanzania. Protocol for a cross-sectional study

Dear Dr. Machange:

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