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Article History

Received: 4 January 2025

Accepted: 16 April 2026

First Online: 20 April 2026

Declarations

:

: Ethical approval for this study was obtained from the Research Ethics Committee (REC) of the University of Health and Allied Sciences (UHAS) before data collection, under reference number UHAS-REC B.10 [051]23–24. Written informed consent was obtained from all participants through signed or thumb-printed consent forms. To ensure anonymity, unique codes were assigned to participants, preventing any direct tracing of information to individuals. Additionally, all completed questionnaires were securely stored under lock and key by the principal investigator for confidentiality. To facilitate effective communication, five community health officers, who were also community volunteers fluent in both English and the local languages spoken in the study areas, assisted with translation and interpretation during data collection. These officers were well-educated and proficient in reading and understanding both English and the respective local languages. Instead of translating the questionnaire into local languages beforehand, they provided real-time interpretation to ensure accuracy and consistency in responses. The study’s purpose was clearly explained to participants before the interviews, and they were informed of their right to withdraw at any point without consequence. Participants were also assured that all responses, including private statements, would remain strictly confidential. Data collection and recruitment took place between June 9, 2024, and October 2024. However, this process was not continuous, as interruptions occurred due to financial constraints related to accommodation and transportation, as well as chieftaincy conflicts in certain study areas. These challenges extended the duration of data collection beyond the initially planned timeline.

: Not applicable.

: The authors declare no competing interests.