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Article History

Received: 30 March 2026

Accepted: 3 August 2026

First Online: 8 August 2026

Declarations

Ethics approval and consent to participate: The study was reviewed and approved by the Institutional Review Board at SPHMMC (PM 23/1001) and the CIHLMU Center for International Health at Ludwig-Maximilians-Universität München in Munich, Germany (opinion no. 24–0362). After receiving ethical approval, initial caregiver cohort recruitment followed sequential, chronological screening of the pre-existing waiting list. The project coordinator nurse then contacted 186 eligible caregivers by telephone and invited them to an in-person intake at the unit. Those who agreed to enroll in the training were provided with a standardized participant information sheet. Literate participants read the document independently, while illiterate participants were read the document aloud in Amharic. They were assured that declining to participate would not impact their routine medical care. A separate written consent process was administered to the resident facilitators. This guaranteed that their focus group feedback, implementation performance and fidelity metrics would be completely anonymized and handled outside of academic channels. This ensured that their participation or critical evaluations would not affect their residency evaluations or their professional standing with senior consultants. Written informed consent was obtained from all participants, including both caregivers and facilitators, before data collection. All procedures were conducted in accordance with the ethical principles outlined in the Declaration of Helsinki.

Consent for publication: Not applicable.

Competing interests: The authors declare no competing interests.