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Article History

Received: 2 May 2021

Accepted: 1 February 2022

First Online: 10 February 2022

Declarations

:

: Ethical approval was granted by the Kenya Medical Research Institute (KEMRI) Scientific and Ethics Review Unit (KEMRI/SERU/CGMR-C/122/3649) and the National Commission for Science, Technology, and Innovation (NACOSTI) Kenya.The ethics review committee approved the use of both written (for the interviews) and verbal (for the observations) informed consent in this study. Therefore, written informed consent was sought from all study participants before interviews. All interview participants provided consent to participate in the study. For the observations of audit meetings, information sheets were provided, and the study was explained to meeting participants, following which verbal consent was sought to allow JJ to participate in audit meetings. This allowed for a continued consent process, which involved a brief re-introduction of the study at the beginning of every meeting and seeking consent to participate, as such, participants had an opportunity to express discomfort (if any) with being observed. The verbal consent was documented as part of the field notes.

: Not Applicable.

: The authors declare that they have no competing interests.