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.