The study received ethical approval from the Institutional Review Board (IRB) of the College of Health Sciences at Addis Ababa University. We had permission from IRB not to have consent as the results of the observations were meant to benefit the public at large and we did not seek any identifying information or photos of any individuals. This is indicated in the S4 File. The survey used a random observation tool that does not override the rights of any individual or institution, and the observation was done purely anonymously. A weekly report on the progress of monitoring was submitted to the Ministry of Health of Ethiopia to help to take proactive actions.
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