Factors Influencing Home Births in the Krachi Nchumuru District in the Oti Region, Ghana: a Qualitative Study Philip Djan 1 & Hubert Amu 1 & Samuel H. Nyarko 1,2 # Springer Nature Switzerland AG 2019 Abstract Aim The rate of home births compared with health facility deliveries has severe implications for maternal and child health outcomes. In this paper, we explored the factors that influence home births in rural communities in the Krachi Nchumuru District of the Oti Region, Ghana. Subjects and Methods The paper used qualitative research methods involving in-depth interviews with fifteen women who gave birth at home and traditional birth attendants (TBA). Data were manually analysed using a thematic approach and the results presented in quotes. Results The findings show that costs associated with health facility delivery, sudden onset of labour period, the absence of health facility and personnel, unavailability of transportation, support and care services of the TBA and the opportunity for spiritual assistance and intervention were the key drivers of home delivery among women in the district. The study also shows home births have some negative effects on maternal and child health during and after labour such as malaria, fever, bleeding after circum- cision and a rise in body temperature. Conclusion Several contextual factors encourage home births among women in the Krachi Nchumuru District, Ghana. There is, therefore, the need to increase health facilities and personnel to provide skilled delivery care and improve the transportation infrastructure in the district. Keywords Homebirth . Traditional birth attendant . Maternal and child health . Krachi Nchumuru district Introduction Homebirth is an attended or unattended childbirth in a non- clinical setting, typically using natural childbirth methods that take place in the residence rather than in the hospital or a birth centre and usually attended by a midwife or lay attendant with experience in managing it (Farlex 2018). Home delivery con- tinues to be a major problem in developing countries. Globally, about 303, 000 women die from pregnancy and childbirth each year and about 99% (302, 000) of these deaths occur in develop- ing countries, with sub-Saharan Africa alone accounting for about 66% (201,000) (WHO et al. 2015). Delivering babies at health facilities has been recognised as one of the key factors of reducing maternal mortality (United Nations 2005; Stender 2015). Antenatal and delivery services are meant to monitor and ensure the safety of pregnant women and their babies in order to prevent and reduce the incidence of maternal morbidity and mortality. In this regard, complications of pregnancy and unsafe deliveries carried out at home are some of the leading causes of maternal mortality (WHO et al. 2015). Also, evidence shows that the uptake of maternal health services in developing coun- tries has significant consequences for safe transition of the moth- er through pregnancy and childbirth as well as the survival and health of the child during early infancy (Daniels et al. 2013). In Ghana, the percentage of births attended by skilled health professionals has experienced some progress over time. Health facility delivery has increased from 42% in 1988 to 73% in 2014 (Ghana Statistical Service et al. 2015). However, many deliveries are still believed to take place at home, particularly in the rural communities, attended by * Samuel H. Nyarko samharrenson@gmail.com Philip Djan akwrahdjanphilip@gmail.com 1 Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences (UHAS), PMB 31, Hohoe, Ghana 2 Institute for Demographic and Socioeconomic Research, University of Texas at San Antonio, 301 S. Frio St, San Antonio, TX 78207, USA Global Social Welfare https://doi.org/10.1007/s40609-019-00163-2