Abstract

Background: In Indonesia, the placement of village midwives began in 1989. However, this program was deemed not to be in line with the reduction in maternal and infant mortality rates.

Aim: To explore the experience of midwives in remote areas and identify the factors inhibiting the success of this program.

Methods: This study is a qualitative study with an ethnographic approach. Data collection used focus group discussions (FGDs), in-depth interviews, and observations. Seventy-seven midwives were involved in FGDs, sixty-three participants were interviewed, and three remote areas within the Indragiri Hilir regency were observed. A thematical analysis was used to analyze the gathered data.

Results: This study’s findings reveal that one village midwife is responsible for a large area. Geographical conditions, culture, transportation, and tidal river may delay the referral process. Also, the lack of villager awareness in regard to health, community culture, and low water quality contributed to the health community status in the remote areas. Furthermore, village infrastructures, potential hazards, and compensation elucidated village midwives’ unwillingness to stay in remote areas.

Conclusion: Many factors influence the ineffective village midwife program. Some corrective actions are needed to narrow the gap between the government’s expectations and the problems faced by the village midwives.

Keywords: Village midwives, remote areas, geographical conditions, tidal river, referral