Refugee education is a post-conflict rehabilitation opportunity aligned with universal education for all. Refugees undergoing post-conflict rehabilitation follow mainstream education system for Uganda (Sirin, 2015). It is aimed to achieve Ugandas national education objective of all children to access quality education and to be equipped with skills and knowledge relevant to live productively with the host community. Despite most literature not talking about self-reliance in edu-cation, the Self-reliance Strategy (SRS) in Uganda is based in the Uganda Refugee Act, (2006) and 2010 refugee legal and regulatory framework, (Parliament of Uganda, 2006). These provided for rights of refugees to movement, education and access to resources like agricultural land for food production. Calls were made for collaborated effort to refugees training and liveli-hood programs, so that refugees are enabled to live in urban areas and attain livelihoods that are run by refugees themselves or the refugee supporting organiz-ations in Uganda. The efforts were needed to ensure that refugees are empowered in the Ugandas model. These self-reliance and livelihoods trainings program are part of what is known as Self-reliance strategy (SRS) and Development assistance for Refugees (DAR). The works of (Sarah, 2006; and Tania, 2006; Hovil, 2007) did not reflect much success to that effect since they were out only two or three year after the SRS policy was promulgated. The SRS was aimed to empower refugees in the development and main-tenance category, and known urban refugees in order to have their space in the city environment as (Easton-Calabria, 2016;  Betts et al., 2019) asserted.

Barriers to education like inadequate skilled teachers, language and curricula variations across education systems, cost-implications, cultural-lingual and inclu-sion issues systemically inhibit achievement of quality education, (Midttun, 2000a). These issues and invest-ment gaps limited optimization of education benefit. The met expectations of refugees for independent livelihood are overshadowed by the complex refugee education demand. In most camp-based learning insti-tutions little or no shared responsibility was reported to hinder achievement of their maximum potential (Fresia & Känel, 2016). Significant infrastructure and budge-tary limitations faced by UNHCR stifle delivery on protection and life sustaining assistance activities, (MoES, 2018; UNHCR, 2020). Popular education parameters of Ugandas excellent performance are on access and education equity as an end. But oppor-tunities for resilience, ability of refugees to support themselves on life needs, and mechanisms by which educational managers provide long-term solutions in education programs (United Nations, 2010; UNHCR, 2015) were studied. 

The UNESCO rates quality education as education for all (EFA) based on facilitation and teaching. The study found out that implementers are constrained, teacher-learner ratios are high and education outcome mea-sured by indicators of achievement, performance and productivity after school are still low despite increased access. Therefore, refuge education advocates stressed need for expansion of geographical and cultural hori-zons of schools and participation (UNESCO, 2014; UNDP, 2018). UNHCRs Synclair observed that it is undesirable for one group of the population to be severely under-educated relative to other groups, especially when there is an ethnic dimension (Khanam and Ali, 2022; Synclair, 2001). 

Good practices like involvement of refugees in a gen-dered manner at all levels of education planning and implementation, and relevance of programs design to enhanced skills and access opportunities. Inclusiveness and functional alternative and accelerated education programs enabled refugees to become self-reliant and contribute to host community development. Increased commitment of refugees, to take their education seri-ous and support from development partners like UNHCR, drove the changes. These emanate from good practices of actors, (United Nations, 2000a) and part-nership in delivery of education service for refugees and sustainable refugee strategy enshrined in inter-national instruments (Khalid, 2011; UNHCR, 2013; UNHCR, 2019). Efforts to ensure that education ac-cess delivers value, skills and usable knowledge for refugees, like asserted by (Sommers, 2003; Dryden, 2016; Dryden, 2011) have paid back. Ugandas app-roach and initiatives are applauded as a global model on refugees intervention especially education among others. 

The study explored education interventions imple-mentation for refugees in relation to best practices leading to satisfying learners expectations and resol-ving the limitations to refugee education. A mixed research approach was used in the study. By applying qualitative methods, opinions and views manifested in qualitative statements. Quantified indicators were deri-ved by quantitative research techniques during the process of gathering and analyzing measurable values to establish quantitative relationships among variables as (Creswell, 2004; Fadeel, 2008) asserted. The Case studies were rural and urban communities of Kampala and Kiryandongo. These were selected to explore and compare variations among beneficiaries, and refugee education actors practices. Variations across gender, private school educated and government schools stu-dents were studied. Deep exploration enabled making appropriate description of situations in rural and urban schools. School, community and national systems were brought in focus to explore their integrated relevance in education pursuit. Descriptive statistics of this study derived or validated facts and figures of multi-factorial relevance that existed. These as (Barbara, 2005; Coo-per & Schindler, 2006) argued, were useful in mea-surement of characteristics of differing values, signi-ficance and intervals. In-camp refugees and urban refugees were studied. Each participating student represented a household. UNHCR staff in charge of education and protection, staff of implementing partners (IPs), local community leaders and District Education Officers, Office of Prime Minister were key informants. Teachers, School Management Committee members and school heads were involved in in-depth field-based studies.

Sample size and Sample calculation

193 participants were drawn from sample population of 370. The sample size was selected in due consider-ation of the smallest representative sample using Krejcie and Morgan, (1970) sample size determination table (Amin, 2005). The sample was calculated by Slovenes formula from a student population of 5000 in target schools to give a sample population of 370 from which 193 accessible students were selected. A confidence level of 95% and a confidence interval of 5% were based on in the determination of samples.

Subjects and selection method 

The students studied were selected from schools in refuge communities in Kampala Central Division and Kiryandongo refugees settlement. Main participants were carefully selected to represent gender perspec-tives at school level. Kiryandongo hosts 4.8% (67680) (Bureau of Statistics, 2017) of refugees in Uganda. According to UNBOS, 76,210 are urban refugees (2012 housing census) but according to UNHCR refugee response portal, Kampala hosts 59910 refugees inclu-ding asylum seekers. 34% of these are children 0-17 years, (UNHCR, 2018). However, field estimates of UNHCR in Kiryandogo showed close to 5000 children and youth were in school. Samples of students were selected randomly. Key informants were selected using purposive sampling technique. Data was collected using student-administered questionnaires, Focus Group Discussions (FGDs) and school leavers were traced for interviews. Key Informants Interviewed included local community leaders, heads of schools and institutions, District Education Officers, School Management Committee Members particularly chair-men of SMCs, Refugee welfare council leaders and teachers.

Inclusion Criteria 

Study participants were students in primary and secondary schools in the refugee host community or settlement. Respondents were refugee children of age between 6 and 17 according to Ugandas lowest school entry and maximum average age at secondary school. These were only students in schools at the time of this study and school leavers known to have studied in the participating schools, identified by community leaders. 

Procedural methodology 

A pilot study was done prior to field work duration to map out the study participants locations. During this piloting and reconnaissance, study tools were tested with teachers, students and administrators. Alternative questions were captured suitable to elicit necessary data. The pilot helped to determine suitable focus for Kampala and Kiryandogo study sites, and appropriate time of collecting data from various primary sources. Permission and information that guided the fieldwork was obtained from the District Education Office (DEO), Office of Prime Minister (OPM) and Refugee Welfare Committees (RWC). Using pilot study, the tools were tested for reliability using a set of ten items of Likert scale to determine Cronbachs coefficient alpha reliability of questionnaires. Relevance of the tool analysis gave Cronbachs alpha α=0.624 and exp-loratory responsiveness of α=0.838 which are accep-table for internal consistency of results. During pre-testing, study tools were tried out on 4 expert; one potential respondent and three experts to elicit opin-ions on relevance, responsiveness and quality assu-rance of tools. Validity was tested by CVI method. Using the formula CVI=S-CVI/UA. Based on scale validity index (S-CVI) divided by universal agreement thus, the researcher determined that; Based on rating of the tools using the S-CVI technique during pre-testing by 4 experts judgement. 3 out of 4 experts universally agreed to valid tool, giving an S-CVI= .75. With acceptability rate of =0.8 this was appropriate evidence of good content validity. The suggested changes were integrated to make tools to suit the research paradigm. Participants informed consent to participate was sought. All adult respondents were supplied with con-sent forms and assented. Participants were free to with-draw at any point they felt uncomfortable to continue with the study. For participating minors, consent of their parents was sought, on top of child assent forms signed. Permission and study clearance letters were sought from the graduate school, Makerere University Research Ethics Committee and National Council for Science and Technology procedures for research clear-ance. 

Documents were reviewed including retrieved articles on theory, strategy papers, policy and program reviews reports of agencies and governments. Data was collec-ted by questionnaires that consisted of close ended and open-ended questions. The close ended questions eli-cited precise answers while diverse opinion and detai-led answers were obtainable by open-end questions. Close-ended questions were administered on refugee students but questionnaires for teachers and heads of schools were structured. Themes created guided FGDs in refugee communities and schools. 8-12 participants in categories of males and females formed a focus groups at both rural and urban schools. Six groups of female and male students were selected. One group was mixed and it was made of students taking alter-native program (which are students who are above 6 years, the age of first entry in primary school in Uganda). These are known as accelerated learning/-alternative education program (ALP/AEP) students. School leavers, graduates of schools and colleges ans-wered the question of attribution. Key Informants Interviews were conducted with UNHCR officials, education officers at district level and OPM officials to confirm policy and program framework views and practices. These provided opinions and decision pers-pectives at implementation level and answers to management questions. Interview guide with pre-determined questions were administered for verbal discuss-ions, inter-actions and probing.

Statistical Analysis

Data was coded and thematically aligned to institu-tional management, actors and beneficiaries. Themes involved inputs-output of educational arrangements, implementation and management processes, theoretical and empirical relationship of data upon which cons-truction of theory of change and models were cons-tructed. Qualitative data coding and analysis were done using iNvivo 12 software. Deductive coding was used to reflect themes under structural quality dimension, education process quality dimension and outcomes quality dimension. As such data was reviewed to iden-tify emerging issues and themes in line with research questions, objectives and theoretical and philosophical constructions. Evidence to support these codes was linked to create relationships that were merged into emerging sub-themes or grouped under pre-defined sub-themes and themes. The resultant themes were displayed and compared through text descriptions and quotes. Analyses were grouped on KII (information from education officials, service providers and com-munity members) and FGDs (information from pupils, students and teachers). Responses relevant to man-agement of education, quality and associated out-comes, and published literature on refugee education initiatives were interpreted. Philosophical postulations, theoretical views and best practices in education, specific to education in emergencies were interpreted to discern their relevance to the study. Education man-agement documents and field data relevant to con-temporary management of education in Uganda, Kiryandongo district, policy and working paper of UNESCO, UNHCR, UNICEF and Windle Inter-national Uganda were integrated to create mean-ng. Quantitative data processing and analysis was done in Stata v14 statistical software. Text data captured on some parts of the questionnaire were coded numeri-cally according to emerging topics before ana-lysis. Analysis was disaggregated on age, level of education, rural and urban criteria. Descriptive statistics reflec-ting mean, percentages and tabulation were generated to compare variations in estimates of some education indicators such as access and progress rates between sub-groups, efficiency rations and an infrastructural input determine opportunities and, output and out-comes of education.

The findings showed education access patterns of refugees in settlements and outside the settlements in urban centers of Kampala. The factors affecting access to education at early childhood, primary, secondary and post-secondary levels were revealed. The available education programs, activities and interventions and support given to meet education expectations of refu-gees were discovered. Factors influencing access to education at various levels, as well as coordination, planning and management best practices of education mandated agencies and communities were found out. The leaders of education actors namely government entities, schools and NGOs explained efforts made to cater for holistic education among refugees. 

Access to public and private schools in refugee com-munities

Children access primary and secondary education at public and community-based schools. In both types of schools, Ugandas education curriculum is taught. Public primary education is free, scholarships are given in secondary schools by organizations and the district gives scholarships for special needs children. Generally, notable patterns in enrolments and dropouts are detailed below; Over-enrolment is common in lower grades of primary and secondary schools. Due to switching children to new education curricula and limited resources to organize catch-up classes, over enrolments in lower grades notably, primary one to four, and senior one is experienced. Over-age for grade enrolments is the most common at primary and sec-ondary level schools. It was common to find over-age children for grades they were enrolled in. In particular, some children in primary schools were over-age by three or more years. This is directly related to over enrolments in lower grades (higher numbers per class), missed school years and grade repetitions. 

Enrollment and out-of-school rates at primary and secondary school level

In response to gender variations, retention of children in schools, opportunities to access education, age at first entry in school question across education cohort and numbers in private or government aided schools by grade, the researcher found out that access to edu-cation was better at primary level, with only 13% of primary school-aged children out of school com-pared to 50% of secondary school-aged children not in School. However, this 50% is an over-estimate since some 15 and 16 years olds were still in primary school. In general, however, these patterns are not unique to refugee children, they apply equally to host community children. The percentage of school-age children who are out of school is higher in urban areas (Kampala) than in rural areas (Kiryandongo). There are lower out of school rates at primary level than secondary level in Kampala and Kiryandongo. From the number of youth out of school is high at 50% in urban areas and 45.2% in rural settlements. Kiryandongo represents a good story of education intervention implementation be-cause more refugee families children are in school. An out of school rate of 10.8% against 23.1% in urban areas respectively was found out. This implies that the stu-dents observations that schools charge discourage-ing fees rate in secondary and tertiary institutions is responsible for high youth numbers out of school.  UNHCR officer interviewed stated that, UNHCR is only mandated to give primary education support. “When children qualify for secondary they join USE school for which they pay fees set by USE standards at 41000/- and parents pay. If they do not have money to pay their children do not go to school.” (KII, 2018) Nevertheless, many youth were left incapacitated and resort to unacceptable behaviors like sports bating, gambling, crime and young marriages.

Refugee Access to Education by Gender and Equity in Refugee Communities

The gendered access to education in Kampala and Kiryandongo reflected positive trends. According to respondents answering questionnaires in table 1 below, 75.9% against 24.1% male to female in Kampala dis-trict compared to 81.1% against 18.9% males to females in Kiryandongo district. Nevertheless, these percentage figures of respondents do not mean that the schools have more males than females. Analyses of proportion of males to females district student statis-tics reflected high population of girls staying in school for primary than secondary. This was attributed to district and national campaign of Universal Secondary (USE) and Primary education (UPE) and Kiryandongo district education strategies and policy of “Go to School, Back to School and Stay in school.” Increased enrolment is a laudable achievement for this approach. 

Level of Access and Completion of Non-Academic Programs by Refugees

According to findings, academic and non-academic education programs aimed at giving refugees skills for self-reliance are provided in refugee communities. Such programs are available for students in refugees settlements than their counterparts in the city. The urban refugees support their education by self-emp-loyment in Micro and Medium enterprises so it is hard to sustain themselves in school. Non-academic pro-grams include English language training for both nationals and refugees sponsored by Refugee Law Project (RLP), business management skills, pastry and baking trainings. Females and males enrollment and completion rates in professional and technical varied greatly. Higher enrollment and completion rates were found among females than males. With the increased demand for support for skills building at the most productive levels number of beneficiaries of TVET and tertiary education partners support programs in-creased.

Nature of refugees accessing education from re-fugee settlements

An interview with UNHCR inquired about the level at which refugees in Bweyale are assisted; composition by countries origin and their capacity to meet edu-cation cost. The study found out that students joined the settlement at different periods of the academic year or in different years. For example in an FGD of 10 members from primary 5 classes they reported joining the school in 6 different years. It was also noted that students frequently change schools, districts or coun-tries and join camp schools at any time of the year. This staggered enrollment has negative implication on planning, timely provision of adequate services and facilities, and learning coordination. It is a major design and implementation issue. Refugees get edu-cation from community schools in the settlement or in the vicinity and are free to choose a private or public co-educational school. Students are free to enroll in schools and programs of their choice available across the district. A busy morning start of refugee children going to school was observed, and buses were seen plying roads across Bweyale Township and Kiryan-dongo settlement carrying students from camps to their respective school destinations. The situation is similar in Kampala where refugees go to various schools each morning. Unlike Kiryandongo, in Kampala where there are no specific schools for refugee and confine-ment camps, the population of refugee students is smaller than that of nationals in schools. It also pre-supposes that few refugees are integrated with host communities compared to students living in settle-ments. Few students are supported by development organizations in urban schools. This is so, because students in the city are expected to live in the camp and no support is directly given to such students in Kampala. 

Families either cover their education expenses or go back to the camps, which they reject. Kiryandongo district education sector planning data shows res-pective number of refugees by program as in. Higher students numbers are in primary school, followed by secondary school. Vocational education and AEP have the lowest numbers enrolled. Opportunities for education reduced as the student advanced to a higher level.

Access to scholastic support provided by develop-ment organizations

The students were asked individually in their FGDs to mention items they received and donating organiz-ations apart from general donation to the school. A wide range of scholastics like instructional books and, personal health and hygiene materials were provided to students. Personal items such as sanitary material for girls, scholastics like pens and books, mathematical sets, uniforms and school fees in exceptional cases were distributed in Kiryandongo. Respondents dis-closed that, although schools were set up on commu-nity-based mobilization students get scholarships in secondary schools. School infrastructure is directly build at school including classroom blocks, co-curri-cular equipment, sports grounds, and ECD play centers, and furniture and food (manna pack or rice) have enabled education. Students excellent in sports were sponsored in schools, colleges & universities too. 

Vocational training sponsorship for the school leavers, peace clubs and TVET equipment important life changing support. The Table 1 above measures access to education level based on respondents household characteristics. It is used to depict the metrics and standards attained in delivery of education to refugees and the magnitude of influence of each variable on quality of education given to refugees in Kampala and Kiryandongo. Each respond gave responses representa-tive of their household.

Factors influencing patterns of access to primary and secondary school education

Table 1: Access patterns and level of education measures based on demographics of respondents households.

Number of children per household

From questionnaires, respondents presented inform-ation concerning the number of children of school going age of different categories in a household. That is to say, children under five years, between 6 years and 18 years in relation to children in school per hou-sehold represented by the respondent. On average, a refugee students household/family in Kampala and Kiryandongo had 2.1 children less than five years, while the average number of children between 6 years and 18 years per household was 5.1. On average, the number of children in school per household was 3.9. 

By district specific figures, Kampala reported the lowest average number of children aged between 6-18 years per household at 3.1, and 1.2 for the under-five age. On average 2.4 children were in school in Kam-pala compared to Kiryandongo with 4.6 children per household in school. For the number of children between ages 6-18, Kiryandongo settlement reported an average of 6.0, twice as much as Kampala district average. The account for overwhelming numbers of enrollment in the refugee settlements.

Involvement of parents and students in their edu-cation and household level of education

As per Table 1 above, the more educated the parents are in refugee communities the more they support education of the children. Involvement of students and parents in education decision making was emphasized by the education institution leaders and development organizations involved in education pillar implement-ation. This has increased enrollment and kept children in school. In Kiryandongo 43% of students confirmed their household heads had attended secondary school while 48% had completed Senior 6 level. 

Only 8% reported primary level of education among their household heads. The study found out that education attained by household heads positively influences how they perceived education and it affects the way parents in settlements participate in planning and discussing decision making on education matters of children. In Kampala district, heads of refugee households were reported to have completed primary schools and attended secondary school. 38.9% had attended secondary school while 35.2% had completed senior 6 levels. Only 22.2% had completed primary school. The figure shows that in both districts average household heads had attained secondary education while other lowest educated household heads were at 3.7%.

Table 2: Sources of income of respondents household.

Refugee education expectations and objectives in Uganda exceed psychotherapy, psychosocial healing, and traumatic pacification. Durable assistance and solutions through education must endeavor not to leave any one behind. The study discovered increased oppo-rtunities at all levels and improved patterns of access to education for all irrespective of their age, socio-economic status or gender, level of income and spatial location of rural or urban students. Inconsistencies influenced level and access to education such as; age of enrollment, household income, participation and level of education of head of household, and nature of refugees in schools, refugee perception of quality education, are factors associated with access to edu-cation. In refugee communities education access level and pattern vary between rural and urban schools. A number of factors are responsible for variation at respective age, gender, income level and numbers in school. Similarly, interventions made by the govern-ment and development partners mandated to deliver education to the people of concern suffering “double vulnerability” in host countries. This vulnerability is either from teacher qualification, systemic and struc-tural weakness like unqualified teachers, poorly paid teachers. Such vulnerability factors affect already vulnerable refugees. Access to public and private pri-mary and secondary schools figures indicated impro-vement in access and patterns of access to schools of their choice. Whereas, indiscriminate entry helps refugee children to catch up, it affects appropriate lear-ning. Appropriate age is essential for successful lear-ning linked to learning tasks matched with capabilities of a learner. In Kiryandongo and Kampala schools, implementing and operational partners have initiated a framework where different age groups are given a second chance to access a kind of school, training or program suitable to level of a learner.  Accelerated Learning Programs (ALP) was set up to give students above age of first entry access to school when the regular school ends. The education given is functional. Access to primary and secondary school education levels figures show significant achievement. However, there are limited academic opportunities for youth, aged above 15 years and who had not completed secondary school education before joining the refugee settlements. Some key informants (KIs) reported many children aged 15 years and above who failed to enroll in either academic system or Technical and Vocational Education Training courses. Overall, it was observed that children aged above 15 years face greater chal-lenges to fit in Ugandas national education system; formal academic schools or TVET institutions. Grade progression by children was better at primary school level than at secondary school level, where higher dropout rates were reported. This pattern is similar for indigenous children. There are certainly many barriers to progression at higher academic levels including quality of education as noted by some of the KIs, high cost of secondary education, early marriage and in-creased pressure on the youth to quit school, as they grow older. District specific initiatives for mobilization of communities to take children to school and the retracking approach to attract back to school students who had dropped out of school have increased enroll-ment and access to education with a view that “no child is left behind”. This district specific education intervention approach was adopted in 2015 in response to a high dropout rate of girls and early marriage effect of low school retention. Mobilization of parents in the community was increased through adoption of the slogan “Go to school, Back to school and Stay at School”. This slogan applies to refugees and nationals taking education in indigenous schools both private and public. Everyone took responsibility to make sure all children go to school and the drop out returns to school and all keep in school until completing the school cycle. The Non-academic and Vocational interventions have made an impact on refugees self-reliance. Alter-native education programs provided by organizations like Refugee Law Project, Danish Refugee Council, Whitaker Peace and Development initiative, Windle International Uganda, UNHCR to-gether with the district local government and Kiryan-dongo town council enhanced skills and abilities of refugees. Peace clubs built students skills to live peacefully in schools and communities because stu-dents learned how to resolve internal conflicts. Ana-lyzes indicate that non-academic interventions offered an opportunity adults and students which had missed education through years of conflict in countries of origin.

An interview with UNHCR inquired about the level at which refugees in Bweyale are assisted; composition by countries of origin and their capacity to meet education cost.  The study ascertained the criteria of access to refugee settlement support. The settlements mainly gave support to refugees at rehabilitation and development stage of UNHCR categorization. Fully registered refugees whose statuses are cleared after critical emergency assistance access schools in the settlements. In Kampala, self-settled refugees were found to be the group predominantly taking education in the city. Education helps children admitted to settlements to reconnect mainstream life, start engag-ing in their own development and integration with their host community. This is follows screening and clea-rance for development support targeting empower-ment to live a meaningful self-sustaining life. Access to educational support was noted to have increased opportunity for learning. The researcher found out that students were classified according to who and the kind of support especially personal items they received as criteria of access to student facilities; School fees are paid by government only for primary school. And parents and guardians take responsibility of paying secondary school fees. However, excellent students get a scholarship that is to say for sportsmen and academic excellence. On completion of UACE, some students are sponsored by district or Implementing Partners for university or college education if they score at least 8 points. For example, one of the teachers who was sponsored by the organization completed and was teaching in the only settlement secondary school. So, selection standards are clear it is fair for everyone to have equal opportunity to access it on personal merit.

The education model of Uganda gives hope for self-reliance of refugees. Because of various programs at-tended by students, skills building opportunities increased. Children and youth friendly spaces were created in schools. Children who missed school in their home countries during or prior to conflict joined to Accelerated learning program designed to offer edu-cation to children above the age of first entry in primary schools of Uganda. Refugees, despite being visitors in Uganda were supported by government to become independent through education as they live with host communities. It is crucial to mobilize public and private support to government and refugees be-cause student numbers overwhelmed the existing district capacity. UNCHR, government and imple-menting partners make adequate investment in refugee education. The benefits of educating refugees would exceed current returns to both individuals and host countries. Many children missed school in urban centers where they or their families had no job oppo-rtunities compared to their counterparts in refugee settlements. Therefore, programs and policy should be monitored and evaluated mostly in regard to educating refugee children especially in urban primary and vocational schools.  Despite positive trends observed by the study, the cost of education in cities and equally at secondary school in refugee communities exceeds the capacity of refugees to pay because of meagre income from their micro-businesses. Many of urban refugees especially at ECD level missed education or dropped out of secondary school due to inability to pay school fees.

The authors are thankful to the individual participants insightful responses and respective institutions whose contribution made the study completion possible.

The author (s) declares that there is no potential con-flict of interest concerning the research, authorship and or publication of this article.