Johns Hopkins Bloomberg School of Public Health: The INFO Project

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Dr. Jim Shelton's Pearls "Pearl" for the week of January 5, 2004

Indonesia Private Sector Engine

In the Indonesia transition to major reliance on the private sector, which of the following sources of supply carried the lion’s share?

• Hospital
• Clinic
• Doctor
• Midwife
• Pharmacy

Correct answer: Midwife

The 2 midwife or "bidan" cadres of Indonesia have become a remarkable resource for contraception. The DHS lists them (under private sector) as Nurse/midwife (or higher level D-4 midwife so-called because she has about 4 years of advanced school) and Village/midwife (or bidan di desa.) The bidan di desa is the product of a special 1 year program for underserved areas. She receives a small government stipend, but the community is expected to provide the majority of her needs (thus you could rightly argue that she is not purely private sector.) Together these midwife cadres provide contraception to 46% of all contraceptive use in Indonesia and 68% of the leading method – injectables.

The "Pearls" offer answers to commonly asked questions about family planning. These "Pearls" are prepared by Dr. James D. Shelton, Senior Medical Scientist, Office of Population, United States Agency for International Development (USAID)

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