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Article History

Received: 8 April 2026

Accepted: 8 July 2026

First Online: 19 July 2026

Declarations

Ethics approval and consent to participate: Not applicable. Formal ethics approval was not required for this study because it used only publicly available, aggregated, country-level secondary data and did not involve direct participation by human participants, identifiable personal information, human tissue, biological material, or interventions. In accordance with the National Institute for Medical Research Guidelines on Ethics for Health Research in Tanzania (3rd ed., 2023), institutional ethics committee or IRB review was not required because no identifiable human participant data were collected or analysed. All analyses of secondary human data were performed in accordance with relevant guidelines and regulations and with the principles of the Declaration of Helsinki. Not applicable. Consent to participate was not required because the study used publicly available, aggregated secondary data and did not recruit individual participants or analyse identifiable individual-level data.

Consent for publication: Not applicable.

Competing interests: The authors declare no competing interests.