Abstract
<jats:p>Background Skilled birth attendance is essential to reduce maternal and neonatal mortality. However, the use of skilled delivery services is still low in many rural areas of Ghana including the Sene East District. This study investigated the level and determinants of skilled birth attendance among women who delivered in the district in the last 12 months. Methods A community-based cross-sectional study was conducted among 430 women who delivered within the last 12 months. The respondents were selected from Child Welfare Clinics by simple random sampling. Data was collected using a structured questionnaire and analysed using logistic regression. Variables with p-values <0.05 at the bivariate level were included in the multivariable logistic regression model. Statistical significance was p < 0.05. Results The prevalence of skilled birth attendance among respondents was 64.9%. In a multivariable logistic regression model, women who had a previous delivery at home were less likely to deliver with skilled birth attendants during the most recent pregnancy than first-time mothers (AOR = 0.1, 95% CI: 0.02–0.41). Women who had delivered at a traditional birth attendant's (TBA) place during their previous delivery had significantly lower odds of skilled birth attendance (AOR = 0.1, 95% CI: 0.01–0.44). On the other hand, women who had previously delivered in a health facility were six times more likely to use skilled birth attendants than first-time mothers (AOR = 6.3, 95% CI: 1.32–30.7). Also, mothers living more than 10 km from the nearest health facility were 70% less likely to use skilled birth attendance than mothers living within 5 km of a health facility (AOR = 0.3, 95% CI: 0.14–0.80). Conclusion The uptake of skilled birth attendance in Sene East District is suboptimal. Enhancing access to health facilities, strengthening antenatal care services and addressing barriers to skilled delivery may improve maternal health service utilization in the district.</jats:p>