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Article History

Received: 17 June 2025

Accepted: 20 January 2026

First Online: 29 January 2026

Declarations

:

: The study received ethical approval from the Harvard IRB protocol # IRB24-0272, dated April 5, 2024; the Neno District Health Office, letter dated May 6, 2024, to conduct the study in the Neno District, and the NHSRC protocol # 04/07/4455, dated August 23, 2024. Furthermore, the ethical principles in the Declaration of Helsinki [ ] were followed so that all participants were informed about the study’s aim and objectives through the RA, who shared the information sheet by reading aloud in the presence of the witness. Participants were then provided with their consent to participate by signing or providing a thumbprint on the consent form, which the witnesses were also asked to sign. The witnesses were present only during the consent signing process and were asked to move during interviews to maximise participant confidentiality. The participants were given a unique identifier to protect their identity, and the study team conducted themselves with good clinical practice training.

: Not applicable.

: The authors declare no competing interests.