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Article History

Received: 12 January 2025

Accepted: 6 March 2026

First Online: 18 March 2026

Declarations

:

: This study involved the use of patients’ medical records and databases. The research was conducted in compliance with the Declaration of Helsinki and all relevant national guidelines and regulations [ , ]. Ethical clearance was granted from the Institutional Review Board of Ambo University with reference number AUWC/PG/11/16. The Ethics Committee of Ambo University, Woliso campus, waived the requirement for informed consent on behalf of patients’ medical records and databases. Official support letters were obtained from the Zonal Health Office. Then, an official letter was submitted to the selected health facilities, and signed permission was obtained to access the ART clients’ medical records and databases. Written consent was also obtained from the ART providers and data clerks. To maintain confidentiality, patient names and unique ART numbers were not included in the data extraction checklist, and data were not used for any purpose other than the stated study objectives.

: Not applicable.

: The authors declare no competing interests.