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Article History

Received: 14 February 2024

Accepted: 25 September 2025

First Online: 13 January 2026

Declarations

:

: The study adhered to the declaration of Helsinki, to uphold the highest ethical standards for research involving human participants. The design, data collection, and reporting followed the principles of beneficence, respect for persons, and justice, and ethical considerations in every process and instrument was ensured. Ethical approval was obtained from the following institutions: Stellenbosch University Health and Research Ethics Committee 2 (HREC2) S18/10/254; AMREF Ethics and Scientific Review Committee (ESRC)P652/2019; Moi Teaching and Referral Hospital-Moi University Institutional Research and Ethics Committee (IREC)0003484; Kenyatta National Hospital-University of Nairobi Ethics and Research Committee (ERC)KNH-ERC/RR/86. Research License from the National Commission for Science, Technology, and Innovation (NACOSTI) Ref. no.8777616. Permission was also sought from the County government, while the respondents gave informed consent.

: Not applicable (as our manuscript does not contain any personal information or data in any form, including any individual details, images or videos).

: The authors declare no competing interests.