Contextual Effect of Community Health Center on Health Surveillance Personnel Performance in Early Detection of Preeclampsia in Semarang, Central Java

Zella Cahyandaru1), Didik Tamtomo2), RB Soemanto3)


1)Masters Program in Public Health, Universitas Sebelas Maret

2)Faculty of Medicine, Universitas Sebelas Maret

3)Faculty of Social and Political Sciences, Universitas Sebelas Maret



Background: Although the precise pathophysiology of pre-eclampsia remains un­known, this condition continues to be a major cause of maternal and fetal mortality. Good performance is needed by health workers in detecting early preeclampsia. The pur­­pose of this study was to determine the contextual effect of community health cen­ter on health surveillance personnel per­formance in early detection of preeclampsia in Semarang, Central Java.

Subjects and Method: A cross sectional study was conducted in 26 community health centers in Semarang, from October to December 2018. A sample of 148 health surveillance personnels was selected by exhaustive sampling. The dependent variable was performance. The inde­pen­dent variables were motivation, stress, satisfaction, age, education, incentive, leadership style, and supervision. The data were collected by questionnaire and analyzed by a multilevel linear re­gression.

Results: Health surveillance personnel performance was positively associated with motivation (b= 0.09; 95% CI= 0.05 to 0.14; p<0.001), stress (b= 0.08; 95% CI= 0.01 to 0.16; p= 0.035), satisfaction (b= 0.09; 95% CI= 0.04 to 0.14; p<0.001), incentive (b= 0.56; 95% CI= 0.09 to 1.03; p= 0.021), leadership style (b= 0.20; 95% CI= 0.07 to 0.33; p= 0.002), and supervision (b= 0.27; 95% CI= 0.14 to 0.40; p<0.001). Health sur­veillance personnel performance was negatively associated with age (b= -0.09; 95%CI= -0.17 to -0.02; p= 0.019). It was negatively asso­ciated with education but it was sta­tis­tically non-significant (b= -0.27; 95% CI= -1.01 to 0.48; p= 0.483). Com­munity health center had contextual effect on performance with ICC= 10.5%.

Conclusion: Health surveillance personnel performance is positively associated with mo­ti­vation, stress, satisfaction, incentive, leadership style, and supervision. Health surveillance per­sonnel performance is negatively associated with age. It is negatively asso­ciated with edu­cation but it was statistically non-significant. Community health center has a considerable con­tex­tual effect on performance.

Keywords: health surveillance, performance, early detection, preeclampsia, multilevel analysis

Correspondence: Zella Cahyandaru. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java, Indonesia. Email: Mobile: +6287832622469


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