The Village Midwife Program and the Reduction in Infant Mortality in Indonesia

Ranjan Shrestha, Ohio State University

Indonesia introduced over 50,000 midwives in villages across the country in the 1990s to provide primary care to women without easy access to health facilities. Using the Indonesian Family Life Survey (IFLS), this paper estimates the impact of this program on infant mortality. Since women choose the type of assistance during delivery and where they give birth, regressing mortality outcomes against the choice of services will lead to biased estimates due to the correlation between the choice of services and unobserved characteristics of the women. Furthermore, the non-random placement of the program also needs to be considered when estimating the program effect. In order to overcome the problem of endogeneity, mortality outcomes and program prevalence are aggregated at the district level and the program effect is estimated taking district fixed effects. The results suggest that the program is associated with a reduction in neonatal mortality, but not with post-neonatal mortality.