Maternal knowledge, attitudes, and practices on zinc deficiency in coastal Bangladesh: A structural modelling study

Zinc deficiency is a critical public health issue, particularly among under-five children in low- and middle-income countries, such as Bangladesh, with significant implications for growth, immunity, and cognitive development. Despite its high prevalence, maternal knowledge, attitudes, and practices (KAP) regarding zinc deficiency remain understudied, especially in vulnerable coastal regions. Hence, this study aimed to assess maternal KAP relating to zinc deficiency and explore their interrelationships using Structural Equation Modelling (SEM) in coastal Bangladesh.

A cross-sectional study was conducted from February to July 2023 across three coastal districts (Noakhali, Lakshmipur, and Chattogram) of Bangladesh. Data were collected from 378 mothers with under-five children using an interviewer-administered questionnaire. SEM was employed to assess the relationships among maternal knowledge, attitudes, and practices regarding zinc deficiency.

The majority of mothers (96 %) exhibited low knowledge about zinc deficiency, while around 41 % held positive attitudes toward addressing zinc deficiency, and only 10 % reported good practices related to addressing zinc deficiency. SEM analysis revealed a significant positive effect of maternal knowledge on maternal attitudes toward zinc deficiency (β = 0.03, P = 0.003). Additionally, maternal attitudes toward zinc deficiency had a significant and notable influence on practices related to addressing zinc deficiency (β = 0.08, P < 0.001).

Maternal KAP regarding zinc deficiency was suboptimal, with attitudes serving as a key driver of practices. Interventions should prioritize community-based education and attitude modification to improve zinc-related practices and mitigate deficiency in coastal Bangladesh.