Received: 12 January 2018
Accepted: 2 October 2019
First Online: 15 October 2019
Ethics approval and consent to participate
: Ethical approval was obtained from the Johns Hopkins School of Public Health Institutional Review Board (JHSPH IRB) (reference number 0005303), which met the criteria for exemption under 45 CFR 46.101(b), Category (5). In Ethiopia, we did not ask the National Research Ethics Review Committee (NRERC) to obtain ethical approval/waiver for the following two reasons: a) This study had no significant risks on study participants as approved by JHSPH IRB; b) NRERC is primarily focused on providing ethical decisions for clinical trials involving new drugs, experimental research and studies that require human biological specimens/samples. Instead of NRERC ethical approval, the human resources for health experts at FMoH reviewed the study protocol and granted permission to conduct the study. In addition, the FMoH wrote support letter to all eleven regional health bureaus to collaborate with study team members during data collection period. In reference to the FMoH support letter, all regional health bureaus sent permission letters to health facility managers to facilitate data collection activities.Verbal consent was obtained from each study participant as approved by JHSPH IRB. All study participants were received information on the study objectives and recruitment process. To protect participants from risks, the study did not record participants’ names, identification numbers and names of health facilities where he or she worked. Data collector interviewed study participant in a private room without disrupting patient care and other health service activities. After completing interview, data collectors put questionnaires in a sealed envelope to keep all answers confidential to anyone at the sample health facility or any other health facility. Data were also entered in a computer with unique random generated ID numbers given for each study participant.
: Not applicable.
: The authors declare that they have no competing interests.