Perceived need of information and education about conception preparedness (CP) among engaged and soon to be married couples: a qualitative survey

Preconception care, especially education, has been shown to improve maternal, neonatal, and child health outcomes. Although the journey to conception marks a significant milestone for many individuals and couples, there is a scarcity of studies on the needs of engaged and soon-to-be-married couples regarding conception preparedness (CP). This study aimed to explore the information and education needs related to conception preparedness among engaged couples on the verge of marriage. A qualitative, descriptive, and exploratory design was employed. Just one to two months away from getting married couples were recruited at premarital counseling sites, including churches and sector administration offices, between June and July 2024 and through purposive sampling 40 officially engaged couples across five provinces in Rwanda participated. With a discussion guide, focus group discussions (FGDs) were conducted to gain in-depth insights from participants. Audio-recorded and transcribed verbatim data were analyzed using MAXQDA software and an inductive thematic analysis was done. Ethical clearance No. 337/CMHS-IRB/2024 was obtained from the University of Rwanda, and permissions from local administration in districts and sectors were secured. Most participants were aged 21 to 30 years and lived in rural areas. Five key themes emerged regarding conception preparedness: knowledge and understanding, motivators for seeking information, desired educational content, preferred information sources, and urgency of education. While all recognized its benefits for reducing pregnancy risks and promoting family health, many associated conception preparedness mainly with HIV testing and believed it concerned only women. Few were aware of the timing and full components of preconception care. Almost all expressed a strong interest in learning about lifestyle behaviors and medical care during this period. Health professionals were the preferred information source, with schools, churches, and social media also mentioned. Nearly all participants considered this education urgent before they get married. A significant desire for information and education on conception preparedness was reported by most of participants with also many of them expressing various misconceptions and misbeliefs around pre-pregnancy preparedness. Therefore, targeted preconception education and awareness programs tailored specifically to engaged couples before marriage are needed.