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Article History

Received: 23 November 2024

Accepted: 28 July 2025

First Online: 6 August 2025

Declarations

:

: This study utilized secondary data from The DHS Program. The DHS program adheres to stringent ethical protocols for data collection, anonymization, and public access. The survey procedures were approved by ICF International’s Institutional Review Board (IRB) and comply with ethical standards for human subjects research, including those outlined in the Belmont Report and U.S. Department of Health and Human Services regulations (45 CFR 46). As the data are anonymized and publicly available, no additional ethical approval or individual consent was required for this analysis.

: Not applicable.

: The authors declare no competing interests.