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Article History

Received: 15 January 2026

Accepted: 22 June 2026

First Online: 1 July 2026

Declarations

:

: In accordance with the Declaration of Helsinki, this study strictly observed and followed all applicable ethical guidelines for human-subjects research. Written informed consent was obtained from all adults and key informants after they reviewed information sheets provided in either English or Chichewa. All participants were informed of their right to decline participation or withdraw from the study at any time without any impact on their routine healthcare. To ensure participant confidentiality, unique study IDs were utilized, and all consent forms have been kept in secure storage.This study was approved by the College of Medicine Research Ethics Committee (COMREC), certificate number P.06/22/3655, under the Kamuzu University of Health Sciences (KUHeS). Both written and verbal consent were obtained before the interviews.

: Not applicable.

: The authors declare no competing interests.