{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:39:25Z","timestamp":1753879165824,"version":"3.41.2"},"reference-count":52,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T00:00:00Z","timestamp":1728432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006641","name":"UNICEF","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006641","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Maternal &amp; Child Nutrition"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This study sought to understand reported impacts of the COVID\u201019 pandemic on maternal and child health and nutrition behaviours during the first 1000 days of life. This qualitative and participatory substudy was embedded within mixed methods formative research conducted during 2020\u20132022 across two urban, three rural and one estate sector site in Sri Lanka. Semi\u2010structured interviews among caregivers of children aged 6\u201323 months (<jats:italic>n<\/jats:italic>\u2009=\u200934), influencers of caregivers, such as health workers (<jats:italic>n<\/jats:italic>\u2009=\u200937), leaders (<jats:italic>n<\/jats:italic>\u2009=\u200910) and pregnant women (<jats:italic>n<\/jats:italic>\u2009=\u200920) were conducted. Participatory workshops (<jats:italic>n<\/jats:italic>\u2009=\u200914) triangulated interview findings. Interview data were analyzed to identify salient themes using Dedoose. Numerical data from voting conducted in workshops were summed and triangulated with interview data. Findings suggest that the COVID\u201019 pandemic and imposed restrictions shaped maternal and child health and nutrition behaviours through a complex interplay of factors. Imposed restrictions and changes to the food system contributed to temporary unemployment for wage workers and reduced purchasing power to maintain food security for vulnerable households. While deciding whether to seek care, fears of infection prevented usual care\u2010seeking decisions. Also, reduced incomes and disrupted public transportation made transport to health care facilities for antenatal care services difficult. Once women reached facilities, medical services and quality of care were negatively impacted. Implementing expanded community\u2010based services during home visits focused on the first 1000 days and beyond was one effective strategy to maintain maternal and child health and nutrition during the early pandemic in Sri Lanka.<\/jats:p>","DOI":"10.1111\/mcn.13731","type":"journal-article","created":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T09:39:23Z","timestamp":1728466763000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A qualitative exploration of the COVID\u201019 pandemic on health and nutrition behaviours during the first 1000 days in Sri Lanka"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0822-4880","authenticated-orcid":false,"given":"Teresa R.","family":"Schwendler","sequence":"first","affiliation":[{"name":"Department of Nutritional Sciences Pennsylvania State University University Park Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Upul","family":"Senarath","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Colombo Colombo Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiranya","family":"Jayawickrama","sequence":"additional","affiliation":[{"name":"Family Health Bureau, Ministry of Health Colombo Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhammica","family":"Rowel","sequence":"additional","affiliation":[{"name":"United Nations Children's Fund, Sri Lanka Country Office Colombo Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noor","family":"Kawmi","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences Pennsylvania State University University Park Pennsylvania USA"},{"name":"Pennsylvania State College of Medicine Hershey Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Safina","family":"Abdulloeva","sequence":"additional","affiliation":[{"name":"United Nations Children's Fund, Sri Lanka Country Office Colombo Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chithramalee","family":"De Silva","sequence":"additional","affiliation":[{"name":"Family Health Bureau, Ministry of Health Colombo Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0929-3252","authenticated-orcid":false,"given":"Stephen R.","family":"Kodish","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences Pennsylvania State University University Park Pennsylvania USA"},{"name":"Department of Biobehavioral Health Pennsylvania State University University Park Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,10,9]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/oby.22996"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/osp4.499"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(23)00279-7"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czz174"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0277-9536(97)10018-1"},{"volume-title":"Research methods in anthropology: Qualitative and quantitative approaches","year":"2011","author":"Bernard H. R.","key":"e_1_2_11_7_1"},{"key":"e_1_2_11_8_1","unstructured":"Central Bank of Sri Lanka. (2020).Annual report 2020.https:\/\/www.cbsl.gov.lk\/en\/publications\/economic-and-financial-reports\/annual-reports\/annual-report-2020"},{"volume-title":"Research design: Qualitative, quantitative, and mixed methods approaches","year":"2008","author":"Creswell J. W.","key":"e_1_2_11_9_1"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15430421tip3903_2"},{"volume-title":"Qualitative inquiry and research design: Choosing among five approaches","year":"2016","author":"Creswell J. W.","key":"e_1_2_11_11_1"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-7093.1991.tb00236.x"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.4038\/jccpsl.v26i5.8347"},{"volume-title":"Impact of the COVID\u201019 pandemic on early child cognitive development: Initial findings in a longitudinal observational study of child health","year":"2021","author":"Deoni S. C.","key":"e_1_2_11_14_1"},{"key":"e_1_2_11_15_1","unstructured":"Department of Census and Statistics. (2017).Sri Lanka demographic and health survey 2016.http:\/\/www.statistics.gov.lk\/Resource\/en\/Health\/DemographicAndHealthSurveyReport-2016-Contents.pdf"},{"volume-title":"Impact of the COVID\u201019 pandemic on employment in Sri Lank","year":"2023","author":"Department of Census and Statistics","key":"e_1_2_11_16_1"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1547-5069.1987.tb00609.x"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp2005638"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gloenvcha.2007.09.002"},{"volume-title":"Annual report 2020","year":"2020","author":"Family Health Bureau","key":"e_1_2_11_20_1"},{"key":"e_1_2_11_21_1","unstructured":"Family Health Bureau. (2023).National statistics: RHMIS routine data family health bureau.https:\/\/fhb.health.gov.lk\/index.php\/en\/statistics\/statistics-2"},{"key":"e_1_2_11_22_1","unstructured":"FAO UNICEF IFAD WFP & WHO. (2022).The State of Food Security and Nutrition in the World 2022: Repurposing food and agricultural policies to make healthy diets more affordable.https:\/\/www.fao.org\/publications\/home\/fao-flagship-publications\/the-state-of-food-security-and-nutrition-in-the-world\/en"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-003188"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.51368"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/0890334420949514"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2021.114523"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/aepp.13096"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.appet.2021.105119"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/0379572115598447"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu11061330"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-14027-6"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2020.10.023"},{"volume-title":"Qualitative data analysis: An expanded sourcebook","year":"1994","author":"Miles M. B.","key":"e_1_2_11_33_1"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejsp.2420150303"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.3389\/fdgth.2021.739476"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1038\/s43016-021-00319-4"},{"volume-title":"Qualitative research & evaluation methods: Integrating theory and practice","year":"2014","author":"Patton M. Q.","key":"e_1_2_11_37_1"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2021.08.015"},{"volume-title":"Sri Lanka health system review","year":"2021","author":"Rajapaksa L.","key":"e_1_2_11_39_1"},{"volume-title":"COVID\u201019 health system response monitor: Sri Lanka","year":"2022","author":"Rajapaksa L. C.","key":"e_1_2_11_40_1"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1093\/cdn\/nzab051_035"},{"key":"e_1_2_11_42_1","unstructured":"Seneviratne R. Fernando N. Attygalle D. Dong D. &Higashi H.(2023). The impact of COVID\u201019 pandemic on health service delivery in Sri Lanka.World Bank Group."},{"volume-title":"Impact of health literacy on fear of Covid\u201019, protective behavior, and conspiracy beliefs: University students' perspective","year":"2021","author":"Shaukat R.","key":"e_1_2_11_43_1"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1177\/03795721231197249"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.7441\/joc.2012.01.04"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.10.023106"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10433-010-0168-y"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.5993\/ajhb.29.1.5"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.30875\/4a0b4159-en"},{"volume-title":"Assessing food security status among urban and rural vulnerable groups in Sri Lanka during COVID\u201019 [unpublished brief]","year":"2021","author":"World Food Programme","key":"e_1_2_11_50_1"},{"volume-title":"Sri Lanka: Food security monitoring: Remote household food security survey brief\u2014January 2023","year":"2023","author":"World Food Programme","key":"e_1_2_11_51_1"},{"volume-title":"Sri Lanka panel survey on food security [unpublished presentation]","year":"2022","author":"World Food Programme, Johns Hopkins University: Alliance for a Healthier World, & Wayamba University","key":"e_1_2_11_52_1"},{"volume-title":"Third round of the global pulse survey on continuity of essential health services during the COVID\u201019 pandemic: November\u2013December 2021","year":"2022","author":"World Health Organization","key":"e_1_2_11_53_1"}],"container-title":["Maternal &amp; Child Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.13731","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T09:58:35Z","timestamp":1734429515000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/mcn.13731"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,9]]},"references-count":52,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1111\/mcn.13731"],"URL":"https:\/\/doi.org\/10.1111\/mcn.13731","archive":["Portico"],"relation":{},"ISSN":["1740-8695","1740-8709"],"issn-type":[{"type":"print","value":"1740-8695"},{"type":"electronic","value":"1740-8709"}],"subject":[],"published":{"date-parts":[[2024,10,9]]},"assertion":[{"value":"2023-12-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13731"}}