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Article History

Received: 5 March 2025

Accepted: 2 July 2025

First Online: 16 October 2025

Declarations

:

: Our study was conducted in accordance with the principles outlined in the Declaration of Helsinki. The study protocol was reviewed and approved by the Health Research and Ethics Committee of the University of Nigeria Teaching Hospital, Eastern State (reference number: NHREC/05/01/2008B-FWA00002458-1RB00002323), as well as by the London School of Hygiene and Tropical Medicine, UK (LSHTM reference: 14 540–1).

: This study primarily involved household caregivers, or individuals who were knowledgeable about the healthcare access of the household members over the six months prior to the data collection date. Prior to participation, informed consent was acquired from each respondent. This was preceded by a comprehensive oral explanation, which outlined the study’s objectives, potential risks and benefits, supplemented by an information sheet. Participants’ comprehension of these details was confirmed before any interviews commenced. Participation was entirely voluntary, with respondents made fully aware of their right to decline or withdraw at any stage of the interview process. The confidentiality of all participants was rigorously upheld, with no personally identifiable information, such as names, being recorded. Consent to publish data was also obtained from each household representative who volunteered to participate in the study.

: The authors declare no competing interests.