Later, as the pre-services training was claimed to be inadequate, an additional two-week in-service training was carried out for village midwives in the form of classroom-based training as well as clinical training for the management of normal delivery and life-saving skills [13, 15, 16].By 1996, more than 50,000 village midwives had been placed in villages in Indonesia, and the one-year pre-service training was then replaced by a three-year specialist program for high school graduates [13, 17].
A comprehensive strategy to increase the availability, accessibility, and affordability of delivery care services should be considered in these West Java areas.
Health education strategies are required to increase community awareness about the importance of health services along with the existing financing mechanisms for the poor communities.
Between 1970 and the early 1990s, health personnel were employed in the public sector, and with the implementation of the contract scheme, doctors and midwives, not including nurses, worked for a prescribed time period of around three years for the government and then proceeded to either a private practice or a specialist training .
It has been observed that the distinction between private and public clinical practice in Indonesia remains unclear .
Attention to maternal health was demonstrated in 2000 when 147 heads of state and government and 189 nations in total signed the Millennium Declaration, in which the proportion of births assisted by trained birth attendants became an important indicator to measure the progress of improving maternal health (Millennium Development Goal 5) [11, 12].
In 1989 the Indonesian Government embraced the concept of the Safe Motherhood Initiative through the implementation of the "Village Midwife" program.
This study aims to explore the perspectives of community members and health workers about the use of delivery care services in six villages of West Java Province.
A qualitative study using focus group discussions (FGDs) and in-depth interviews was conducted in six villages of three districts in West Java Province from March to July 2009.
In low and middle-income countries many deliveries still occur at home and without the assistance of trained attendants [4–7].
This has generated serious concern, since women who develop life-threatening complications during pregnancy and delivery require appropriate and accessible care.