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Article History

Received: 15 November 2024

Accepted: 16 September 2025

First Online: 14 October 2025

Declarations

:

: The protocol to conduct and publish the findings from this study was approved by the Catholic University of Health and Allied Sciences/Bugando Medical Centre Joint Ethical Committee (CREC/668/2023) and the University of Calgary (REB23-0674), in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki. Permission to conduct this study was granted by the regional administrative and local government authorities. Participant identities were not included on the questionnaires or in the analysis, only numbers were used to maintain confidentiality.

: Not applicable.

: Informed assent or consent was obtained from all individual participants included in the study. For those participants less than 18 years of age, their assent was obtained and their parents’ or guardians’ (i.e., husbands’) consent was sought and obtained prior to participation the study. Tanzanian law does not recognize mature minors. For all participants less than 18 years of age parents or legal guardians (e.g. husband) are legally required to provide consent for the participant to take part in a research study. We assessed the capacity of adolescent women under 18 years to participate by having them provide written assent.

: The authors declare no competing interests.