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Article History

Received: 24 February 2026

Accepted: 20 July 2026

First Online: 28 July 2026

Declarations

Ethics approval and consent to participate: This study was conducted in accordance with the ethical principles outlined in the World Medical Association’s Declaration of Helsinki. Ethical approval was obtained from the Institutional Review Board (IRB) of the University of Gondar, College of Medicine and Health Sciences, Institute of Public Health (Reference number: 3278, 2025). Official permission was also secured from the Gondar City Administration, relevant sub-city administrations, and the Gondar City UPSNP office. Prior to data collection, all participants were informed about the study’s objectives, procedures, benefits, and potential risks, and written informed consent was obtained from each participant. Participation was entirely voluntary, and participants were informed of their right to refuse or withdraw from the study at any time without any consequences. Confidentiality and anonymity were strictly maintained by using coded identifiers instead of personal information. All data were securely stored and used solely for research purposes, ensuring privacy throughout data collection, analysis, and reporting.

Consent for publication: Not applicable.

Competing interests: The authors declare no competing interests.