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Article History

Received: 22 June 2025

Accepted: 3 November 2025

First Online: 5 December 2025

Declarations

:

: We obtained ethical approval from the Ethical Review Board of the Nepal Health Research Council (IRC registration number: 113_2024/Ref no: 2132) and from the Kathmandu University Institutional Review Committee (KU-IRC: 165/24). We also obtained permission from the Dhulikhel municipality before beginning data collection. During the consent process, we explained the potential risks and benefits of participating in the interviews to the participants. All respondents provided written informed consent. Literate participants signed the consent form, while illiterate participants gave their thumbprint along with the signature of a caretaker or witness. We informed participants that their involvement was voluntary, that they could skip any questions they did not wish to answer, withdraw at any point during the interview, and that their responses would remain confidential. The study obeyed the ethical standards defined in the Declaration of Helsinki.

: Not applicable.

: The authors declare no competing interests.