The village midwife is a network of the Puskesmas. The Village Midwife implements the Local Area Monitoring “ Maternal and Child Health (PWS-KIA) program in one village/kelurahan in the working area of ‹‹the Puskesmas. The village midwife is placed and resides in one village within the working area of ‹‹the Puskesmas. The purpose of placing midwives in villages is to improve the quality and equitable distribution of health services to reduce maternal and infant mortality rates, because maternal and child health (MCH) plays a role in community health development efforts. This article describes the motivational factors in the form of self-efficacy and work engagement that affect the performance of village midwives. The performance of the village midwife is divided into task performance and contextual performance of the village midwife.
The Infant Mortality Rate (IMR) represents health services’ ability, quality, and capacity (Tarigan et al., 2017). Indonesia has categorized IMR into 3 groups; Neonatal Mortality Rate (AKN), Infant Mortality Rate (IMR), and Toddler Mortality Rate (AKABA). Viewed from the age group, 69% of deaths occurred in the neonatal state, with 80% of all neonatal deaths reported in the first six days of life (Kementrian Kesehatan Republik Indonesia, 2020). This is closely related to Sustainable Development Goals (SDGs), one of which is to end infant mortality by reducing the Neonatal Mortality Rate to 12 per 1,000 live births (Ministry of Health of the Republic of Indonesia, 2019). Based on empirical evidence on Neonatal Mortality, 88.6% were early neonatal deaths (0-7 days) and 11.4% were late neonatal deaths (7-28 days) (Raharni et al., 2012).
The strategy implemented by the government in reducing the high Infant Mortality Rate (IMR) in Indonesia is to place midwives in villages. Midwives must be adequately skilled to provide health services based on established standards, especially those in villages as they spearhead maternal and child services to increase PWS-KIA coverage (Adiputri et al., 2014). These midwives are required to have good, active, and dynamic abilities, for the community to welcome and acknowledge them. This is especially important as the program to reduce MMR and IMR in Indonesia is 73% determined by the expertise of midwives in serving patients, especially village midwives (Erlandia & Gemiharto, 2014).
The number of respondents in this study was 151 village midwives. The results of this study present data on the characteristics of respondents and tables of variable frequency distributions and analysis results. Table 1 describes the characteristics of the sample of this study, namely 151 village midwives who participated in this study shows that most of the village midwives who are respondents are Gen X (35-50 years old). Gen X is a generation level that can adapt to change and has a way of dealing with problems with their own choices (Eisner, 2005) and most of the midwives have a diploma III education background and are civil servants village midwives. Midwives with civil servant status may be a driving force in carrying out their duties and responsibilities. Almost half of the village midwives in the Pamekasan district health center have worked for 11-15 years. The working period is related to the experience possessed by the midwife while carrying out her duties and responsibilities because it is considered that midwives who have experience can carry out their duties well.
Gen X is an individual generation level. They solve the problems of their own choice. Gex’s weakness is not adapting to technology (Çelik et al., 2021). Gen X has an independent personality, but this behavior also shows a lack of commitment due to the ability to adapt quickly to change (Christopher et al., 2017). Most of the midwives have a diploma III educational background and are civil servants village midwives. Midwives with civil servant status may be the driving force in carrying out their duties and responsibilities. Almost half of the village midwives in the Pamekasan district health center have worked for 11-15 years. The working period is related to the experience possessed by the midwife while carrying out her duties and responsibilities because it is considered that midwives who have experience are able to carry out their duties well. Term of service turned out to be able to motivate employees which had an impact on performance (Heidarian et al., 2015).
Self-efficacy affects the performance of midwives in detecting neonatal emergencies through work engagement. The midwife has not yet optimally mastered the field she is working on, in this case detecting neonatal emergencies through the integrated management of young infants, so the performance of midwives is not considered optimal, which is indicated by the lack of contextual performance dimensions. However, with a high dedication dimension, which shows midwives have feelings of pride, are very enthusiastic, and feel it is important to carry out comprehensive and quality midwifery care for infants, including providing emergency first aid to young infants, to improve the performance of village midwives as shown in high task performance dimensions.
Author: Prof. Dr. Hj. Sri Iswati, S.E., M.Si., Ak.
Journal: Performance of village midwives in detecting neonatal emergency through self efficacy and work engagement as mediation: Cross-sectional study in Pamekasan Regency, Indonesia
