Ethical clearance was obtained from the Institutional Ethical approval Committee of Wollega University. A formal letter from the Institute of health sciences of Wollega University was written to the Bule Hora district, and then the permission and support letter was written to each health facility. Written consent was obtained from each study participants after explaining the purpose of the data collection and before the interview. Respondents’ names were not written on the questionnaire for anonymity and confidentiality of their information. Assent was obtained from participants under the age of 18 years, and was approved by Institutional Ethical approval Committee of Wollega University to provide informed consent on their own behalf. They were also informed that they were free to withdraw from the interview and study at any time. This study was conducted in accordance with the Declaration of Helsinki.
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