Data processing and analysis

All interviewers underwent an intensive 3-day training program that specifically addressed qualitative methodologies, data collection tools, research ethics, and communication protocols, thereby fostering a shared understanding among them. The training was led by distinguished experts in the fields of qualitative research and public health. Transcription and translation services were provided by the proficient staff of Knowledge to Action (K2A), who were entirely independent from both the interview process and the study itself. Subsequently, the transcribed and translated data underwent meticulous scrutiny by language experts to ensure the utmost accuracy and validity. The interviews were first transcribed verbatim in Nepali and then translated into English. The transcripts were reviewed line by line and validated with audio recordings to maintain accuracy. The notes taken during the FGD were cross-checked by the moderator to ensure accuracy.

The data were analysed using qualitative content analysis. First, open coding was performed by independent researchers, and these codes were discussed within the study team. Second, the agreed codes were grouped into categories and themes. The themes were decided, and developed, and finalized based on the study objectives. However, any new and relevant themes emerging from the data were also added. Finally, these codes and themes were cross-examined, reviewed, and finalized after an agreement among the independent coders. The entire data analysis process was guided and carried out under the supervision of the research leader.