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Article History

Received: 22 March 2025

Accepted: 18 September 2025

First Online: 21 October 2025

Declarations

:

: First, ethics approval was secured from the IRB of St. Paul’s Hospital Millennium Medical College (SPHMMC) Research and Resources Mobilization Directorate (Ref. No: PM23/401/23/01/2024). In addition, prior permission and support letters were obtained from all participating institutions, including the Federal Democratic Republic of Ethiopia’s Refugees and Returnees Service (RRS), Gambella Region RRS (Gambella branch office), and the Somali Region RRS (Jigjiga branch office). Verbal informed consent was sought before any data were collected. The majority of study participants were using contraceptive methods without the knowledge of their male partners and mothers-in-law. Asking for written informed consent could cause discomfort for the study participants. Moreover, the SPHMMC IRB typically requires verbal informed consent for all research other than clinical trials involving invasive procedures. Thus, before enrolment, verbal informed consent was obtained by discussing with potential participants about the study objectives, procedures involved, study requirements, potential benefits and risks of participation, privacy, and data confidentiality using the local language (to ensure participants’ full understanding). All study participants were informed that they could cancel their consent at any time without any harm. Furthermore, privacy and confidentiality were maintained by not exposing individual identifiers, not transferring the data to a third party, and using it for research purposes only.

: Not applicable.

: The authors declare no competing interests.