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Article History

Received: 10 December 2019

Accepted: 30 December 2019

First Online: 8 January 2020

Ethics approval and consent to participate

: This study was approved by the Nepal Health Research Council Ethical Review Board under Reg. No. 350/2017. The District Education Office of each district also approved the study. All respondents were informed that their participation was voluntary and they could withdraw from the study at any time. They were also ensured of data confidentiality and anonymity. For the qualitative part of the study, all respondents signed an informed consent form. For the quantitative part of the study, which collected data from students, information sheets were distributed to the children’s parents in advance to explain the study. We planned to but could not receive a written consent from all parents because most of them could neither read nor sign. Principals and teachers therefore made phone calls to the parents to obtain their verbal consent and the school principals then signed the consent on their behalf. The protocol deviation report was approved by the Nepal Health Research Council Ethical Review Board (Ref. No. 1256).

: Not applicable

: The authors declare that they have no competing interests.