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Article History

Received: 14 May 2025

Accepted: 21 August 2025

First Online: 30 August 2025

Declarations

:

: The authors declare no competing interests.

: All methods were conducted in accordance with the relevant guidelines and regulations. The study protocol was approved by the [Wolkite University]. Informed voluntary consent was obtained from all study participants. The technical proposal for this study was submitted to the Institutional Health Research Ethics Review Committee (IHRERC) at Wolkite University, College of Health and Medical Sciences with reference number RCSUILC/022/15, where it received ethical clearance and approval. Following this, an official letter of cooperation was issued to the Gurage Zone Administration Health Office to facilitate the research. Subsequently, the Gurage Zone Administration Health Office sent letters of cooperation to the selected woredas. Written consent was obtained from all study participants.

: Information about the study was provided to participants, including its potential disadvantages and benefits. They were informed of their right to refuse or withdraw from the study at any time without any negative consequences. Participants’ confidentiality was ensured by omitting names from the questionnaires, and the information collected was used solely for the stated purposes of the study. Data collection occurred only after obtaining written and signed voluntary consent from participants, and only those who signed the consent were included in the study.

: It is not relevant because this manuscript cannot hold a person’s data in any form (including individual details images or videos).