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Article History

Received: 14 January 2024

Accepted: 26 August 2025

First Online: 2 October 2025

Declarations

:

: Ethical clearance was obtained from the Institutional Review Board (IRB) of Dire Dawa University (protocol number DDU-IRB-2023-192). Following approval, an official letter of support was submitted to the Dire Dawa Regional Health Bureau. Subsequently, permission was obtained from the management bodies of each selected kebele. Participants were informed that their participation was voluntary and that they could withdraw at any time if they felt uncomfortable with the questionnaire. Written informed consent was obtained from all participants prior to the interviews, which were conducted privately in designated counseling rooms. To ensure anonymity, no names or personal identifiers were recorded on the questionnaires. Furthermore, all fundamental principles of human research ethics—including respect for persons, beneficence, voluntary participation, confidentiality, and justice—were strictly observed.During data collection, if participants exhibited injuries related to recent harmful traditional practices or experienced psychological or mental health issues due to these practices, data collectors and supervisors provided appropriate counseling. Depending on the situation, first aid was administered, and referrals were made to relevant health facilities.

: This part is not applicable because the manuscript contains no person’s data in any form (including individual details, images, or videos).

: The authors declare no competing interests.