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Article History

Received: 2 October 2017

Accepted: 5 June 2018

First Online: 18 June 2018

Ethics approval and consent to participate

: All studies were submitted to local institutional review board (IRB) for ethical clearance.Kenya: The University of North Carolina at Chapel Hill IRB and the Kenya Medical Research Institute Ethics Review Committee.Malawi: The University of North Carolina at Chapel Hill IRB, Malawi’s National Commission for Science and Technology (NCST), and National Committee for Research in Social Sciences and Humanities.Tanzania: Tanzania’s Commission for Science and Technology (COSTECH).Zambia: American Institute for Research IRB and the University of Zambia’s Research Ethics Committee.Zimbabwe: American Institute for Research IRB and the Medical Research Council of Zimbabwe.Written consent to participate was obtained in Kenya and Tanzania and verbal consent in Malawi, Zambia, and Zimbabwe where enumerators signed forms documenting that consent was asked and received. Verbal consent was given ethical approval in these settings as available data indicated that a large proportion of our main respondent sample would be illiterate and thus unable to read and sign a consent form.

: The authors declare that they have no competing interests.

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