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Article History

Received: 5 July 2023

Accepted: 15 May 2025

First Online: 23 May 2025

Competing interests

: The authors declare no competing interests.

: This study received full ethical clearance from the Institutional Review Board of Hawassa University's College of Social Sciences and Humanities (Reference: CSSH/309/2022, dated 01/06/2022), confirming compliance with both international and institutional research ethics standards. The research protocol strictly adhered to the ethical principles outlined in the Declaration of Helsinki and the Hawassa University’s principles and research guidelines.

: Informed consent was obtained orally from all participants, including focus group discussants and key informants, prior to their participation in the study, which was conducted between June 2 and June 30, 2022. The consent process was carried out by the principal investigator and trained local research assistants. All participants were adults residing in the Wonisho district of the Sidama Region, Ethiopia. They were provided with clear and comprehensive information about the study’s purpose, the procedures involved, and the potential benefits of their participation.