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Detailed information about the study was provided, and informed written consent was obtained from mothers or caregivers. For illiterate mothers or caregivers, the information was explained in detail in the presence of an impartial witness. Both the mothers or caregivers and the witness signed the consent forms. No copies of school achievement data were retained, ensuring that confidentiality was maintained.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical 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":"3417"}}