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Article History

Received: 10 November 2025

Accepted: 6 March 2026

First Online: 11 March 2026

Declarations

:

: This study received ethics approval from the Jaramogi Oginga Odinga University of Science and Technology (JOOUST) Ethics Review Committee (Approval No: ERC 16/01/23) and a research license from the National Commission for Science, Technology and Innovation (NACOSTI) (License No: NACOSTI/P/25/414763). Permission was obtained from the Kisumu County Department of Health and Seme Sub-County Health Management Team. Written informed consent was obtained from all participants after explaining the study’s purpose, voluntary nature of participation, confidentiality measures, and right to withdraw without consequences. All data were anonymized and reported in aggregated form to protect participant identity. Electronic data and audio files were stored on password-protected computers accessible only to the research team. All procedures performed in this study involving human participants were conducted in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

: Not applicable.

: The authors declare no competing interests.