Ethical Considerations

Ethical approval was obtained from the institutional review board of Rift Valley University Department of Public Health. Following this permission was sought and successfully obtained from Addis Ababa public health research and emergency management directorate Bureau, and from the Akaki Kality subcity health office. Further, permission to conduct the research was requested and obtained from the administrative body of Akaki Kality subcity Health Office. An information sheet was prepared and given to all study participants to obtain informed verbal consent. All participants were informed of the aim and purpose of the study and their participation was voluntary. Verbal informed consent was approved by the ethics committee, and that this study was conducted in accordance with the Declaration of Helsinki. The name of the participant was not asked, instead a code number was used to ensure anonymity and confidentiality throughout the study.