Research ethics: All study materials will be submitted for approval by the institutional review boards of Durbar Mahila Samanwaya Committee (DMSC) Ethical Committee, the World Health Organization (WHO) Ethics Review Committee (ERC), the University of Manitoba (UM) Health Research Ethics Board (HREB), and by the Indian Council on Medical Research (ICMR) through the Health Ministry's Screening Committee (HMSC). The procedures, risks, and benefits of study participation will be explained to all potential study participants and informed consent will be obtained from those who are willing to participate prior to their participation in the study. The project will follow all guidelines for human subjects research as mandated by the Government of India, as this is the location of the proposed project. In addition to this, a Data Safety and Monitoring Board will be established at Ashodaya to monitor the safety of participants and the scientific integrity of the study across all study sites.