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Article History

Received: 3 September 2024

Accepted: 1 April 2026

First Online: 15 April 2026

Declarations

:

: Ethical approval was not required, as this study used secondary, anonymized, spatially aggregated district-level data. However, authorization to access and use district-level aggregated data from the District Health Information Management System Version 2 (DHIMS-2) database was obtained from the Ghana Health Service through established procedures.

: Informed consent from participants was not required, as the study used district-level aggregated data from the District Health Information Management System Version 2 (DHIMS-2) database, obtained from the Ghana Health Service through established procedures.

: The authors declare no competing interests.