Fogarty Global Health Fellow, School of Medicine, University of North Carolina at Chapel Hill, 130 Mason Farm Road, Campus Box 7030, Chapel Hill, NC, 27599.
Stud Fam Plann. 2013 Dec;44(4):389-409. doi: 10.1111/j.1728-4465.2013.00366.x.
Indonesia established its Village Midwife Program in 1989 to combat high rates of maternal mortality. The program's goals were to address gaps in access to reproductive health care for rural women, increase access to and use of family planning services, and broaden the mix of available contraceptive methods. In this study, we use longitudinal data from the Indonesia Family Life Survey to examine the program's effect on contraceptive practice. We find that the program did not affect overall contraceptive prevalence but did affect method choice. Over time, for women using contraceptives, midwives were associated with increased odds of injectable contraceptive use and decreased odds of oral contraceptive and implant use. Although the Indonesian government had hoped that the Village Midwife Program would channel women into using longer-lasting methods, the women's "switching behavior" indicates that the program succeeded in providing additional outlets for and promoting the use of injectable contraceptives.
印度尼西亚于 1989 年设立了乡村助产士计划，以应对高产妇死亡率。该计划的目标是解决农村妇女获得生殖保健方面的差距，增加计划生育服务的可及性和使用率，并扩大现有避孕方法的组合。在这项研究中，我们使用来自印度尼西亚家庭生活调查的纵向数据来研究该计划对避孕措施的影响。我们发现该计划并没有影响总体避孕普及率，但确实影响了方法的选择。随着时间的推移，对于使用避孕药具的女性，助产士与增加使用注射避孕方法的几率和降低使用口服避孕药和植入避孕方法的几率有关。尽管印度尼西亚政府曾希望乡村助产士计划能引导妇女使用更长效的方法，但妇女的“转换行为”表明，该计划成功地为注射避孕方法提供了更多的渠道，并促进了其使用。
