Psychosocial Factors Affecting the Performance of Community Health Center Employees

Authors

  • Nadia Fitriana Fariati Master’s Program in Public Health, Universitas Sebelas Maret
  • Setyo Sri Rahardjo Faculty of Medicine, Universitas Sebelas Maret
  • Bhisma Murti Master’s Program in Public Health, Universitas Sebelas Maret
  • Ratih Puspita Febrinasari Faculty of Medicine, Universitas Sebelas Maret
  • Anik Lestari Faculty of Medicine, Universitas Sebelas Maret

DOI:

https://doi.org/10.26911/

Abstract

Background: Community Health Centers (Puskesmas) serve as primary healthcare facilities whose effectiveness is strongly influenced by employee performance. Psychosocial factors such as motivation, leadership perception, delegation of authority, and social capital play an essential role in enhancing work effectiveness. However, unclear task distribution and suboptimal delegation practices remain common challenges that may weaken employee performance. This study aimed to examine psychosocial factors associated with employee performance in Puskesmas.

Subjects and Method: This quantitative study employed a cross-sectional design and was conducted in 17 Community Health Centers across Surakarta, Central Java, Indonesia, from June to July 2025. A total of 224 employees were selected using proportional random sampling. Data were collected using structured questionnaires that had been tested for validity and reliability. Multivariate data analysis was performed using path analysis to assess both direct and indirect relationships among variables.

Results: Employee performance was directly influenced by the delegation of authority and responsibility (b= 0.42; 95% CI = 0.32 to 0.53; p < 0.001) and motivation (b = 0.34; 95% CI = 0.23 to 0.45; p <0.001). Performance was indirectly influenced by social capital and leadership perception through motivation, as well as by motivation and leadership perception through the delegation of authority and responsibility. Length of employment, employment status, and gender showed direct but statistically non-significant effects on employee performance.

Conclusion: Employee performance in community health centers can be enhanced through effective delegation of authority and responsibility, increased motivation, positive leadership perception, and strengthened social capital. In contrast, gender, employment status, and length of employment were not significant determinants of performance

Keywords:

performance, delegation of authority, motivation, leadership perception, social capital

Published

16-01-2026

Downloads

Issue

Section

Articles

How to Cite

Psychosocial Factors Affecting the Performance of Community Health Center Employees. (2026). Journal of Health Policy and Management, 11(1), 116-127. https://doi.org/10.26911/

How to Cite

Psychosocial Factors Affecting the Performance of Community Health Center Employees. (2026). Journal of Health Policy and Management, 11(1), 116-127. https://doi.org/10.26911/

References

Al-bori M, Al-ameri A (2025). The impact of delegation of authority on employee performance at Yemeni Banks in the Capital Municipality of Sana’a. An-Najah Univ J Res. 39(8):571-588. https://doi.org/10.35552/0247.39.8.2438

Alviana C, Arini A, Respatiningsih H (2024). Pengaruh kompetensi sumber daya manusia, literasi keuangan, modal keuangan, dan modal sosial terhadap kinerja UMKM (The effect of human resource competence, financial literacy, financial capital, and social capital on UMKM performance). Eqien-J Ekon Bisnis. 11(1):171–179. https://stiemuttaqien.ac.id/ojs/index.php/OJS/article/view/660

Bakker A, Demerouti E (2017). The job demands-resources model: state of the art. J Manag Psychol. 22(3):309–328. https://doi.org/10.1108/02683940710733115

Cao Q, Chen C , Hu L, Hsiao Y (2025). Social capital and job performance: a moderated mediation model of organi¬zational citizenship behaviors and psychological capital. Behav Sci. 15(6):1–21. https://doi.org/10.3390/-bs15060714

Farah A, Dewi D, Kumalasari D, Wahyu S, Hana L (2025). Managing perform-ance with a gender perspective : analysis of career development, rewards , and punishments. Stud Ilmu Manaj Organ (SIMO). 6(2):305–316. https://doi.org/10.35912/simo.v6i2.4255

Haemmerli M, Powell-Jackson T, Goodman C, Thabrany H, Wiseman V (2021). Poor quality for the poor? A study of inequalities in service readiness and provider knowledge in Indonesian primary health care facilities. Int J Equity Health. 20(1):1–12. https://-doi.org/10.1186/s12939-021-01577-1

Kalogiannidis S (2020). Impact of effective business communication on employee performance. Eur J Bus Manag Res (EJBMR). 5(6): 1–6. https://doi.org/-10.24018/ejbmr.2020.5.6.631

Kamajaya A, Nurani N (2024). The effect of work motivation and work environ-ment on employee performance in hospitals. J Ekon. 13(03):1360-1369. https://doi.org/10.54209/ekonomi.v13i03

Kim M, Beehr TA (2023). Empowering leadership improves employees posi-tive psychological states to result in more favorable behaviors. Int J Hum Resour Manag. 34(10):2002–2038. https://doi.org/10.1080/09585192.2022.2054281

Li L, Feng Z, Zhu M, Yang J, Yang L (2024). The influencing factors of nurses job engagement in tertiary, a grade hospitals in East China: A cross-sectio¬nal study. Nurs Open. 11(9): 1–17. https://doi.org/10.1002/nop2.70037

Mathebula B, Barnard B (2020). The factors of delegation success: accountability, compliance and work quality. Expert J of Bus Manag (EJBM). 8(1):76–97. http://business.expertjournals.com76

Merga H, Fufa T (2019). Impacts of working environment and benefits packages on the health professionals job satisfact¬ion in selected public health facilities in eastern Ethiopia: Using principal component analysis. BMC Health Serv Res. 19(1):1–8. https://doi.org/10.¬1186/s12913-019-4317-5

Moradi T, Rezaei M, Alavi N (2024). Delegating care as a double-edged sword for quality of nursing care: a qualitative study. BMC Health Serv Res. 24(1):1–12. https://doi.org/10.-1186/s12913-024-11054-4

Norasiah, Sugiati T (2025). The Influence of independence and task complexity on auditor performance with job satis¬faction as a mediating variable. Eduvest J Univ Stud. 5(7):81–90. https://doi.org/10.59188/eduvest.v5i7.51510

Pomaranik W, Kludacz-Alessandri M (2024). Talent management practices and other factors affecting employee performance in the public healthcare sector in Poland: an empirical study using structural equation modelling. BMC Health Serv Res. 24(1):1-16. https://doi.org/10.1186/s12913-024-12169-4

Pramudito D, Widjaja G (2022). Tanggung jawab hukum dalam pelimpahan wewenang beda profesi kesehatan (Legal responsibility in the delegation of authority between health profess-ions). J Cross-Border. 5(1):365–384. https://journal.iaisambas.ac.id/index.php/Cross-Border/article/view/1091

Pratama I, Juhari A, Zulqornain I (2024). Pengaruh gaya kepemimpinan dele-gatif dan motivasi terhadap kinerja karyawan pada PT. Berkat Anugerah Mulia Bekasi (The effect of delegative leadership style and motivation on employee performance at PT. Berkat Anugerah Mulia Bekasi). J Ilm Manaj Kewirausah. 04(2):114–123. https://-doi.org/10.71277/83a1v497

Rajabi S, Hasanzadehtabrizi M (2025). Social and psychological capitals impact on employee performance at Kerman university of medical sci-ences. Discov Psychol. 5(1):1-14. https://doi.org/10.1007/s44202-025-00377-w

Shah M, Kazmi S, Anjum B (2020). The impact of delegation of authority on job satisfaction, job performance and organizational growth at higher educa¬tional institutions in Sindh. J Glob Soc Sci Rev (GSSR). 5(3):32–45. https://-doi.org/10.31703/gssr.2020(v-iii).04

Thirikwa P, Mwangi E, Njoroge K (2024). Influence of short-term employment contracts on performance of health care workers at Nakuru County level 4 and 5 public hospitals. Int J Health Med Nurs Pract. 6(6):31–51. https://-doi.org/10.47941/ijhmnp.2212

Tomizh H, Saadon M, Nordin A, Almahas-neh Y (2022). The mediating effect of job satisfaction on the relationship between the delegation of authority and the performance of employees. J Corp Gov Organ Behav Rev. 6(4):100–109. https://doi.org/10.22495/cgobr-v6i4p9

Ugoani J (2020). Effective delegation and its impact on employee performance. Int J Econ Bus Adm. 6(3):78–87. http:-//www.aiscience.org/journal/ijeba

Van Tuin L, Schaufeli W, Van den Broeck A (2021). Engaging leadership: Enhan-cing work engagement through intrin¬sic values and need satisfaction. Hum Resour Dev Q. 32(4):483–505. https:¬//doi.org/10.1002/hrdq.21430

Wang Y (2023). Empowering leadership: A conflict resolver and a performance booster for organizations. PLoS ONE. 18(11):1–17. https://doi.org/10.1371/-journal.pone.0294351

Wider W, Fauzi M A, Kasim N M, Yusuf M, Siti A, Quyume S, Cloyd M, Hossain S (2025). The impact of online social capital on innovative job performance: mediated by work engagement. Discov Sustain 6(1):1-15. https://doi.org/10.¬1007/s43621-025-01224-7