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Determinants of Midwife Performance in Lactation Management in Surakarta and Karanganyar, Central Java Nurul Wahidah; Endang Sutisna Sulaeman; Uki Retno Setia Budihastuti
Journal of Health Policy and Management Vol. 3 No. 1 (2018)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Exclusive breastfeeding has been recommended by World Health Organization for reduction of infant illness and death. Midwives have an important role in lactation management, which includes: (1) Teaching all lactating mothers on how to successfully breastfeed and sustain it up to 2 years or more; (2) Coming in contact with mothers and infants to promote, protect, and support breastfeeding. However, exclusive breastfeeding coverage was still low at 80% nationally, 76.7% in Surakarta, and 61.1% in Karanganyar in 2016, suggesting low midwife performance in lactation management. This study aimed to determine factors associated with midwife performance in lactating management in Surakarta and Karanganyar, Central Java.Subjects and Method: This was an analytic observational study with a cross-sectional design. The study was conducted in community health center in Surakarta and Karanganyar, Central Java, from April to June 2018. A sample of 200 midwives was selected by simple random sampling. The dependent variable was performance in lactation management. The independent variables were skill, motivation, experience, health facility, and work load. The data were collected by questionnaire and analyzed by a multilevel logistic regression.Results: Midwife performance in lactation management increased with better skill (b= 2.06; 95% CI= 0.48 to 3.65; p= 0.011), strong motivation (b= 1.15; 95% CI= -0.09 to 2.41; p= 0.070), work experience (b= 2.06, 95% CI= 0.69 to 3.44, p= 0.003), and available facility (b= 2.29, 95% CI= 0.89 to 3.68, p= 0.001). Performance decreased with higher workload (b= -1.47; 95% CI= -2.76 to -0.18, p=0.025). Community health center had a contextual effect on midwives performance with ICC= 34.8%.Conclusion: Midwife performance in lactation management increases with better skill, strong motivation, work experience, and available facility. Performance decreases with higher workload. Community health center has a contextual effect on midwives performance.Keywords: performance, lactation management, determinant, midwifeCorresp ondence:Nurul Wahidah. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami No. 36 A, 57126, Surakarta, Central Java. Email: wahidahnurul246@gmail.com.Journal of Health Policy and Management (2018), 3(1): 26-33https://doi.org/10.26911/thejhpm.2018.03.01.04

Path Analysis on the Deterninants of Health Cadres Ability in Early Detection and Management of Pregnancy Risk Factors in Sleman, Yogyakarta, Indonesia Istri Yuliani; Bhisma Murti; Endang Sutisna Sulaeman; Tedjo Danudjo Oepomo
Journal of Health Policy and Management Vol. 4 No. 1 (2019)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Every pregnant woman has the potential to experience risk, so it is necessary to get serious attention and special treatment by health workers, family, and community. One role of the community is as the health cadres. This study aimed to examine the determinants of health cadre ability in early detection and management of pregnancy risk factors.Subjects and Method: The research used quantitative method and cross-sectional approach. There were 269 health cadres participating as research samples. The sampling technique used is multistage cluster random sampling. Data were collected using a questionnaire with a Likert scale. Data analysis is done using path analysis.Results: Cadre’s ability in early detection of pregnancy risk factors was affected by attitude (b= 0.38; SE=0.10; p<0.001), experience (b=0.38; SE=0.10; p<0.001), motivation (b=0.63; SE=0.14; p<0.001), compensation (b=0.68; SE=0.19; p<0.001), workload (b=0.64; SE=0.23; p= 0.005), education and training (b=0.68; SE=0.19; p=0.001), supervision (b=0.99; SE=0.17; p<0.001), perceived seriousness (b=0.73; SE=0.16; p<0.001), and perceived benefit (b=0.84; SE=0.18; p<0.001). Cadre’s ability in the management of pregnancy risk factors was affected by attitude (b= 0.54; SE= 0.12; p<0.001), experience (b= 0.18; SE= 0.10; p= 0.079), motivation (b=0.36; SE=0.15; p=0.014), compensation (b=0.64; SE=0.20; p=0.001), supervision (b = 0.36; (b= 0.49; SE = 0.18; p= 0.008), and early detection of pregnancy risk factors (b= 0.29; SE= 0.05; p<0.001).Conclusion: Cadre’s ability in early detection of pregnancy risk factors is affected by attitude, experience, motivation, compensation, workload, education and training, supervision, perceived seriousness, and perceived benefit. Cadre’s ability in the management of pregnancy risk factors is affected by attitude, experience, motivation, compensation, supervision, and early detection of pregnancy risk factorsKeywords: health cadres, early detection, management, pregnancy risk factors, path analysisCorrespondence: Istri Yuliani. Doctoral Program in Community Development/Empowerment, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: istriyuliani1@gmail.com. Mobile: 08122796697Journal of Health Policy and Management (2019), 4(1): 47-58https://doi.org/10.26911/thejhpm.2019.04.01.06

Effect of Leadership Style of the Head of the Community Health Center and Other Determinants on the Health Personnel Performance in Boyolali, Central Java David Marwandi; Endang Sutisna Sulaeman; Pawito Pawito
Journal of Health Policy and Management Vol. 5 No. 1 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Leadership in health services is needed to utilize resources efficiently, design management processes, and encourage health workers to work towards achieving common goals. The purpose of this study was to analyze the effect of leadership style of the head of community health center and other determinants on the performance of health personnel.Subjects and Method: This was an analytic observational study with a cross sectional design. The study was conducted in Boyolali, Central Java, from June to July 2019. A sample of 206 health personnel from 22 community health centers was selected for this study. The dependent variable was the performance of health personnel. The independent variables were perceived transformational leadership, perceived income, type of community health center, accreditation status, education level, tenure, training, community health center, and employee status. The data were collected by questionnaire and analyzed by a multilevel multiple linear regression run on Stata 13.Results: Health personnel performance increased with transformational leadership style (b= 2.23; 95% CI= 0.94 to 3.52; p <0.001), type of health workers (b= 1.80; 95% CI= 0.10 to 3.49; p = 0.037), and accreditation status (b= 3.01; 95% CI= 0.58 to 5.44; p= 0.015). Health personnel performance increased with education ≥Diploma III (b= 0.55; 95% CI= -1.46 to 2.56; p= 0.592), tenure ≥3 years (b= 0.05; 95% CI= -1.49 to 1.59; p = 0.947), adequate income (b= 1.16; 95% CI= -0.10 to 2.42; p= 0.072), and had attended training (b= 0.67; 95% CI= -0.68 to 2.03; p= 0.329), but they were statistically non-significant. Health personnel performance decreased with the status of civil servant (b= -1.32; 95% CI= -3.82 to 1.16; p= 0.298) and treatment status of community health center with hospitalization (b= -2.97; 95% CI = -5.03 to -0.91; p = 0.005).Conclusion: Health personnel performance increases with transformational leadership style, type of health workers, accreditation status, education ≥Diploma III, tenure ≥3 years, adequate income, and had attended training. Health personnel performance decreases with the status of civil servant and treatment status of community health center with hospitalization.Keywords: transformational leadership style, health personnel, performance.Correspondence:David Marwandi. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: david.marwandi88@gmail.com. Mobile: +6281348789393Journal of Health Policy and Management (2020), 5(1): 74-84https://doi.org/10.26911/thejhpm.2020.05.01.07

Application of Health Belief Model on Factors Affecting Participation in the National Health Insurance Scheme among Informal Sector Workers in Kudus, Central Java Anom Dwi Prakoso; Endang Sutisna Sulaeman; Arief Suryono
Journal of Health Policy and Management Vol. 5 No. 1 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Universal Health Coverage is the mandate of the Pancasila and 1945 Constitution. UHC's target on January 1st, 2019 is that all Indonesians are covered by the National Health Insurance (JKN). Meanwhile, the participation of informal workers as of May 1, 2019 only reached 57%. The cross subsidy system is not optimal and the budget deficit will continue to be experienced because there are still many citizens who have not joined JKN. This study aimed to analyze the determinants of the participation of informal workers in the national health insurance program in Kudus using the Health Belief Model.Subjects and Method: This was case control study,conducted in 5 sub-districts in Kudus Regency, Central Java from September to October 2019. Total of 200 informal workers were selected by purposive sampling, it were devided into two groups including 100 in case group and a 100 in control group. The dependent variable was the participation of informal workers in the JKN program. The independent variables were perception of vulnerability, perception of seriousness, perspective of benefits, family support, self-efficacy, and social environment. The data collection was performed using a questionnaire and data analysis with logistic regression using stata 13.Results: The participation of informal workers in the JKN program increased with knowledge of ≥Senior high school (b = 5.09; 95% CI = 0.32 to 9.87; p = 0.036), high perception of vulnerability (b = 3.01; 95% CI = 0.26 to 5.75; p = 0.031), high perceived seriousness (b= 5.38; 95% CI = 2.14 to 8.61; p= 0.001), high perceived benefit (b= 3.86; 95% CI= 0.39 to 7.34; p= 0.029), strong family support (b= 7.26; 95% CI= 2.69 to 11.82; p= 0.002), strong self-efficacy (b = 3.98; 95% CI = 0.98 to 6.98; p= 0.009) and a supportive social environment (b = 4.51; 95% CI= 1.61 to 7.40; p= 0.002).Conclusion:Knowledge, perception of vulnerability, perception of seriousness, perceived usefulness, family support and social environment influence the participation of informal workers in the JKN program.Keywords: universal health coverage, national health insurance, health belief modelCorrespondence: Anom Dwi Prakoso, Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: anomdwiprakoso@gmail.com. Mobile: +62895363054393.Journal of Health Policy and Management (2020), 5(1): 61-73https://doi.org/10.26911/thejhpm.2020.05.01.06

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