Paper Title
Maternal Knowledge, Attitude, and health-Seeking Behaviour among Rural Mothers in Heilongjiang Province, China

Receiving appropriate care and educating mothers by providing them with adequate health information is important to improving their health-seeking behavior. Inequality between rural and urban health services is a big challenge to achieve the Sustainable Development Goal3 (SDG3) in China. Limited studies have evaluated rural communities’ health information needs before supplying health information services. This study aimed to assess the level of knowledge, and attitude among mothers, and highlight barriers to the use of health care services in rural areas of Heilongjiang province. Mothers in their reproductive age conditioned they had at least one child were included. The total 448 participants were interviewed by using a structured self-administered online survey. Additionally, individual in-depth interviews (IDIs) with 12 mothers, 4 midwives, and 2 health leaders were conducted to meet the objectives of the study. In this study, 56.0% (CI: 51.6-60.7), and 48.9% (CI: 44.0-53.8) of mothers had good knowledge and positive attitude towards maternal health care services, respectively. The correlation between knowledge and attitude mean score was significant, positive, and weak (r=0.312, P-value=0.000). In contrast to the knowledge level, mothers' attitude level was significantly associated with delivery at health facilities. Mothers' knowledge and attitude levels were not significantly associated with antenatal and postnatal care utilization. The shortage of human resources and medical equipment, cost of services, poor driven mass media, shortage of teaching and training materials, distance between home and health facilities, health leaders’ perceptions of mothers’ low awareness of benefits of health care services, and a perceived need of the mothers were associated with health services underutilization. The study concluded that increasing awareness on the benefits of maternal health care services and improving access to health facilities by rural women are important in enhancing maternal health behaviour among rural mothers. Keywords - China, Health Behaviour, Knowledge and Attitude, Triangulation Data Sources.