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Article History

Received: 22 January 2026

Accepted: 16 April 2026

First Online: 21 April 2026

Declarations

:

: Before conducting the study, ethical approval was obtained from the Amhara Regional Public Health Institute Ethical Review Board with reference No: APH I/De/Di/619 . And a formal permission letter was secured. The aim of the study was clearly explained to each participant, and oral informed consent was obtained. Participants were informed of their right to withdraw from the study at any time during the interview or examination, and written consent was also documented. Confidentiality was maintained by removing all personal identifiers from the data collection tools, and the data were securely stored. Finally, participants were informed that the study results would be published, and they were assured that their identities would remain confidential. This study adhered to the Declaration of Helsinki 2024.

: Not applicable.

: The authors declare no competing interests.