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Article History

Received: 23 April 2025

Accepted: 2 July 2025

First Online: 19 August 2025

Declarations

:

: All methods were conducted following the regulations and principles of the Helsinki Declaration (World Medical Association, 2013). This study was approved by the Ghana Health Service Ethics Review Committee (GHS-ERC:026/05/24). Consent to participate and to extract children’s (aged 24–35 months) information from the immunization folder was obtained from the children’s parents and, in some cases, their caregivers. The parents or caregivers who provided informed consent were 18 years and above. The parents or caregivers either signed or thumbprinted the informed consent forms on behalf of the children. The study was voluntary, and the consenting process was explained to participants so they could willingly decide to participate. Participants had the flexibility to withdraw at any time during the survey process. Permission to conduct the study in the selected facilities was obtained from the Ghana Health Service through Simprints Technology. The various regional and district directorates for health services were engaged for permission in their respective regions and districts to conduct the research.

: Not applicable.

: The authors declare no competing interests.