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Article History

Received: 9 November 2022

Accepted: 21 August 2023

First Online: 5 September 2023

Declarations

:

: Ethical approval for conducting this study was obtained from the National Health Research Ethics Review Committee (NatHREC) in Tanzania [NIMR/HQ/R.8a/Vol. IX/3729]. Approval to collect data in regions and councils was requested and granted by the President’s Office Regional Administration and Local Government, Regional Secretariat, and Local Government Authorities where the study was conducted. Written informed consent was obtained from each participant prior to administering the survey or interview and they were assured confidentiality and anonymity for their individual responses. Participants were informed about the voluntary nature of their participation, the right to withdraw at any time for any reason, and were provided with the opportunity to ask any questions.

: Not applicable.

: The Program in Global Surgery and Social Change and the Center for Reforms, Innovation, Health Policies and Implementation Research received funding from the GE Foundation for this study. James T. Kengia, Ntuli A. Kapologwe, Cindy Chwa, Tuna Cem Hayirli, Albino Kalolo, Ally Kinyaga, Noor Zanial and Shehnaz Alidina had financial support from GE Foundation for the submitted work. Tuna Cem Hayirli is also supported by award Number T32GM007753 and T32GM144273 from the National Institute of General Medical Sciences. David Barash is employed by GE Foundation, which funded this work. James T. Kengia and Ntuli A. Kapologwe are employed by the President’s Office Regional Administration and Local Government (PO-RALG). Steven J. Staffa, and John Meara have nothing to declare. The authors have had no financial relationships with any organizations that might have an interest in the submitted work in the previous three years and no other relationships or activities that could appear to have influenced the submitted work.