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Article History

Received: 6 August 2025

Accepted: 28 April 2026

First Online: 26 May 2026

Declarations

Funding: This work was supported by Kreditanstalt für Wiederaufbau (KfW).

Conflict of interest: The authors do not have any conflicts to report.

Ethics approval: This study was conducted in accordance with the Declaration of Helsinki. Ethical approval was obtained from the Institutional Review Boards (IRBs) of Heidelberg University Hospital (Ref: S-136/2022) and the Cambodian Ministry of Health (Ref: 058). Data were collected, stored, and analyzed using the cloud-based ETiCCS platform, which ensured security and confidentiality. All personally identifiable information was excluded from the analysis.

Consent to participate: Informed consent was obtained from all participants prior to data collection.

Consent for publication: Not applicable. No identifiable individual data or images are included in this manuscript.

Data availability: The datasets generated and/or analyzed during the current study are not publicly available. The data can be requested from the corresponding author on reasonable request.

Code availability: No custom code or computational model was used in this study. All analyses were conducted using standard spreadsheet-based calculations.

Author contributions: KS, MDA, and ZZ designed the study, KS and ZZ analyzed the data, interpreted the data and drafted the manuscript. All authors revised the manuscript and approved the final version.