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 delivery.
In the current study, 80% of study participants delivered their child at home and were assisted by non-skilled birth attendants which were comparable to the studies conducted in Kenya  , Gozamin district of Gojjam, Ethiopia  , where 67.7% and 75.3% of women gave birth at home.
On the other hand, this result is higher than the results of other studies conducted in Oromia region (58%)  , Amhara (31%)  , Malawi (29%)  , Nigeria (31.5%)  , Ghana (48%)  and Tanzania (44%)  . The difference of the result of the present study from those of the previous studies could be attributed to the socioeconomic, cultural factors, and geographical variation that may vary among the studies. However, nearly a similar magnitude was reported in Awi zone (84%) .
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 is supported by studies conducted in Zambia and Senegal [30,32]. This could be due to the fact that mothers who engage in agriculture (farming) activities may have their own product and income that can make them economically empowered and hence may confers little decision-making power but in contrary house wives were economically reliant on their husband’s income. This may discourage them from seeking health facility birth. Hence, empowering women may serve as a reinforcer for health facility birth.
As to the finding of this study, ANC visit was found significantly associated with home delivery. Mothers who do not attend ANC visit were 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 the studies done in Oromia regional state , Tanzania , and Nigeria . 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 .
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 [30,32]. 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.
Furthermore, 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 the study conducted in northern part of Ethiopia in Tigray region , 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 neighboring without hearing that the women is in labor. In line with this, 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 . 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.