Document is current

Article History

Received: 11 May 2026

Accepted: 14 August 2026

First Online: 20 August 2026

Declarations

Ethics approval and consent to participate: Ethical clearance for this study was formally obtained from the Institutional Review Board (IRB) of Woldia University under protocol number WDU/IRB/04/17, ensuring adherence to established ethical standards. All procedures involving human data were performed in accordance with relevant ethical guidelines and regulations, including the Declaration of Helsinki. Subsequently, letters of cooperation were submitted to the Amhara Public Health Institute (APHI) and comprehensive specialized hospitals within the Amhara region to facilitate institutional support and collaboration. The research proposal underwent thorough review by the respective institutional review boards, which evaluated the study’s methodology, ethical considerations, and potential risks. Following approval, formal letters of permission were issued to the concerned authorities within the participating hospitals. Furthermore, official authorization to conduct the study was secured from the clinical directors and heads of relevant departments and units, ensuring administrative support for data collection. To maintain participant confidentiality and uphold ethical integrity, patient identifiers such as names and medical record numbers were deliberately excluded from the data collection tools, thereby safeguarding personal information throughout the research process.

Consent for publication: None.

Competing interests: The authors declare no competing interests.