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Article History

Received: 1 March 2026

Accepted: 8 July 2026

First Online: 21 July 2026

Declarations

Ethics approval and consent to participate: Ethical approval for this study was obtained from the Vaal University of Technology Research Ethics Committee (VUT REC, approval number FRECMS-20082025-229). The study was conducted in accordance with the principles of the Declaration of Helsinki, the South African National Health Research Ethics Council (NHREC) guidelines, and the Department of Health’s Ethics in Health Research (2015) guidelines. The VUT’s RECs subscribe to the research integrity standards set out in the Singapore Statement and also follow recommended guidelines, practices, and regulations set out by the Medical Research Council, the Belmont Report, and the Nuremberg Code. Prior to the interviews, participants received written information about the study, including its aim and their right to decline participation or withdraw at any time without providing a reason. Written and/or oral informed consent was obtained from all participants before the interviews. Participants were assured that their anonymity and confidentiality would be protected. Audio recordings and transcripts were stored securely in accordance with institutional data management procedures and were accessible only to the research team.

Consent for publication: Not applicable.

Generative AI statement: The author(s) declared that Generative AI was not used in the creation of this manuscript. AI-assisted tools were applied only to refine grammatical style, reference formatting and for the design of Fig. 1.

Competing interests: The authors declare no competing interests.