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Article History

Received: 9 July 2025

Accepted: 14 September 2025

First Online: 21 October 2025

Declarations

:

: This study is a secondary analysis of publicly available and anonymized data from the 2020 Somaliland Demographic Health Survey. The original survey was conducted under the authority of the Somaliland government, and the relevant national institutional review boards approved all protocols. The original data collection team obtained informed consent from all participants. As the data used in this study were fully de-identified and publicly accessible, no further ethical approval was required.

: Not applicable. This study does not contain any person’s data in any form (including individual details, images, or videos). All data were analyzed in an aggregated and anonymized format.

: The authors declare no competing interests.

: Informed consent was obtained from all individual participants included in the original survey. For participants under the age of 18, informed consent was obtained from a parent and/or legal guardian.