Copyright (c) 2025 Siti Maisaroh,Dessi Juwita
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Unmet Family Planning Needs and the Role of Village Midwives in Contraceptive Services in the Community
Corresponding Author(s) : Siti Maisaroh
International Research of Multidisciplinary Analysis,
Vol. 3 No. 11 (2025): International Research of Multidisciplinary Analysis
Abstract
Background: Midwives are the primary providers of contraceptive services in the community, but the unmet need for family planning in Indonesia is declining slowly. Objective: To describe national trends in unmet need, the role of midwives in contraceptive services, and variations in the prevalence of family planning users across provinces and their relationship with the midwife-to-population ratio. Methods: An ecological study using open-access secondary data: the 1991–2017 SDKI series (World Bank), the 2022 Indonesia Health Profile (contraceptive users by method, service location, and province), and the 2020 midwife-to-population ratio per 100,000. Associations were assessed using Spearman’s correlation (95% CI via Fisher’s z-test), the Kruskal–Walli’s test, and the Mann–Whitney test. Results: Unmet need decreased from 17.0% (1991) to 10.6% (2017), with the rate of decline slowing. In 2022, 59.9% of PUS were family planning participants; 61.6% of modern method users were served at midwife clinics; 61.9% received injections and 22.3% used IUDs. The median prevalence of family planning participants across 33 provinces was 56.7% (IQR 49.5–63.6), with nine provinces below 50%. The midwife-to-population ratio was negatively correlated with the prevalence of family planning participants (ρ = −0.32; 95% CI −0.61 to 0.03; p = 0.066; excluding Papua and West Papua, ρ = −0.45; p = 0.011). Conclusion: The availability of midwives per capita does not guarantee the utilization of family planning services; strengthening counseling and comprehensive family planning services by village midwives, as well as indicators of geographic access, are necessary.
Keywords
Download Citation
Endnote/Zotero/Mendeley (RIS)BibTeX
- Ahmed, S., Li, Q., Liu, L., & Tsui, A. O. (2012). Maternal deaths averted by contraceptive use: An analysis of 172 countries. The Lancet, 380(9837), 111–125. https://doi.org/10.1016/S0140-6736(12)60478-4
- Ariyanti, L., Dasuki, D., & Wilopo, S. A. (2017). Availability of health resources and unmet family planning needs: A provincial-level analysis. Community Medicine News, 33(1), 49–54. https://journal.ugm.ac.id/bkm/article/view/9868
- Cleland, J., Bernstein, S., Ezeh, A., Faundes, A., Glasier, A., & Innis, J. (2006). Family planning: The unfinished agenda. The Lancet, 368(9549), 1810–1827. https://doi.org/10.1016/S0140-6736(06)69480-4
- Ministry of Health of the Republic of Indonesia. (2021). Indonesia Health Profile 2020. Ministry of Health of the Republic of Indonesia. https://layanandata.kemkes.go.id/file/profil-kesehatan/2020/bab-5.pdf
- Ministry of Health of the Republic of Indonesia. (2023). Indonesia Health Profile 2022. Ministry of Health of the Republic of Indonesia. https://layanandata.kemkes.go.id/file/profil-kesehatan/2023/bab-5.pdf
- Larasanti, A., & Ayuningtyas, D. (2022). Effects of family planning service utilization determinants on unmet need incidents using generalized structural equation modeling. AJOG Global Reports, 2(4), Article 100088. https://doi.org/10.1016/j.xagr.2022.100088
- Nuryana, D., Cahyani, R. A., Rahayu, S., Romadlona, N. A., Liyanto, E., Daisy, L., Hartiti, W., Ratnawati, M. E., Utomo, B., & Magnani, R. J. (2023). Unmet need for family planning in Indonesia and its associated factors. Makara Journal of Health Research, 27(1). https://doi.org/10.7454/msk.v27i1.1403
- Renfrew, M. J., McFadden, A., Bastos, M. H., Campbell, J., Channon, A. A., Cheung, N. F., Silva, D. R. A. D., Downe, S., Kennedy, H. P., Malata, A., McCormick, F., Wick, L., & Declercq, E. (2014). Midwifery and quality care: Findings from a new evidence-informed framework for maternal and newborn care. The Lancet, 384(9948), 1129–1145. https://doi.org/10.1016/S0140-6736(14)60789-3
- ten Hoope-Bender, P., de Bernis, L., Campbell, J., Downe, S., Fauveau, V., Fogstad, H., Homer, C. S. E., Kennedy, H. P., Matthews, Z., McFadden, A., Renfrew, M. J., & Van Lerberghe, W. (2014). Improvement of maternal and newborn health through midwifery. The Lancet, 384(9949), 1226–1235. https://doi.org/10.1016/S0140-6736(14)60930-2
- World Bank. (2025). World Development Indicators: Unmet Need for Contraception (% of Married Women Aged 15–49) [Data set]. World Bank. https://api.worldbank.org/v2/country/IDN;KHM;PHL;THA;VNM/indicator/SP.UWT.TFRT
References
Ahmed, S., Li, Q., Liu, L., & Tsui, A. O. (2012). Maternal deaths averted by contraceptive use: An analysis of 172 countries. The Lancet, 380(9837), 111–125. https://doi.org/10.1016/S0140-6736(12)60478-4
Ariyanti, L., Dasuki, D., & Wilopo, S. A. (2017). Availability of health resources and unmet family planning needs: A provincial-level analysis. Community Medicine News, 33(1), 49–54. https://journal.ugm.ac.id/bkm/article/view/9868
Cleland, J., Bernstein, S., Ezeh, A., Faundes, A., Glasier, A., & Innis, J. (2006). Family planning: The unfinished agenda. The Lancet, 368(9549), 1810–1827. https://doi.org/10.1016/S0140-6736(06)69480-4
Ministry of Health of the Republic of Indonesia. (2021). Indonesia Health Profile 2020. Ministry of Health of the Republic of Indonesia. https://layanandata.kemkes.go.id/file/profil-kesehatan/2020/bab-5.pdf
Ministry of Health of the Republic of Indonesia. (2023). Indonesia Health Profile 2022. Ministry of Health of the Republic of Indonesia. https://layanandata.kemkes.go.id/file/profil-kesehatan/2023/bab-5.pdf
Larasanti, A., & Ayuningtyas, D. (2022). Effects of family planning service utilization determinants on unmet need incidents using generalized structural equation modeling. AJOG Global Reports, 2(4), Article 100088. https://doi.org/10.1016/j.xagr.2022.100088
Nuryana, D., Cahyani, R. A., Rahayu, S., Romadlona, N. A., Liyanto, E., Daisy, L., Hartiti, W., Ratnawati, M. E., Utomo, B., & Magnani, R. J. (2023). Unmet need for family planning in Indonesia and its associated factors. Makara Journal of Health Research, 27(1). https://doi.org/10.7454/msk.v27i1.1403
Renfrew, M. J., McFadden, A., Bastos, M. H., Campbell, J., Channon, A. A., Cheung, N. F., Silva, D. R. A. D., Downe, S., Kennedy, H. P., Malata, A., McCormick, F., Wick, L., & Declercq, E. (2014). Midwifery and quality care: Findings from a new evidence-informed framework for maternal and newborn care. The Lancet, 384(9948), 1129–1145. https://doi.org/10.1016/S0140-6736(14)60789-3
ten Hoope-Bender, P., de Bernis, L., Campbell, J., Downe, S., Fauveau, V., Fogstad, H., Homer, C. S. E., Kennedy, H. P., Matthews, Z., McFadden, A., Renfrew, M. J., & Van Lerberghe, W. (2014). Improvement of maternal and newborn health through midwifery. The Lancet, 384(9949), 1226–1235. https://doi.org/10.1016/S0140-6736(14)60930-2
World Bank. (2025). World Development Indicators: Unmet Need for Contraception (% of Married Women Aged 15–49) [Data set]. World Bank. https://api.worldbank.org/v2/country/IDN;KHM;PHL;THA;VNM/indicator/SP.UWT.TFRT