A good start in life: an investigation on basic ECD Knowledge and practices in two districts of Zambezia Province

A good start in life: an investigation on basic ECD Knowledge and practices in two districts of Zambezia Province. Background: The timespan between pregnancy and a child's third year of life is crucial, since 80% of the baby’s brain develops in this period. Almost 250 million children under 5 from low and middle income countries miss the opportunity to reach their full growth potential, impacting their possibilities in life. This study aims to investigate the basic ECD knowledge among young people and pregnant women, and to assess practices and behaviours. Materials and Methods: A 14-items survey was administered to women and mothers in labour with their partners, aged from 10 to 24 years, referring to five Healthcare Centres (HC) across Mocuba and Quelimane Districts (Zambezia Province) between May and June 2022. The research was implemented within a framework of a Cuamm project in collaboration with Unicef Mozambique. Two scores, “level of ECD knowledge” (ranging from 5-high to 20-low), and “behaviour during pregnancy”, (from 0-bad practice, to 4-good practice), were developed. A univariable logistic regression analysis assessing the association between each of the two scores and the independent variables was performed. P was considered significant when <0.05. Results: 1052 people answered the questionnaire, mostly women (88.7%). The level of ECD knowledge was generally low (median = 14, IC: 13-16), and negatively associated with being a pregnant or a new mother (p= 0.001) and attending a traditional doctor (p= 0.033). Being from Quelimane urban setting appears to be linked to a higher level of knowledge, compared to rural settings like Mugeba areas (p<0.001). The “behaviour during pregnancy” score was good for 64.6% of the pregnant women enrolled, and positively correlated with being from Quelimane district (p<0.001), a high level of ECD knowledge (p= 0.009), and with having heard from healthcare professionals about the importance of the interaction with the baby (p<0.001). Conclusions: The level of knowledge of ECD was generally low, demonstrating the importance of structuring interventions to sensibilize the new parents about this topic. The promotion of models and behaviours of "positive parenting", birth preparedness and parent-child interaction should become a priority for public health intervention at the community level through existing platforms, and in HC through specific trained personnel.