Ethics.
This study was approved by the University of Zambia Biomedical Research Ethics Committee (Ref. No. 004-05-19) and the Boston University Medical Center Institutional Review Board (Ref. No. H-38950). Informed consent was waived by both institutional review boards for the COVID-19 questionnaire responses and demographic data due to the impracticality of consenting during parenting group meetings. Additionally, the National Health Research Authority; the Ministry of Health at the national, provincial, and district levels; and traditional chiefs in these districts granted official government approval to conduct the overarching study.