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First Online: 15 August 2018

Ethics approval and consent to participate

: The study was approved by and overseen by appropriate ethical committees in each countries including the National Ethics Committee for Health Research on Humans of the Ministry of Health of Cameroon; Kenya Medical Research Institute; University of Ibadan/University College Hospital Ethical Review Committee; Human Science Council Research Ethics Committee in South Africa: Malawi’s National Health Science and Research Committee. One case study that compared two countries was reviewed by three committees; in Togo by Togo Comite de Bioethique Pour la Recherche en Sante) and in South Africa by Human Sciences Research Council Research Ethics Committee, and University of Pretoria Health Sciences Research Ethics Committee. All country research teams followed appropriate ethics principles to protect the research subjects, including participant privacy and confidentiality, voluntary participation, the risks and benefits of research and how research findings would be shared. Participants provided verbal or written documentation of consent to participate.

: Not applicable.

: The authors declare that they have no competing interests.

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