Symbolic Violence and Gestational Anemia: The Invisible Power of the Husband in Therapeutic Adherence

This article investigates the non-compliance with medical recommendations for the prevention and treatment of gestational anemia among pregnant women followed at the Regional Hospital Center (CHR) of Séguéla, in relation to the exercise of marital authority. Relying on a qualitative approach based on semi-structured interviews, the study explores the social, cultural, and symbolic logics shaping prenatal health decisions—particularly in contexts where patriarchal norms continue to structure conjugal relations. Although some women exhibit a relatively high level of education or health awareness, the legitimacy of the husband as the head of the household and primary decision-maker remains a decisive factor. This authority manifests in the refusal or delegation of certain medical prescriptions, including iron supplementation, regular antenatal consultations, compliance with nutritional advice, and the completion of a Complete Blood Count (CBC) test, aimed at preventing anemia. By drawing on Bourdieu’s theory of domination, the work of Sehi Bi Jamal on masculine legitimacy within the household, also Akindès work on the influence of beliefs on maternal nutritional practices despite a good understanding of anemia, and Coulibaly’s research on food taboos, this article demonstrates that adherence to biomedical recommendations cannot be explained solely by individual, economic, or knowledge-based factors. Instead, it is rooted in deeply entrenched gendered power relations. The study underscores the urgent need to recalibrate maternal health policies to reflect these sociocultural realities, thereby enhancing the effectiveness of interventions aimed at combating gestational anemia and maternal mortality.