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Article History

Received: 23 July 2025

Accepted: 14 August 2026

First Online: 26 August 2026

Declarations

Ethics approval and consent to participate: Institutional Review Board of Mekelle University (IRB-MU) approved the study. This study was conducted in accordance with the ethical standards of the institutional research committee and the 1964 Declaration of Helsinki and its later amendments. After securing ethical clearance, the Tigray Institute of Policy Studies submitted an official request to the relevant Tigray Regional Office for a cooperation letter under the state of emergency. The letter was obtained, through which permission and cooperation were sought from the district/local offices. The offices were briefed about the objectives of the study. They were assured that the data would be kept confidential and utilized only for its identified purpose. Given that data collection occurred during active conflict from June to July 2021, participant and researcher safety were prioritized. Official permission letters were obtained from local authorities and command centers. All data collectors were recruited locally, fluent in Tigrinya, and received training on ethical procedures and risk assessment. Before each interview, data collectors conducted an immediate on-site threat assessment and proceeded only if the household was not under immediate armed control or at risk of proximity. Informed consent was obtained from each participant, who was asked to participate after being briefed on the study’s purpose, risks, benefits, and rights. Participants were informed that their participation was voluntary and that they had the right to withdraw from the study at any time or to decline to answer questions. Assurance of privacy during the interview and of the confidentiality of information was also provided. Information about the households and individuals that could be traced was de-identified, and data was stored with passwords. To ensure the safety of participants and interviewers during data collection, a permission letter was secured from the command center. Each data collector was told to ensure the safety of the participants and themselves by ensuring that households were not under immediate armed control/armed individuals were not in their proximity. All the data collectors were recruited from the same region and spoke the same language, which gave study participants freedom. Each data collector had the letter when moving from home to home and traveling. Procedurally, there was a written information sheet and an informed consent form with two options: agree and disagree to participate in the study. Before they started asking the study questions, the interviewer read all the content/information and asked the participant to choose and tick the box along the selected option. If the interviewee agreed to participate, the interviewer would proceed with the study.

Consent for publication: Not applicable.

Competing interests: The authors declare no competing interests.