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The decades-long global efforts to reduce maternal morbidity and mortality have shown overall progress, but most developing countries are still lagging significantly. This study aimed to assess the prevalence of non-institutional childbirths in the Gambella State and to identify socio-demographic factors responsible for non-institutional utilization of available birth services by reproductive-aged mothers. A community-based cross-sectional study design was adopted using a multi-stage random sampling technique. Binary logistic regression