How migration shapes modern contraceptive use among urban young women: Evidence from six African countries

Jessie Pinchoff; Isabel Pike; Karen Austrian; Kathryn Grace; Caroline Kabiru

doi:10.1371/journal.pone.0307141

Peer Review History

Original SubmissionFebruary 27, 2024
30 Apr 2024 Decision Letter - Patrick Ifeanyi Okonta, Editor PONE-D-24-07930How Migration Shapes Modern Contraceptive Use among Urban Young Women: Evidence from Six African countriesPLOS ONE Dear Dr. Pinchoff, 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 Jun 14 2024 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. 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If consent was waived for your study, please include this information in your statement as well. [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 Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: No Reviewer #2: 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 Reviewer #2: 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 Reviewer #2: 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: Title The authors have addressed an important area of population health that link migration to facility visits and contraceptive among use adolescent girls and young women. I have generally enjoyed reading the manuscript but there are issues that must be addressed before the paper may be considered for publication. Abstract: 1.There is minor grammatical error in the abstract line 31 2. May the authors include key results from their logistic regression model (Odds or Odds ratios and their corresponding 95% confidence intervals) in their result section of their abstract. Background The authors have presented important information in the background. However, they have not indicated the proportion of migrants that are young aged 15 to 24. Demographic and Health Surveys have information on these estimates for both. The authors alluded to the scarcity of studies on migration and family planning use, I agree with the authors but there are studies they could have referenced including their quantitative findings e.g. contraceptive prevalence rate among young women, odd ratio of contraceptive use comparing migrants to non-migrants. Methods This study used data collected in 6 African countries. Observations within countries could be correlated; this should have been investigated to assess evidence or significant correlation. The authors needed to apply multilevel modeling approach or models that can adjust for clustering of observations within countries other than using naïve logistic regression model. The clustering could even apply at countries level if there were clusters within countries. Use of naïve logistic regression violates the independence of observations assumption of the generalized linear models to which logistic is part of. These need to be addressed. Discussion The discussion is well written. The authors mentioned in the discussion that there were wide variations in the exposure (migration) and outcomes, this is consistent with clustering as suggested in the methods section. The authors will need to rework results based on my suggestion in methods and update both results and methods. Reviewer #2: This is a nice paper and my comments are mostly pretty minor. I thought it was very well written- the intro and framing in particular. The research question itself, measured outcomes, and reason for questions are all clear. Its kind of hard to draw any highly relevant policy conclusions from the somewhat mixed findings, but that is research. My comments are below. First two seem critical to me, others are more minor. 1) Given that this is a life-course analysis, why did you use cross sectional rather than longitudinal data that is available in PMA? Were the migration questions not asked often enough? Or did you not have a large enough sample with life events in the longitudinal data? Please address why you made that analytic choice, because the obvious choice would be to look at migrants in the panel data, so you can follow individual women over time. (I am sure there was a good reason, its just good to explain the choice to the reader) 2) On pg 6, line 205- you say that you are using 2 yrs as a cutoff point for recent migration, but on page 7 line 249 you say migration within the last year is recent migration. Again on line 286, you say within the last yr is recent migration, but in 307-308, you define based on a 2 yr cutoff. Looks like the actual regressions use one year- but text switches back constantly between describing 1 yr and 2 yrs as ‘recent migration’. I’m guessing this is because there were several versions of the analysis done and you landed on the 1 yr timeframe- and you just need to update the text. But if there is a substantive reason that you use the two different time periods to define ‘recent’ and you used them both in different parts of the analysis somehow, then please make that clearer to the reader. 3) The citation style switches back and forth constantly throughout the text (sometimes it’s a number, sometimes its author and yr). Presumably from multiple authors and not a big deal, but definitely needs fixing. 4) Also in the category of ‘update text’ the education categories described in lines 313 314 should be changed to match the regression wording (which makes more sense, actually- when I first read the text I thought you had overlapping categories with “secondary” in two different categories) 5) I would like a sentence or two more explanation of how order for first birth-migration might matter (lines 254- 257). You just say ‘in theory it might matter if women who gave birth before migrating are less likely to have visited a facility”.. But alternately, I might argue women who migrate rural-urban may have more access to facilities than they did in rural area, where health care infrastructure can be minimal. Since this 'order' question is a key part of the analysis, i think you should spend a few more sentences explaining. 6) What are the scheffe’s tables actually adding? If they are important to the analysis, say something about them in the text. If not, I’d pop them in an appendix. 7) Are you really certain 91% of 15-24 yr olds in urban Uganda have migrated? If that is what the data says- then okay. But it seems implausibly high. ******** 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: Reuben Christopher Moyo 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 REVIEWER FEEDBACK.docx https://doi.org/10.1371/journal.pone.0307141.r001
Revision 1
24 Jun 2024 Author Response 2. Please include a complete copy of PLOS’ questionnaire on inclusivity in global research in your revised manuscript. Our policy for research in this area aims to improve transparency in the reporting of research performed outside of researchers’ own country or community. The policy applies to researchers who have travelled to a different country to conduct research, research with Indigenous populations or their lands, and research on cultural artefacts. The questionnaire can also be requested at the journal’s discretion for any other submissions, even if these conditions are not met. Please find more information on the policy and a link to download a blank copy of the questionnaire here: https://journals.plos.org/plosone/s/best-practices-in-research-reporting. Please upload a completed version of your questionnaire as Supporting Information when you resubmit your manuscript. This has been completed and uploaded as Supporting Information. 3. Please provide a complete Data Availability Statement in the submission form, ensuring you include all necessary access information or a reason for why you are unable to make your data freely accessible. If your research concerns only data provided within your submission, please write "All data are in the manuscript and/or supporting information files" as your Data Availability Statement. We have a complete Data Availability statement, but all of our data is publicly available and this is a secondary data analysis. 4. Please include your full ethics statement in the ‘Methods’ section of your manuscript file. In your statement, please include the full name of the IRB or ethics committee who approved or waived your study, as well as whether or not you obtained informed written or verbal consent. If consent was waived for your study, please include this information in your statement as well. We have added a sentence at line 273 that we did not require IRB approval because this is entirely a secondary data analysis of publicly available data. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 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: Title The authors have addressed an important area of population health that link migration to facility visits and contraceptive among use adolescent girls and young women. I have generally enjoyed reading the manuscript but there are issues that must be addressed before the paper may be considered for publication. Abstract: 1.There is minor grammatical error in the abstract line 31 We have corrected this error, thank you for catching it. 2. May the authors include key results from their logistic regression model (Odds or Odds ratios and their corresponding 95% confidence intervals) in their result section of their abstract. We have added key results with numbers in the results section of the abstract. Background The authors have presented important information in the background. However, they have not indicated the proportion of migrants that are young aged 15 to 24. Demographic and Health Surveys have information on these estimates for both. The authors alluded to the scarcity of studies on migration and family planning use, I agree with the authors but there are studies they could have referenced including their quantitative findings e.g. contraceptive prevalence rate among young women, odd ratio of contraceptive use comparing migrants to non-migrants. We have added a statistic in the methods section, and have some discussion of migration and gender literature, however most statistics available refer to international migration, often from parts of Africa to Europe or the Middle East, and very few were found that relate to more the rural-urban within-country movement. We found it extremely challenging to find estimates of this kind of urban mobility within a country. We also do have our own statistics from the PMA but have left them in the results section. We did not quantify the relationship between migration and each outcome but rather the more complex versions related to migration in the sequence of events and recency of the migration (so we do not present migrants vs non-migrants). Methods This study used data collected in 6 African countries. Observations within countries could be correlated; this should have been investigated to assess evidence or significant correlation. The authors needed to apply multilevel modeling approach or models that can adjust for clustering of observations within countries other than using naïve logistic regression model. The clustering could even apply at countries level if there were clusters within countries. Use of naïve logistic regression violates the independence of observations assumption of the generalized linear models to which logistic is part of. These need to be addressed. This was a major oversight in the writing of the methods section! We have added a sentence at line 320. All models adjust for the enumeration area or village level to adjust the standard errors and account for the clustering of observations within villages, and we also adjust for the country. This was done in all models presented, we just did not write this information in the methods! Discussion The discussion is well written. The authors mentioned in the discussion that there were wide variations in the exposure (migration) and outcomes, this is consistent with clustering as suggested in the methods section. The authors will need to rework results based on my suggestion in methods and update both results and methods. Thank you! Yes the results and tables reflect models correctly adjusted for clustering at the enumeration area or cluster/village level. We have added this critical detail to the methods. Reviewer #2: This is a nice paper and my comments are mostly pretty minor. I thought it was very well written- the intro and framing in particular. The research question itself, measured outcomes, and reason for questions are all clear. Its kind of hard to draw any highly relevant policy conclusions from the somewhat mixed findings, but that is research. Thank you, we agree the findings are a bit mixed, but the potential disruptive effect of migration for such young women arriving in urban areas may highlight the need to tailor interventions or services to meet their needs. My comments are below. First two seem critical to me, others are more minor. 1) Given that this is a life-course analysis, why did you use cross sectional rather than longitudinal data that is available in PMA? Were the migration questions not asked often enough? Or did you not have a large enough sample with life events in the longitudinal data? Please address why you made that analytic choice, because the obvious choice would be to look at migrants in the panel data, so you can follow individual women over time. (I am sure there was a good reason, its just good to explain the choice to the reader) This is for a few reasons, first, yes the sample size was not very large with the longitudinal data, as only a subset of women were followed. The survey also was not designed to capture information about migration, so it wont capture migration very well as women who migrated may have been less likely to be followed up. We worried about attrition in the follow up surveys, and differential loss to follow up, as again these surveys are not aiming to capture migration. We decided to use the cross-sectional survey data for all women available using their most recent information and capture historical migration. Future analyses that track women in their movement within a country will be very useful, but the study must be carefully designed for this purpose. 2) On pg 6, line 205- you say that you are using 2 yrs as a cutoff point for recent migration, but on page 7 line 249 you say migration within the last year is recent migration. Again on line 286, you say within the last yr is recent migration, but in 307-308, you define based on a 2 yr cutoff. Looks like the actual regressions use one year- but text switches back constantly between describing 1 yr and 2 yrs as ‘recent migration’. I’m guessing this is because there were several versions of the analysis done and you landed on the 1 yr timeframe- and you just need to update the text. But if there is a substantive reason that you use the two different time periods to define ‘recent’ and you used them both in different parts of the analysis somehow, then please make that clearer to the reader. Yes this is correct, we ran the analysis both ways and had very similar overall findings, choosing to present the 1 year version here. We have fixed the issues throughout and aligned. 3) The citation style switches back and forth constantly throughout the text (sometimes it’s a number, sometimes its author and yr). Presumably from multiple authors and not a big deal, but definitely needs fixing. Thank you for catching this ! We have aligned all references to be numeric. 4) Also in the category of ‘update text’ the education categories described in lines 313 314 should be changed to match the regression wording (which makes more sense, actually- when I first read the text I thought you had overlapping categories with “secondary” in two different categories) Agreed, these categories are a bit confusing but we have aligned the categories based on how the variable is derived and to ensure no overlap in the titles. They basically mean everything up to completing secondary vs actually completed secondary, but it was not clear, we hope now it is. Thank you! 5) I would like a sentence or two more explanation of how order for first birth-migration might matter (lines 254- 257). You just say ‘in theory it might matter if women who gave birth before migrating are less likely to have visited a facility”.. But alternately, I might argue women who migrate rural-urban may have more access to facilities than they did in rural area, where health care infrastructure can be minimal. Since this 'order' question is a key part of the analysis, i think you should spend a few more sentences explaining. We have added some additional thoughts here and a new reference on the subject. 6) What are the scheffe’s tables actually adding? If they are important to the analysis, say something about them in the text. If not, I’d pop them in an appendix. We debated this and agree we will move them into an appendix. They do not add so much on their own. 7) Are you really certain 91% of 15-24 yr olds in urban Uganda have migrated? If that is what the data says- then okay. But it seems implausibly high. 91% is quite high, we went back and confirmed. The proportion is even quite high among the full dataset of 15-24 year olds (85%) before we make restrictions. Potentially this is related to how they surveyed in Uganda. Attachments Attachment Submitted filename: response to reviewers.docx https://doi.org/10.1371/journal.pone.0307141.r002
2 Jul 2024 Decision Letter - Patrick Ifeanyi Okonta, Editor How Migration Shapes Modern Contraceptive Use among Urban Young Women: Evidence from Six African countries PONE-D-24-07930R1 Dear Dr. Pinchoff, 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 will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager® and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, 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, Patrick Ifeanyi Okonta, MBBCh, MPH, FWACS, FMCOG, MD, DRH Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0307141.r003
Formally Accepted
12 Jul 2024 Acceptance Letter - Patrick Ifeanyi Okonta, Editor PONE-D-24-07930R1 PLOS ONE Dear Dr. Pinchoff, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset If revisions are needed, the production department will contact you directly to resolve them. If no revisions are needed, you will receive an email when the publication date has been set. At this time, we do not offer pre-publication proofs to authors during production of the accepted work. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few weeks to review your paper and let you know the next and final steps. Lastly, 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 customercare@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 Professor Patrick Ifeanyi Okonta Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0307141.r004

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