COVID-19 pandemic has resulted in the death of hundreds of thousands of people globally. Several preventive measures have been recommended to reduce the spread of the disease. However, the level of knowledge, attitudes, and practices (KAP) of these preventive measures among pregnant women, are yet to be evaluated in South Africa. Therefore, the objective of this study was to determine the KAP towards COVID-19 among pregnant women. The purpose was to identify KAP gaps of pregnant women and develop educational materials and implement programmes. A questionnaire-based cross-sectional study was undertaken. Student’s t-test, ANOVA test, Pearson’s correlation test and Binary logistic regression analysis was carried out. Majority of the respondents were single (71%), unemployed (52%), and had low education (78% had either no or less than 12 years education). More than half (51.2%) had vulnerable comorbidities for COVID-19 infection and complication. Both knowledge and attitude mean of pregnant women were found to be low at 43.5% and 30% respectively. However, their practice on prevention of COVID-19 was good at 76%. Knowledge was found to be significantly positively correlated with practice towards COVID-19 (r= 0.111). Women having good knowledge were seven times more likely to practice positively regarding COVID-19 (P=0.019). Women having 1-5 years of education were 94% less likely to practice good towards COVID-19 prevention (P=0.018) compared to those having post matric education. The pregnant women in this research had inadequate knowledge and attitude of COVID-19 infection. However, preventive practices were good among them. Mass education and communication strategies are thus required to improve the knowledge and attitudes of pregnant women towards COVID-19.

BackgroundBangladesh is one among the few countries of the world that provides free medical services at the community level through various public health facilities. It is now evident that, clients’ perceived quality of services and their expectations of service standards affect health service utilization to a great extent. The aim of the study was to develop and validate the measures for perception and satisfaction of primary health care quality in Bangladesh context and to identify their aspects on the utilization status of the Community Clinic services.MethodsThis mixed method cross sectional survey was conducted from January to June 2012, in the catchment area of 12 community clinics. Since most of the outcome indicators focus mainly on women and children, women having children less than 2 years of age were randomly assigned and interviewed for the study purpose. Data were collected through FGD, Key informants interview and a pretested semi- structured questionnaire.ResultsAbout 95 % of the respondents were Muslims and 5 % were Hindus. The average age of the respondents was 23.38 (SD 4.15) and almost all of them are home makers. The average monthly expenditure of their family was 95US $ (SD 32US$). At the beginning of the study, two psychometric research instruments; 24 items perceived quality of primary care services PQPCS scale (chronbach’s α = .89) and 22 items community clinic service satisfaction CCSS scale (chronbach’s α = .97), were constructed and validated. This study showed less educated, poor, landless mothers utilized the community clinic services more than their educated and wealthier counterpart. Women who lived in their own residence used the community clinic services more frequently than those who lived in a rental house. Perceptions concerning skill and competence of the health care provider and satisfaction indicating interpersonal communication and attitude of the care provider were important predictors for community clinic service utilization. Perception related to the quality of management, administration, physical environment of the service point and satisfaction addressing health promotion and women health issues played significant role on community clinic’s services utilization.ConclusionsBesides parental education and income, client’s perception and satisfaction played significant role in community clinic service utilization. Provider’s perception of service quality should be studied. The study findings will enable policy-makers to improve quality of primary health care services, realizing providers’ and patients’ ideas of community clinic service quality.

Background: Bangladesh is one among the few countries of the world that provides free medical services at the community level through various public health facilities. It is now evident that, clients' perceived quality of services and their expectations of service standards affect health service utilization to a great extent. The aim of the study was to develop and validate the measures for perception and satisfaction of primary health care quality in Bangladesh context and to identify their aspects on the utilization status of the Community Clinic (CC) services. Methods: This mixed method cross sectional survey was conducted from January to June 2012, in the catchment area of 12 Community Clinics (CCs). Since most of the outcome indicators focus mainly on women and children, women having children less than two years of age were randomly assigned and interviewed for the study purpose. Data for the development of perceived service quality and satisfaction tools were collected through Focus Group Discussion (FGD), key informants interview and data for measuring the utilization status were collected by an interviewer administered pretested semi-structured questionnaire. Results: About 95% of the respondents were Muslims and 5% were Hindus. The average age of the respondents was 23.38 (SD±4.15) years and almost all of them are home makers. The average monthly expenditure of their family was 7462.92 (SD±2545) BDT equivalent to 95 (SD±32) US$. To measure lay peoples' perception and satisfaction regarding primary health care service quality two scales e.g. Slim Haddad's 20-item scale for measuring perceived quality of primary health care services (PQPCS) validated in Guinea and Burkina Fuso and primary care satisfaction survey for women (PCSSW) developed by Scholle and colleagues 2004; is a 24-item survey tool validated in Turkey were chosen as a reference tools. Based on those, two psychometric research instruments; 24 items PQPCS scale (chronbach's α=0.89) and 22-items Community Clinic Service Satisfaction (CCSS) scale (chronbach's α=0.97), were constructed and validated for measuring perceived service quality and satisfaction in Bangladesh context. This study showed mothers with pre-primary education [(χ2=4.20, p=0.04), AOR with 95% CI=1.89 (1.03, 3.53)] utilized the limited curative care services more than educated mothers. On the contrary, higher income families [for income group 5000-10,000 BDT χ2=8.83, p=0.003 and AOR with 95% CI=0.37(0.19, 0.71)] and [for income group above 10,000 BDT χ2= 5.02, p= 0.025 and AOR with 95% CI=0.40 (0.18, 0.89)] and families having cultivable lands [for 5-10 decimal group χ2=5. 51, p=0.19, and AOR with 95% CI=0.56 (0.35, 0.91)] and [for>10 decimal group χ2=6.70, p=0.010, and AOR with 95% CI=0.50 (0.29, 0.84)] utilized the limited curative care services less than their poorer and landless counterpart. The same relationship was observed in case of health education and Antenatal Care (ANC) and Postnatal Care (PNC) services. Women who lived in their own residence used health ed...