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Article History

Received: 21 April 2026

Accepted: 8 June 2026

First Online: 12 June 2026

Declarations

Ethics approval and consent to participate: Ethical approval was obtained from the University of Health and Allied Sciences Research Ethics Committee (UHAS-REC) prior to commencement of data collection. Institutional permission was granted by the North Dayi District Health Directorate. Written informed consent was obtained from all participants aged 18–19 years. For participants below 18 years, written parental/guardian consent and adolescent written assent were obtained. Participation was entirely voluntary with the right to withdraw at any point without consequence. Confidentiality was maintained through participant coding (PA01–PA11); audio recordings and transcripts were stored securely, accessible only to the research team. All procedures were conducted in accordance with the Declaration of Helsinki.

Consent for publication: All authors have reviewed and approved the final manuscript and consent to its publication. No individual personal data, images, or details that could identify participants are presented in this manuscript. All participant data are reported using assigned codes (PA01–PA11).

Competing interests: The authors declare no competing interests.