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Article History

Received: 24 September 2025

Accepted: 17 December 2025

First Online: 3 January 2026

Declarations

:

: All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments. Ethical approval was obtained from the Nepal Health Research Council (NHRC) (Ref. no. 272–2021). Informed consent was obtained from all individual participants included in the study. Participants were informed about the study’s purpose, procedures, potential risks and benefits, and their right to withdraw at any time without penalty. Written consent was obtained from literate participants; for participants who were not literate, a thumbprint was obtained in the presence of an impartial witness after the consent form was read aloud.

: All participants provided written informed consent for participation and for the publication of anonymized study findings. All data presented have been de-identified and contain no information that could identify individual participants.

: The authors declare no competing interests.

: Not Applicable.