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Ethical approval was obtained from the research and ethics committees of Gulu University (GUREC-2024-990) and the Uganda National Council for Science and Technology (SS3477ES). Administrative clearance was obtained from the Chief Administrative Officers of Lira and Ibanda, and then the Local Council chairpersons for the respective villages where the data was collected. All study participants provided voluntary written informed consent after explaining the purpose, benefits, and risks of participating in the study. We ensured participants\u2019 privacy by conducting interviews in a quiet environment without other people. Interviewers were trained in techniques for asking sensitive questions and recognizing signs of distress. This ensured they approached the conversations in a supportive and considerate manner. At the end of each interview, participants were thanked for their time and provided with a debriefing about the study\u2019s objectives. Participant identities were anonymized in the transcripts, and audio recordings were securely stored, restricting access to the study team.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"777"}}