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Article History

Received: 6 February 2025

Accepted: 7 January 2026

First Online: 28 January 2026

Declarations

:

: The authors declare no competing interests.

: This study does not require approval from the ethics committee, as it does not fall within the scope of Law No. 2009-17 of March 9, 2009, which establishes the Code of Ethics for Health Research and to which this committee is subject. According to Article 3 of this law, its application is limited to health research, which includes: epidemiological research, biomedical research, research in traditional medicine, research on health systems, and research in social and human sciences. Article 4 further specifies that research in social and human sciences pertains to the study of social and human factors influencing the health status of individuals and societies. Moreover, Article 8 states that the ethical and scientific approval of the National Ethics Committee for Health Research (CNERS) is a prerequisite for conducting any research within these categories. Finally, based on Article 2 of Decree No. 2009 − 729 of August 3, 2009, which defines the missions and responsibilities of CNERS, we consider that this study does not fall within the scope of research requiring ethics committee approval. We did not collect data on humans in the strict sense, nor any data directly linked to individuals. However, we gathered factual information about processes and services provided to communities of stakeholders. The data used and analyzed are not publicly available but can be provided upon request.

: Data collection was based on a protocol established by the authors in accordance with the French GDPR (General Data Protection Regulation) guidelines and IRD (French Research Institute for Development) directives and reglementations. Informed consent was obtained from all participants and by their legal representatives.