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Ethical approval was obtained from the Institutional Review Board (IRB) of the College of Medicine and Health Sciences, Hawassa University (Ref No: IRB\/270\/16; date 18\/06\/2024). Following IRB approval, letters of support and cooperation were obtained from the Sidama Region Health Bureau. Prior to data collection, written informed consent was obtained from all mothers or caretakers of preschool-aged children. Participants were provided with detailed information regarding the study\u2019s objectives, procedures\u2014including questionnaires, anthropometric measurements, and venipuncture for blood sampling\u2014along with potential risks and benefits, and their right to withdraw at any point without repercussions. Confidentiality was strictly maintained by assigning unique identification codes to all participant data. To uphold ethical responsibility, all participating mothers or caretakers were informed of the test results, and any children identified as undernourished or anemic were referred to local health posts for appropriate care and intervention.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"168"}}