Background: In Ethiopia, maternal health programs are considered as a priority issue in public health interventions. Beside, every pregnant woman gave birth at the health facility with skilled provider. Despite this initiative, maternal and neonatal mortality in Ethiopia is the highest in the world which may have to do with preference for home delivery. However, evidences are limited. Thus, the aim of this study is to explore why women prefer home delivery in Assosa District.

Methods: A phenomenological study design was employed. Study participants were women who gave birth at home within one year prior to study. Face to face interview was conduct in local language. The interview was made conducive place. Eight indepth interviews were conducted at which level of saturation reached. Then, data was analysis thematically using OpenCode 4.02 software.

Result: A total of eight women who gave birth at home were interviewed. Based on their response, six themes were emerged: woman awareness (home delivery have no any impact on health outcome, has no any benefit, perceive that facility delivery expose newborn for pneumonia); perceive poor quality of health services (shortages of medical supply, lack of commitment/motivation, lack of skill and absenteeism of HWs); women experience (previous experience and absence of bad exposure in home delivery, perceived bad experience in facility delivery, labour process is fast and urgent, labour occur at rainy season, night and weekend days); trust on TBA (TBA is near to and available at any time and more experience/skillful); social networking (while women gave birth at home, family/community members were washing her bodies with warm water and put near to the fire; preparing coffee ceremony and genfo and muk for lady) and accessibility and availability (far distance, transportation and financial problems) which intensified home delivery.

Conclusion: Women in the study areas were plan and prefer to deliver at health facility but they failed and gave birth at home because of different reasons that can be attributed to home delivery. Thus, these issues need to be addressed by considering the specific factors related to women and health system.

Keywords: Qualitative, home delivery, women perspective, Assosa, Ethiopia