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Article History

Received: 10 August 2021

Accepted: 30 March 2022

First Online: 22 April 2022

Declarations

:

: The study protocol was reviewed and approved by the AMREF Ethics and Scientific Research Committee (ESRC) (protocol ID: AMREF-ESCR P429/2018), and the University of Nairobi/Kenyatta National Hospital Ethics and Research Committee (protocol ID: KNH-ERC/A/384) in Kenya. Permits to conduct the study were also obtained from the Kenyan National Commission for Science, Technology and Innovation (NACOSTI) and from each participating health facility. The study protocol was also approved in Nigeria by the National Health Research Ethics Committee of Nigeria (NHREC) (protocol ID: NHREC/01/012007–20/08/2018). In Burkina Faso, approval was provided by the Institutional Ethics Committee of the Nouna Health Research Center and the Comité d’éthique de la recherche en santé (health research ethics committee -CERS) (Protocol ID: 2018–10-124), as well as authorization letters from the Ministries of Health in all the countries that were also sent to all the seven regional Directors of health. In all countries, all patients provided written informed consent prior to participation. In accordance with the requirements from the Burkina Faso ethics committee, we sought both parental consent and participant assent for all young women under 18 years. An impartial witness was required for all participants who were illiterate or incapable of reading.

: Not applicable.

: The authors declare that they have no competing interests.