Health Education and Health Promotion

en Selective Mediating Role of Quality of Work Life on Health Worker Performance in Decentralized Systems Descriptive & Survey Aims: This study analyzed whether quality of work life consistently mediates the relationships between organizational commitment, healthy work environment, motivational climate, career development, and health worker job performance in decentralized primary care systems. Instrument & Methods: This explanatory quantitative study used validated measures to assess organizational commitment, workplace quality, motivation, career progression, quality of work life, and job performance among 320 primary healthcare workers in the local government of Aceh, Indonesia. Indirect and direct relationships were examined using partial least squares structural equation modeling. Findings: Quality of work life significantly mediated the effects of motivational climate (β=0.147; t=3.467; p=0.001) and career development (β=0.105; t=2.974; p=0.003) on job performance, but did not mediate the effects of organizational commitment (β=0.01; t=1.106; p=0.269) or healthy work environment (β=0.006; t=0.86; p=0.39). Healthy work environment (β=0.216; t=6.279; p<0.001) and organizational commitment (β=0.423; t=6.569; p<0.001) significantly influenced job performance independently of quality of work life, while motivational climate had a marginal direct effect (β=0.115; t=1.878; p=0.06). The paths from organizational commitment (β=0.035; t=1.227; p=0.22) and healthy work environment (β=0.021; t=0.895; p=0.371) to quality of work life were not significant. Conclusion: Quality of work life improves health professionals’ performance in decentralized health systems by selectively mediating the effects of motivational climate and career development, while organizational commitment and health environment influence performance through other direct pathways.   Quality of Work Life,Job Performance,Healthcare Workers,Health Systems Plan, 139 145 http://hehp.daneshafarand.org/browse.php?a_code=A-10-1-92&slc_lang=en&sid=4 M. Yuda Pratama 1003194753284600380419 1003194753284600380419 Yes Department of Public Health, Faculty of Public Health, University of Northern Sumatra, Medan, Indonesia I. Yustina 1003194753284600380420 1003194753284600380420 No Department of Public Health, Faculty of Public Health, University of Northern Sumatra, Medan, Indonesia N. Nurmaini 1003194753284600380421 1003194753284600380421 No Department of Public Health, Faculty of Public Health, University of Northern Sumatra, Medan, Indonesia Z. Zulkarnain 1003194753284600380422 1003194753284600380422 No Department of Industrial and Organizational Psychology, Faculty of Psychology, University of Northern Sumatra, Indonesia G. Silaban 1003194753284600380423 1003194753284600380423 No Department of Public Health, Faculty of Public Health, University of Northern Sumatra, Medan, Indonesia E. Mutiara 1003194753284600380424 1003194753284600380424 No Department of Public Health, Faculty of Public Health, University of Northern Sumatra, Medan, Indonesia N.L. Lubis 1003194753284600380425 1003194753284600380425 No Department of Public Health, Faculty of Public Health, University of Northern Sumatra, Medan, Indonesia S. Sumardiyono 1003194753284600380426 1003194753284600380426 No Department of Occupational Safety and Health, Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia