BackgroundThe world is facing the Coronavirus pandemic which is highly infectious. A number of measures have been put in place to prevent its spread among the population. However, for these preventive measures to be effective, the population requires an appropriate and sufficient knowledge. Thus, a survey was conducted with the aim of assessing the awareness, knowledge, attitude and practices towards measures for prevention of the spread of Covid-19 amongst Ugandans. Methods This was a cross-sectional study conducted during the lockdown in Uganda. An online questionnaire and a snowballing approach was used for participant recruitment of 18 years above literate Ugandans. Data collection was done from 6 th to 15 th April 2020 during which 1763 people participated. We analyzed all data using STATA 14.2, applying appropriate statistical tests. ResultsOut of 1763 participants, 97.6% were aware of the current pandemic. 83.9% of participants had a good knowledge score (21.8/27), 72.4% had a good attitude and 85.3% were practicing measures to prevent the spread of the Coronavirus disease. The ordered logistic regression showed that being a Health worker was significantly associated with a high knowledge (aOR:6 (3.32-10.93); a good attitude (aOR:2.5(1.68-3.8)]) and good practice (aOR:2.9 (1.95-4.2). On contrary, being a driver, business entrepreneur and a security personnel were found to have less rate in awareness, knowledge, attitude and practice. ConclusionsUgandans had a good overall awareness, knowledge, attitude and practice. However, there is still a gap of knowledge, attitude and practice among drivers, business entrepreneur and security personnel. There is a need to mobilize the population in the country to have the same degree of awareness and knowledge which will have an impact on attitude and practice to prevent spread of COVID-19.

Introduction Quality perinatal care is recognized as an important birth process and outcome. During the coronavirus disease 2019 (COVID‐19) pandemic, quality of perinatal care was compromised as the health care system grappled with adapting to an ever‐changing, uncertain, and unprecedented public health crisis. Methods The aim of this study was to explore the quality of perinatal care received during the COVID‐19 pandemic in the United States. Data were collected via an online questionnaire completed by people who gave birth in the United States after March 15, 2020. The questionnaire included the Mothers on Respect Index and the Mothers Autonomy in Decision Making validated measures. Low‐quality perinatal care was defined as decreased respect and/or autonomy in the perinatal care received. Responses were geocoded by zip code to determine COVID‐19 case‐load in the county on the date of birth. Multivariate regression analyses described associations between respect and autonomy in decision‐making for perinatal care and levels of COVID‐19 outbreak across the United States. Results Participants (N = 707) from 46 states and the District of Columbia completed the questionnaire. As COVID‐19 cases increased, participants’ experiences of autonomy in decision‐making for perinatal care decreased significantly (P = .04). Participants who identified as Black, Indigenous, and people of color, those who had an obstetrician provider, and those who gave birth in a hospital were more likely to experience low‐quality perinatal care. Those with a midwife provider or who had a home birth were more likely to experience high‐quality perinatal care in adjusted models. Discussion Variability in experiences of high‐quality perinatal care by sociodemographic characteristics, birth setting, and provider type may relate to implicit bias, structural racism, and inequities in maternal health and COVID‐19 outcomes for birthing people from marginalized communities.

Key Points Question What are rural hospital administrators’ beliefs about safety, financial viability, and community need for offering obstetric care? Findings In this survey of US rural hospitals providing obstetric care, administrators reported needing at least 200 annual births for safety and financial viability. Local maternity care needs strongly influenced hospital decisions to maintain obstetric services, even below that threshold; 1 in 4 surveyed hospitals were unsure if they would continue providing obstetric services. Meaning Policies to improve rural obstetric care access should account for administrative concerns about safety, workforce, financial viability, and community needs.

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