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Article History

Received: 20 July 2025

Accepted: 9 April 2026

First Online: 18 April 2026

Declarations

:

: Ethical clearance was obtained from Jimma University, the Institute of Health, and the Institutional Review Board (JUIH/IRB) with Reference number JUIH/IRB/346/2023. The letter of cooperation was also obtained from JUIH/IRB and submitted to Gomma Woreda Health Bureau. The study adhered to the principles of the Helsinki Declaration. Prior to data collection, the purpose of the research was clearly communicated to all participants, and written informed consent was obtained. For participants under 18 years of age appropriate assent and parental/guardian consent procedures were followed in accordance with ethical guidelines. Participants were informed that their involvement was entirely voluntary and that they could withdraw at any time without penalty. To ensure confidentiality, no identifying information such as names was recorded on the consent forms, thereby safeguarding participant privacy.

: Not applicable.

: The authors declare no competing interests.