Contraceptive practice in Indonesia: Did the Village Midwife Program make a difference?

Indonesia established its Village Midwife Program in 1989 to address gaps in access to reproductive health care for rural women. Two of the program’s goals were to (1) improve accessibility and utilization of family planning services and to (2) enhance the mix of contraceptives available. Using data from the Indonesia Family Life Survey, this study examines the program’s effect on contraceptive practice. We present intent-to-treat estimates that control for nonrandom placement of midwives using communitylevel fixed effects. We show that village midwives did not affect contraceptive prevalence. For women using contraceptives, midwives increased the odds of injectable contraceptive use, decreased the odds of oral contraceptive use, and decreased the odds of contraceptive implant use. Although the Government hoped that village midwives would channel women into longer-lasting methods, the women’s switching behavior indicates that the program succeeded in providing additional outlets for a preferred method type.