<![CDATA[ABSTRACTPurpose—This study aims to examine the effects of Perceived Organisational Support (POS) and Leader-Member Exchange (LMX) on employee performance, with work engagement serving as a mediating variable among health workers in public health facilities in Medan.Method – This study employed a quantitative approach. The population consisted of health workers from 41 public health facilities in Medan. A total of 180 respondents were selected using a convenience sampling technique. Data were collected through questionnaires, interviews, and documentation. The data were analysed using Structural Equation Modelling (SEM) with SmartPLS 3.0.Results – The findings reveal that Perceived Organisational Support (POS) has a significant positive effect on employee performance and work engagement. Likewise, Leader-Member Exchange (LMX) significantly influences employee performance and work engagement. In addition, work engagement has a significant positive effect on employee performance. The mediation analysis further indicates that work engagement significantly mediates the relationships between POS and employee performance, and between LMX and employee performance.Originality/Novelty – This study offers a research model that integrates POS, LMX, work engagement, and employee performance in the context of public health services. It also highlights the mediating role of work engagement in explaining how organisational support and leader-member relationships contribute to better employee performance.Implications – theoretically, this study contributes to the employee performance literature by highlighting work engagement as a mediating mechanism linking perceived organisational support and leader-member exchange to employee performance. Practically, the findings suggest that public health institutions can improve human resource effectiveness and service quality by strengthening organisational support and fostering high-quality leader-employee relationships.]]>
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