Regression results.

The COVID-19 pandemic extensively impacted maternal, neonatal, and child health (MNCH) in Bangladesh. Misconceptions arising from a lack of knowledge related to the virus contributed to reduced uptake of MNCH services, which eventually helped increase maternal and neonatal mortality rates during the pandemic. In this study, we assessed the knowledge and practices related to COVID-19 prevention among the mothers of under-2 children in Bangladesh. The study was conducted in May 2021 as part of a broader research project related to COVID-19 response on MNCH service utilization. We collected data from 2207 mothers in six districts of Bangladesh using a multi-stage cluster sampling technique. We constructed weighted and unweighted composite knowledge and practice scores and identified different socio-demographic characteristics associated with the scores using multilevel generalized mixed-effect linear regression models. In general, the mothers revealed poor knowledge and practices related to COVID-19. On a weighted scale of 100, the mean composite knowledge and practice scores were 32.6 (SD = 16.4) and 53.1 (SD = 13.9), respectively. The mothers presented inadequate knowledge about COVID-19 transmission, symptoms, and the recommended preventive measures. At the same time, maintaining a safe physical distance was the least practiced preventative measure (10.3%). Level of education, access to television, and the internet were significantly positively associated with their knowledge and practices related to COVID-19. Knowledge score was also positively associated with the practice score (OR = 1.26; p-value <0.001). Mothers living in islands or wetlands scored poorly compared to those living in inland. The results indicate significant gaps in knowledge and practices related to COVID-19 prevention among mothers of under-2 children. Addressing these gaps, particularly by targeting mothers with lower levels of education and residing in hard-to-reach geographic locations, could consequently help enhance MNCH service uptake during pandemics like COVID-19.

新冠疫情对孟加拉国的孕产妇、新生儿与儿童健康（maternal, neonatal, and child health, MNCH）造成了广泛冲击。因对该病毒认知不足引发的认知误区，导致MNCH服务使用率下降，最终使得疫情期间的孕产妇及新生儿死亡率上升。
本研究针对孟加拉国2岁以下儿童的母亲群体，评估其新冠防控相关的认知与行为实践。研究于2021年5月开展，是一项聚焦新冠疫情背景下MNCH服务利用情况的大型疫情响应研究项目的子课题。研究采用多阶段整群抽样方法，从孟加拉国6个行政区的2207名母亲中收集数据。研究人员构建了加权与未加权的综合认知及行为实践评分体系，并通过多层广义混合效应线性回归模型，分析了与评分相关的各类社会人口学特征。
整体而言，受访母亲对新冠防控的认知与行为实践均处于较低水平。在满分为100的加权评分体系中，综合认知评分与综合行为实践评分的均值分别为32.6（标准差SD=16.4）与53.1（标准差SD=13.9）。受访母亲对新冠病毒的传播途径、临床症状及推荐防控措施均存在认知不足的问题，其中保持安全物理距离是践行最少的防控措施，仅为10.3%。
受教育水平、电视与互联网的可及性，与受访者的新冠防控认知及行为实践呈显著正相关。认知评分同样与行为实践评分呈显著正相关（优势比OR=1.26，p值<0.001）。居住在岛屿或湿地地区的母亲，其评分显著低于内陆地区的母亲。
研究结果表明，2岁以下儿童的母亲群体在新冠防控相关认知与行为实践方面存在显著缺口。针对性填补这些缺口，尤其是针对受教育水平较低及居住在交通不便地理区域的母亲，可有效提升新冠疫情等公共卫生危机期间MNCH服务的使用率。