Postpartum Women's Knowledge and Attitude on Skilled Birth Attendants and Its Association with Traditional Birth Attendants' Utilization in Assin Fosu Municipality, Ghana

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.