PONE-D-21-33298Trend of anemia among women reproductive age group in Ethiopia from 2005-2016: A Further analysis of Ethiopian demographic health survey.PLOS ONE

Dear Dr. Tsegaye,

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 could you complete revisions according to those set out by reviewer 1 who has set out changes per line. 

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Academic Editor

PLOS ONE

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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: Yes

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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: Thank you very much for the opportunity of reviewing this work. Anemia is a major public health problem globally that affects the most vulnerable, including women of childbearing age, pregnant women, and children under 5-years, mostly in low- and middle-income countries. Analysis of its trends and associated factors are relevant to tackle down anemia through policies and programs focused on its various determinants.

General comment: Authors wrote very poor English, many of sentences were hard to understand. I strongly suggest the authors search for English proofreading services / checking by English native speakers to enhance English writing and reading. Data analysis was very poor which need to re-check, including the selected variables.

Title: This manuscript reported both the trend and factors associated with anemia among women of reproductive age. I suggested to revise the title of your manuscript to include factor associated with anemia. Also, women of reproductive age means the group of women aged 15-49 years itself, so, it is better to remove word ‘group’ after women of reproductive age throughout this manuscript. In addition, in my understanding we usually call: Demographic “and” Health Survey (DSH), Please revise the correct word of this survey? if my comment is correct, you need to revise this word throughout manuscript.

Abstract

Background. Please check the information regarding to anemia is the most common cause of indirect morbidity?

Methods. Please revise these paragraph, many information is not related to the result section, particularly the odds ratio, 95% confidence interval are not showing in the result section at all.

Result. Please revise all sentences because in the main text did not show the results of the positive or negative association of several factors with anemia.

Conclusion. Authors recommended several unrelated ideas which is not consistent with the findings from this study. Authors should revise this paragraph.

The introduction or background section: It is better to reconstruct this paragraph by describing the situation of anemia from global, regional (high-income/low-income countries), and country levels, respectively. Additionally, this study aimed to analyze the trend of anemia in Ethiopia, however, in this section is not describe about the trend of anemia as the priority problem in this study. Moreover, this section is significantly long text, I strongly recommend the authors divided this section at least two paragraphs.

Line 63. It is better to give the definition of anemia for a common understanding for the readers.

Line 66. Please revise this sentence with evidence regarding the cause of anemia, because “it might be caused” is not a clear statement because anemia can caused by infections, genetic conditions,… etc. So, Please clarify the cause of anemia.

Line 74-76. Can you give more information how this sentence related to anemia among women of reproductive age, particularly what kind of extra foods and supplement needed during pregnancy and lactation? Also, what is the mechanism of the physiological changes, metabolism, growth of fetus and breast feeding during pregnancy and lactating affect to anemia among these women?

Line 80-81. Physiological and nutritional change need to clarify for the completeness of sentence and can be merged with line number 74-76.

Line 84. What is the meaning of grand multiparity?

Line 90-92. In my opinion, using the word “previous studies” instead of the word “former studies” might be better, which is commonly used in scientific report. In addition, I am not sure about the intention of author would like to talk about this sentence on how is related to anemia research?

Line 94-95. What kind of the existing policies and programs which is addressed to anemia problem among women of reproductive age in Ethiopia? What is the barriers of these policies and programs which could not reduce the prevalence of anemia among these women in Ethiopia? Author might additional raise these important problem in this manuscript.

Line 99-101. Please revise this sentence: First point: This study “aimed” to analyze the trend and factors associated with anemia among…., Second point: If you use the word women of reproductive age, you need to use the same wording throughout manuscript to avoid the misunderstanding. Third point: the national data using to analyze in this study should be clearly with exact name and years.

Methods

General comment on study setting section. This paragraph is quite complicated in term of sentence order and unrelated ideas. This paragraph should be clearly provided information regarding to settings and locations where the data were collected and locations in which the study was carried out, including the country, region, city. Also, authors could provide other information about settings and locations that could have affected a study’s external validity such as social, economic, cultural environment and other special aspect of study settings, if applicable. In addition, I would like to suggest the authors to provide the decision trees that would be innovative to explore such data (merely a thought) in order to show the readers on how the sample were selected and excluded at each stages.

Line 107-109. Please revise this sentence started from About 20%..... until in rural areas by giving the exact numbers/percentages of people living in rural and urban areas. Nearly 80% is not exact number of 80%.

Line number 109-110. 1st point, I am not sure that we can say 4.6 individuals/persons or what is the meaning of 4.6 persons? 2nd point, This study used three different dataset of 2005, 2011 and 2016, but in this sentence mentioned only the survey conducted in 2016.

Line 111-137. Data source/study design, study population and sampling technique. The text of this section can be divided in three paragraphs separately under this sub-heading.

- Data source should be clearly mentioned the source of datasets using/analyzing in this study, year of conducting these surveys, type of data (primary/secondary datasets?) along with providing information about these surveys.

- Study population.

- Sampling technique. In my understanding the DHS survey used the multi-stage cluster sampling technique. Authors can re-check in the report of each original surveys, and please provide the related information into this section.

- DHS surveys typically provide altitude and smoking-adjusted levels of hemoglobin. In your study, I truly believe that smoking is not a concern; however, altitude might be. During data collection and building databases, some factors were used to adjust the levels of hemoglobin?

Line 116. Authors should provide the full text for EDHS as the first time state follow by the abbreviation in blanket. Also, this study used three cross-sectional data of 2005, 2011, and 2016 but the sampling frame mentioned only in 2016. Can authors provide the reason on this matter for clarification.

Line 165. non-governmental organizations.

Line 126. What is the different between cluster and EA in this sentence?

Line 127-134. 17,067 households had women of reproductive age. Can authors clarify why all of these women were not include? What is the eligible selection criteria?

Study variables

General comment for this section. This section is absolutely complicated with unnecessary information. It is better to separate this section into two paragraphs to show the dependent and independent variables separately, and under the independent variables can be divided in two categorization of socio-demographic characteristics of the participants follow by reproductive characteristics. Furthermore, due to this section describe specifically for the study variables, therefore, the information regarding to data collection and its process should be mention in above section of the data source/study design, study population and sampling technique.

Many independent variables were not mentioned in this section, but showed in result’s tables such as work status, residence, region, frequency of reading new papers, frequency of watching TV, Abortion, electricity, telephone, menstruated in the last six months. On the other hands, many independent variables mentioned in this section, but not showed in result’s tables such as husband educational status, age at first pregnancy, number of birth, number of antenatal visit, and current pregnancy. Authors must re-organize it clearly, and each variables must show its categorization, for example: education (uneducated vs educated).

Line 139-144. Authors provide two times regarding the definition of anemia among non-pregnant women, authors can select one of them. Also, please provide full definition regarding of anemia among pregnant and non-pregnant women because its definitions used the different cut point for mild, moderate and severe anemia.

Line 180. Please give the full text of CSA before it first statement of its abbreviation.

Data management and statistical analysis.

In statistical section, please refer to any post-hoc corrections to correct for multiple comparisons during your statistical analyses. If these were not performed please justify the reasons. Additionally, in your statistical analyses, please state whether you accounted for clustering by Kebeles or region?. For example, did you consider using multilevel models?

Line 187 and 201-201. Which version of SPSS used to analyze the data? And it should follow by showing the name of its company?

Line 188. How many datasets were analyzed for this study? Three or four? And it should be mentioned the year of each datasets!!

Line 189-190. Authors must understand this section which must provide only the statistical tests used/analyzed by yourselves.

Line 191. Are authors used the sampling weight for all analyzes?

Line 193-194. Which statistical tests whether chi-square or logistic used to analyzed the date?

Line 194: In which criteria that authors selected variables into multivariable logistic regression? And how do you treat with multicollinearity problem? These can be strengthened with a reference at least.

Line 195-196. I did not see the odds ratio and 95% confidence interval in the result’s tables.

Line 196-197. Which number of p-value consider as statistical significant 0.25 or 0.05 and please cited a reference?

Line 198-200. Please rephrase this sentence, I don't understand. Also, what is the different between univariate and bivariate analyses?

Line 203-208. Ethical consideration: Understandable, the secondary data analysis is not required the double ethical approval, however, authors should provide additional details regarding participant consent as well as which organization/agencies provided ethical approval for these surveys. Please ensure that you have specified what type you obtained (for instance, written or verbal, and if verbal, how it was documented and witnessed). If the need for consent was waived by the ethics committee, please include this information.

Result

Can authors show the number of participant in result’s tables 1 and 2 for each categories of each variables follow by its percentages?

Many independent variables were not showed in result’s tables 1 and 2 but mentioned in method section such as husband education, marital status, age at first pregnancy, number of birth, number of antenatal visit, current pregnancy. Authors need to re-check for clarification!!!

Authors did not show the result of logistic regression analyses with the result of odds ratio and 95% confidence interval?

Why the menstruated information was asked in the last six weeks? Because the menstruation were usually happened as monthly basis.

Line 210. Please revise this sub-heading. The correct word is “characteristics” and please re-check this word in other section as well.

Line 211. Mean age of the participants was 28, is ±9.6 years the standard deviation? Please provide clearly in such phrase.

Line 211-214. Majority mean more than half. Please revise the related sentences, along with providing full description of result of selected variables from each year of surveys 2005, 2011, and 2016, respectively. Due to this study used three different datasets from different years, authors should be careful to provide the clear description.

Line 216-217. In result section, authors should provide the exact number of percentage of each selected variable. The least proportion is not a common used in scientific report.

Table 1. (i) Please revise the name of this table, (ii) showing two p-value in a table can cause misunderstanding, other might select one of them and need to explain in statistical analyses section. (iii) age category is not in the similar frequency, for example: 15-19 years is within 5 years but other category of 20-29 years is within 10 years, do you have any reference to strengthen this categorization?

Line 226-230. I recommend to re-interpret the results of the table 2?? A swell as revising the name of the table 2.

Line 237-249. It is better to show the figures before or after the result’s interpretation. Authors should interpreted each figure with a separate texts.

Line 239-240. What is the different between 47.7% and 47.7 percentage points?

Line 250-256. I am not sure that the result in this section came from which tables? The results are not show!!!!

Discussions:

In your discussions, please take care to avoid statements implying causality from correlational research. For example, avoid the use of terms such as "increased/reduced risk", "influenced by", “likely to” or “resulted in." Instead, consistently use terms such as "associated with" or "associations."

Line 261. Anemia vs anaemia are American and British English, please select one of them for whole manuscript.

Line 261-265. Authors don’t need to give the definition of anemia in this section which is already mentioned in the background section.

Line 266. In statistic, to show the full number like 68% must follow by dots zero as 68.0%, authors should revise other full numbers as well.

Line 265-277. It is good to compare the prevalence with other countries, however, the author should try to find the evidence to answer why the trend of prevalence of anemia was significantly reduced from 2005 to 2011, but increased from 2011 to 2016 in Ethiopia? This should be the main discussion regarding to the findings from this study. Had it any policy/intervention or event which influenced to this unstable trends? The comparison of prevalence of anemia among children and pregnant women with women of reproductive age might led to unrelated ideas, because the study participants are different. Also, authors should provide the year of the references’ cited for example in line 275-277, recent national DHS and other surveys were conducted in which years? is that only one reference for respective countries?

Line 277-278. What is the reduction of anemia among women of reproductive age important for child health?

Line 228-280. What is the meaning of this sentence “anaemia prevalence remains high and haemoglobin levels remain low in the low income countries”?.

Line 280-281. “If these trends are continued, the likelihood of reducing anemia by half from 2011 levels by 2025 in all regions among reproductive age women”. This prediction might be happened and might not be happened as well, the scientific research should come up with the fact and real evidence.

Line 282-283. What is the group of lower wealth indexes? According to tables’ result showed five categories from poorest to richest group? Which group is the reference group?.

Line 283-285. Can authors provide more evidence regarding to women from high socioeconomic status reduced risk of infection/morbidity which is contributed to reduce the prevalence of anemia?

Line 289-292. Can authors provide more evidence regarding to social beliefs and climatic conditions factors contribute to the reduction of anemia among women living in Tigray region? which is lover than in other regions.

Line 295-300. Why the marital status was discussed in these lines? According to result’s table, this study did not include this variable. It seem like authors raise unrelated ideas.

Line 300-303. Author showed the result of a study conducted in Indonesia, I am not sure how is related to the findings from this study? The explanation or reference from other studies should always come up after showing your findings.

Line 302-305. Authors need more discussion regarding to abortion, history of menstruation and electricity factors associated with anemia among women of reproductive age??? There is no explanation of these factors.

Do this study have any limitations?

Conclusion

Line 308-309. What is the meaning of percentage points?

Line 309-312. Please re-check the variables and re-phrases the sentences in these lines.

Line 312-314. How the policy-makers enhance the socio-demographic characteristics and basic infrastructure that could be contribute to reduce the prevalence of anemia? Authors should recommend the practical ideas which is related to the findings from this study?

Line 314-315. Please consider your recommendation with practical ideas in accordance with the findings from this study?

Line 315-316. Please consider your suggestion again on how to balanced the various factors among different state in Ethiopia? And how these factors prevent anemia in these states.

Reviewer #2: This is an interesting paper reporting anemia prevalence in Ethiopia. Should be checked for biostatistics .The paper could be shorten and comparison with prevalence of anemia in other African countries.

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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

Reviewer #2: No

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PONE-D-21-33298R1Trend and factors associated with anemia among women reproductive age in Ethiopia: A Further analysis of Ethiopian Demographic and Health Survey from 2005-2016.PLOS ONE

Dear Dr. Berhan Tsegaye,

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:   dear author ,  there are still grammatical errors in the manuscript . please correct them also review your statistical analysis as suggested by reviewer. 

Please submit your revised manuscript by 5th Oct 2022. 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 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,

Sidrah Nausheen, FCPS

Academic Editor

PLOS ONE

Journal Requirements:

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.

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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 #2: 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 #2: Partly

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

Reviewer #2: N/A

**********

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 #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

**********

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 #2: The paper could be published after statistical review.Although not very novel but is an important attempt to study anemia

in developing country

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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 #2: No

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[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.

PONE-D-21-33298R2Trend and factors associated with anemia among women reproductive age in Ethiopia: a multivariate decomposition analysis of Ethiopian Demographic and Health survey.PLOS ONE

Dear Dr. Tsegaye,

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. ==============================Dear author

there are multiple grammatical mistakes which need to be corrected

you said menstruation in last six months is associated with anemia. every woman has menstruation, but all are not anemic. so please change you statement and write heavy menstruation is associated with anemia.

reading news paper has protective effect in your study then why using mobile phone is not protective . mobile phone and social media gives you more information so please correct line 510 and 511.

why are you associating anemia with electricity ?? it does not make sense . either remove it or give logical interpretation

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

Please submit your revised manuscript by Jan 21 2023 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 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,

Sidrah Nausheen, FCPS

Academic Editor

PLOS ONE

Journal Requirements:

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:

dear author

there are multiple grammatical mistakes which need to be corrected

you said menstruation in last six months is associated with anemia. every woman has menstruation, but all are not anemic. so please change you statement and write heavy menstruation is associated with anemia.

reading news paper has protective effect in your study then why using mobile phone is not protective . mobile phone and social media gives you more information so please correct line 510 and 511.

why are you associating anemia with electricity ?? it does not make sense . either remove it or give logical interpretation

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

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 #2: All comments have been addressed

**********

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 #2: Yes

**********

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

Reviewer #2: 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 #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 #2: Yes

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6. Review Comments to the Author

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The paper is acceptable for publication

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Trend and factors associated with anemia among women reproductive age in Ethiopia: a multivariate decomposition analysis of Ethiopian Demographic and Health survey.

PONE-D-21-33298R3

Dear Dr. Berhan Tsegaye,

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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Kind regards,

Sidrah Nausheen, FCPS

Academic Editor

PLOS ONE

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