Postpartum Women's Knowledge and Attitude on Skilled Birth Attendants and Its Association with Traditional Birth Attendants' Utilization in Assin Fosu Municipality, Ghana
Benjamin Kwasi Amoako *
Department of Public Health, Ghana Health Service, Assin Fosu Municipal Health Directorate, Assin Fosu, Ghana and Department of Public Health, School of Public Health, University of Port Harcourt, Port Harcourt, Nigeria.
Michael Oppong Yeboah
Department of Public Health, Akramaman Health Centre, Ga West Municipal Health Directorate, Amasaman, Accra, Ghana.
Samira Mastura Sulleman
Department of Population and Reproductive Health, Mana Mission Hospital, Accra, Ghana.
Jerdu Bin-eranaa Nuhu
Department of Public Health, School of Public Health, University of Port Harcourt, Port Harcourt, Nigeria.
John Kwame Agbenyeavu
Department of Public Health, School of Public Health, University of Port Harcourt, Port Harcourt, Nigeria.
Rebecca Tricia Morrison
Department of Population and Reproductive Health, University of Port Harcourt, Port Harcourt, Nigeria.
Boaz Ahulu
Department of Public Health, School of Public Health, University of Port Harcourt, Port Harcourt, Nigeria and Department of Public Health, Community Health Nursing Training College, Akim Oda, Ghana.
Oscar Vetsi
Department of Public Health, Disease Control Unit, Ghana Health Service, Ada West District, Sege, Ghana.
Abubakar Alhassan
Department of Public Health, Federal University of Health Sciences, Azare, Bauchi State, Nigeria.
Porbilla Ewura Ofosu-Apea
Department of Public Health, School of Public Health, University of Port Harcourt, Port Harcourt, Nigeria.
Richard Kwaku Essien
Department of Public Health, Abuakwa South Municipal Health Directorate, Ghana.
Eric Addo Owusu
Department of Population and Reproductive Health, University of Port Harcourt, Port Harcourt, Nigeria.
Dadia Stephen
Department of Public Health, Ghana Health Service, Kpandai District Health Directorate, Kpandai, Ghana.
Donne Kofi Ameme
Ghana Field Epidemiology and Laboratory Training Programme (Ghana FELTP), Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Accra, Ghana.
Best Ordinioha
School of Public Health, University of Port Harcourt, Port Harcourt, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Aims: To evaluate sociodemographic correlates and questionnaire-defined knowledge and conditional attitudes associated with reported monthly traditional birth attendant (TBA) visits among women who had a TBA-assisted delivery in Assin Fosu Municipality, Ghana.
Study Design: Community-based cross-sectional analysis.
Setting and Participants: Two hundred and fifty postpartum women who reported a TBA-assisted delivery in the previous 24 months were interviewed in Assin Fosu Municipality between July and September 2026.
Methods: The outcome was the study questionnaire's binary indicator of at least one reported monthly TBA visit during the most recent pregnancy. Ten knowledge items and five conditional-attitude items were scored according to the original instrument. Descriptive tests and Firth-penalised logistic models were used.
Results: Of 250 respondents, 202 (80.8%; 95% CI 75.5–85.2) met the monthly-visit classification. The adjusted model reported higher odds for women aged 30–42 years (aOR 3.80; 95% CI 1.69–9.12) and for those with moderate or poor knowledge scores (aOR 2.41; 95% CI 1.16–5.18), and lower odds for those with less favourable conditional attitude scores (aOR 0.27; 95% CI 0.10–0.71). After further adjustment for parity, antenatal booking, and perceived distance, the age association weakened. Planned sampling allocations differed from the analysed urban/rural distribution; the monthly-contact measure and two knowledge items also have interpretative limitations.
Conclusion: The observed associations are exploratory and apply to the recruited TBA-delivery group. Validation of the study measures and sampling-based analysis are important before drawing population-level conclusions. Communication about professional roles, local care costs, and respectful maternity care warrants further study.
Keywords: Traditional birth attendants, skilled birth attendance, knowledge, attitudes, maternal health services, antenatal care, Ghana