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Article History

Received: 17 September 2024

Accepted: 13 May 2025

First Online: 2 September 2025

Declarations

:

: Prior to the commencement of data collection, ethical approval was obtained from the West Wollega Zonal Health Department Research and Ethics Review Committee (Reference No. 845/WEFGWL/2024), issued on May 28, 2024. In addition, formal permission letters were submitted to the respective woreda administrative offices to secure authorization and cooperation. Given that the study involved children under the age of five, comprehensive ethical safeguards were applied. Informed consent was carefully obtained from each child’s mother or legal guardian after providing a clear explanation of the study’s objectives, procedures, potential risks, and benefits. The consent process was conducted in a language participants fully understood, primarily Afan Oromo. Participation was entirely voluntary, with participants free to withdraw at any time, and strict confidentiality of all collected data was maintained throughout the study.

: Not applicable.

: The authors declare no competing interests.