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Article History

Received: 9 July 2024

Accepted: 18 November 2024

First Online: 23 November 2024

Declarations

:

: The ethical approval committee of Debremarkos University approved the data collection and provided an ethical clearance certificate (Ref: NCS/4069/18/15). While a waiver of written consent was approved owing to financial constraints and the nature of the research setting, we acknowledge that this decision may raise concerns. The committee carefully considered the local context, which often necessitates flexibility in consent processes, particularly in settings where written consent may pose challenges. For participants under the age of 18, consent was obtained from parents or guardians, and verbal consent was documented in written notation by the researcher and witnessed by a third party. We ensured that the ethical committee’s oversight was fundamental in ensuring participant rights and confidentiality throughout the study.

: Consent to publish the results of this study was obtained from all participants involved. For minors, parental or guardian consent was secured before publication. The manuscript has not been published elsewhere and is not under consideration for publication in any other journal. The authors agree to submit this manuscript to this journal for publication as original research.

: The authors declare no competing interests.