Ethical approval and consent to participate
Ethical approval to conduct this study was obtained from the Institutional review board of the College of Medicine and Health Sciences in Rwanda (Approval notice: No 058/CMHS IRB/2016). The study staff explained the purpose of the study and procedures to mothers both verbally and in writing. Then, informed written consent was obtained from every participant mother for the total 12-month study period prior to participation. Mothers were assured that their participation was voluntary, confidential and that they were free to withdraw from the study at any time.