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Article History

Received: 22 January 2026

Accepted: 11 March 2026

First Online: 25 March 2026

Declarations

:

: All methods are in accordance with the Declaration of Helsinki. As this is a secondary analysis, ethical approval was not applicable. However, the National Health Research and Training Institute (NHRTI) and National Health Research Authority in Zambia granted ethical approval for the conduct of the ZDHS.

: Not applicable.

: The authors declare no competing interests.