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Article History

Received: 28 November 2024

Accepted: 29 July 2025

First Online: 6 August 2025

Declarations

:

: The study protocol was reviewed and approved in Kenya by the AMREF Ethical and Scientific Review Committee (P658/2019), the University of Nairobi/Kenyatta National Hospital Ethical Board (IREC/2019/290), and Moi University Teaching and Referral Hospital (P643/07/2019), while the National Commission for Science, Technology, and Innovation provided the research authorization (NACOSTI/P/19/9256/32022). In Liberia, the protocol and study materials were reviewed and approved by the University of Liberia’s Institutional Review Board (IRB), also known as UL-PIRE (now the Atlantic Center for Research and Evaluation (ACRE) Institutional Review Board, Protocol #21-07-275). The Ethics and Scientific Committee, Ministry of Health, Sierra Leone, approved the study (no approval number assigned). In addition, all study procedures were conducted in accordance with guidelines and regulations for human subject research and as peculiar to each country. Written informed consent was obtained from all participants during the study. In Liberia, we interviewed the health providers only if the women/girls consented to their providers responding to our questionnaire. However, the requirement was not needed in Kenya and Sierra Leone.

: Written informed consent was obtained from all the participants during the study.

: The authors declare no competing interests.