Social networks and social support during cervical cancer treatment among women at a tertiary referral facility in Ghana: A qualitative descriptive study
Rufai, F.; Dowuona, R. E.; Annung-yen, D.; Delali, D. K.; Adam, A.
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Background: Cervical cancer remains a leading cause of cancer death among women in sub-Saharan Africa, with Ghana experiencing persistently high mortality linked to late diagnosis and constrained treatment access. Beyond its clinical burden, cervical cancer treatment is a socially demanding experience requiring women to mobilise financial, practical, informational, and emotional support over time. This study explored the social networks surrounding women during cervical cancer treatment and the social support exchanged within them at a tertiary referral facility in Ghana. Methods: A qualitative descriptive design, informed by an interpretivist epistemological orientation, was employed. Eight women receiving treatment at the National Centre for Radiotherapy, Oncology and Nuclear Medicine, Korle-Bu Teaching Hospital, Accra, were recruited using criterion-based purposive sampling and interviewed individually using a semi-structured guide until data saturation was reached. Interviews were audio-recorded, transcribed verbatim, and analysed using reflexive thematic analysis, supported by Atlas.ti version 7.5.7. Results: Five themes were generated. Disclosure functioned as a gatekeeping process through which women selectively determined who entered their support network, shaped by anticipated stigma. Despite valuing the support they received, women displayed marked reluctance to request it directly, relying on indirect strategies and expressing gratitude regardless of whether support met their actual needs. Support networks consistently narrowed around a single family member, most often a daughter or sibling, who provided the bulk of financial, practical, and informational assistance, while more peripheral relationships receded. Social support functioned not merely as emotional comfort but as a precondition for accessing and continuing treatment at all, particularly given widely inadequate insurance coverage. Finally, some women experienced discomfort reconciling their need for support with a prior identity as habitual providers of care to others. Conclusion: Social networks and support during cervical cancer treatment in Ghana are actively constructed through disclosure, constrained by reluctance to seek help, and concentrated around a single caregiver, functioning as a determinant of whether treatment can be accessed and sustained rather than merely a source of comfort. Formalizing support around, rather than in place of, these informal networks could strengthen both access to and continuity of cervical cancer care in similarly resourced settings.
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