The present study revealed the magnitude of home delivery among women in the reproductive age group who gave birth in the preceding two years. ANC visit, occupation of mothers, traditional remedies and Decision-making power were significantly associated with home deliver.
In the current study, 80% of study participants delivered their child at home and were assisted by non-skilled birth attendants which was comparable to the study conducted in Kenya [16], where 67.7% of women gave birth at home. But the magnitude is slightly higher when compared to other findings from Oromia region [14], Amhara [9], Malawi [16], Nigeria [22], Ghana [28] and Tanzania [29] where the magnitude of home delivery was 58%, 31%, 29%, 40%, 48% and 44%, respectively. The difference could be attributed to the socioeconomic, cultural factors and geographical variation that may vary among the studies. However, nearly similar magnitude was reported in Awi’s study 84% [28].[29, 30].
In this particular study; mothers’ occupation was found to be a predictor of home delivery. Mothers who are farmers were two times less likely to give birth at home compared to those who were house wife [AOR: 0.21 95% CI: 0.21 (0.08–0.57). This finding is in line with study conducted in Zambia and Senegal [29,31]. The probable reason for this might be mothers who engage in agriculture (farming) may have their own product and income that can make them economically empowered and decisive by their own but in contrary house wives are economically reliant on their husband’s income. In many African countries has also been described majority of women requests permission from their husbands and relatives to go to health facility.
As to the finding of this study, ANC visit was found significantly associated with home delivery. Mothers who do not attend ANC visit are five times [AOR: 95%CI: 5.1(1.6–15.8)] more likely to give birth at home as compared with mothers who do attend ANC visit. The finding is in line with study done in Oromia regional state [9], Tanzania [29], and Nigeria [22]. This could be explained due to nearly the same socio-economic status among sub Saharan African countries. In addition, not getting adequate information and counseling about the condition of their babies and themselves may also be an additional factor which favors them in experiencing home delivery, but the opposite is true for those who do attend ANC. However, some studies argue that, ANC visits would have an inverse association with home delivery as women who are told their pregnancy is fine may feel encouraged to deliver at home [27].
The study also found that home delivery was significantly associated decision making. Mothers who decide with their Husband for the place of delivery were less likely to give birth at home compared to those who decide by themselves. This finding is supported by other studies done in Zambia and Senegal [29, 31]. This could be due to the fact that mothers who make decisions with their husband have highest self-confidence and transparency, and these self-confidences may give them equal opportunity and help them to exercise their right of equality. But most of the time especially in cultural society, majority of women requests permission from their husbands and relatives to go to health facility which has been described in many studies conducted in African countries.
In this study, traditional remedies were also found to be another determinant factor for home delivery. Mothers who don’t prefer traditional remedies were less likely to deliver at home compared to those who prefer traditional remedies. This study was in line with study conducted in Tigray region Ethiopia [11] illustrating that many mothers perceive and belief pregnancy and child birth as a natural gift from God and most of the time ends up with short and easy deliveries, even the one who is in neighbor without hearing that the women is in labor. There is a cultural belief regarding the pregnant women that blessing her to end in good outcomes. A study among women in Nigeria also came up with the same finding [22]. This could be explained by under development of modern medical management in Africa and medicalization of western country over African led them to focus on herbal and traditional remedies and healing. Furthermore, the possible reason for mothers to choose traditional remedies is not only about perception, culture and believe but also it is related to in accessibility, affordability and inequity in health coverage and service across the country.