Galore International Journal of Applied Sciences and Humanities Vol.3; Issue: 2; April-June 2019 Website: www.gijash.com Original Research Article P-ISSN: 2456-8430

Analysis of the Officials Performance in Public Health Center of Kurima and Dekai in Yahukimo

Elisabeth Rombe Payung1, Yermia Msen2, A.L. Rantetampang3, Anwar Mallongi4

1Magister Program of Public Health, Faculty of Public Health, Cenderawasih University, . 2,3Lecturer of Master Program in Public Health. Faculty of Public Health, Cenderawasih University, Jayapura 4Environmental Health Department, Faculty of Public Health, Hasanuddin University, Makassar.

Corresponding Author: Anwar Mallongi

ABSTRACT quite good and do not have an adequate impact to the service in both health centers. Incentive Background: Health service development in for the officers helps them financially but it does refers to the 2020’s National System not have a positive impact to the performance of of Health. The vision of the system is to fulfill the officials since it is not based on the official’s the human rights. In its implementation, performance. In both health centers, the officials Indonesia government set it into health’s admit that neither the leader of the health center development planning. One of the planning is to nor the health’s department in the Yahukimo encourage the health services. regency do not make any supervision. Public health center is the foreground public services to fulfill the health right. To make it Keyword: Performance, Health officials, Health sure, the performance of the official is a must. Center, Kurima, Dekai Objective: To describes the connection between some factors; motivation, leadership, 1. INTRODUCTION relationship, facilitation, safety, incentive and For this reason, health development supervision with the performance of health held at the Puskesmas aims to create a services’ official in public health center of community that: Has healthy behavior Kurima and Dekai. which includes awareness, willingness and Method: Qualitative description which use both method of interview and field observation. 18 ability to live healthy; Able to reach quality informants had been interviewed come from health services; Live in a healthy public health center of Kurima and Dekai, and environment and; Have optimal health from the Health department of Yahukimo status, both individuals, families, groups and regency. communities (Permenkes 75, 2014). As the Result: The motivation of the officials in both first strata health service center and the public health center are good. Most of the District Health Office Technical informants feel responsible to the health Implementation Unit, the Puskesmas is services. Leadership have a significant impact to responsible for organizing health the activation of the officials in both public development in an area. Health services at health centers. Relationship between the the puskesmas are comprehensive, officials in both public health centers get bad appraisal since most of the informants told that integrated, and sustainable which includes they do not work as a good team. Both public individual health services and public health health centers are different according to the services. Therefore the puskesmas functions facilitation they have. The facilitations in to conduct basic health services, referral Dekai’s public health center is most complete health services, epidemiological than in Kurima’s public health center. Some investigations and outbreaks of outbreaks officers in Kurima’s health center admit that the (KLB) and conduct health promotion and safety in the road from Wamena to Kurima community empowerment. becomes an obstacle for them to go to the health center. But in both health center, the safety are

Galore International Journal of Applied Sciences and Humanities (www.gijash.com) 1 Vol.3; Issue: 2; April-June 2019 Elisabeth Rombe Payung et.al. Analysis of the Officials Performance in Public Health Center of Kurima and Dekai in Yahukimo Regency

To carry out these functions in order years. In general, Yahukimo District to achieve the goals of the puskesmas, the received the lowest rating compared to other government issued a Minimum Service districts in from the Eight (8) aspects Standard (SPM) to measure the performance assessed. The eight aspects are (1) Office of each puskesmas so that the puskesmas Secretariat, (2) Public Health Sector, (3) could provide health services. To make Health Service Sector, (4) Disease optimal health development efforts in Prevention and Control (P2P), (5) Health accordance with these minimum service Resources Sector, (6) UPT AIDS, Malaria standards, each puskesmas must be and TB, (7) UPT Regional Health supported by good employee performance. Laboratory Office and (8) Kadinkes. Employee performance is the result of a Although this assessment is general for the complex and continuous process carried out district health office, the performance of the by employees (internal factors) and also puskesmas, as a technical agency from the carried out by agencies or institutions. Good district health office, also influences this employee performance is of course an assessment. The low position of the expectation for all institutions that employ Yahukimo District Health Office is closely employees, because the performance of related to the performance of the employees is ultimately expected to increase puskesmas. the overall output of the agency. Therefore, it is also very important An organization, both government to see an overview of the determinant and private, is always driven by a group of factors that affect the performance of HR in people who play an active role in achieving the Puskesmas. It is intended that efforts to the goals of the organization. Organizational improve the performance of human goals certainly will not be achieved if the resources at the Puskesmas can be carried performance of members or employees is out effectively and efficiently. This study not optimal. According to Mangkunegara seeks to get an overview of the performance (2002) in Pasolong (2010) performance is of puskesmas in Yahukimo by sampling two the result of work in quality and quantity health centers in Yahukimo. The two achieved by someone in carrying out their puskesmas that are the focus of this research functions in accordance with the are Dekai Puskesmas and Kurima Health responsibilities given to them. Likewise the Center. The two Puskesmas were chosen purpose of the puskesmas is very much because they were still easily accessible and determined by the performance of health the number of staff placed in the two workers who are placed in the Puskesmas. puskesmas met the Minimum Service HR determines the achievement of the Standards from the aspect of manpower. stated goals. Without active human Dekai Health Center is one of the resources, the puskesmas becomes passive active health centers. The Puskesmas is and does not function properly because located in the center of Dekai with the status employees are the drivers who carry out of an outpatient health center. While the everything that is the task and function of Kurima health center is a health center with the business to achieve the goals of the an inpatient status. From the initial puskesmas. Therefore, improving HR observation, the Puskesmas Kurima was less performance is an important requirement active and more often there were no officers that deserves attention if you want to reach who came to serve. It is far from the city the health center goals. center of Dekai but close to the City of The Papua Province Health Office in Wamena with road access that can be the district health performance report report passed by vehicles. in the Papua Province revealed that the Yahukimo District Health Office occupied 2. MATERIALS AND METHODS the lowest position for two consecutive 2.1 Research Design

Galore International Journal of Applied Sciences and Humanities (www.gijash.com) 2 Vol.3; Issue: 2; April-June 2019 Elisabeth Rombe Payung et.al. Analysis of the Officials Performance in Public Health Center of Kurima and Dekai in Yahukimo Regency

This type of research is an The focus of this study limits itself observational study with a descriptive to the study of; work motivation, leadership, qualitative design approach. According to work relations, work support facilities, Syaodih (2008) in Pongtiku (2016) that security, incentives and supervision at 2 qualitative research is a study aimed at puskesmas namely Dekai health center and describing and analyzing phenomena, Kurima health center from 33 health centers events, social activities, attitudes, beliefs, in the Yahukimo health service area. This perceptions, thoughts of individuals as well was done by researchers considering the as groups. This type of research is area, the time of the study and the distance qualitative with a case study approach, travelled by each remote health center. which is a method of research conducted 2.3. Place and Time of Research with the aim of describing the problem that This research was conducted for 5 months, occurs to conclude the image objectively namely July to November 2018 at Kurima (Swarjana, 2013). Qualitative research Health Center and Dekai Yahukimo District examines participant perspectives with Health Center, Papua Province. strategies that are interactive and flexible. 2.4. Population and Informants Qualitative research is intended to 1. Population understand social phenomena from the Population is the total number of research perspective of participants. objects (Sugiyono, 2009) in Pongtiku According to Bogdan & Taylor (2016). In qualitative research population (1990) in Imam (2017) Qualitative research can be interpreted as a social situation is a research procedure that produces (Social Situation). The social situations in descriptive data in the form of written or this study were employees of the Dekai oral words from people who behave health center and the Kurima health center. observably directed at the background and 2. Informant individuals holistic (whole). For that The sampling technique used in this study qualitative research cannot isolate was purposive sampling. According to individuals or organizations into variables Sugiyono (2012) a purposive sampling or hypotheses but view them as part of a technique is a technique of determining whole. Research guided by a qualitative samples with certain considerations. In paradigm is defined as a research process to determining the size of the sample taken in understand human or social problems by the Social Situation, researchers only choose creating a comprehensive and complex respondents who are considered to really picture presented in words, reporting master the problems that the researchers detailed views obtained from informant examine. The researcher only observed the sources, and carried out in settings that condition of the research location that was natural. This was chosen to see the relevant to the problems studied. complexity or complexity of the problems In this study the researcher took samples that occurred in Yahukimo District health based on the following characteristics: centers. Although it has been a common 1. Dekai Puskesmas staff complaint that many puskesmas in Papua, 2. Kurima Health Center staff especially in remote areas are lacking or 3. Health Office staff even inactive, the reasons behind that have C. Data Sources not been revealed clearly so that the The data sources in this study were solutions that have been taken so far have collected through in-depth observation and not been able to overcome the problem. For interviews. Arikuntono (2012) in Pongtiku this reason, the researcher wants to describe (2016) suggests that the source of data in the complexity of the problems that exist in research is the subject from which data is Yahukimo District Health Centers. obtained. In qualitative research the data 2.2 Research Focus sources are humans as respondents, written

Galore International Journal of Applied Sciences and Humanities (www.gijash.com) 3 Vol.3; Issue: 2; April-June 2019 Elisabeth Rombe Payung et.al. Analysis of the Officials Performance in Public Health Center of Kurima and Dekai in Yahukimo Regency sources, sources of places and events. In this the community assisted by cadres. Every study, sources of information obtained from day we start the service by praying with the primary data include field observations, patient and then continuing with the service interviews and other secondary data until the patient runs out ” Informant 3 "My obtained from documents in the health motivation is working because I feel sorry center and health office. for them, the old road from the new village arrived at the puskesmas, there is no The primary data source is a number of service" Informant 4 "... my motivation is information directly obtained from the main working huh ... because we have become informants in this study: employees here." Informant 5 "... my 1. Head of the Kurima Health Center motivation works diligently here because 2. Administration Section of Puskesmas this is my village, the sick I have the Kurima community ... it is a pity if they are sick but 3. Kurima Health Center pharmacist the puskesmas is closed, want to go to 4. Kurima Midwife Puskesmas wamena far ... need more fees ..."Informant 5. Nurse at the Kurima Health Center 11 "Our motivation is to work because we 6. Head of Pustu of Puskesmas Kurima have been given responsibility ... only 7. Head of Dekai Health Center sometimes we do not go to work because of 8. Administration Section of Dekai Health constraints on travel ... then sometimes I Center also have business going to the office ... it 9. General Physician of Dekai Health Center takes a long time because the business there 10. Dekai Puskesmas Dentist is also not easy, tickets are also difficult, 11. Dekai Midwife Midwife sometimes just waiting for weeks can get a 12. Nurses of Dekai Health Center ticket .." Triangulation informants in this study: Informant 15 "... employees rarely enter 1. Health Office work, let alone those who live in the city, a. Health Department Secretary later they will come if there are posyandu b. Head of Sub Division of Finance activities ... so cadres who come to serve 1. Society patients more often ..." Informant 16 ".. The triangulation informant in this study Employees now rarely enter work, was to confirm the informant's statement puskesmas often close” regarding the performance at the puskesmas. 2) Dekai Health Center While the written secondary sources came Informant 6 "... my motivation works from the library data, the profile of the because I want to serve the community in Yahukimo district health office, the profile accordance with the profession oath and of the Dekai health center and the profile of what we have learned ..." the Kurima health center. Informant 7 "... my motivation is because I have become an employee ... even though I 3. RESULTS am only an official note, I still diligently 3.1 Motivation enter, I feel I have a responsibility here" Motivation is an impulse that arises Informant 8 "My motivation to work is in a person to be able to carry out their because of my responsibility ..." Informant 9 duties in accordance with the maximum "My motivation is because I feel I have a ability they have, following the quote from responsibility to serve the community ..." an interviewer about motivation Informant 10 "My motivation is because I 1) Kurima Health Center have been given responsibility ... but I have Informant 1 "My motivation is working huh to pay so I have to work well ..." ... because I have een paid recently ... I have Informant 12 "My motivation is to work a community" Informant 2 "I served with actively because I have been given my heart because of my faith in God. I serve responsibility by the leadership; this is the

Galore International Journal of Applied Sciences and Humanities (www.gijash.com) 4 Vol.3; Issue: 2; April-June 2019 Elisabeth Rombe Payung et.al. Analysis of the Officials Performance in Public Health Center of Kurima and Dekai in Yahukimo Regency responsibility of the community and also as employees must be diligent, because the a form of service for God ..." leadership period enters work and we do Informant 17 "... I have been treated here for not, we will be embarrassed hearted ... several times between families and I myself leadership now rarely enters, the leaders also have treatment, the officers serve us often go to service .." Informant 4 "... the well, the puskesmas is always open, only leader must be firm and diligent ... so that very many patients have fewer officers so everyone will join in" Informant 5 "... the we wait for a long time to finish ... from leader must be assertive ... those who are registration to completion. all must wait a not active must dare to sanction ... don't let long time " Informant 18 "... I have been it go, so the others will become lazy" treated for the third time, good service, Informant 11 "I think all employees are officers serve us well ..." adults so there is no need to wait for orders Informant 13 "... employees who have from me to just work, all of them have their motivation are not all the same so there are respective assignments, so just run those who have work enthusiasm, feel they according to their duties ... I often do not have responsibility and are active and some enter because of business matters, take care are lazy ..." Informant 14 "... employees of drug delivery and so on ..it needs time to who are diligent because they have work take care of goods, not just for a while, motivation, if they are lazy because there is sometimes tickets are difficult .. no sense of responsibility." 2) Dekai Health Center From the results of the interview it was Informant 6 "The leader must be concluded that the informants' work firm in making decisions ... leadership is motivation was different, most of the now good, it can embrace all, even though informants had motivation because of their there are still people who are lazy to know sense of responsibility as employees, but that's how it is" Informant 7 "leaders because they were already paid and some must be firm and brave to give sanctions to claimed to have motivation to work as a friends who are lazy ... so that all work is form of service for God. good ..." 3.2 Leadership Informant 8 "The leader must be assertive ... Leadership is a way of how a leader uses his the leadership is now good, cumin is still influence to achieve organizational goals not firm, so the lazy ones come in just santé through good relations with his ..." subordinates. The following are excerpts Informant 9 "The leader must be more from interviewees' interviews regarding assertive, so that those who are lazy to enter leadership; can be doubtful ..." Informant 10 "Current 1) Kurima Health Center leadership is good, able to embrace Informant 1 "The leader must give a good everyone, even though there are still people example for us so that we are active in who don't care, I think it's normal, come working, if the active leader enters for sure back to each of them, Sis ..." Informant 12 we will all be ashamed if we do not enter ... "... as leaders we must be able to see the leadership currently closed, rarely employees according to their roles and meeting, not transparent ..." functions ... educational background, to be Information 2 "if a good leader must pay able to speak with them well ... not all attention to all employees ... give an employees like us are natural but as leaders example, be diligent and open ... the current we must remain good to them without leadership type is too ignorant, the discriminate ... " employee does not go to work, the Informant 13 "... the character of the puskesmas often closes he does not take employee is different - so we as leaders quick action .. just let it be " Informant 3 "if must be able to see them as a whole ... there the leader is diligent, we can ... our are some things that must be firm but other

Galore International Journal of Applied Sciences and Humanities (www.gijash.com) 5 Vol.3; Issue: 2; April-June 2019 Elisabeth Rombe Payung et.al. Analysis of the Officials Performance in Public Health Center of Kurima and Dekai in Yahukimo Regency times are not ... there are those who can be Informant 6 "We are here compact. firm but there are also those who are hard he Especially ahead of accreditation ... but is lost, I want to go to work ... back again, as there are some friends who are lazy to enter a leader must be able to see the character of because of dislike of other friends ... yeah ... his subordinates " Supporting information 4 so already, I think that is common in "... the leadership must provide a good communities everywhere, depending on the example ... if the leader is diligent and firm leadership how to embrace all parties" all employees are all active ... must be brave Informant 7 "Actually, if the work enough to give sanctions to those who do relationship continues ... the effect is all not work" From the results of the interview, active ... but there are some friends who are it was concluded that the leader must set a lazy because they don't like authoritarian good example for his subordinates, most of friends ..." the informants said that the role model was Informant 8 "If all compact work is good ... very influential on the activeness and we are here, especially before accreditation, enthusiasm of the employees at work. all move together, yeah but there are still some who are in conflict ... finally some 3.3 Work Relationships friends are not active working ... Working together with other people in one authoritarian attitude of friends who workplace is certainly required to be able to sometimes make other friends lazy to know work together. The following is an excerpt ... all understand it ... because the team's from the interviewer's interview regarding work must understand and support each work relations; other ... " 1) Kurima Health Center Informant 9 "... if in my opinion the Informant 1 "... cooperation is very collaboration as a team must work so that important ... we all have to be compact and we work comfortably, feel one team and move ... don't make any kind of strongholds even one family ... we can all work together ..." Information 2 "if all cooperation is good in one team, yes even though there are all work will go well ... we can all work friends who have authoritarianism ... but together here just as there is a standard others all is well, we are becoming more suspicion-suspicion once it becomes a compact even before accreditation, a lot of barrier" Informant 3 "We are now not good work must be done together so ... " at relationships with all employees friends Informant 10 "We are here compact, all can ... some are suspicious of each other, so work together well, if lazy people come to other friends are lazy to come in ..." know too, well ... maybe they have a Informant 4 "... we are all compact but some problem with friends or don't like leaders or friends are kind of lazy to know so everyone anything ..." Informant 12 "... we emphasize sometimes gets lazy to know that ..." all of us open here ... cooperate well, if Informant 5 "... if our cooperation is good anyone who doesn't like friends is natural ... here, only that there will be some lazy but not because it becomes an obstacle to friends so ... if the leader arranges the work, if there is no standard, like it is schedule, then all teams are active ..." normal ... I always emphasize to always be Informant 11 "cooperation is important, it's able to work together especially if we are just that there are some friends who are lazy here from various ethnic groups and to know, if there is an activity everyone is characters, so we can understand each other invited to get involved but that's how it is ...... "Informant 13 "... the kind of employee is this sometimes there are some friends who different so we as leaders must be able to don't like each other, there are suspicions see them as a whole ... there are those who about activity funds and so on ... they are are lazy to know ... they are not compact, it suspicious too much so ... " is normal ... depends on the leader 2) Dekai Health Center ..."Supporting informant 4 "... compactness

Galore International Journal of Applied Sciences and Humanities (www.gijash.com) 6 Vol.3; Issue: 2; April-June 2019 Elisabeth Rombe Payung et.al. Analysis of the Officials Performance in Public Health Center of Kurima and Dekai in Yahukimo Regency is important ... if there are those who are etc. must also be stored in Wamena because lazy to know ... there are those who do not there is no electricity in the puskesmas, the like it that is normal in teamwork" medicine will be damaged ... " From the results of the interview it was Informant 5: "if there are official service concluded that less harmonious work facilities, only employees do not live in relations could hamper cooperation, most of official homes, employees including the the informants said that if all were able to head of the Puskesmas live in the city of work together as a team it would affect good Wamena. Other facilities also exist such as work results. Most of the informants said the Pusling car, but it was stored in Wamena there were obstacles in teamwork because because it was difficult to bring to Kurima there was an authoritarian attitude and there because the roads were bad and the Yetni was suspicion of activity funds, which times often flooded, there were also many caused some employees to be inactive. facilities at the puskesmas which were lacking such as electricity, stationery was 3.4 Work Facilities limited. Work facilities are tools that are very much Informant 11: "We have facilities that are needed in supporting the work of very lacking, the most needed is electricity, employees, facilities can be in the form of want to keep the medicine, etc ... we are physical functions as a primary or auxiliary overwhelmed with it ... there were solarsell tool in carrying out work and also in the but it was lost ... now the drugs that need to framework of shared interests related to be stored in our refrigerator are stored in work. The following is an excerpt from the wamena so that it is safe, there is a interviewee regarding work facilities treatment room but the bed is not there, the 1) Kurima Health Center mattress, pillow and others are not there, we Informant 1.: "They are not active because have coordinated with the department but maybe they do not want to go to the village, said the proposed item was rejected so until they are often afraid because the security on now the inpatient room is not used, friends the trip is sometimes not safe, the road is not also want to stay home how if there is no good, the car cannot penetrate until the electricity, an ambulance is also available puskesmas, and there are also no electricity but we use it to transport friends from the problems." Informant 2.: Work facilities are airport here ... just to the end of the time, very minimal, or lacking, work facilities do can't get to the puskesmas, the bridge is not exist, while medicines must be broken .. " transported from the puskesmas with 2) Dekai Health Center difficult field conditions. electricity used to Informant 6: "Facilities in the puskesmas are be there, use dynamo but su disappeared ... I sufficient, official housing for puskesmas don't have an official house myself, I live in employees is available but not all are my own house. " Informant 3. "The most occupied by puskesmas employees. There needed facilities are lighting equipment and are also other facilities such as Pusling cars clean water. There are houses but and motorbikes for employees, medical employees don't use them, most of them live devices are sufficient, medicine is also in Wamena. " sufficient ... " Informant 4. "Homes for puskesmas Informant 7 "facilities are quite complete employees are available. We used to sleep at here, all are equipped before accreditation home for employees when we divide the ..." schedule into the office, but now the house Informant 8 "Puskesmas facilities are quite is not used anymore. Only one house we complete before accreditation, only the IPal still use sometimes, only now we rarely live machine cannot be run, while waiting for in the official house because there is no the technician, there are 2 units for the electricity. Medicines such as immunization, doctor's house, 10 paramedics are there but

Galore International Journal of Applied Sciences and Humanities (www.gijash.com) 7 Vol.3; Issue: 2; April-June 2019 Elisabeth Rombe Payung et.al. Analysis of the Officials Performance in Public Health Center of Kurima and Dekai in Yahukimo Regency only 4 units are active, 4 units are initially in respondents said that work facilities and pkm but I have already been assigned to supporting facilities such as electricity were another agency but it still remains there, not available, which prevented health while 2 units are occupied by a health workers from working. While in Dekai service person ... there are 5 vehicle Public Health Center, most respondents said motorbike facilities, all for PKM people ” that the work facilities were sufficient Informant 9 "the facilities in the puskesmas enough to assist health workers in carrying are quite complete ... medical devices and out their duties. medicines are sufficient, which I feel is lacking in housing and vehicle facilities, 3.5 Security health workers are also lacking" Comfort needs have a very broad range, not Informant 10 "Facilities are all complete, only physical security but also only IPAL machines are functioning, psychological security, for example free supporting facilities for employees are quite from pressure or intimidation from other complete as there are houses near the parties. The following is an excerpt from the puskesmas but not all of them are occupied interviewer's interview regarding Security; by employees in the puskesmas" 1) Kurima Health Center Supporting informants 12 "... all the Informant 1: "... they are often afraid facilities have been prepared, only the ipal because security in travel is sometimes not machine has not functioned because there safe, but not every day there is a conflict so are still technicians waiting, those who lack security is actually not too bad. The supporting facilities such as houses ... many Puskesmas is also close to Koramil. " puskesmas employees are out-of-the-way Informant 2: "Actually, if the officers stayed have no vehicles so if it rains they are in the prepared house, it would be safe difficult to come to work , I already know because beside him was the Kurima that there are no public vehicles, so it is Koramil. But they live in the city more so difficult if you don't get a vehicle and there the security reasons continue. " is no house ... that prevents them from going Informant 3: "... Security that is usually to work ... " complained of by inactive friends because Informant 13 "... the government continues there are often drunk people on the road. to strive for facilities, but not all can be But if you live in a house that is here, it will completed in the near and concurrent time, be safe because it is close to the Koramil must be gradual, kurima health facilities and the Kurima Police Station. Indeed, there such as houses, temporary hospitalization were cases of theft of solar cell panels in equipment are tried to be gradually employees 'homes, but that was because completed, but there are also home facilities there were no officers living in the like Kurima did not use either, finally it was employees' homes. damaged ... the health center decree while Informant 4: "... We used to go there twice a fighting for additio nal houses ... all planned week, as long as we messed up once a week. but gradually "Informant 14 "... fixed We were afraid on the road so we entered it facilities are budgeted according to the if the group, if there was activity. If there needs and the adequacy of available funds ... are no activities, now don't go again. " only the problem is the facilities are Informant 5: "Let me have the task of equipped but if the energy is lacking, then studying but if the lecturer does not enter I the facilities will not be maximized .." often come to work. Indeed, there are often From the results of the interview, it can be people who are drunk but that need not be concluded that the majority of respondents afraid because they respect us who are said that the puskesmas facilities greatly health workers and teachers. " affected the performance of health workers. Informant 11 "security issues here that for At the Puskesmas, Kurima, most friends who live in the city rarely go to

Galore International Journal of Applied Sciences and Humanities (www.gijash.com) 8 Vol.3; Issue: 2; April-June 2019 Elisabeth Rombe Payung et.al. Analysis of the Officials Performance in Public Health Center of Kurima and Dekai in Yahukimo Regency work, for fear that the road is often blocked disturbances only occasionally occurred by drunken people ... so if you leave from during the service to the villages. the wamnea to the kurima, make an 3.6 Incentives appointment so the road is crowded ..." The purpose of inseintive systems is 2)Puskesmas Dekai essentially to increase employee motivation Informant 6: "... if it's about safety, we feel in trying to achieve organizational goals by safe here ... the service is still running ... offering financial incentives by exceeding except for the great tribal war ..." Informant basic wages and salaries (Handoko, 2010). 7: "... our services are not disturbed by The following is an excerpt from an security, except services outside the informant interview regarding incentives; building such as posyandu ... sometimes 1) Kurima Health Center people get drunk crossing on the road ..." Informant 1: "... All rights are paid directly Informant 8: "if we are here our security is to each account. So both active and non- rarely a problem unless the tribal war is active ones can all, good incentives exist, great ... we are closed just in case ..." very helpful for us to fulfill our needs " Informant 9: "... our services have never Informant 2: "Both salaries and incentives been disturbed by security problems, except are smooth and are transferred directly to services outside the building such as each person's personal account, incentives posyandu ... if there is no interference at the are actually good but they should not be puskesmas .." given to those who don't work" Informant 3: Information 10: "... our services have never "Employee rights have no problems. been subject to security problems, Informant Always smooth. But not all employees 12 "... because our security here is not so come to work. Incentives are also influential, because the puskesmas is far transferred directly to the account of each from the community housing if our big employee including employees who are not tribal war is closed ..." Supporting active " informants 13 "... the government continues Informant 4: "... Incentives or other rights to seek security for all employees, both at are smooth unless operational funds are only the Kurima Puskesmas and the Puskesmas given to employees who take part in Dekai ... the Kurima itself is next to the activities." Koramil, it's just on which roads are Informant 5: "I am actually on a learning lacking, so the house is prepared for them to assignment but often come to work too. All stay ... so it shouldn't the reason for the rights so far are smooth including security on the road for them is not going to incentives, incentives are very helpful for us work ... " Informant 14 "... security remains ... " Informant 11 "Rights - all rights are the government's attention." smooth, salaries and incentives, if activity From the results of the interviews it money and services are not valid if they do could be gathered that most of the not participate in activities" informants said the security at the two 2) Dekai Health Center Puskesmas was conducive and did not have Informant 6: "... Employee rights all a direct impact on health services at the smoothly including incentives except BPJS Puskesmas, a small number of informants services that often stagnate ..." Informant 7: said that sometimes there were security "... Employee rights all go well; except for disturbances while on their way to the the capitation of BPJS, we are struggling to Puskesmas from Wamena. Whereas in the take care of the health office because the Dekai Health Center the security issue did reason is not yet liquid, it is still unclear, we not directly affect the services at the have dealt with it but it has not been Puskesmas, a small portion of the completed. " informants said that the security Informant 8: "All rights are good, yesterday the incentive was too late to be paid, the

Galore International Journal of Applied Sciences and Humanities (www.gijash.com) 9 Vol.3; Issue: 2; April-June 2019 Elisabeth Rombe Payung et.al. Analysis of the Officials Performance in Public Health Center of Kurima and Dekai in Yahukimo Regency reason was not clear from the health office, because there were no reports from the head incentives were not paid based on employee of the puskesmas that the Health Service did activity, all paid the same, so there was no not know of inactive employees. influence on employee motivation and 3.7 Supervision performance ..." Informant 9: "Our Supervision is observations made incentives are smooth, but not paid based on directly and periodically by superiors on the attendance, all receive the same ... enter work carried out by subordinates and then if work with those who don't enter and still problems are found, direct instructions or accept the same ..." assistance are given to overcome them. By Informant 10: "The incentives we received conducting supervision activities were smooth, very helpful in service ... systematically it will motivate to improve these needs were very expensive, so the work performance. The following is an existence of insnet was very helpful for us excerpt from an interviewer's interview ..." Informant 12 "... Employee rights run regarding supervision; well, for distribution of services only for 1) Kurima Health Center those who are active, if they are not active Informant 1: "... there is no supervision like they cannot ..." this for us to be lazy to know too." Informant 13 "... Now that there are Informant 2: "Actually if there is employees in the district, we already know supervision from the leader it will have a but they are difficult to accept, all rights good effect on performance ..." Informant 3: have been granted, but do not want to carry "... if leaders often come down see we can. out obligations, incentives are intended to We will work as well as we can ... " help them and so that they work actively. If Informant 4: "... the duty of the official must you want to cut incentives for those who are come down so that he knows what happened not active from our service, it can be at the puskesmas ... if the reports from the important that is a report from the head of head of the puskesmas are not enough." the puskesmas .." Informant 5: "Health service people should Informant 14 "... We cannot hold salary or often go down and sit with us. discuss the employee incentives without instructions problem ... " from the head of service or secretary. The 2) Dekai Health Center head of the puskesmas should report to the Informant 6: "... if there is supervision it is leadership so that we at the office can find very good ..." out who is not active, if there is no report Informant 7: "... it should be so ... there is from the head (head of the Puskesmas) we some kind of supervision from the superior will not know who is not active. If the directly ... but this is rarely used by the activity report at the Puskesams, Kurima supervisor so ..." Informant 8: "Supervision and Dekai run smoothly so we don't know is important to see our problems directly in that there are those who never enter work the field, help find a solution that is fast and but the rights are still accepted, if there are good for us all, only that is rarely done by reports, they will be held they have superiors so ... we really hope that but" incentives, because the incentives are to Information 9: "We sincerely hope that the motivate them to actively work ... " supervision system will run so that there is Based on the results of interviews about an increase in performance for health incentives it was concluded that the workers here ..." Information 10: "If there is incentive payment system had no obstacles, supervision, it is permissible, everything is paid directly to the accounts of each health controlled and feels cared for, there is also a worker and not based on activity or problem that is not protracted, it will be attendance. According to an informant's resolved quickly ..." confession regarding the confirmation of the Informant 12 "..this supervision is important incentive payment system, this happened ... the leader descends the court may, don't

Galore International Journal of Applied Sciences and Humanities (www.gijash.com) 10 Vol.3; Issue: 2; April-June 2019 Elisabeth Rombe Payung et.al. Analysis of the Officials Performance in Public Health Center of Kurima and Dekai in Yahukimo Regency just wait for the report from us ..." (2015), Loho (2017) and Farida (2018) Informant 13 "..we continue to try to which illustrate that motivation greatly supervise the puskesmas but there are a affects employee performance. According to number of obstacles that we face, especially Nursalam's theory (2015) The ability to the districts that need money ... so in the carry out tasks is the main element in future we have planned well, so that assessing one's performance, but the task supervision can be carried out to all cannot be completed properly without being puskesmas gradually ..." Informants 14 ".. supported by a willingness and motivation. supervision is very important so that the Whereas according to Notoatmodjo (2010) needs and problems of puskesmas can be motivation is an impulse that arises in a accommodated by all in the budget person either consciously or unconsciously properly." Based on the results of the to take certain actions to achieve a certain interview, it was concluded that supervision goal, an effort that can cause someone or a had not run optimally. group of people to be moved to do something to achieve a certain goal or get 4. DISCUSSION satisfaction of the things done. 4.1 Motivation 4.2 Leadership Work motivation comes from The effectiveness of leaders in internal individuals that give rise to dealing with organizational activities today encouragement or enthusiasm to work hard. is largely determined by the quality of the Motivation is a force that encourages an relationship (relationship) between leaders employee to be able to lead and direct and subordinates. Relationships between employees to do their jobs. leaders and subordinates should not only be A person's motivation in work limited to formal work relationships where determines his activity in carrying out his leaders act as superiors for their duties. This is very evident in the field subordinates in the organization, but the findings by researchers. If the Kurima relationship must be broadly established Community Health Center is not always where leaders can act as partners for active every day because there are no subordinates overcome various obstacles officers who routinely serve the community and can motivate subordinates to achieve in every day, Anjelma is very active. From the employment (Priyono, 2006). results of interviews and direct observations 4.3 Work Relationships on the field every day the head of the Pustu Work relationships are a person's Anjelma provided services to the people effort in a work team, or in other words how who came to the pustu and this was even a group of people unite to collaborate and acknowledged by several people who were work together to achieve a common goal. met by researchers in the field. Most of the From the interview results it can be informants at the Kurima Health Center said concluded that the two Puskesmas have a their motivation was working because they less harmonious working relationship, this felt responsible but this did not affect their can be seen from the results of interviews activity, the puskesmas often closed and with the Kurima Puskesmas, which most services did not work. While at Dekai informants said that they were less compact Public Health Center some informants said in working, the work team did not work and their motivation to work was because they the division of tasks was unclear. Some felt responsible, and this had a good impact informants said there was mutual suspicion on their activity. between them so that the work relationship This illustrates that the motivation became tenuous and affected their and willingness of health workers to work performance. Whereas at Dekai Public will affect their performance. This research Health Center as revealed by most is in line with previous studies by Ulinnahu informants that their working relations are

Galore International Journal of Applied Sciences and Humanities (www.gijash.com) 11 Vol.3; Issue: 2; April-June 2019 Elisabeth Rombe Payung et.al. Analysis of the Officials Performance in Public Health Center of Kurima and Dekai in Yahukimo Regency running well, there is cooperation and clear the Kurima Health Center there is no division of team work especially before the electricity installation from PLN at the accreditation of compactness is clearly very Kurima Health Center. However, a few visible, although there are a small number of years ago the local government had informants who say that cohesiveness provided facilities in the form of solar cell among employees prevents employees the installations for the Puskesmas as well as dominant one and has an authoritarian the employee housing of the puskesmas, but nature that disturbs the comfort of some most of these solar cell equipment had now friends which causes them to be inactive been stolen so that it was an obstacle for 4.5 Work Facilities health workers to live in their homes. From observations during research Both the Dekai health center and the both at the Dekai Community Health Center Kurima health center are both equipped with and at the Kurima Health Center, several ambulance facilities. There are also 5 supporting facilities were provided for motorbikes for employees at the Dekai employees. There are 10 houses provided Puskesmas, while there are no motorbikes in for employees in the Kurima health center Kurima in the past few years. and 12 houses for employees at Dekai From the results of interviews, most Puskesmas. However, only the housing of the informants at the Kurima Health housing of Puskesmas in Dekai is used. Of Center said that work facilities were the 12 houses provided, only 4 houses were lacking, both direct facilities such as office used by employees at the Dekai Health stationery, medical devices and medicines Center. 4 other houses were occupied by and other supporting facilities that employees who had not worked at the Dekai hampered their performance in providing Puskesmas and the other two were occupied health services. Whereas at the Dekai by employees of the Yahukimo District Community Health Center the facilities are Health Office. While most of the houses in sufficiently adequate for the main facilities the Kurima health center are not occupied. in services and other supporting facilities. Only two employees of the Kurima health This research is in accordance with center are used by local health cadres. While the theory that advice and infrastructure are most employees live in the city of Wamena, supporting tools for the success of a process some live in private homes in Kurima. of effort carried out in public service Other facilities that have been because if this is not available then all provided by the local government to support activities carried out will not achieve the the work of the Kurima health center staff expected results according to the plan. are clean water, there is a clean water tank According to Moenir (2012) facilities are all built in the yard of the Kurima health center. types of equipment, work equipment and The condition of the reservoir is still good facilities that function as the main tools / and is still used today, including by local assistants in carrying out work and also in residents. While for Dekai health centers, the framework of interests that are currently water was obtained by officers from the associated with work organizations. This well. There are no significant obstacles for research is in line with previous research by employees of the Dekai health center to get Rundungan (2015) and Farida (2018) which clean water. illustrate that work facilities or facilities and Meanwhile for Electricity employees work supporting facilities influence at Dekai Health Center have enjoyed better employee performance. But research electricity in the past year. Electricity at the conducted by Loho (2017) is not in line Puskesmas and housing staff at the Dekai which illustrates that work facilities do not Health Center were obtained from the affect the performance of nurses at Wamena Timika State Electricity Company, the Hospital. Dekai customer service post. Whereas for

Galore International Journal of Applied Sciences and Humanities (www.gijash.com) 12 Vol.3; Issue: 2; April-June 2019 Elisabeth Rombe Payung et.al. Analysis of the Officials Performance in Public Health Center of Kurima and Dekai in Yahukimo Regency

performance appraisal but as a form of 4.5 Security encouragement for employees to be more From observations in the field when active in carrying out their duties. This researching security issues is often the incentive is received directly by employees reason for the inactivity of health workers. through a bank account. Kurima Health Center itself is right next to Based on the results of interviews, Kurima Koramil and only about 10 minutes most of the informants revealed that the walk from Kurima Police Station. However, incentives so far had no problems and the road from Wamena to Kurima often greatly helped employees financially, only becomes unsafe due to conflicts or the the problem was because incentive presence of drunk people who block the payments were not based on employee road and ask for money. The issue of activity which caused an adverse impact on security for Kurima Health Center is more their performance, there was a presumption related to security when traveling from that was active or not the same, they can Wamena to Kurima. This has an impact on still receive incentives so that incentives are the presence of officers who live in the city no longer considered compensation for their of Wamena. Meanwhile, employees who hard work but the rights that all employees live in Kurima themselves generally do not must accept. have difficulties in terms of security. This According to Simamora (2007) was evident in the attendance list of officers employees will be motivated if the at the Puskesmas where the most frequently incentives they receive are related to the entered offices were employees who lived in performance they perform. Whereas Kurima. Meanwhile Dekai Health Center is according to Hnadoko (2010) for the in the middle of the city which is relatively majority of employees, money is still a safe unless there are horizontal conflicts strong and even the strongest motivator. The between the people. However, horizontal purpose of the incentive system is conflicts did not occur every day, which did essentially to increase employee motivation not significantly affect the work security of in trying to achieve organizational goals by the officers at Dekai Health Center. offering financial incentives beyond basic In the hierarchy of one's needs wages and salaries (Handoko, 2010). according to Maslow in Priyono (2006) the This research is in line with previous need for security is the second need after research by Farida (2018) which illustrates physiological needs. After physiological that incentives can affect the achievement of needs are met, the need for security will be JKN officers' performance in Mimika the next driver. district. 4.6 Incentives 4.7 Supervision Incentives are additional income Supervision is an important factor to earned by each worker on performance control employee performance. However, achievements or as a form of compensation from observations in the field and for difficult working conditions and discussions with supervisory staff on the environments both in terms of access, the Kurima Health Center it did not go well. scope of work area, challenges or related to Most of the informants in Kurima Public the high cost of living. This is given to Health Center said that supervision was workers to motivate workers to keep rarely done even in 2018 it had never been delivering satisfactory results. Yahukimo done, either internally in the Puskesmas or Regency is actually a district with a high from the District Health Office. number of incentives compared to several Distant distances also contributed to other districts in the province of Papua. (see the oversight of the district health office. If table 3.5) Providing incentives in Yahukimo you want to supervise, the health district is not based on employee department must go to Wamena by plane

Galore International Journal of Applied Sciences and Humanities (www.gijash.com) 13 Vol.3; Issue: 2; April-June 2019 Elisabeth Rombe Payung et.al. Analysis of the Officials Performance in Public Health Center of Kurima and Dekai in Yahukimo Regency and then continue with the land route to the 3. The working relationship at the Kurima Kurima Health Center. Budget issues Health Center is not well established while become obstacles in terms of supervision in the Puskesmas Dekai it is also less (interviews with informants 13 and 14) harmonious. Meanwhile, supervision is easier to 4. Work facilities at the Kurima Health do at Dekai Health Center because of the Center are lacking, while in the Puskesmas close distance. However, supervision is not Dekai work facilities and supporting followed by strict action against employees facilities are adequate. who are not active, both the head of the 5. Security at the Kurima Health Center has Puskesmas and the Health Office (according no problems, there are only disruptions on to the majority of information) have known the way to the Puskesmas from Wamena officers who are not actively carrying out while in the Puskesmas Dekai security is their duties but there is no firm action. The conducive. absence of decisive action against these 6. Incentives at the Kurima Health Center inactive employees affects other employees and Dekai Health Center are very who are actively carrying out their duties. financially helpful, there are no obstacles in The omission of those who are not active the payment system, but they are not paid but still get a salary and incentives makes based on employee performance. active employees even able to leave their 7. Supervision in the Kurima Health Center duties and result in the absence of service to and Dekai Health Center has not run the community. optimally. According to Kreitner and Kinicki (2006) in Farida (2008) states that there are REFERENCES a number of factors that influence the  Anwar Mallongi, Current Issue Ilmu organizational environment, the most Kesehatan dan Lingkungan, 2016. Writing important of which are supervision. While Revolution. Yogyakarta, Indonesia Ilyas (2001) states that supervision is a  Anwar Mallongi., Teknik Penyehatan process that refers to members of work units Lingkungan, 2014. Smart Writing, Yogyakarta, Indonesia to contribute positively so that  Azwar, A.A (2010). Pengantar Administrasi organizational goals are achieved. The Kesehatan. Edisi ketiga. Jakarta: Bina Rupa ability of supervisors or supervisors to Aksara Publisher effectively hire personnel to achieve  Farida (2018). Faktor-Faktor Yang departmental goals is important for the Mempengaruhi Kinerja Petugas Jaminan success of supervisors from external control Kesehatan Nasional Di Lingkingan Dinas institutions who will be less sensitive in Kesehatan Kabupaten Mimika. Tesis assessing subordinate performance and will Program Magister IKM Uncen 2018 evaluate more negatively than supervisors  Gunawan Imam (2013), S.Pd.,M.Pd. Metode with internal control. Previous research Penelitian Kualitatif Teori &Praktik. Bumi conducted by Loho (2017) and Farida Aksara, Jakarta. (2018) is in line which illustrates that  Hadari Nawawi (2007), Manajemen sumber supervision can affect employee daya manusia untuk bisnis yang kompetitif, Gajamada University, Yogyakarta performance.  Hasibuan Malayu S.P (2012). Manajemen Sumber Daya Manusia (Edisi Revisi). 5. CONCLUSION Jakarta: Bumi Karsa. 1. Work motivation for employees at the  Handoko (2010). Management Personalia Kurima Health Center and Dekai Health dan Sumber Daya Manusia, ed kedua, Center is good. BPFE, Yogyakarta 2. Leadership at the Kurima Health Center  Herdiansyah, Haris. (2010). Metodologi is still not maximal while in the Puskesmas Penelitian Kualitatif: Yogyakarta : Penerbit Dekai is quite good. Salemba Humanika.

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 https://www.dicto.id, Apa Yang Dimaksud  Pasolang Harbani (2010) Teori Administrasi Dengan Teori Dua – Factor (Two Faktor Publik. Alfabeta, Bandung Theory), diakses tanggal Diakses tanggal 3  Peraturan Menteri Kesehatan Republik November 2018 Indonesia Nomor 43 Tahun 2016 Tentang  http://lib.ui.ac.id/detail?id=72192&lokasi, Standar Pelayanan Minimal Bidang analisis kinerja Puskesmas sei lala dan Kesehatan Puskesmas Kuala Cinaku di Kabupaten  Pongtiku,dkk (2016). Metode penelitan Indragiri hulu Tahun 2002, Diakses tanggal kualitatif saja. Nulisbuku.com 11 Oktober 2018  Prawirosentono S dan Primasari D (2008)  Himawan Febtiono (2016), Kinerja pegawai Kinerja dan Motivasi Karyawan. Edisi dalam pelayanan kesehatan masyarakat di Ketiga. Yogyakarta Puskesmas Sempaja Kota Samarinda, e-  Priyono (2007). Pengantar Manajemen. journal.ip.fisip-unmul.ac.id diakses tanggal Surabaya: Zifatama Publisher, Diakses tanggal 16 November 2018 https://www.researchgate.net/publication/30  Ilyas (2001), Kinerja Teori, Penilaian dan 474884. Diakses tanggal 3 November 2018 Penelitian. Pusat Kajian Ekonomi  Rundungan (2015), Analisis Kinerja Kesehatan Fakultas Kesehatan Masyarakat, petugas kesehatan gigi terhadap pelayanan UI, Jakarta kesehatan gigi dan mulut di poliklinik gigi  Kristiandy (2015), Anslisis Kinerja RSUD Datoe Binangkang Kabupaten Puskesmas Karangayu Kota Semarang, Bolaang Mongondow,  Loho S (2017) Faktor-Faktor Yang  Simamora Henry (2007), Manajemen Mempengaruhi Kinerja Kinerja Perawat Pemasaran Internasional, Jilid II Edisi 2, Dalam Pelayanan Perawat Di Rumah Sakit PT.Rineka Cipta, Jakarta Umum Daerah Wamena Kabupaten  Sugiyono (2013). Metode Penelitian Jayawijawa. Tesis Pasca Sarjana IKM Administrasi. Bina Pustaka, Bandung. Uncen  Ulinnuhu (2015), Analisis Kinerja  Mangkunegara, P.A.A (2009). Manajemen Puskesmas Pancol Kota Semarang, Journal Sumber Daya Manusia Perusahaan. fik.unnes.ac.id Bandung: Rosdakarya.  Notoatmodjo S (2010). Ilmu Perilaku How to cite this article: Payung ER, Msen Y, Kesehatan. Jakarta: Rineke Cipta Rantetampang AL et.al. Analysis of the officials  Nursalam (2015), Manajemen keperawatan performance in public health center of Kurima aolikasi dalam praktek keperawatan and Dekai in Yahukimo regency. Galore professional, Salemba Medika, Jakarta International Journal of Applied Sciences &  Mahmudi (2010), Manajemen Kinerja Humanities. 2019; 3(2): 1-15. Sektor Publik: UPP AMP YKPN, Yokyakarta

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