Objectives This study examined the association
between household savings and related economic measures
with utilization of skilled birth attendants (SBAs) at last
birth among women living in peri-urban households
(n = 381) in Ghana and Nigeria. Methods Data were
drawn from the 2011–2014 Family Health and Wealth
Study. Multivariable logistic regression models were used
to estimate the odds of delivery with an SBA for individual
and composite measures of household savings, expected
financial means, debt, lending, and receipt of financial
assistance, adjusting for demographic and reproductive
characteristics. Results Seventy-three percent (73 %) of
women delivered with an SBA during their last birth
(89 %, Ghana; 63 %, Nigeria), and roughly one third
(34 %) of households reported having any in-cash or inkind
savings. In adjusted analyses, women living in
households with savings were significantly more likely to
deliver with an SBA compared to women in households
without any savings (aOR = 2.02, 95 % CI 1.09–3.73).
There was also a consistent downward trend, although nonsignificant,
in SBA utilization with worsening financial
expectations in the coming year (somewhat vs. much better:
aOR = 0.70, 95 % CI 0.40–1.22 and no change/worse
vs. much better: aOR = 0.46, 95 % CI 0.12–1.83). Findings
were null for measures relating to debt, lending, and
financial assistance. Conclusion Coupling birth preparedness
and complication readiness strategies with savings-led
initiatives may improve SBA utilization in conjunction
with targeting non-economic barriers to skilled care use