Research Articles Open Access Competence.
Rewards, and Geographic Proximity in Nutrition Practitioner Performance Fauzie Rahman1.
Syamsul Arifin2*.
Rosihan Adhani3.
Meitria Syahadatina Noor4.
Husaini Husaini5.
Muhammad Abdan Shadiqi6.
Neka Erlyani7.
Muhamad Muslim8 1Medical Science Doctoral Program.
Faculty of Medicine and Health Sciences.
Lambung Mangkurat University.
Banjarbaru.
Indonesia 2Master of Public Health Science Study Program.
Faculty of Medicine and Health Sciences.
Lambung Mangkurat University.
Banjarbaru.
Indonesia 3Dentistry Study Program.
Faculty of Dentistry.
Lambung Mangkurat University.
Banjarmasin.
Indonesia 4Master of Public Health Science Study Program.
Faculty of Medicine and Health Sciences.
Lambung Mangkurat University.
Banjarbaru.
Indonesia 5Master of Public Health Science Study Program.
Faculty of Medicine and Health Sciences.
Lambung Mangkurat University.
Banjarbaru.
Indonesia 6Psychology Study Program.
Faculty of Medicine and Health Sciences.
Lambung Mangkurat University.
Banjarbaru.
Indonesia 7Psychology Study Program.
Faculty of Medicine and Health Sciences.
Lambung Mangkurat University.
Banjarbaru.
Indonesia 8The Head of the Department of Communication and Informatics.
Government of South Kalimantan Province *Corresponding Author: E-mail: syamsularifin82@yahoo.
ARTICLE INFO
Manuscript Received: 02 Oct, 2024 Revised: 14 Feb, 2025 Accepted: 23 Feb, 2025 Date of publication: 02 Oct, 2025 Volume: 5 Issue: 3 DOI: 10.
56338/jphp.
KEYWORDS
Stunting.
Competence.
Rewards.
Geographical Proximity.
Performance.
Management Span
ABSTRACT
Introduction: Based on data from the Indonesian Health Survey, the stunting rate in South Kalimantan Province in 2023 reached 24.
The target for reducing the national stunting rate in 2024 is 14%.
Nutrition practitioner play a diverse and crucial role in handling stunting, from assessment and education to policy intervention and advocacy.
This study aims to determine the effect of competence, appreciation and geographical proximity on the performance of nutrition practitioner with management span as a moderating variable in preventing stunting cases.
Methods: This type of research is observational analytic with a cross-sectional design.
The location of this research is at the Health Center in the working area of the South Kalimantan Provincial Health Office and the duration of the research is 2 months.
The sample of this research is 280 respondents who were taken using the cluster sampling technique.
The data collection method uses a questionnaire.
Ethical approval was obtained from the Health Research Ethics Commission of the Faculty of Medicine and Health Sciences.
Lambung Mangkurat University with number No.
067/KEPK-FKIK ULM/EC/V/2024
and participants signed the Informed Consent.
Results: The findings show that geographical proximity .
= 0.
658, p = 0.
has no significant effect on TPG performance, indicating that the distance between program targets and TPG members does not influence outcomes.
In contrast, competence .
= 5.
404, p = 0.
, rewards .
= 3.
766, p = 0.
, and management range .
= 2.
577, p = 0.
have a significant positive impact on performance, where higher competence and more frequent rewards lead to improved results.
The results further demonstrate that management range strengthens the effect of both rewards .
= 3.
872, p = 0.
and competence .
= 549, p = 0.
on performance, indicating that effective coordination enhances their impact.
However, the interaction between management range and geographical proximity .
= 0.
742, p = 0.
is not significant, suggesting that distance does not moderate the influence of management range on Conclusion: Competence and reward is the factor influencing performance, while geographical proximity do not show significant influence.
Competence, rewards, geographical proximity, and management span simultaneously influence performance with a contribution of 71% (RA = 0.
This finding suggests the need for organizations to focus on improving TPG competencies through continuous training, skill development, and knowledge enhancement.
In addition, it is important to explore other factors outside the research model that may have a significant impact on performance, including intrinsic motivation and better work system support.
Publisher: Pusat Pengembangan Teknologi Informasi dan Jurnal Universitas Muhammadiyah Palu Page | 494 J.
Public Heal.
Pharm.
: 494-501
INTRODUCTION
Stunting is a condition where a person's height is less than normal based on age and gender .
The World Health Organization .
said that the incidence of stunting in the world reached 22% or 149.
2 million in 2020.
The results of the Indonesian Nutritional Status Survey (SSGI) by the Ministry of Health showed that the prevalence of stunting in Indonesia fell from 24.
4% in 2021 to 21.
6% in 2022.
South Kalimantan is one of the provinces with stunting incidents that experienced an up and down trend in 2021 stunting in South Kalimantan reached 30.
0% and in 2022 decreased by 24.
Based on data from the Indonesian Health Survey (SKI), the stunting rate in South Kalimantan Province in 2023 reached 24.
7% .
, .
The target for reducing the incidence of national stunting in 2024 is 14% .
This picture makes stunting a major threat to the quality of society which will affect the nation's This is because stunted children experience disturbances in physical growth .
hort stature/dwarfis.
and brain development, which will affect their abilities and achievements in school, productivity and creativity at a productive age .
Appropriate intervention through a combination of sensitive and specific nutritional interventions has been shown to reduce the prevalence of stunting by >3% per year.
The most effective program components between 19862015 were nutrition education, nutrition counseling, child growth promotion, immunization, hygiene sanitation and social safety nets.
Nutrition practitioner in the field play an important role in operationally implementing various nutrition programs through the Public Health Efforts Sector (UKM) at the Health Center.
Nutrition practitioner play a diverse and crucial role in handling stunting, from assessment and education to intervention and policy advocacy.
Through the performance of nutrition practitioner who help ensure that children get the nutrition they need to grow and develop properly, and contribute to efforts to reduce the prevalence of stunting.
Therefore, it is necessary to evaluate the performance of nutrition practitioner at the health center so that the program being run can run effectively and efficiently .
Performance is defined as the work results achieved by a person or group of people in an organization according to their authority and responsibility .
According to Gibson Et Al .
, performance is influenced by individual factors .
bilities and skills, background, demographics, and task perception.
, psychological factors .
erceptions, attitudes, personality, learning and motivatio.
Ainsworth.
Smith and Millership .
, performance is influenced by role clarity, competence, environment, fit between organizational values and rewards .
Michael Armstrong .
explains that performance is influenced by abilities and skills, motivation, work environment, leadership, rewards and organizational factors .
esources, leadership, rewards, job structure and desig.
Salam's research .
related to performance states that competence has a significant effect on the performance of employees of the South Sumatra Provincial Health Office (P = 0.
This shows that if competence increases, employee performance will also increase, conversely if competence decreases, employee performance will also decrease .
According to Nurlindah's research .
there is no relationship between competence and performance (P = 0.
Rewards are also a motivator for employees to work in a company .
Sari LN's research .
shows that there is a relationship between reward provision and employee performance .
= 0.
On the other hand, according to Noorhidayah's research .
, there is no relationship between rewards and the performance of health workers with a significant value .
=0,.
Research according to Arifin S .
good process performance is influenced by internal domicile in the fostered village .
= 0.
The geographical proximity factor is interpreted as the location or position of a place compared to the position of other areas on earth which also influences performance.
Geographical conditions are one of the most dominant factors influencing the accessibility of health services because everything related to geographical conditions.
Coordination efforts are also made in its implementation, this is closely related to the management span.
The management span is the number of employees or subordinates who can be effectively controlled by a manager or supervisor at one time.
To choose a management span, managers must consider the relationship between managers and subordinates in two groups of two or more, as well as pay attention to the one-toone relationship directly with subordinates .
Based on the description, the purpose of this study is to determine the effect of competence, awards, and geographical proximity on the performance of nutrition practitioners in South Kalimantan Province.
In addition, analyzing the role of management span as a moderating variable.
Page | 495 Competence.
Rewards, and Geographic Proximity in Nutrition Practitioner Performance METHOD This study is an analytical observational study with a cross-sectional design.
The population in this study were all nutrition practitioner at health centers in the work area of the South Kalimantan Provincial Health Office in 2023, totaling 692 people.
The research sample 280 nutrition practitioner with a minimum education of D3 Nutrition and a minimum work period of 3 months.
The sampling method used the cluster sampling technique.
The location of this study was at the Health Center in the work area of the South Kalimantan Provincial Health Office.
The research instrument used a questionnaire that had been tested for validity and reliability.
Data collection was carried out through an offline survey for two months in July-August 2024.
Respondents were given a consent form and instructions for filling out the questionnaire.
Performance measurement in this study was conducted using a combination of methods, namely self-reported questionnaires from respondents and objective data, such as work target achievements and annual performance evaluations, to enhance the validity of the findings.
Data analysis used the Partial Least Square (PLS) method, with a normality test performed using AMOS software version 24.
In addition, a multicollinearity test was performed by examining the correlation matrix between independent variables to identify the potential for very high relationships between variables that could cause To test the hypothesis, this study used the Structural Equation Modeling (SEM) approach, which allows analysis of the relationship between latent and observed complex variables.
In this study, several steps were taken to control potential confounding variables that could affect the relationship between independent and dependent variables.
Factors such as age, length of service, and workload of nutritionists were controlled through stratification techniques and covariate analysis.
In addition, alternative models were tested to show whether other variables, such as education level or work motivation, had a significant effect on the performance of nutrition practitioners.
A moderation regression test was conducted to test how far the range moderated the management of the relationship between competence, rewards, and geographic proximity to the performance of nutritionists.
Ethical Approval This study has received approval from the Health Research Ethics Committee of the Faculty of Medicine and Health Sciences.
Lambung Mangkurat University with approval number No.
067/KEPK-FKIK ULM/EC/V/2024.
All participants of the nutrition practitioner of the health centers in the working area of the South Kalimantan Provincial Health Office have given their consent before participating in the study.
The confidentiality of all participants is strictly maintained during the research process.
RESULTS
Based on table 1, shows that the subjects in this study were more female .
90%) than male .
10%).
overview of the age category obtained that the subjects in this study were aged 20 years to 65 years (M = 35.
= 8.
with the majority being in the age category 31-44 years .
21%).
The description of the last education range was found to be diverse, namely from SMA equivalent.
Diploma i.
Diploma IV.
Strata one (S.
, to Master (S.
which in this study was dominated by TPG Diploma i graduates .
57%).
The length of service of the subjects was also found to be between 1 year and 35 years (M = 10.
SD = 8.
with the majority having worked for 1-10 years .
64%).
Positions were found to vary, but the position as Nutrition Program Coordinator/Manager was more dominant .
78%).
Table 1.
Characteristics of Research Subjects Characteristics Gender Age Education Category Male Female < 31 Years 31 Ae 44 Years > 45 Years Senior High School Diploma i Diploma IV Frequency 16,10 83,90 34,29 48,21 17,50 0,36 58,57 13,21 22,50 Page | 496 J.
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Length of Working Period Position 1 Ae 10 Years 11 Ae 20 Years > 20 Years Nutriologist / Nutritionist Nutrition Program Coordinator / Manager Other 5,36 59,64 27,14 13,22 19,29 76,78 3,93 Source: Primary Data The results of the study in table 2 show that geographical proximity .
= 0.
658, p = 0.
has no significant effect on TPG performance, indicating that the distance between program targets and TPG members does not influence outcomes.
In contrast, competence .
= 5.
404, p = 0.
, rewards .
= 3.
766, p = 0.
, and management range .
= 2.
577, p = 0.
have a significant positive impact on performance, where higher competence and more frequent rewards lead to improved results.
Table 2.
Interpretation of direction and significance of influence between variables Influence between Variables T statistic (|O/STDEV|) P values Geographic Proximity -> Performance Competence -> Performance Rewards -> Performance Range Management -> Performance Source: Primary Data Description Insignificant Significant effect Significant effect Significant effect The results of management span moderation on the relationship between competence, rewards, geographic proximity, and performance can be seen in table 3.
The results show that management range strengthens the effect of both rewards .
= 3.
872, p = 0.
and competence .
= 3.
549, p = 0.
on performance, indicating that effective coordination enhances their impact.
However, the interaction between management range and geographical proximity .
= 0.
742, p = 0.
is not significant, suggesting that distance does not moderate the influence of management range on performance.
Table 3.
Moderation Analysis of Management Span on the Relationship between Competence.
Rewards.
Geographical Proximity and Performance Variable Relationship
T statistic (|O/STDEV|) P values Description Management Range x Geographic Proximity 1
No Moderation > Performance Range Management x Competence -> Significant Moderation Performance Management Range x Rewards -> Significant Moderation Performance Source: Primary Data
DISCUSSION
This study involved 280 Nutrition Management Workers (TPG) spread across health centers in South Kalimantan.
The majority of respondents were female .
3%), had an average age of 35.
33 years, and most had a Diploma i education .
%).
Most respondents .
65%) showed high performance.
The analysis showed that competence and rewards were the main factors influencing TPG performance, while geographical proximity did not have a significant effect.
Regression analysis revealed that the variables studied contributed 33.
5% to performance, 5% was influenced by other factors outside this research model.
Performance is defined as the work results achieved by a person or group of people in an organization according to authority and responsibility and influenced by individual factors and psychological factors .
The Page | 497 Competence.
Rewards, and Geographic Proximity in Nutrition Practitioner Performance findings of this study indicate that performance for TPG can be influenced by competence while awards and geographical proximity do not affect performance.
The findings of this study are consistent with the findings of Ainsworth et al.
which states that competence and awards can affect performance .
Pramularso's research .
also found something similar where competence can affect performance, because competence is an important part that can improve employee performance .
However, the results of this study differ from Supiyanto .
who reported no significant influence of competence on employee performance.
This difference in results may be due to variations in organizational context, type of work, or characteristics of the respondents studied.
Supiyanto .
studied cooperative employees, while this study focused on nutrition practitioner, who may have different competency demands.
In addition, other factors such as organizational culture, reward systems, and work environment can moderate the relationship between competence and performance .
Al-Gassimi et al .
in their research found that competency aspects such as knowledge .
and communication .
affect nutrition practitioners so that they need to improve their knowledge and communication skills in order to have an impact on improving the nutrition services provided to patients .
Similar research conducted on nurses also found that the better their competency, the better their performance.
Thus.
TPG competency greatly influences their performance in handling stunting cases.
Good competency includes knowledge .
, skills .
, and attitudes .
nterpersonal relationship.
needed to carry out tasks effectively .
Competence can be used to predict performance .
Competence can be used to predict performance .
Competence is a basic characteristic possessed by an individual that is causally related to the fulfillment of the criteria required to occupy a position .
Employee competence needs to be continuously improved so that the quality of human resources it has can continue to compete and keep up with developments in the era and technology.
Therefore, organizations need to conduct employee training, especially for employees who already have special positions and tasks that require competence in certain skills where updating knowledge will be useful in improving the quality of work results .
in the future .
From a policy perspective, these findings indicate the need to strengthen the strategy for developing the competency of nutrition workers through various initiatives.
One step that can be taken is to continuously improve training and competency development, covering not only technical skills but also communication and managerial skills.
In addition, the government can implement a competency certification system for nutrition workers as a form of professional recognition, which can be the basis for job promotions and competency-based incentives.
Strengthening supervision and regular technical guidance is also needed to ensure increased capacity of nutrition workers in providing more optimal services.
Then, awards have a significant influence on performance.
This is in line with the results of research by Herawati et al.
which found that there was a significant influence between awards and employee performance.
When employees are given awards such as prizes and/or short-term incentives, it will be able to improve the quality of employee performance .
Research by Oktaviana and Wahyono .
states that one of the triggers for health workers to provide quality services is the attention of superiors in the form of awards for both service and recreation, so that good performance will be realized and provide satisfaction to patients .
Murphy's research .
also highlights that an effective reward system plays an important role in improving organizational performance by combining intrinsic and extrinsic rewards, and not only focusing on salary .
The main purpose of the award is to motivate employees to continue to make optimal contributions, while increasing their satisfaction with their work and organization .
Employee motivation and performance are greatly influenced by the perceived value of the awards given.
Therefore, good reward management, integrated with organizational design, strategy, and culture, can significantly improve performance and productivity .
In theory and practice, this research confirms the relevance of competency and reward models in explaining employee performance in critical sectors such as community nutrition services.
Emphasize the importance of continuous competency development as an effort to drive people towards higher productivity.
This is also in accordance with the basic theory mentioned by Maslow .
, where rewards occupy the fourth level of needs in the hierarchy of needs, in the form of a sense of being valued socially and professionally through recognition and incentives .
Therefore, these findings provide implications for policy makers to further prioritize workforce competency development and provide a performance-based reward system while still evaluating other factors at play beyond this research model, such as intrinsic motivation and modern technology support.
Geographic proximity factor is defined as the location or position of a place compared to the position of other areas on earth which also influences performance.
Geographical conditions are one of the most dominant factors Page | 498 J.
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influencing the accessibility of health services because everything related to geographical conditions such as distance, travel time, and transportation facilities cause less than optimal utilization of health facilities and result in worse health outcomes .
However, the results of this study contradict the findings in the field where there was no significant influence between geographical proximity and performance.
This is because in the context of this study, there are other factors that more dominantly influence performance compared to geographical proximity.
For example, in the competency variable which plays a more significant role in driving performance, regardless of geographical proximity.
In addition, technological developments and easier access to information can also reduce obstacles caused by distance, so that performance is no longer too dependent on geographical factors.
Policies that support accessibility to technology and resources can reduce the gap between remote areas and other areas, enabling more equitable and quality nutrition services.
This study makes a significant contribution to understanding the factors that influence the performance of nutrition practitioner, but it is important to note some limitations.
First, this study was only conducted in a health center within the South Kalimantan Provincial Health Office, so the results may not be generalizable to a national or international context.
Second, the cross-sectional study design only captures the relationship between variables at a specific point in time and does not allow for long-term changes or dynamics.
Third, as much as 66.
5% of the variation in performance is influenced by other factors outside the research model, indicating that there are still other important variables that have not been explored.
This study provides valuable insights into the factors that influence TPG performance, some limitations need to be noted, such as the cross-sectional study design that cannot establish causal relationships and other variables outside the model that may influence performance.
Future research should focus on using longitudinal designs to establish causal relationships and explore other factors, such as intrinsic motivation and work system support, which have the potential to improve our understanding of the determinants of TPG performance and inform the development of more effective policies and practices.
The discussion section interprets the findings of this study in the context of existing research, explores their practical implications, evaluates their strengths and limitations, and provides recommendations for future research.
CONCLUSION
This study aims to determine the effect of competence, reward, geographical proximity, and management span on the performance of Nutrition Implementing Personnel (TPG) at Health Centers in the Work Area of the South Kalimantan Provincial Health Office.
The aim is to determine the extent to which these factors affect TPG The results of the study indicate that competence and reward has a positive and significant effect on performance, meanwhile geographical proximity do not show a significant effect.
In addition, management span significant moderate the relationship between competence and reward to performance and management span does not moderate geographical proximity to performance.
Simultaneously, the four variables contribute 71% to performance (RA = 0.
This indicates that 71% of the variation in performance can be explained by the independent variables (Competence.
Reward.
Geographical Proximit.
and the moderating variable.
In addition, providing measurable performance-based incentives and strengthening leadership support and structured supervision can improve TPG motivation and performance.
It is important to improve the accessibility of resources in remote areas to support TPG in carrying out their duties more optimally.
Further research with longitudinal designs and exploration of other factors influencing performance, such as motivation and organizational support, is also needed to enrich policies that can improve the quality of nutrition services in Puskesmas.
Although this study provides valuable insights into factors influencing TPG performance, several limitations need to be noted, such as the crosectional study design that cannot establish causality, and other variables that may influence performance but were not examined.
Future research should focus on longitudinal designs to establish causal relationships, as well as exploring other factors such as motivation, supervision, and leadership support that have the potential to improve our understanding of TPG performance and inform the development of more effective policies and practices.
AUTHORAoS CONTRIBUTION STATEMENT FR: Conceptualization and design of the research, drafting the initial manuscript, and coordinating all research activities.
SA: Data collection and analysis, making significant contributions to the methodology section, and critically reviewing the manuscript.
RA: Providing corrections and feedback on the results of statistical analyses.
Page | 499 Competence.
Rewards, and Geographic Proximity in Nutrition Practitioner Performance data interpretation, and discussing the novelty of the research findings.
MNS: Identifying relevant research, developing the theoretical framework and conceptual framework.
H: Contributing to the discussion, the novelty of the research findings, and policy recommendations.
MAS: Supervising data collection, quality control, contributing to the introduction section, reviewing research instruments, and revising the manuscript.
NE: Reviewing the methodology and research instruments, providing input on research findings, and drafting policy recommendations.
CONFLICTS OF INTEREST
The authors declare that there are no conflicts of interest related to the publication of this article.
SOURCE OF FUNDING STATEMENTES
This research did not receive any specific grants from funding agencies.
ACKNOWLEDGMENTS
The authors express their deepest gratitude to all parties who contributed to this research.
In particular, the authors would like to thank the Health Office of South Kalimantan Province and all nutrition practitioner at the community health centers throughout South Kalimantan Province who participated in this study, the Expert Team in Health Policy and Management.
Public Health Nutrition Experts, and Health Promotion and Behavioral Science Experts who provided input on the content of the research instruments, as well as the author's institution, the Faculty of Medicine and Health Sciences at Lambung Mangkurat University.
BIBLIOGRAPHY