Author contributions
GG is the principal investigator, conceptualizing the research idea, drafting the proposal, collecting data, analyzing it, writing up the whole manuscript, and communicated with co-authors and organized their works in the manuscript. MA drafted the proposal and wrote the methodology part. SG consulted and participated in the data analysis process and arranged the order of the manuscript. Furthermore, NA consulted in the technical language edition and wrote the results part. All authors significantly contributed from protocol development to the manuscript writing process.We gratefully acknowledge Jimma University, the MoH of Ethiopia, the Oromia Health Bureau, and the Zonal and Woreda Health and Education offices for their invaluable assistance in conducting this study. Furthermore, we thank all the study participants, school directors, homeroom teachers, data collectors, and supervisors.