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STRUCTURAL EQUATION MODELING (SEM) : DETERMINANT OF JOB
SATISFACTION OF MIDWIVES IN WEST SULAWESI PROVINCE
AZIS SUDARMO, ANOESYIWAN MOEINS, MUHAMMAD RIDWAN,
MIEKE RAHAYU AND MESWANTRI
Abstract: The background of this study was how to improve midwives job
satisfaction in West Sulawesi Province. The purpose of the study was to determine
and analyzes, both partially and simultaneously, the leadership, competence, work
environment, and work motivation towards job satisfaction of West Sulawesis
midwives.
The research model used in the study was descriptive and explanatory model,
used to test the hypothesis. Study populations were 941 midwives from the districts
in West Sulawesi Provinces area. Subjects was first selected by using Slovin
Theory to determine the number of primary health centers, and then implementing
proportional random sampling to find 275 midwives as respondents. Subjects
selection used the theory of Hair et all, which were the 5-10 x Parameter, or 5x55
indicators = 275 respondents. Data collection was done using questionnaire.
Hypothesis test was done using Structural Equation Modeling or SEM with LISREL
8.70 program.
Study result was processed using 2nd CFA (Second Order Confirmatory Factor
Analysis). This study proved that there are positive and significant correlation
between leadership, competence, and work environment variable to work motivation
of the midwives both partially and collaboratively with determination coefficient
(R2) value of 0.55 or 55%. This study also proved that leadership, competence,
work environment, and work motivation affect job satisfaction with contribution
of 86%, where the most dominant variable affecting work motivation was leadership
and the most dominant variable affecting job satisfaction was work environment.
This result explained that work motivation variable did not mediate the other 3
variables, leadership, competence, and work environment, so it is as No Mediating
variable, while the dominant variable affecting job satisfaction was work
environment, especially nonphysical work environment dimension. Meanwhile, to
improve work motivation needs a strong leadership, especially in maintenance of
managerial skills such as: work planning, work supervision and evaluation,
formulating alternative problem solutions, and creating a conducive working
environment.
A. Introduction
The development of health sector as an integral part of national development is a
shared responsibility between the Central Government, the Local Government,
both in Provincial and/or District level, the community, as well as the business
sector. Health development is directed to increase awareness, willingness, and
capability to implement healthy lifestyle for each person to realize the highest level
Keywords: Leadership, Competence, Work Environment, Work Motivation, Work Satisfaction
344 AZIS SUDARMO, ANOESYIWAN MOEINS, MUHAMMAD RIDWAN AND ET AL.
of well-being. The success of health development could be seen as an investment for
development of socially and economically productive human resources.
The province of West Sulawesi, with its capital Mamuju, lies between 0°12' to
3°38' of the South Latitude and 118°4315" to 119°543' of the East Longitude,
with Central Sulawesi province on the north border and Makassar Strait on the
west border. The southern and eastern border is South Sulawesi province. The
total area of West Sulawesi Province is 16,787.18 km² covering 6 (six) districts of
Majene Regency, Polewali Mandar Regency, Mamasa Regency, Mamuju Regency,
North Mamuju Regency and Central Mamuju Regency.
Performances or coverage related with various efforts to reduce infant mortality
also tend to be not maximized, data at least in the last 3 (three) years since 2013
showed that Infant Mortality Rate (IMR) and the number of death in infant tend
to increase. This condition also directly corresponding with the percentage of
midwives assisted deliveries which tend to decrease. One of the factors causing the
not maximized performance coverage of mother and infant health services as
explained above is supposedly because of the low job satisfaction of midwives.
Low work motivation is presumably related to the lack of opportunities for
midwives to attend training, especially technical training. The 2016 data shows
that only about 69.5% of the total 768 midwives attended technical training,
excluding midwives from Mamasa District. The type of trainings they joined was
also very limited. Some of the technical trainings that should be attended by
midwives include Basic Obstetric and Neonatal Emergency Training, Normal Birth
Attendance, Maternal Perinatal Audit, Inter Personal Communication, Birth
Planning and Complication Prevention Program, and others.
Other factor that is also suspected to cause midwives dissatisfaction are their
work areas which are difficult to reach due to various reasons, including geographical,
economic, and socio-cultural constraints.
The condition of data coverage or achievement for both K1 and K4 not only
has continued to decline for the last 5 years since 2010, but the numbers are also
far below the specified SPM standard, could be assumed are caused by midwivess
low work motivation and the leadership in the primary health center which has not
functioned well.
Other data also shows that during the period of 2015-2016, only about 2.5% or
24 midwives were awarded as exemplary midwives on the district level and only 12
or 1.26% among 941 people were awarded as exemplary midwives on provincial
level. While the national midwife award was only given to one midwife. The lack of
appreciation from leaders towards performance and achievement can lead to
demotivation, moreover if also not supported by the availability of standard midwifery
facility.
D. Literature Review
Article 33 states that the Primary Health Center (PHC) is headed by a Head who
is responsible for all activities in the PHC. To achieve PHCs goals effectively and
efficiently, Head of PHCs are required to implement management functions which
STRUCTURAL EQUATION MODELING (SEM) 345
are the functions that must be carried out by the PHCs head in an organized,
sequential, and sustainable manner (Sulaeman, 2014:71).
Robbins & Judge (2013:315) defined leadership as an ability to influence a
group to achieve a vision or purpose. It appears that leadership is not just an
ability to influence, but also has a vision of the companys goals. Further, Wirawan
(2014:7) stated that leadership is the act in which leader persuades followers to act
to achieve certain goals that describe the values and motivations, desires, needs
and expectations of leaders and followers. Where the ability of leaders to support
the activities of the company through the value and motivation that exist in every
human resources, in order to achieve corporate goals.
According to Munir Baderel (2012:183), leadership is an attempt to influence
others personally (interpersonal), through communication process, to achieve
something or some purpose. This definition includes that the user influence through
interpersonal relationships, through an effective communication process to achieve
the goals set.
Spencer & Singer (1993) in Moeheriono (2012:5) defined A competency is an
underlying characteristic of an individual that is casually related to criterion
referenced effective and or superior performance in a job and situation. From the
definition can be said that the competence is a basic characteristic inherent in a
person with causal relation to the effectiveness and excellent performance in a
particular job or situation. Dessler (2011:169) stated, competencies are demonstrable
characteristics of the person that make performance possible. That is mouthful so
let us be more specific job. Competencies are observable and measureable behaviors.
From the above understanding can be concluded that the competence is a
characteristic that can be demonstrated by someone who shows the performance of
a specific job and can be observed and measured.
Another definition put forward by Wibowo (2012:324) which stated that
competence is the ability to carry out work based on skills, knowledge and supported
by the attitude demanded by a particular job. A person who has good competence
will be able to finish the job well. Competence can be said to be a skill performed
in the completion of a given task to a certain person (Jacob, 2016:38).
Jackson, Schuler & Werner (2010:205), defined competence as a pattern of
knowledge, skills, abilities, behaviors and other characteristics that can be measured
and needed to perform a job role or job function well. Competence is an important
determinant factor for a person in producing excellent performance, in a competitive
collective and a key in determining organizational success. In other words, with
good competence it will create high performance and will impact on organizational
performance (Sedarmayanti, 2010:127).
According to Sedarmayanti (2013:22), work environment is the whole tooling
tools and materials encountered, the surrounding environment around which a
person works, methods of work, as well as arrangement of work either as individuals
or as a group.
According to Silalahi (2013:118), the work environment is the whole elements,
both within and outside the boundaries of the organization, either directly or
346 AZIS SUDARMO, ANOESYIWAN MOEINS, MUHAMMAD RIDWAN AND ET AL.
indirectly impact on the managerial activities to achieve organizational goals.
Meanwhile, another definition of work environment according to Sutrisno (2012:118)
is the overall means and infrastructure work around working employees that can
affect the implementation of work.
In addition, in the work environment there should also be no difference or
discrimination to avoid disputes. This is as stated by Bernadin & Russel (2013:58),
employment decision making or working conditions that are unfairly advantageous
to members of one group compared to members of another groups. The statement
indicates that the creation of a work environment intended for members of a working
organization should not be distinguished, since every member of the group will
compare it with others.
Brody (2013:56) cited the opinion of Fillmore H. Stanford about motivation,
motivation as an energizing condition of the organism that serves to direct organism
toward the goals of a certain class. This means motivation is a condition that
moves people towards a certain goal. Motivation is all the power that exists in a
person who gives will, direction and maintains the behavior in question.
Bangun (2012:313) mentioned that there are 3 things contained in motivation,
namely the existence of efforts, organizational goals and needs. When human
resources are motivated, HR will try hard to get what it wants, but it is likely that
a high level of effort will lead to achievable performance outcomes and achieve job
satisfaction that is beneficial to the organization. Therefore, in order for the
organization to achieve its objectives, it should consider the quality, intensity and
consistency of the efforts made by HR. Bangun (2012:313) also mentioned that
motivation can come from within a person, in this case the employee, commonly
referred to as intrinsic motivation and comes from outside, usually called extrinsic
motivation.
Mangkunegara (2011:47) stated that work motivation is a term used in
organizational behavior to describe the forces within the individual, which illustrate
the level, direction and persistence of effort expended at work.
Mangkunegara (2011:94) suggested that Job satisfaction is the favorable-ness
or unfavorable-ness with employee view of their work, which means that job
satisfaction is a pleasant or unpleasant feeling the employees views their work as.
The same theory is also put forward by Handoko (2010:193) which stated that job
satisfaction is a pleasant or unpleasant emotional state in which employees see
their work.
The proper form of introduction program, which also result in the acceptance
of a person both as a member of the working group and part of the organization,
sincerely and honorably, also generally result in a higher level of job satisfaction.
Environmental situations can also affect the level of job satisfaction (Hauser et al,
2010:13).
Tiffin (in Sutrisno, 2012:76) suggested that job satisfaction is closely related to
the attitudes of employees toward their own work, work situation, and cooperation
between leaders and fellow employees. Based on this understanding, Sutrisno defined
job satisfaction as a feeling of pleasure or displeasure of a worker in seeing and
STRUCTURAL EQUATION MODELING (SEM) 347
doing his work, if a person is happy with his work, then the person is satisfied with
his work and vice versa.
E. Methods
Given the design, this study was grouped into descriptive and verificative study.
The type of investigation in this study is causality which is to test the causal
relationship between research variables. The unit of analysis in this study is all
PHC midwives with civil servant status in West Sulawesi Province. Time horizon
in this research is cross sectional, meaning that the research was done at one
particular time.
The population of this research is the PHCs midwives with civil servant status
in West Sulawesi Province work area. The sample size was determined by observing
the analytical techniques used in the hypothesis test that is the Structural Equation
Model.
There are 5 variables used in the study, so that the minimum sample size
required was 200 respondents. Taking into account the presence of data outliers
(Hair et al, 2010:303) and the principle that the greater the sample size the better,
the minimum sample size in this study used a 1:5 ratio, i.e. 5 respondents for each
parameter in the study (Hair et al, 2010:605). This research has 55 parameters
(indicators), hence obtained minimum sample size equal to 275 respondents.
F. Result and Discussion
According to primary data analysis, the study results and discussions are as follow:
Figure 1: Overall Matrix
Source: LISREL 8.70
Leadership variable measured by 3 (three) dimensions namely leadership behavior
(X1), managerial skills (X2) and motivator skill (X3). Based on respondents
perceptions, the average score is ��3.887. The highest score is on the KP9 item
348 AZIS SUDARMO, ANOESYIWAN MOEINS, MUHAMMAD RIDWAN AND ET AL.
(4,133) regarding encouragement to achieve target while the lowest score is on the
KP11 item (3,467) regarding the award. These data indicates that leadership is
generally categorized well. The most notable dimension is about giving
encouragement to achieve target, while the lowest impact is on the indicator about
award. This result proves that the indicator about awards needs more attention.
Competence variable measured by 3 (three) dimensions namely technical skill
(X4), conceptual skill (X5) and human skill (X6). Based on respondents perception,
the competence variable has an average score of � 3.940. The highest score is on
the KM9 item (4,233) regarding cooperation with co-workers, and the lowest score
is on KM4 item (3,467) regarding understanding of administration. These data
indicates that competence is generally categorized well. The most notable dimension
is about cooperation with colleagues, while the lowest one is the understanding of
the administration. This result proves that the indicator about understanding of
administrations needs more attention.
Work environment variable measured by 2 (two) dimensions namely physical
environment (X7), and non-physical environment (X8). Based on respondents
perception, the work environment variable has an average score of � 3,710. The
highest score is on item LK11 (4,343) regarding the recognition from coworkers
and the lowest score is on item LK5 (2,200) regarding work environment safety.
These data indicate that work environment is generally categorized well. The most
notable dimension is about recognition from coworkers, while the lowest position is
on the indicator of work environment safety. This result proves that the indicator
of work environment safety needs attention.
Leadership and work motivation variables have positive correlation with the
value of 0.71, competence and work motivation variables have positive correlation
of 0.53 and the work environment has a positive correlation of 0.67 towards work
motivation, meaning that if leadership, competence and work environment increases
its influence on work motivation will also increase. The implications of these empirical
research facts indicate that if enough attention is given to leadership, competence
and work environment variables, work motivation will improve as well. Leadership,
competence and work environment variables proved to affect work motivation.
Based on the picture 1.1, leadership variable turned out to give the greatest influence
to work motivation with the value of 0.71 compared to other variables.
Significant statistical test proved that leadership have a significant correlation
with job satisfaction (9.21) with significant test limit value ttable 1.96. The results
showed that leadership influenced job satisfaction. This relationship can be
interpreted that changes in job satisfaction are influenced by leadership variable.
Significant statistical test proved that competence have a significant correlation
with job satisfaction (8.89) with significant test limit value ttable 1.96. The results
showed that competence has an effect on job satisfaction. This relationship can be
interpreted that changes in job satisfaction are influenced by competence variable.
Significant statistical test proved that work environment have a significant
correlation with job satisfaction (9.98) with significant test limit value ttable 1.96.
The results showed that work environment has an effect on job satisfaction. This
STRUCTURAL EQUATION MODELING (SEM) 349
relationship can be interpreted that changes in job satisfaction are influenced by
work environment variable.
Significant statistical test proved that work motivation have a significant
correlation with job satisfaction (7.93) with significant test limit value ttable 1.96.
The results showed that work motivation has an effect on job satisfaction. This
relationship can be interpreted that changes in job satisfaction are influenced by
work motivation variable.
Leadership and job satisfaction variables have positive correlation with the
value of 0.72, competence and job satisfaction variables have positive correlation of
0.68, work environment and job satisfaction have positive correlation of 0.79, and
work motivation has a correlation with the value of 0.60 towards job satisfaction,
meaning that if leadership, competence, work environment, and work motivation
increases, its influence on job satisfaction will also increase. The implications of
these empirical research facts indicate that if enough attention is given to leadership,
competence, work environment, and work motivation variables, job satisfaction
will also improve significantly. Leadership, competence, work environment, and
work motivation variables proved to affect job satisfaction. Based on the picture
1.1, work environment variable turned out to give the greatest influence to job
satisfaction with the value of 0.79 compared to other variables.
G. Conclusion
1. Leadership has a positive and significant correlation with work motivation.
This result shows that leadership has an important role in supporting work
motivation, which also means that work motivation depends on the given
leadership. Whereas the most dominant dimension in building leadership
construct is managerial skill (X2=0.81), while its impact on work motivation is
0.71. (Picture 1.1).
2. Competence has a positive and significant correlation with work motivation.
This shows that competence also important to increase work motivation, which
also means that work motivation is determined by competence. Whereas the
most dominant dimension in building competence construct is attitude
(X6=0.83), while its impact on work motivation is 0.53 (Picture 1.1).
3. Work environment has a positive and significant correlation with work
motivation. This shows that work environment has a role in supporting work
motivation, meaning that work motivation is determined by the surrounding
work environment. Whereas the most dominant dimension in building work
environment construct is nonphysical environment (X8=0.80), while its influence
on work motivation is 0.67 (Picture 1.1).
4. Leadership, competence, and work environment collaboratively has a positive
and significant correlation with work motivation. This shows that leadership,
competence, and work environment also have an impact on work motivation.
The most dominant variable in influencing work motivation is leadership variable
(0.71) and the most dominant dimension in building work motivation construct
is physiological needs (Y1=0.82). Contribution of leadership, competence, and
work environment variable towards work motivation is 0.55 or 55%, while the
350 AZIS SUDARMO, ANOESYIWAN MOEINS, MUHAMMAD RIDWAN AND ET AL.
remaining 0.45 are other variables which were not observed in this study.
Result of exogenous variables influence on endogenous variable shows that
fcount(7.59) > ftable(2.67) which means that Ho is rejected and there are influence
of leadership, competence, and work environment together towards work
motivation (Picture 1.1).
5. Leadership has a positive and significant correlation with job satisfaction.
This shows that leadership has a role in supporting job satisfaction, which
means that job satisfaction is determined by the leadership they received.
Whereas the most dominant dimension in building leadership construct is
managerial skill (X2=0.81), while its influence on job satisfaction is 0.72
(Picture 1.1).
6. Competence has a positive and significant correlation with job satisfaction.
This shows that competence also important in ensuring job satisfaction, which
also means that job satisfaction is determined by competence. Whereas the
most dominant dimension in building competence construct is attitude
(X6=0.83), while its impact on work motivation is 0.68 (Picture 1.1).
7. Work environment has a positive and significant correlation with job satisfaction.
This shows that work environment has a role in maintaining job satisfaction,
meaning that job satisfaction is determined by work environment. Whereas the
most dominant dimension in building work environment construct is nonphysical
environment (X8=0.80), while its influence on work motivation is 0.79 (Picture
1.1).
8. Work motivation has a positive and significant correlation with job satisfaction.
This result shows that work motivation has an important role in supporting
job satisfaction, which also means that job satisfaction depends on the work
motivation. Whereas the most dominant dimension in building work motivation
construct is physiological needs (Y1=0.82), while its impact on job satisfaction
is 0.60. (Picture 1.1).
9. Leadership, competence, work environment, and work motivation together have
positive and significant correlation with job satisfaction. This shows that
leadership, competence, work environment, and work motivation are very
important in improving job satisfaction. The most dominant variable in
influencing job satisfaction is work environment variable (0.79) and the most
dominant dimension in building job satisfaction construct is internal work
relation satisfaction (Y9=0.86). Contribution of leadership, competence, work
environment, and work motivation variable towards job satisfaction is 0.86 or
86%. The remaining 0.14 or 14% are other variables influencing job satisfaction
but are not observed in this study. Result of exogenous variables influence on
endogenous variable shows that fcount(8.27) > ftable(3.12) which means that Ho is
rejected and there are influence of leadership, competence, and work environment
together towards work motivation.
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