Background Understanding factors associated with home births is crucial for identifying appropriate interventions
for mother and child survival and attaining the Sustainable Development Goals. No national studies have explicitly examined the distribution of home birth and its contributing factors. This study aims to assess the distribution
of home birth and the contributing factors among mothers of reproductive age 15–49 years in Somalia.
Methods We analyzed the data of 8,631 mothers who gave birth within five years preceding the survey and provided responses on variables studied. The data was obtained from the 2020 Somali Health and Demographic Survey. Respondents’ characteristics were summarized using descriptive analysis. Chi-square tests were applied to test
the association between the distribution of home birth and each predictor. Multivariate logistic regression was used
to assess factors contributing to home birth. We employed the STROBE checklist for manuscript reporting.
Results The prevalence of home birth among reproductive mothers in this study was, 75.5% (95% CI: 0.74–0.76).
Living in the Northeast (AOR=1.48, 95% CI: 1.17–1.86), no level of education (AOR=2.38, 95% CI: 1.84–3.06), no media
exposure (AOR=3.67, 95% CI: 3.25–4.13), poor household wealth status (AOR=3.80, 95% CI: 3.07–4.71), maternal
autonomy (AOR=1.36, 95% CI: 1.21–1.53), need companionship to treatment facility (AOR=1.20, 95% CI: 1.07–1.36),
and no antenatal visits (AOR=3.91, 95% CI: 1.66–9.26) were associated with increased likelihood of home births
among mothers. By contrast, urban and rural residences, low parity, and first-trimester antenatal visits were associated
with a decreased likelihood of home births among mothers of reproductive age 15–49 years in this study.
Conclusion The Somali government has made efforts to improve maternal health utilization and reduce the associated deaths. However, three-quarters of Somali mothers still undergo home births. To lower home births in Somalia,
government and non-governmental organizations should consider scaling institutional births by improving maternal
level of education, media accessibility, and household wealth status. Priority emphasis must be given to the maternal
knowledge of the benefits of antenatal visits for both herself and her baby