Ethical clearance was obtained from Woldia University, College of Health Sciences, Research and Community Service Review Committee (RCSRC). A formal letter of permission and support was written to RHB from Woldia University and finally to selected health facilities. The study participants were informed about the purpose of the study, their right to refuse. Written and signed voluntary consent were obtained from study subjects before distributing the questionnaire. The respondents were also told that the information obtained from them was treated with complete confidentiality and did not cause any harm to them. All methods were carried out in accordance with relevant guidelines and regulations.

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