Population-level Impacts of Religious Leader Training on Perceptions and Practices of Maternal and Child Health Care among Underserved Communities in Bangladesh: Evidence from a Quasi-experimental Repeat Cross-Sectional Study
1
Centre for Injury Prevention and Research Bangladesh (CIPRB), Dhaka, Bangladesh
2
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
3
Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Religious leaders are trusted community influencers in Bangladesh and can advance maternal and child health (MCH), particularly in underserved settings. We assessed the population-level impact of a national training program for religious leaders on knowledge, attitudes, practices, and behaviors (KAPB) related to antenatal care (ANC), facility-delivery, and essential newborn care (ENC).
METHODS:
We conducted repeated cross-sectional household surveys among imams, female religious-school teachers, and parents of children aged 0-2 years in 17 clusters across eight hard-to-reach districts in Bangladesh at baseline (2019, n=3,808) and endline following the training program (2021, n=3,746). Standardized questionnaires captured domain-specific KAPB indicators. Multivariable logistic regression compared endline with baseline, adjusting for age, sex, education, and occupation.
RESULTS:
Baseline and endline populations were socio-demographically similar, with minor differences in education. Compared with baseline, endline participants showed about two-fold increase in ANC knowledge (aOR 2.3, 95% CI 2.1–2.6), positive attitudes (aOR 1.5, 95% CI 1.4–1.6), and reported ANC use (aOR 2.3, 95% CI 2.1–2.6). Knowledge of risk in home-delivery increased markedly (aOR 11.9, 95% CI 9.5–14.9), alongside modest improvements in practice of facility-delivery (aOR 1.5, 95% CI 1.4–1.6). ENC knowledge improved substantially (aOR 8.9, 95% CI 7.8–10.1), with increased early breastfeeding and standard bathing practices (aOR 1.8, 95% CI 1.7–2.0). Religious leaders also reported increased dissemination of healthcare messages at endline.
CONCLUSIONS:
Training religious leaders was associated with improved community knowledge and practices across the MCH care continuum, suggesting that integrating such engagement into national health communication platforms may enhance coverage in underserved settings.
Religious leaders are trusted community influencers in Bangladesh and can advance maternal and child health (MCH), particularly in underserved settings. We assessed the population-level impact of a national training program for religious leaders on knowledge, attitudes, practices, and behaviors (KAPB) related to antenatal care (ANC), facility-delivery, and essential newborn care (ENC).
METHODS:
We conducted repeated cross-sectional household surveys among imams, female religious-school teachers, and parents of children aged 0-2 years in 17 clusters across eight hard-to-reach districts in Bangladesh at baseline (2019, n=3,808) and endline following the training program (2021, n=3,746). Standardized questionnaires captured domain-specific KAPB indicators. Multivariable logistic regression compared endline with baseline, adjusting for age, sex, education, and occupation.
RESULTS:
Baseline and endline populations were socio-demographically similar, with minor differences in education. Compared with baseline, endline participants showed about two-fold increase in ANC knowledge (aOR 2.3, 95% CI 2.1–2.6), positive attitudes (aOR 1.5, 95% CI 1.4–1.6), and reported ANC use (aOR 2.3, 95% CI 2.1–2.6). Knowledge of risk in home-delivery increased markedly (aOR 11.9, 95% CI 9.5–14.9), alongside modest improvements in practice of facility-delivery (aOR 1.5, 95% CI 1.4–1.6). ENC knowledge improved substantially (aOR 8.9, 95% CI 7.8–10.1), with increased early breastfeeding and standard bathing practices (aOR 1.8, 95% CI 1.7–2.0). Religious leaders also reported increased dissemination of healthcare messages at endline.
CONCLUSIONS:
Training religious leaders was associated with improved community knowledge and practices across the MCH care continuum, suggesting that integrating such engagement into national health communication platforms may enhance coverage in underserved settings.
| eISSN: | 2654-1459 |
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