e-ISSN: 2549-0281 Publisher: Masters Program in Public Health, Sebelas Maret University, Jl. Ir Sutami 36A, Surakarta 57126, Central Java, Indonesia Editor in Chief: Prof. Ari Natalia Probandari, dr., M.P.H., Ph.D Sebelas Maret University, Solo, Indonesia Aim and Scope The Journal of Health Policy and Management (JHPM) is a peer-reviewed, open-access international journal that publishes original research articles, systematic reviews, and meta-analyses on a four-monthly basis. Since its establishment on October 21, 2015, JHPM has served as a critical platform for disseminating high-quality, policy-relevant research that informs and influences health care systems and public health governance worldwide. JHPM provides a forum for researchers, policy-makers, health care managers, public health professionals, and academics to engage with evidence-based insights into the formulation, implementation, and evaluation of health policy and management practices. The journal embraces multidisciplinary and integrative approaches to better understand complex health challenges and generate innovative, actionable solutions. The scope of JHPM spans a wide array of topics, including but not limited to: Health policy development and analysis Health systems management and governance Health economics and financing Epidemiological research with policy implications Public and social policy in health Strategic health planning and administration Equity and access in health care delivery Ethical and philosophical dimensions of health policy Global health policy and comparative health systems JHPM welcomes rigorous research from scholars and practitioners across the globe, with a strong emphasis on contributions from low- and middle-income countries (LMICs). We especially encourage submissions that address urgent health system issues, propose innovative models of care, or evaluate health policy impacts in diverse settings. By promoting dialogue across disciplines and geographies, the Journal of Health Policy and Management aims to foster practical knowledge, inform policy decisions, and support the advancement of efficient, equitable, and sustainable health systems worldwide.
Masters Program in Public Health, Sebelas Maret University
Association Between Pharmacy Staff Communication Interaction Quality and Outpatient Satisfaction at ‘Aisyiyah Bojonegoro Hospital
Background: The quality of communication interaction between pharmacy staff and patients is a critical component of healthcare service delivery. Effective communication enhances patient understanding, comfort, and trust, which ultimately influence patient satisfaction. A preliminary assessment at ‘Aisyiyah Bojonegoro Hospital indicated varying levels of patient satisfaction with pharmaceutical services, suggesting potential gaps in communication quality and service performance. Subjects and Method: This study aimed to analyze the association between the quality of communication interaction among pharmacy staff and outpatient satisfaction at ‘Aisyiyah Bojonegoro Hospital. An analytical quantitative study with a cross-sectional design was conducted. A total of 377 outpatients were selected as the sample. Data were collected using structured questionnaires and analyzed using Spearman rho correlation and multiple logistic regression. Results: Bivariate analysis showed a significant relationship between communication interaction quality and patient satisfaction (p < 0.001; r = 0.514), indicating a moderate to strong positive correlation. Multivariate analysis demonstrated that communication quality remained a significant predictor of patient satisfaction (OR = 0.61; 95% CI = 0.39–0.96; p = 0.033), while other variables such as age, education level, gender, and marital status were not statistically significant. Conclusion: There is a significant association between the quality of communication interaction of pharmacy staff and outpatient satisfaction. Communication quality is a key determinant of patient satisfaction. Therefore, improving interpersonal communication skills through training and continuous evaluation is essential to enhance service quality.
Copyright (c) 2026 Journal of Health Policy and Management
Evaluation of the Implementation of the Hospital Management Information System at Sentra Medika Hospital, Cikarang
Background: Sentra Medika Cikarang Hospital migrated from Avicenna to Teramedic in December 2024. Initial evaluations revealed infrastructure constraints, user literacy, and interface complexity that impacted system effectiveness. Objective: To measure the effectiveness of the implementation of Teramedic SIMRS through quantitative and qualitative analysis, and to formulate optimization recommendations. Subjects and Method: Convergent mixed methods design: cross-sectional survey (n = 111 respondents) for variables of wait time, data accuracy, interface, organizational support, satisfaction; and in-depth interviews with 15 key informants from IT, inpatient, medical records, pharmacy, and HR units. Quantitative data were analyzed using descriptive statistics, paired t-tests, and multiple linear regression. Qualitative data were analyzed thematically. Results: The survey showed an average reduction in clinical data wait time from 110 (SD= 15) to 86 (SD= 12) minutes (p < 0.001), an increase in medical record accuracy from 92% to 97% (p < 0.01), and an average user satisfaction score of 4.1/5. Regression analysis confirmed that digital literacy ( β = 0.45, p <0.001) and organizational support (β= 0.37, p < 0.001) significantly influenced satisfaction. Qualitative findings identified four main themes: infrastructure challenges (power outages, network), user adaptation and training, UX/UI design, and module integration. Conclusion: Teramedic SIMRS improves efficiency and data quality, but infrastructure and interface barriers need to be addressed through UPS upgrades, redundant networks, ongoing e-learning modules, and periodic UX/UI audits.
Factors Affecting Job Satisfaction and Performance of Health Workers at Community Health
Background: Motivation, leadership, career development, and rewards or incentives are important determinants of job satisfaction and performance among healthcare workers at Community Health Centers (CHCs). This study aimed to analyze and estimate the association between motivation, leadership, career development, rewards/incentives, job satisfaction, and the performance of healthcare workers. Subjects and Method: This was a cross-sectional study involving 200 healthcare workers from CHCs in Kerinci Regency, Jambi Province, conducted from October to November 2024. Samples were selected using accidental sampling. The dependent variable was health worker performance, the mediating variable was job satisfaction, and the independent variables were motivation, leadership, career development, and rewards/incentives. Data were collected using structured questionnaires and analyzed using path analysis. Results: Healthcare workers with high motivation were more likely to perform well than those with low motivation (b=0.31; CI 95%=0.18 to 0.45; p<0.001). Healthcare workers with high job satisfaction were more likely to perform well than those with low job satisfaction (b=0.43; CI 95%=0.30 to 0.46; p<0.001). Healthcare workers with high job satisfaction were more likely to be well motivated than those with low job satisfaction (b=0.21; CI 95%=0.13 to 0.29; p<0.001). Health workers who had a positive perception of leadership were more likely to be satisfied with their work than with a negative perception (b=0.74; CI 95%=0.68 to 0.80; p<0.001). Conclusion: The performance of healthcare workers in CHCs was directly affected by motivation and job satisfaction. Higher motivation and job satisfaction were associated with improved health worker performance.
Copyright (c) 2025 Journal of Health Policy and Management
Meta-Analysis: Exploring the Impact of Marital Status, Work Environment Conditions, Education, Gender, and Age on Job Satisfaction among Healthcare Professionals
Background: Health is a very complex field because it focuses on healthcare providers. The quality of healthcare can be determined through the job satisfaction of healthcare workers. Factors that can affect the job satisfaction of healthcare workers can be assessed based on marital status, working conditions, education, gender, and age. The purpose of this study was to estimate the effect of marital status, working conditions, education, gender, and age on job satisfaction among healthcare workers. Subjects and Method: A meta-analysis study was conducted in accordance with the PRISMA flow chart and PICO model. Population: healthcare workers. Intervention: female, >30 years old, bachelor's degree, single, and good working environment. Comparison: male, <30 years old, diploma, married, and poor working environment. Outcome: job satisfaction. Data were obtained from the Google Scholar, PubMed, BMC, ScienceDirect, Elsevier, and Springer Link databases. The keywords used were “gender” AND “age” AND ‘education’ AND “marital status” AND “work environment” AND “job satisfaction” AND “health workers” AND “cross-sectional” AND “aOR”. Data analysis was performed using Review Manager 5.3 software. Results: This meta-analysis included 12 cross-sectional studies from Myanmar and Ethiopia. The sample size was 3,962 health workers. Marital status (aOR= 1.43; 95% CI= 1.03 to 2.00; p= 0.003) and good working conditions (aOR= 1.55; 95%CI= 1.18 to 2.04; p= 0.002) significantly increased job satisfaction among health workers. Bachelor's degree (aOR= 1.51; 95% CI= 0.53 to 4.83; p= 0.400), female gender (aOR= 1.34; 95% CI= 0.87 to 2.05; p= 0.180), and age >30 years (aOR= 1.81; 95% CI= 0.81 to 4.09; p= 0.150) increased job satisfaction among healthcare workers but were not statistically significant. Conclusion: Marital status, work environment conditions, education level, gender, and age affect job satisfaction in health workers.
Evaluation of Anesthesia Management Care in the Central Surgical Installation
Background: Effective anesthesia management is essential to ensure patient safety, minimize perioperative complications, and promote optimal recovery. Comprehensive planning across the pre-, intra-, and postoperative phases allows anesthesiologists to deliver systematic and high-quality care. Evaluating each component of anesthesia services context, input, process, product, and outcome is crucial for maintaining professional standards and improving patient satisfaction. Therefore, this study aimed to evaluate anesthesia care arrangements (pre-, intra-, and postoperative) at the Central Surgical Installation of dr. Soepraoen Kesdam V/Brawijaya Malang Hospital using the CIPP evaluation model. Subjects and Method: This qualitative evaluative study was conducted from June 1 to July 1, 2024, employing the Context, Input, Process, and Product (CIPP) framework. Five anesthesiologists were selected through probability sampling. Data were collected through in-depth interviews, direct observations, document reviews, and Focus Group Discussions, and analyzed through data reduction, classifica­tion, and interpretation. Results: Evaluation of the context and input components showed that anesthesia services complied with professional standards and ASKAN guidelines, supported by adequate human resources, infrastructure, and standard operating procedures. The process component including assessment, diagnosis, intervention, implementation, evaluation, and documentation was implemented adequately but not fully aligned with the ASKAN guidelines. Product evaluation indicated satisfactory documentation quality with partial conformity to the 2023 ASKAN edition. The outcome showed stable patient hemodynamics and high satisfaction levels. Conclusion: Context and input components were well-implemented, while process and product evaluations were adequate but require improved documentation to align with the latest ASKAN standards.
The Influence of Servqual Indicators in Measuring Health Service Quality and Patient Satisfaction
Background: Health services are organized efforts by individuals or institutions to prevent and treat diseases, restore health, and improve community well-being. Both government and private healthcare institutions play a crucial role in ensuring accessible and high-quality services. The quality of health services is a key determinant of patient satisfaction. This study aimed to assess the SERVQUAL indicators in measuring the quality of health services and patient satisfaction at Diponegoro National Hospital. Subjects and Method: A cross-sectional study was conducted at Diponegoro National Hospital, Semarang, in July 2024. A total of 200 patients were recruited using accidental sampling. The dependent variables were service quality and patient satisfaction, while the independent variables included age, education, gender, and financing method. Data were collected using structured questionnaires and analyzed through path analysis. Results: The concept of service quality was represented by SERVQUAL indicators: reliability (b= 0.61; 95% CI= 0.46–0.76; p<0.001), assurance (b= 0.50; 95% CI= 0.35–0.64; p<0.001), tangibles (b= 0.67; 95% CI= 0.56–0.78; p<0.001), and responsiveness (b= 0.66; 95% CI= 0.46–0.76; p<0.001). Patient satisfaction showed a positive structural relationship with service quality (b= 0.31; 95% CI= 0.07–0.55; p= 0.012). The financing method also affected satisfaction, with insured (BPJS) patients reporting higher satisfaction than general patients (b= 0.15; 95% CI= 0.02–0.27; p= 0.015). Conclusion: Health service quality is defined by multiple SERVQUAL indicators, including reliability, assurance, tangibles, empathy, and responsiveness. Patient satisfaction is positively associated with service quality and influenced by the financing method, indicating the importance of equitable and high-quality healthcare delivery
Impact of Safety Climate on Workers' Safety Practices in the Textile Industry
Background: The textile industry has high risks related to occupational safety and health (OSH), so work accidents often occur. The number of accidents in Indonesia is increasing from year to year. One of the methods to overcome this problem is the implementation of the Occupational Safety and Health Management System. In addition, the safety climate and safety behavior are important indicators in reducing work accidents. This study aims to analyze the influence of the safety climate on safety behavior in the textile industry. Subjects and Method: This was a cross-sectional study conducted in 2 textile companies located in Surakarta and Semarang, in June-August 2024. A sample of 200 workers was selected using simple random sampling. The dependent variable was safety behavior. The independent variables were safety climate, working period and education level. Data collection was carried out using questionnaires and data was analyzed using path analysis. Results: Safety behavior was positively influenced by condusive climate (OR= 5.04; 95% CI= 1.68 to 15.13; p= 0.004), implementing occupational health and safety management system (OR= 55.48; 95% CI= 18.26 to 168.53; p < 0.001), high education (OR= 2.18; 95% CI= 0.99 to 4.81; p= 0.052), and long tenure (OR= 2.78; 95% CI= 0.97 to 7.97; p= 0.056). Conclusion: Safety behavior is positively influenced by condusive climate, implementing occupational health and safety management system, high education, and long tenure.
Effect of Marketing Mix (Product, Place, Promotion, and Price) on Outpatient Patient Satisfaction at Nur Hidayah Hospital, Bantul
Background: Patient satisfaction is an indicator of how well a patient is treated in medical practice, from the point of view of service quality and from how happy the patient is with the services provided. One of the marketing strategies that can be used is the 4P marketing mix that includes a combination of variables or core activities in the marketing system, such as products, distribution, promotions, and prices. This study aimed to analyze the effect of 4P marketing mix strategy on patient satisfaction. Subjects and Method: A cross-sectional study was conducted at Nur Hidayah Hospital, Bantul, Yogyakarta, Indonesia. A sample of 203 patients selected using a simple random sampling. The dependent variable was patient satisfaction. The independent variables were product, place, promotion, and price. Data collection was carried out using a questionnaire and analyzed by path analysis using the STATA 13 application. Results: Marketing mix strategy directly increased patient satisfaction (b= 0.92; 95% CI= 0.87 to 0.98; p<0.001). Product (b= 0.63; 95% CI= 0.54 to 0.72; p <0.001), place (b = 0.52; 95% CI = 0.41 to 0.63; p<0.001), promotion (b = 0.65; 95% CI = 0.55 to 0.74; p<0.001), and price (b= 0.76; 95% CI= 0.68 to 0.83; p<0.001) showed positive and significant loadings, indicating that all four components are strong constructs representing the marketing mix strategy. Conclusion: Marketing mix strategy directly increases patient satisfaction.
Analyzing the Impact of Job Stress, Workload, and Job Satisfaction on Nurse Performance: A Path Analysis
Background: Good performance can help hospitals make profits and maintain the sustainability of their business, and vice versa, a decreased performance can certainly be detrimental to hospitals. Nurses are always required to provide good service even under high pressure, with a large number of patient visits and standard procedures that should not be missed. This study aims to analyze the effect of job stress, workload, and job satisfaction on the nurses’ performance in the inpatient ward of dr. Sayidiman Magetan Hospital, East Java, Indonesia. Subjects and Method: It was an observational analytical study with a cross-sectional approach using a path analysis model. The population in this study was all nurses in the inpatient ward of dr. Sayidiman Magetan Hospital, East Java, Indonesia. The sample in this study was nurses at dr. Sayidiman Magetan Hospital, East Java, Indonesia. The ratio between the number of subjects in a study and the number of independent variables in multivariate analysis is recommended to be 15 to 20 subjects per independent variable. Therefore, the total number of study subjects in this study was 200 people. The study used the simple random sampling technique. The variables in this study were dependent variables and independent variables. The dependent variables included performance, while the independent variables included job stress, workload, and job satisfaction. Results: Nurses' performance in hospital inpatient ward improved with better job satisfaction (b= 0.19; CI 95%= 0.05 to 0.32; p = 0.006) and higher job stress (b = 0.13; CI 95%= -0.01 to 0.26; p = 0.066). Nurses’ performance decreased with heavier workload (b= -0.16; CI 95%= -0.29 to -0.03; p = 0.017). This path analysis model had a good model fit, which was indicated by the following model fit indicators: p = 0.294; RMSEA= 0.034; CFI = 0.98; TLI= 0.92; SRMR= 0.029. Conclusion: Nurses' performance in the hospital inpatient ward improves with better job satisfaction and higher job stress. Nurses' performance decreases with heavier workloads. This path analysis model has good model suitability
The Influences of Leadership, Job Satisfaction, and Work Environment on the Performance of Health Workers
Background: Creating good and quality health services is inseparable from the performance of health workers which can affect the level of patient satisfaction. This study aims to determine the influence of perceived leadership, job satisfaction, and work environment on the performance of health workers at dr. Soediran Mangun Sumarso Hospital. Subjects and Method: The study was conducted with a cross-sectional study design. The approach used was an analytical observational model with a sample size of 200 health workers. This study was conducted at dr. Soediran Mangun Sumarso Hospital, Wonogiri Regency in November-December 2023. A sample of 200 health workers was selected using stratified random sampling. The dependent variable in this study was the performance of health workers. Meanwhile, the independent variables in this study were perceived leadership, job satisfaction, work environment, age, and length of working. Data collection was carried out using questionnaires, and the data were analyzed using a double linear regression analysis model. Results: Each 1 unit increase in the leadership score would be followed by an increase in performance score (b= 0.33; CI 95%= 0.21 to 0.45; p<0.001), job satisfaction (b= 0.14; CI 95%= 0.06 to 0.21; p<0.001), work environment (b= 0.26; CI 95%= 0.06 to 0.46; p=0.010), age ≥37 years (b= 0.19; CI 95%= -0.90 to 1.29; p=0.728), length of working ≥10 years (b= 0.94; CI 95%= -0.16 to 2.04; p=0.093). Conclusion: There is an influence of leadership, job satisfaction, work environment, age, and length of working on the performance of health workers at Dr. Soediran Mangun Sumarso Hospital, Wonogiri.
Factors Related with Work Stress in Informal Industrial Workers in Surakarta
Background: The risk of Occupational Diseases that often occurs in the informal industry is work stress. Work stress is not only caused by internal factors, but also caused by social factors from workers. This study aims to analyze and estimate the influence of social capital and other factors on work stress in informal industrial workers in the city of Surakarta. Subjects and Method: This study uses a cross-sectional study conducted on informal industry workers in Surakarta, Central Java, Indonesia, in April-May 2024. The number of study subjects was 210 people selected with a simple random sampling. The dependent variable was work stress. The independent variables were social capital, income, target achievement and capital borrowing status. Independent variable study data was taken using a questionnaire measuring tool, and for work stress using the Work Stress Questionnaire (WSQ). Data analysis in the form of multiple linear regression using Stata 13. Results: There was an effect of social capital (b= -1.38; 95% CI= -1.86 to -0.89; p<0.001), income (b= -0.56; 95% CI= -0.89 to -0.22; p=0.001), target achievement (b= -19.73; 95% CI= -23.59 to -15.89; p= 0.012) and capital borrowing status (b= 4.24; 95% CI = 0.95 to 7.52; p= 0.012) on work stress. Conclusion: Work stress is significantly affected by social capital, income, target achievement and borrowing status.
Associations between Reliability, Assurance, Physical Evidence, Responsiveness, Empathy, Gender, and Income with Inpatient Satisfaction in Yos Sudarso Hospital, Padang, Indonesia
Background: Patient satisfaction refers to the patient's perception and assessment of the quality of health services he receives. There are many factors that affect patient satisfaction. This study aims to analyze variables that affect patient satisfaction. Subjects and Method: This study is an observational analytical study with a cross-sectional design. This research was conducted on Yos Sudarso Hospital, Padang City, in March-May 2024. A sample of 200 patients was selected by simple random sampling. The dependent variable in this study is patient satisfaction. The independent variables in the study were reliability, guarantee, physical evidence, responsiveness, empathy, gender, and income. Data collection was carried out using a questionnaire and analyzed by path analysis. Results: Patient satisfaction in the health center was influenced by reliability ((b= 0.51; 95% CI= 0.39 to 0.62; p<0.001)), assurance (b= 0.62; 95% CI= 0.52 to 0.72; p<0.001), physical evidence (b= 0.52; 95% CI= 0.41 to 0.64; p<0.001), responsiveness (b= 0.69; 95% CI= 0.60 to 0.78; p<0.001), empathy (b= 0.69; 95% CI= 0.60 to 0.78; p<0.001), gender (b = 0.15; 95% CI = <0.01 to 0.30; p = 0.047), and income (b = -0.31; 95% CI = -0.45 to -0.17; p<0.001). Conclusion: Patient satisfaction is positively influenced by reliability, assurance, physical evidence, responsiveness, empathy, gender, and income.
The Influence of Social Capital, Commitment, Justice, Employee Status, Age, Gender, and Community Health Center Strata on Performance at the Metro, Lampung, Indonesia
Background: The performance of health workers is one of the biggest reasons for the good health services. Various factors affect employee performance such as commitment, employee status, justice and social capital. This study aims to see the influence of social capital along with other accompanying factors such as justice, organizational commitment, employee status, and strata of the Health Center on the performance of Health Center employees. Subjects and Method: This study is an observational analytical study with a cross-sectional design. This research was conducted on 11 health centers in Metro City, Lampung, Indonesia in April - May 2024. A sample of 200 health center employees was selected by simple random sampling. The dependent variable in this study is the performance of health center employees. The independent variables in the study were social capital, fairness, organizational commitment, employee status, health center strata, age, and gender. Data collection was carried out using a questionnaire and analyzed by multiple linear regression. Results: Social capital (b= 0.07; CI 95%= 0.06 to 0.14; p= 0.048), justice (b= 0.13; CI 95%= 0.06 to 0.20; p= <0.001), organizational commitment (b= 0.10; CI 95%= 0.02 to 0.17; p= 0.012), and the strata of the Health Center (b= 1.01; CI 95%= 0.62 to 1.41; p= <0.001) has an influence on improving performance and is statistically significant. Officer status (b= -0.28; CI 95%= -0.56 to -0.01; p= 0.038) had a degrading effect and was statistically significant. Age (b= -0.13; CI 95%= -0.39 to 0.11; p= 0.284) and gender (b= 0.06; CI 95%= -0.35 to 0.11; p= 0.750) has no significant effect on performance. Conclusion: The performance of health center employees is influenced by social capital, justice, organizational commitment, strata, and employee status. Age and gender are not factors that affect performance.
The Relationship between The Use of Mobile JKN Application and Health Services at Majene Regency Hospital
Background: This study is motivated by the digital transformation of BPJS Kesehatan services through the Mobile JKN application to improve the accessibility and efficiency of health services. The purpose of this study is to determine the relationship between the use of the Mobile JKN application and health services at the Majene Regency Hospital. Subjects and Method: This study is a cross sectional study design using a quantitative approach and data collection through a questionnaire conducted at the Majene Regency Hospital, in August-September 2024. The total sample is 100 respondents with a sampling technique, namely purposive sampling. The study subjects were patients who used the JKN mobile application. The independent variable is health services. The intermediate variable is the Mobile JKN application. The dependent variable is satisfaction. The data was analyzed using the Wilcoxon test to see the difference in the level of satisfaction and service quality before and after the use of the Mobile JKN application. Results: The results of the study showed that 91.6% of respondents used the Mobile JKN application, with a significant increase in satisfaction with health services, from an average score of 3,010 to 3,972 after using the application. The use of applications also has an impact on time efficiency and ease of access to health services. The average score of health services (Queue) was higher after the use of the Mobile JKN Application (Mean=4,209; SD=0.645) compared to before (Mean=3.484; SD=0.688), and this result is statistically significant (p=0.000). The health service satisfaction score was higher after using the JKN mobile application (Mean=3,972; SD=0.524) compared to before (Mean=3.010 ; SD=0.522), and this result was statistically significant (p=0.000). Conclusion: There is a positive relationship between the use of the Mobile JKN application and the improvement of the quality and satisfaction of health services at the Majene Regency Hospital.
Analysis of BPJS Mandiri Participant Contribution Payment Compliance Inpatient Service Fines at Dr Mohamad Saleh Probolinggo Regional Hospital
Background: The National Health Insurance Program (JKN) through BPJS Kesehatan is an initiative to equalize the quality of health services for all levels of society. Contributions are an essential factor in the success of a national social security system. The importance of paying BPJS contributions regularly is so that participants get adequate health service guarantees. The study aims to analyze the compliance of BPJS Mandiri participant contribution payments who are subject to inpatient service fines at Dr. Mohamad Saleh Probolinggo Regional Hospital. Subjects and Method: An observational study with a cross-sectional approach was conducted in the inpatient unit of Dr. Mohamad Saleh Hospital, Probolinggo, in May and June 2023. A total of 100 patients were selected for this study. The dependent variable was compliance. The independent variables were knowledge, income, number of family members, perception of illness, access to health services. Data were collected using a questionnaire and analyzed using factor analysis, t-test, f-test and multiple linear regression. Results: The regression coefficient of knowledge variable is 0.018, income is 0.823, number of family members is 0.375, perception of illness is -0.021, access to health services is -0.128. Compliance of contribution payments is influenced by income variable with sig 0.002, number of family members with sig (0.000) and access to health services with sig (0.007). Conclusion: Compliance in payment of BPJS Mandiri participants who are subject to inpatient service fines is influenced by income, number of family members, access to health services. The most dominant factor is income.
Policy Response to Substance Abuse in Selected Higher and Tertiary Education Institutions: A Comparative Review
Background: Substance abuse in Higher and Tertiary Education Institutions (HTEIs) poses a serious threat to students’ academic achievement, mental well-being, and campus safety. Although various interventions have been introduced, the effectiveness of existing policies remains inconsistent. This study compared global literature on school-related substance abuse policies with policy responses in selected Copperbelt HTEIs in Zambia to inform the development of contextually appropriate strategies for substance abuse reduction. Subjects and Method: The study applied the Protocol, Search, Appraisal, Synthesis, and Reporting (PSALAR) framework, guided by the Population, Interest, and Context (PICo) approach. Two colleges and one university in Zambia’s Copperbelt Province were purposively selected, and an exhaustive online search was conducted to identify institutional policies addressing substance abuse. Peer-reviewed English articles (2013–2023) focusing on punitive and remedial school-based policies were reviewed. Inclusion criteria for HTEIs were adapted to align with the PSALAR framework. Results: Three major themes emerged: (1) policy deficiencies and implementation gaps, (2) punitive versus remedial interventions, and (3) limited monitoring and evaluation mechanisms. The dominant issue was finding an effective balance between punitive and supportive policy approaches. The integration of substance abuse education within institutional frameworks was weak, and evidence on the relative effectiveness of punitive versus remedial measures remained inconclusive. Conclusion: Substance abuse policies in Zambian HTEIs predominantly emphasize punitive responses, with insufficient attention to remedial or preventive efforts. Strengthening evidence-based, context-specific, and student-centered policies is essential to reduce substance abuse and advance Zambia’s progress toward Sustainable Development Goal 3.5 by 2030.
Factors Influencing the Health Workers Performance in Community Health Center in Metro, Lampung
Background: Performance is the result of a person's ability to complete tasks and responsibilities competitively. There are many factors that affect a person's performance, each of which affects their own performance. This study aims to analyze the variables that affect the performance of health center employees. Subjects and Method: This study is an observational analytical study with a cross-sectional design. This research was conducted on 11 health centers in Metro City, Lampung in March-April 2024. A sample of 200 health center employees was selected by simple random sampling. The dependent variable in this study is the performance of health center employees. The independent variables in the study were age, training, incentives, motivation, leadership perceptions, and the strata of the health center. Data collection was carried out using a questionnaire and analyzed by multiple linear regression. Results: Employee performance in service at the health center was influenced by age (b= -0.01; CI 95%= -0.01 to -0.02; p= 0.008), training (b=1.08; CI 95%= 1.03 to 1.13; p< 0.001), incentives (b= 1.02; CI 95%= 0.98 to 1.05; p< 0.001), motivation (b= 1.16; CI 95%= 1.08 to 1.22; p<0.001), leadership perception (b= 0.98; CI 95%= 0.93 to 1.03; p<0.001), and the strata of the health center (b= 0.33; CI 95%= 0.10 to 0.54; p=0.003). Conclusion: The performance of health center employees is positively influenced by age, training, incentives, motivation, leadership perception, and strata of the health center.
Path Analysis: Characteristics of Health Service Providers on the Quality of Dental and Oral Health Services
Background: Dental and oral health play a crucial role in improving people’s quality of life. Optimal efforts from dental and oral health workers are essential to achieve better health outcomes. This study aimed to analyze the influence of service provider determinants on the quality of dental and oral health services in hospitals. Subjects and Method: A cross-sectional study was conducted in Semarang City from March to April 2024. A total of 200 patients aged 20–59 years were selected using systematic random sampling. The dependent variable was the quality of dental and oral health services, while the independent variables were motivation, performance, and payment method. Data were analyzed using path analysis. Results: Motivation positively affected the performance of health workers (b=0.99; 95% CI=0.98–1.00; p<0.001). Performance had a significant positive effect on service quality (b=0.44; 95% CI=0.06–0.83; p=0.023). Motivation also directly influenced service quality (b=0.47; 95% CI=0.08–0.85; p=0.017). However, the difference in payment method between patients paying directly and those using BPJS did not significantly affect service quality (b=0.03; 95% CI=–0.03 to 0.09; p=0.415). Conclusion: The quality of dental and oral health services at Diponegoro National Hospital Semarang is significantly influenced by the motivation and performance of health workers, with performance mediating the effect of motivation. Payment method does not significantly influence perceived service quality.
Determinants of Health Worker Performance in Health Care Facilities: Meta-Analysis
Background: Performance is the result of a certain process carried out by all components of the organization on certain resources used. In addition, performance affects organizational goals. This study aims to analyze the influence of training, education level, and gender on performance in health workers. Subject and Method: This study is a systematic study and meta-analysis, with the following PICO : Population = Health workers, Intervention = Training, Higher education level, Female, Comparison = No training, Low education level, Male, Outcome = Performance. The articles used in this study were obtained from several databases, including Google Scholar, PubMed, and ScienceDirect which were published from 2014 to 2024. These articles were collected over a period of 4 weeks. The keywords used by the researcher in searching the database include Community Health Workers OR CHW AND Job Performance OR Work Performance AND Training AND Education Level AND Gender OR Sex. The articles included in this study are full-text articles with a cross sectional study design. Articles are collected using PRISMA flow diagrams. Articles are analyzed using the Review Manager 5.3 application. Results: A total of 14 articles were reviewed in this meta-analysis study from Malaysia, China, India, Ethiopia, Uganda, Cameroon and Ghana. Studies show that healthcare workers with training (aOR=2.94; CI 95%= 1.33 to 6.46; p= 0.007), higher education level (aOR=2.16; CI 95%= 1.62 to 2.88; p<0.001) had a significant influence on performance. Meanwhile, women (aOR=0.92; CI 95%= 0.57 to 1.49; p=0.75) had an insignificant effect on performance. Conclusion: Training and higher education levels can significantly improve performance in health workers, and statistically insignificant performance differences between men and women, women have the possibility of performing well.
Meta-Analysis: Effects of Computer Skill and Management Support on Readiness to Use Electronic Medical Record in Health Workers
Background: Electronic Medical Record (EMR) is an information technology that has proven its benefits in improving service quality. This study aims to analyze the effect of computer skills and management support on health workers' willingness to use EMR. Subjects and Method: This research is a systematic review and meta-analysis study using the PRISMA diagram and PICO model. Population: health workers, Intervention: computer skills and management support, Comparison: low computer skills and no management support, Outcome: willingness to use EMR. The articles used came from Google Scholar, Pubmed, and Elsevier which were published from 2013 - 2023. The keywords used in the search were (computer skills OR Management support) AND (“willingness to use” OR “willingness to utilize” OR “readiness to implement”) AND (EMR OR electronic medical record) AND “odds ratio” AND “cross-sectional study” AND (“health personnel” OR “health workers” OR “health professionals”). The inclusion criteria for this study were full paper articles with cross-sectional studies. The analysis used was multivariate with adjusted Odds Ratio. Eligible articles were analyzed using the Revman 5.3 application. Results: Meta-analysis was conducted on 11 articles with a cross-sectional research design. Health workers who have high computer skills were 2.62 times more likely to use EMR than health workers who have low computer skills (aOR= 2.62; 95% CI= 1.92 to 3.57; p= 0.050). Health workers who received Management support were 1.87 times more likely to use EMR than health workers who did not have Management support (aOR= 1.87; 95% CI= 1.40 to 2.51; p= 0.030). Conclusion: Computer skills and management support influence the willingness to use EMR among health workers.