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Article History

Received: 10 July 2025

Accepted: 17 December 2025

First Online: 23 December 2025

Declarations

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: Ethical clearance was obtained from the Institutional Review Board of the College of Medicine and Health Sciences, Bahir Dar University. Official support letters were also obtained from each participating public referral hospital. Before data collection, all participants were informed about the purpose, procedures, and expected outcomes of the study. Written informed consent was obtained from participants with formal education. For participants without formal education, study information was read aloud in their local language. Verbal consent was obtained in the presence and with the assistance of caregivers, who helped explain and clarify the procedures and purpose. In cases where participants were unable to independently provide informed consent due to illiteracy or other limitations, consent was obtained from a legally authorized representative or appropriate caregiver on their behalf, in accordance with ethical approval. Participants who showed signs of undernutrition during data collection, such as low MUAC, low BMI, visible wasting, or reported poor food intake, were immediately referred to the attending clinicians for further evaluation and appropriate nutrition counseling and management, in accordance with each hospital’s clinical protocol. To ensure confidentiality, only coded identifiers (not personal names) were used on the questionnaires. Ethical principles, including voluntary participation, informed consent, and data privacy, were emphasized during the training of data collectors and supervisors. This study was conducted following the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. This research is original and has not been submitted or published elsewhere.

: Not applicable.

: The authors declare no competing interests.