Ethical clearance letters were collected from University of Gondar research and community service directorate and North Gondar Zone administrative office to care for both the study participants and the researchers. During survey, official letters were written for each district and kebele/village, informed verbal consent was obtained from each client, and confidentiality was maintained by giving codes for each respondent rather than recording their name. Study participants were informed that clients have a full right to discontinue or refuse to participate in the study. Hence, all participants throughout the research, including survey households, enumerators, the supervisors and key informants, were fully informed of the objectives of the study. They were approached friendly in free moods until the end of this research.
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