<![CDATA[Background. Childbirth attended by health care providers at health care facilities is a key strategy for reducing maternal mortality. Midwives are the most common birth attendants in Indonesia, but current policies emphasize that all births should take place at health care facilities. Objectives. To describe trends in birth attendants and delivery settings in Indonesia from 2013 to 2023, the proportion of midwives as birth attendants, and interprovincial disparities between births attended by health workers and births occurring at health care facilities. Methods. A descriptive-analytical study using trend analysis and Spearman’s correlation on downloadable secondary data: Riskesdas 2013 and 2018, SDKI 2017, the 2023 Indonesian Health Survey (SKI), and the 2020 Indonesian Health Profile for data from 33 provinces, as well as the 2020 Population Census (SP2020) Long Form on maternal mortality. Results. Deliveries at health facilities increased from 66.7% (2013) to 79.3% (2018) and 90% (2023), while deliveries attended by health personnel reached 96.1% in 2023. Midwives assisted in about six out of ten births (61% in the 2017 SDKI; 62.7% in the 2018 Riskesdas), while obstetricians accounted for about 29%. According to routine data from 2020, the coverage of deliveries at health facilities ranged from 31.4% in Maluku to 99.6% in DKI Jakarta, and 12 out of 33 provinces remained below 80%. The rate of deliveries at health facilities showed a strong negative correlation with the Long Form SP2020 maternal mortality rate (rho = −0.69; p < 0.001; n = 20). Conclusion. Midwives remain the backbone of childbirth care, and their role has shifted from providing care at home to providing care at health facilities and serving as referral liaisons. Provinces in eastern Indonesia require support to ensure that midwife-assisted deliveries can take place at health facilities.]]>
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