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Article History

Received: 30 July 2026

Accepted: 22 September 2026

First Online: 28 September 2026

Declarations

Ethics approval and consent to participate: The study protocol received approval from the Institutional Review Board of Khyber Medical University (Ref: KMU-EB/2025/1725) and from the ethics committees of Khyber Teaching Hospital, Lady Reading Hospital, and Hayatabad Medical Complex. Written informed consent was obtained from the parent or legal guardian of every enrolled child. Participants were assured of the voluntary nature of participation, the confidentiality of their data, and their right to withdraw at any stage without any impact on the child’s standard of care. Any child found to have severe acute malnutrition or another condition requiring urgent intervention was immediately referred to the facility’s nutrition or medical team, irrespective of study involvement. All data were de-identified using unique study codes, and the electronic database was password-protected, with access restricted to the principal investigator and data manager. The study was conducted in accordance with the Declaration of Helsinki and applicable national guidelines for human subjects research in Pakistan.

Consent for publication: Consent to publish is not applicable for this study, as no personally identifiable information was collected from participants. All data were anonymised and aggregated for analysis.

Competing interests: The authors declare no competing interests.