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Article History

Received: 8 May 2024

Accepted: 25 July 2025

First Online: 18 August 2025

Declarations

:

: Ethical approval was obtained from University of Pretoria Faculty of Health Sciences Research Ethics Committee (778/2020) and the research was conducted in accordance with the Declaration of Helsinki. Authorisation was obtained from the four relevant provincial departments of health via the South African National Health Research Database () to conduct the research in the selected districts. An information leaflet and informed consent document was provided to the focus group participants by e-mail and the interviewer reviewed the document with the participants prior to the start of each focus group. In addition to the purpose of the study, participants were informed of the time needed for the focus group, their right to withdraw and the plans for using the results of the study [27]. Written informed consent was obtained from all participants. In order to maintain confidentiality, participants’ were allocated numbers to use during focus group discussion (rather than names or designations) and names remained masked following data collection, analysis and reporting [27]. To protect the identities of participants, the districts have randomly been designated as A, B,C or D in the results section of this paper.

: The authors declare no competing interests.