Knowledge, attitudes, practices, and adherence to multiple micronutrient supplementation among pregnant women in Rwanda: a mixed methods study

Micronutrient deficiencies among pregnant women remain a public health concern in Rwanda. Multiple Micronutrient Supplementation (MMS) was introduced through routine antenatal care services to address this challenge. However, evidence on women’s knowledge, attitudes, practices, and adherence to MMS is limited. This study assessed knowledge, attitudes, practices, and adherence to MMS among pregnant and lactating women and examined factors associated with knowledge, attitudes, and adherence. High self-reported adherence to MMS was achieved despite limited knowledge, suggesting that positive attitudes, perceived benefits, and trust in healthcare providers are key drivers of adherence. Strengthening ANC counseling, addressing misconceptions, and promoting early ANC attendance may support the effective implementation and scale-up of MMS programmes in Rwanda and similar settings.