Knowledge and Compliance in First 1,000 Days Program among Mothers in Unserved and Underserved Areas

Abstract

Background: The First 1,000 Days (F1KD), spanning conception through a child's second birthday, is a critical period for maternal and child health and nutrition. However, knowledge of recommended practices does not necessarily translate into consistent compliance, particularly in communities facing limitations in access to health services. Objective: This study determined mothers' knowledge and compliance with recommended F1KD practices in selected unserved and underserved barangays in Janiuay, Iloilo, Philippines. It also examined differences according to selected sociodemographic and healthcare-access characteristics and the relationship between knowledge and compliance. Place and Duration of Study: The study was conducted in five selected unserved and underserved barangays in Janiuay, Iloilo, Philippines, namely Barasalon, Canauillan, Quipot, Ubian, and Yabon. Data collection was carried out from March to June 2026. Methods: A quantitative descriptive-correlational design was employed among 103 mothers residing in five selected barangays in Janiuay, Iloilo. Data were collected using a validated, researcher-developed questionnaire comprising 15 knowledge items and 10 compliance items. Data were encoded in Microsoft Excel and analysed using jamovi version 2.6. Descriptive statistics, Mann–Whitney U tests, Kruskal–Wallis H tests, Dwass–Steel–Critchlow–Fligner post hoc comparisons, and Spearman's rank-order correlation were used, with statistical significance set at p < .05. Ethical clearance was obtained from the Iloilo Doctors' College Institutional Review Board. Results: The respondents obtained a mean knowledge score of 11.93 out of 15 (SD = 1.78), indicating high overall knowledge. Nevertheless, knowledge gaps remained concerning exclusive breastfeeding and infant feeding recommendations. The mean compliance score was 7.25 out of 10, indicating partial compliance. Knowledge scores differed significantly across age groups in the overall test, although no specific pairwise age-group comparison was statistically significant. Compliance differed significantly according to source of income (χ² = 9.75, p = .021), with a significant post hoc difference between respondents with agriculture-based livelihoods and those classified as household/unemployed (W = 4.216, p = .015). Knowledge and compliance had a moderate positive correlation (rₛ= .445, p < .001). Conclusion: Mothers demonstrated high knowledge but only partial compliance with recommended F1KD practices. Targeted health education, consistent counselling, follow-up services, and community-based support may help address knowledge gaps and practical barriers to adherence. The findings are relevant to efforts supporting Sustainable Development Goals 2 and 3.