Unlocking the Potential of Health Technology Assessment (HTA) in Indonesian Midwifery: Challenges and Opportunities

Health Technology Assessment (HTA) supports evidence-based decision-making, resource allocation, and healthcare quality. Although Indonesia has established national HTA policies, their application in midwifery remains limited. Given ongoing efforts to reduce maternal mortality and advance health transformation, integrating HTA into midwifery is essential for safe, effective, and cost-efficient care.

This paper critically examines HTA's potential in Indonesian midwifery, identifying implementation gaps, challenges, and opportunities to improve maternal and child health outcomes.

This study employed a narrative review and policy analysis, examining national health policies, HTA guidelines, institutional frameworks, and relevant scientific literature on HTA and midwifery in Indonesia. The analysis focused on identifying structural barriers, implementation challenges, and strategic opportunities for integrating HTA into community-based midwifery services.

The analysis revealed that Indonesia possesses a foundational HTA policy framework supported by national health transformation strategies. However, a significant implementation gap exists between national HTA policies and frontline midwifery practice. HTA activities primarily focus on high-cost hospital technologies, while routine midwifery tools and digital health applications are often adopted without systematic evaluation. Key challenges include limited data availability, decentralized procurement systems, insufficient local HTA capacity, funding constraints, and inadequate knowledge translation mechanisms. Opportunities include strengthened stakeholder collaboration, digital health integration, capacity building for midwives, and development of standardized evaluation mechanisms tailored to midwifery technologies.

Integrating HTA into Indonesian midwifery can enhance evidence-based practice, optimize resource allocation, and improve maternal and child healthcare quality. Addressing policy-practice gaps through capacity development, institutional coordination, and investment in data systems is essential. Strategic HTA implementation can support Indonesia's health transformation agenda and contribute to improved maternal and newborn health outcomes.