Determinants of home delivery among childbearing age women in Gondar zuria district of central Gondar, Ethiopia, 2020

Introduction: Birth is a critical time for the health of the mother and newborn; and place of delivery is a crucial factor for the wellbeing of both. Ethiopia is a major contributor to the worldwide death tax of mothers with a maternal mortality ratio of 412 per 100,000 live. Therefore institutional delivery has paramount importance to get skilled care throughout pregnancy from inception to postnatal care. But in the Amhara region, only 27% of mothers gave birth at the health facility. The objective of the study is to assess determinants of home delivery among childbearing age women in Gondar Zuria district of central Gondar, Ethiopia. The study duration was from January 1 to February 30 2020. Method: Community-based age-matched case-control with the complementary qualitative design was used in Gondar Zuria district. Simple random sampling was used to select study participants for quantitative and purposive sampling used for the qualitative part. The total sample size was 264. Quantitative data were collected by in-depth interviews. Data entry and cleaning was done by epi info and analysis was done using SPSS and results were presented in odd ratios, and tables. Result: Seventy-one 71 (26.9%) of the mothers were in the age range of 31–35 years and 50 (18.9%) of mothers were in the age range of 26-30 years. Logistic regression analyses revealed that living in the rural area (AOR, 9.53; 95%CI; 3.50-25.90), not in union with husband (AOR, 8.35 95%CI; 3.53-22.09), unable to read and write (AOR, 4.50 95%CI; 1.12-18.07) and having a monthly income of less than 600 ETB (AOR, 6.45 95%CI; 2.26-18.37) were more likely to deliver at home. Being unaccompanied by the husband during antenatal care (AOR, 2.34, 95%CI; 1.30-4.22), having no antenatal care visit (AOR, 4.60; 95%CI; 2.02-10.48), traveling on foot to get maternal services (AOR, 2.89; 95%CI, 1.19-7.01), and giving birth of above four (AOR, 4.12, 95%CI; 1.97-8.62) were also more likely to deliver at home. Mothers having good knowledge about danger signs and importance of skilled birth attendance, deliver at health facility twice (AOR, 1.77; 95%CI; 1.06-2.94) than women having poor knowledge. Conclusion: Living in the rural area, traveling on foot, not in union with husband, being uneducated and poor, having no antenatal care visit, poor knowledge of danger signs of pregnancy, and giving birth of above four were the determinant factors to home delivery. Actions targeting maternal education; encouraging the number of ANC visits and making health facilities accessible are the recommended interventions to tackle home delivery.