Variables at the Community Health Center Have the Ecological Effect on the Performance of Health Workers: A Multilevel Evidence from Klaten, Central Java

Abstract

Background: Performance is a work achieve- ment that can be achieved from a job. Employee performance in an organization leads to the ability of employees to complete all tasks that have become their responsibility. Various pro- blems in the workplace can often cause work stress, if it lasts long can cause various disturb- ances. Success in achieving goals is supported by the role of a leader with the leadership style used. This study aimed to examine the effects of work stress and leadership style on the performance of public health workers. Subjects and Method: This was a cross sec- tional study conducted at the Klaten District Health Center, Central Java, from November to December, 2019. A sample of 200 health workers was selected by stratified random sampling. The dependent variable was work performance. The independent variables were work stress, leader- ship style, education, tenure, and type of work. The data were collected by questionnaire and analyzed by a multilevel logistic regression run on Stata 13. Results: Performance of health workers decre- ased with heavy work stress (b= -1.65; 95% CI= - 2.58 to -0.72; p= 0.001). Performance of health workers increased with democratic leadership style (b= 1.40; 95% CI= 0.44 to 2.36; p = 0.004), high education level (b= 1.58; 95% CI= 0.65 to 2.52; p= 0.001), tenure ≥6 years (b= 1.72; 95% CI= 0.73 to 2.70; p= 0.001), and type of work without any additions (b= 2.05; 95% CI= 1.07 to 3.03; p<0.001). Community health center had ecological effect on performance of health workers with ICC= 12.74%. Conclusion: Performance of health workers decreases with heavy work stress. Performance of health workers increases with democratic leader- ship style, high education level, tenure ≥6 years, and type of work without any additions. Commu- nity health center has ecological effect on per- formance of health workers