Factors associated with knowledge and practices of COVID-19 prevention among mothers of under-2 children in Bangladesh.

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.