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Article History

Received: 28 July 2025

Accepted: 11 December 2025

First Online: 29 December 2025

Declarations

:

: This study was conducted in accordance with the ethical principles of the Declaration of Helsinki. Ethical clearance was obtained from the Institutional Review Board (IRB) of Bahir Dar University, College of Medicine and Health Sciences (Protocol number: CMHS/IRB/2076/2024). Official permission letters were also obtained from all participating hospitals and the Amhara Public Health Institute before data collection. Participants were informed about the study’s purpose, procedures, potential risks, and benefits. Confidentiality and anonymity were strictly maintained throughout the research process.

: Before data collection, written informed consent was obtained from all participants after explaining the study objectives, procedures, rights to refuse or withdraw at any time, and assurances of data confidentiality. Only those who provided written consent were included in the study.

: Not applicable. This manuscript does not include any person’s data in any form (such as images, videos, or identifiable personal information).

: The authors declare no competing interests.

: All material included in this manuscript is original work created by the authors. No third-party copyrighted content (figures, images, or tables) has been used, and therefore no permissions are required.

: Language model AI was employed to improve the grammer and spelling checking during manuscript writing.