Exploring Readiness for Change among Community Health Cadres in Indonesia’s Minimum Service Standards Program: A Path Analysis

Ani Afifah (Master’s Program in Public Health, Universitas Sebelas Maret)
Revi Gama Hatta Novika (Master’s Program in Public Health, Universitas Sebelas Maret, Indonesia)
Setyo Sri Rahardjo (Department of Pharmacology, Universitas Sebelas Maret, Indonesia)
Eti Poncorini Pamungkasari (Department of Public Health, Universitas Sebelas Maret, Indonesia)
Anik Lestari (Department of Public Health, Universitas Sebelas Maret, Indonesia)

Journal of Health Policy and Management
Vol. 11 No. 2 (2026)

Background: The increasing workload of integrated health service post cadres in implementing the six minimum service standards has not been fully accompanied by adequate cadre readiness. This condition may affect the optimization of the community-based integrated health service post service quality. This study aimed to analyze the effects of perceived program feasibility, perceived benefits, perceived management support, and self-efficacy on cadre readiness in implementing the six minimum service standards. Subjects and Method: This analytic observational study used a cross-sectional design conducted in Sragen Regency, Central Java, Indonesia, from February to March 2026. A total of 217 active Integrated Health Service Post cadres were selected using purposive sampling from 25 primary healthcare centers. The dependent variable was cadre readiness, while the independent variables included perceived program feasibility, perceived benefits, perceived management support, and self-efficacy. Data were collected using a structured and validated questionnaire developed from the Organizational Readiness for Change framework. Data were analyzed using descriptive statistics, bivariate linear regression, and multivariate path analysis with STATA. Results: Self-efficacy had a direct and significant effect on cadre readiness (b=0.45; 95% CI=0.34 to 0.53; p<0.001). Perceived benefits also had a direct and significant effect on cadre readiness (b=0.34; 95% CI=0.26 to 0.42; p<0.001). Regarding indirect effects through self-efficacy, perceived program feasibility had a significant indirect effect on cadre readiness (b=0.37; 95% CI=0.15 to 0.59; p=0.001). Perceived benefits also showed a significant indirect effect (b=0.29; 95% CI=0.12 to 0.46; p=0.001), as did perceived management support (b=0.16; 95% CI=0.04 to 0.28; p=0.009). Conclusion: Cadre readiness to implement the six MSS is influenced by perceived program feasibility, perceived benefits, management support, and self-efficacy. Strengthening organizational support and cadre capacity is essential for successful implementation.