Family dynamics and structural barriers to antenatal care among a pregnant woman with severe anaemia in rural Ghana: A qualitative single-case study

Vincent Uwumboriyhie Gmayinaam; Patrick Elorm Dzissem; Daniel Buastsi Addae; Bright Kwaku Akponorvi; Eric Anane; George Wak

doi:10.51867/ajernet.7.3.150

Authors

Vincent Uwumboriyhie Gmayinaam University of Health and Allied Sciences https://orcid.org/0000-0001-6997-1903
Patrick Elorm Dzissem University of Health and Allied Sciences https://orcid.org/0000-0001-8678-1298
Daniel Buastsi Addae University of Health and Allied Sciences https://orcid.org/0009-0000-1662-2814
Bright Kwaku Akponorvi Nkwanta South Municipal Health Directorate https://orcid.org/0009-0005-1576-4470
Eric Anane University of Health and Allied Sciences https://orcid.org/0009-0004-7998-3843
George Wak University of Health and Allied Sciences https://orcid.org/0000-0001-6892-1007

DOI:

https://doi.org/10.51867/ajernet.7.3.150

Keywords:

severe anaemia, antenatal care, family support, healthcare access, case study, Ghana

Abstract

Severe anaemia in pregnancy remains a major maternal health concern, particularly in rural areas, where poverty and ignorance worsen the plight of women who fall victim to it. While biomedical determinants are well-documented, the social and familial mechanisms that allow anaemia to reach life-threatening severity before any intervention occurs remain inadequately characterised in the case-report literature. This qualitative single-case examined the familial, sociocultural and structural circumstances surrounding delayed antenatal care access for a 23-year-old unmarried pregnant woman from the Bonakye sub-district of Nkwanta South Municipality in the Oti region of Ghana. At approximately 15 weeks of gestation, she presented with a haemoglobin level of 2.7 g/dL, consistent with severe anaemia. Data were drawn from structured field observations, interviews with selected family members and a review of clinical records from the Bonakye Health Centre and Nkwanta South Municipal Hospital, organised chronologically and interpreted through Bronfenbrenner’s Social Ecological Model and Anderson Behavioural Model of Health Services Utilisation. Family accounts pointed to conflict surrounding the pregnancy, limited support from her household, financial constraints, lapsed health insurance and transportation difficulties as factors behind the delayed and inconsistent care she received. After referral, she was given two units of blood, oral iron and folic acid supplementation, nutritional counselling and follow-up care, and her haemoglobin rose to 7.1 g/dL before discharge. At subsequent follow-up, her haemoglobin had fallen to 6.2 g/dL and she had miscarried, though the available clinical information could not establish the cause. This case shows how household and structural barriers can combine to delay the recognition and management of severe maternal health conditions in rural communities. Strengthened community-based antenatal outreach, family-sensitive health promotion, social support and better access to health insurance and transportation may help such women reach care earlier.

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