<![CDATA[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.]]>
Copyrights © 2025
