Assignment of Copyright and Authorship Responsibilities The undersigned authors hereby affirm that the manuscript entitled: “ ” under the reference number --- is original and that all the statements asserted as facts are based on the author(s) investigation and research. The manuscript has not been published in any form and is not being submitted for consideration or publication elsewhere, in total or in part, except as an abstract of less than 400 words in the form of scientific presentations. The authors are also requested not to submit the present manuscript elsewhere for a period of six months from the date of submission to the International Journal of Community Based Nursing & Midwifery. If the above requirements are not fulfilled, justification for duplicate publication and permission to republish copyrighted materials must be declared and accompanied by a covering letter. In signing this form, the authors acknowledge that they have participated in the work in a substantive way and are prepared to take full responsibility for the data presented herein. The author(s), in the event of the acceptance of the above manuscript for publication, does hereby assign and transfer to that International Journal of Community Based Nursing & Midwifery all of the rights and interests with respect to the above copyright either in its current or any other form including revised or electronically disseminated versions. All authors must sign: (Please mark the corresponding author) Date Name Signature 1 __________ _________________________ _________________________ . ___ ______ ______ 2 __________ _________________________ _________________________ . ___ ______ ______ 3 __________ _________________________ _________________________ . ___ ______ ______ 4 __________ _________________________ _________________________ . ___ ______ ______ 5 __________ _________________________ _________________________ . ___ ______ ______ Manuscript checklist □ Cover letter □ Assignment of copyright and authorship responsibilities (signed). □ Corresponding author's address, phone number, fax number and email address on cover page. □ An informative abstract of no more than 250 words. □ Up to five keywords. □ References in the appropriate format (numbers not exceed 40). □ High resolution figures (jpeg format)