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Article History

Received: 4 February 2023

Accepted: 28 June 2023

First Online: 7 July 2023

Declarations

:

: The current study was built on the analysis of openly accessible secondary data with all identifier information were removed. The Institutional Review Board (IRB) of ICF Macro at Fairfax, Virginia in the USA reviewed and approved the MEASURE DHS Project Phase three. The 2010–2018 DHS’s are considered under that approval. The IRB of ICF Macro complied with the United States Department of Health and Human Services requirements for the “Protection of Human Subjects” (45 CFR 46). The IRB approved procedures for DHS public use datasets do not in any way allow respondents, households, or sample communities to be identified. There are no names of individuals or household addresses in the data files. The geographic identifiers only go down to the regional level (where regions are typically very large geographical areas encompassing several states/provinces). Each enumeration area (Primary Sampling Unit) has a PSU number in the data file, but the PSU numbers do not have any labels to indicate their names or locations. In surveys that collect GIS coordinates in the field, the coordinates are only for the enumeration area (EA) as a whole, and not for individual households, and the measured coordinates are randomly displaced within a large geographic area so that specific enumeration areas cannot be identified. In addition, written informed consent was obtained from a parent or guardian for participants under 16 years old. DHS Program has remained consistent with confidentiality and informed consent over the years. We obtained express approval to use the data from ICF Macro. No further approval was required for this study.The data owners can be contacted at ExternalRef removed and data can be found at ExternalRef removed. Further documentations on ethical issues relating to the surveys are available at ExternalRef removed. We confirm that all methods were carried out in accordance with the relevant guidelines and regulation.

: Not applicable.

: The authors declare no competing interests.