ORIGINAL ARTICLE
Jurnal Ilmiah Kebidanan (The Journal of Midwifer.
Volume 13.
Number 2 : 132-138 DOI: https://doi.
org/10.
33992/jik.
e-ISSN: 2721-8864 p-ISSN: 2338-669X The Correlation between Work Duration and Midwives' Knowledge of Contraceptive Implants with Their Implant Insertion Proficiency Iman Surihartini1.
Sri Rahayu2.
Ni Komang Yuni Rahyani3
1,2,3
Midwifery Department.
Poltekkes Kemenkes Denpasar.
Bali.
Indonesia Corresponding Author: imansurihartini.
kb@gmail.
Article history:
Submitted, 2025/07/12 Accepted, 2025/10/06 Published, 2025/10/31 Keywords:
Knowledge.
Length of Work.
Skills.
Midwives.
Implantable Family Planning.
Cite This Article:
Surihartini I.
Rahayu S.
Rahyani NKY.
The correlation between work duration and midwivesAo knowledge of contraceptive implants with their implant insertion proficiency.
J Ilm Kebidanan (The J Midwifer.
:132-138.
doi:10.
33992/jik.
ABSTRACT
The success of implant insertion is influenced by the skills of midwives as health workers.
Factors such as length of service and level of knowledge are thought to be related to midwives' skills in implant insertion.
The purpose of this study was to determine the relationship between length of service and midwives' knowledge of contraceptive implants with their skills in implant insertion.
This study was a quantitative correlation study with a cross-sectional design.
The population in this study was all midwives in the Darek Community Health Center working area, and the sample was determined using total sampling technique, where the entire population was used as the sample.
The number of samples obtained was 49 midwives in the Darek Community Health Center working area.
The data were analyzed using Fisher's exact test.
The results of this study indicate a significant relationship between length of service and skills .
-value = .
and knowledge and skills .
-value = 0.
This study proves that there is a significant relationship between length of service and midwives' knowledge and skills in implanting The longer the work experience and the better the midwife's knowledge, the better the skills in implanting contraceptive implants tend to be.
INTRODUCTION
The government's Family Planning and Birth Control Program aims to reduce population growth and maternal mortality rates.
One of the most widely used methods of contraception is the contraceptive implant, which is a plastic capsule containing the hormone levonorgestrel.
The advantage of the contraceptive implant lies in its high effectiveness in preventing pregnancy.
Out of 100 users, only about 1 person still experiences pregnancy, which indicates a very good success rate 1 The success of implant placement is highly dependent on the skills of midwives as healthcare Factors such as length of service and knowledge about implant contraception are thought to play an important role in improving midwives' skills.
The experience of healthcare providers is considered important for the workplace because the success of a workplace is influenced by the skills and performance of the healthcare providers themselves.
Performance skills are the actual behaviors displayed by each person as work achievements produced by healthcare providers in accordance with Open Access: http://ejournal.
poltekkes-denpasar.
id/index.
php/JIK ORIGINAL ARTICLE Jurnal Ilmiah Kebidanan (The Journal of Midwifer.
Volume 13.
Number 2 : 132-138 DOI: https://doi.
org/10.
33992/jik.
e-ISSN: 2721-8864 p-ISSN: 2338-669X their roles in the workplace 2.
However, limited training budgets are one of the obstacles to improving midwives' skills in contraceptive services.
In West Nusa Tenggara Province (NTB), only about 50 midwives receive family planning training each year.
Data from NTB Provincial Health Office in 2024, only 4 of them were from Central Lombok District.
There are 49 midwives in Darek Community Health Center, only one attended contraception training in 2024.
As a result, midwives' skills in family planning services, especially implant insertion, are still not optimal.
Many fail to conduct pre-placement counseling, follow standard operating procedures, or provide adequate post-placement counseling.
Several previous studies have shown that midwives' skills in implant insertion are influenced by factors such as work experience and knowledge.
Sugiana, .
3 reported that midwives' work experience and knowledge influence their long-term contraceptive service skills.
Meanwhile.
Septiyana, .
emphasized that the clinical skills of health workers correlate with the length of practice, whereby the longer the work experience, the better the technical skills.
Based on existing research, various studies still highlight aspects of knowledge or work experience separately, and have not been conducted extensively in regions with limited access to training, such as Central Lombok.
Therefore, this study aims to analyze the correlation between length of service and midwives' knowledge of implant contraception with implant insertion skills at the Darek Community Health Center.
Central Lombok Regency.
METHOD
This study is an analytical observation with a cross-sectional approach.
Data were collected using two main instruments: .
a knowledge questionnaire consisting of 15 closed questions that had been validated using the Pearson Product Moment test .
< 0.
with a Cronbach's alpha reliability score of 0.
787, and .
an observational checklist for implant placement skills based on standard operating procedures.
The observation of midwivesAo skills was conducted directly by the researcher assisted by trained enumerators.
Before data collection, the enumerators received standardized training to ensure assessment consistency.
The observation was conducted in a non-blind manner, as the enumerators were aware of the purpose of the study.
The population of this study was all midwives in the working area of the Darek Community Health Center.
Central Lombok Regency, totaling 49 people.
Meanwhile, the sample in this study was determined using total sampling technique, where the entire population became the sample of 49 people.
Data analysis consists of univariate and bivariate analysis.
Univariate analysis aims to explain each research variable grouped according to their respective characteristics, namely respondent characteristics .
ast education, employment status, length of employmen.
, knowledge, and skills.
Meanwhile, bivariate analysis is conducted to determine the relationship between the variables of length of employment and midwife knowledge with skills using the chi-square statistical test.
The analysis was performed using the SPSS v.
26 data processing program.
RESULT AND DISCUSSION
Respondent Characteristics The characteristics of the respondents studied in this research included their level of education, employment status, and length of service as midwives in the Darek Community Health Center working These characteristics were important to analyze because they could influence the knowledge, skills, and performance of midwives in providing health services4.
The characteristics of the respondents in this study are shown in Table 1.
Published by Midwifery Department of Health Polytechnic.
Ministry of Health.
Denpasar.
This is an Open Access (OA) article distributed under the terms of the Creative Commons Attribution Share-Alike 4.
0 International License .
ttps://creativecommons.
org/licenses/by-sa/4.
0/).
ORIGINAL ARTICLE
Jurnal Ilmiah Kebidanan (The Journal of Midwifer.
Volume 13.
Number 2 : 132-138 DOI: https://doi.
org/10.
33992/jik.
e-ISSN: 2721-8864 p-ISSN: 2338-669X Table 1.
Respondent Characteristics Characteristic Education BachelorAos Degree (Midwifer.
Diploma i (Midwifer.
Employment Status Civil Servant (PNS) Government Contract Worker (P3K) Honorary/Intern Work Experience O3 Years >3 Years Frequency .
Percentage (%) The majority of respondents .
76%, n=.
held a Diploma i (D .
in Midwifery, meeting the minimum educational standard for midwives.
In contrast, only 12.
24% .
had a BachelorAos degree (S.
, indicating that most healthcare providers in this field rely on diploma-level education.
Most respondents were honorary/intern workers .
35%, n=.
, suggesting that non-civil servant staff form the backbone of healthcare services at Darek Community Health Center.
The remaining participants consisted of civil servants (PNS, 18.
37%, n=.
and government contract workers (P3K, 14.
29%, n=.
A total of 27 respondents .
10%) had O3 years of work experience, while 22 .
90%) had worked for >3 years.
This indicates that over half of the midwives in the region are relatively new, though a significant proportion have longer-term experience.
Frequency Distribution of MidwivesAo Knowledge and Skill Level Table 2.
Frequency Distribution of MidwivesAo Knowledge and Skill Level Knowledge Level Good Fair Skill Level Good Fair Frequency .
Percentage (%) Cumulative Percentage (%) Table 2 shows the Frequency Distribution of Midwives' Knowledge Levels.
The univariate analysis revealed variations in midwives' knowledge regarding Implant contraception.
Out of 49 respondents, 14 .
6%) demonstrated good knowledge, while 35 .
4%) fell under the fair knowledge category.
These findings indicate that most respondents had a moderate understanding of Implant contraception.
This highlights the need for targeted interventions to comprehensively improve midwives' knowledge in the region.
The data can serve as a foundation for designing evidence-based strategies tailored to the respondents' needs.
Table 2 also presents the frequency distribution of midwives' skill levels.
The univariate analysis revealed variations in midwivesAo skill levels regarding implant contraception.
Of the 49 respondents, 34 .
4%) demonstrated good skills, while 15 .
6%) had fair skills.
These findings indicate that all respondent midwives possess adequate technical proficiency to perform implant contraception procedures.
Open Access: http://ejournal.
poltekkes-denpasar.
id/index.
php/JIK ORIGINAL ARTICLE Jurnal Ilmiah Kebidanan (The Journal of Midwifer.
Volume 13.
Number 2 : 132-138 DOI: https://doi.
org/10.
33992/jik.
e-ISSN: 2721-8864 p-ISSN: 2338-669X The results also reflect positively on the quality of services provided by midwives in the working area of Darek Community Health Center.
West Southwest Praya District.
Central Lombok Regency.
The predominance of good skill levels suggests technical readiness to deliver implant contraception services effectively.
These findings can serve as a foundation for maintaining or enhancing training and supervision programs aimed at further improving midwivesAo competency in implant contraception provision.
Knowledge is the result of a cognitive process in which an individual gains understanding through sensory perception of a specific object, influenced by various factors 5.
Factors affecting knowledge levels include age, education, and work experience6.
The research findings, presented in the table 2, reveal that out of 49 respondents, 14 .
exhibited good knowledge, while 34 .
4%) had adequate knowledge.
This indicates that most respondents possessed sufficient understanding of implant contraception.
Work experience was identified as a key factor influencing knowledge levels7.
Respondents with >3 years of experience tended to have better knowledge compared to those with O3 years.
Data showed that 33 respondents .
3%) with >3 years of experience had good knowledge, whereas only 1 respondent .
%) with O3 years of experience demonstrated good knowledge.
Conversely, 6 respondents .
2%) with >3 years and 9 .
4%) with O3 years had adequate knowledge.
These results suggest that longer work experience significantly enhances knowledge of implant contraception, underscoring its role in improving midwivesAo comprehension.
Another factor contributing to midwivesAo knowledge levels is their educational background 8.
Education plays a crucial role in shaping an individualAos ability to comprehend new information .
According to Law No.
20 of 2003 on the National Education System of the Republic of Indonesia, formal education consists of primary, secondary, and tertiary levels9.
Higher education is generally associated with improved capacity to absorb and apply knowledge in professional practice 10.
The study findings indicate that the majority of midwives held a Diploma i (D.
76%, n=.
, while only 12.
24% .
had a BachelorAos degree (S-.
A strong educational foundation is essential for midwives to understand and implement knowledge about implant contraception, thereby enhancing their professional competency.
Additionally, employment status influences midwivesAo knowledge 11.
The data revealed that most midwives worked as honorary staff or interns .
35%, n=.
, followed by civil servants (PNS) .
37%, n=.
and contract-based employees (P3K) .
29%, n=.
A supportive work environment and opportunities for continuous learning can positively impact midwivesAo knowledge Overall, the findings of this study indicate that midwives' level of knowledge about Implant Contraception is influenced by several factors, including work experience, educational background, and employment status.
Although the majority of midwives demonstrated adequate knowledge, continuous effortsAisuch as regular training or mentoringAiare necessary to further enhance their understanding of Implant Contraception.
Correlation Between Work Duration and MidwivesAo Skill Level Table 3.
Correlation Between Work Duration and MidwivesAo Skill Level Skill Level Good
Adequate Amount
O3 years Work Duration >3 years p-value* Amount
0,002
Published by Midwifery Department of Health Polytechnic.
Ministry of Health.
Denpasar.
This is an Open Access (OA) article distributed under the terms of the Creative Commons Attribution Share-Alike 4.
0 International License .
ttps://creativecommons.
org/licenses/by-sa/4.
0/).
ORIGINAL ARTICLE
Jurnal Ilmiah Kebidanan (The Journal of Midwifer.
Volume 13.
Number 2 : 132-138 DOI: https://doi.
org/10.
33992/jik.
e-ISSN: 2721-8864 p-ISSN: 2338-669X As shown in Table 3, 34 midwives demonstrated good skills in implant contraceptive services, of whom 33 .
1%) had >3 years of work experience, while only 1 .
9%) had O3 years of experience.
Among midwives with adequate skills .
, 9 .
%) had >3 years of experience, and 6 .
%) had O3 years.
FisherAos exact test revealed a statistically significant association between work duration and skill level .
=0.
002 < 0.
, indicating that work experience is significantly associated with midwivesAo competency in implant contraceptive procedures.
Work experience also significantly influences midwivesAo competency.
Data indicate that midwives with over three years of experience tend to demonstrate better skills compared to those with O3 years of practice.
This is evident among midwives with adequate knowledge, most of whom exhibit proficient skills.
Those with longer experience are typically more trained and confident in performing implantable contraceptive procedures.
These findings align with Adnyani, .
17 assertion that increased work experience correlates with enhanced professional skills.
However, although most midwives displayed strong competency, a small proportion exhibited only moderate proficiency.
This suggests that mastering implantable contraceptive procedures requires sustained time and intensive training.
Supporting this.
Williams and Hodges .
18 emphasize that skill improvement depends on repeated practice and hands-on experience.
Thus, continuous training and iterative practice are essential to enhance midwivesAo technical skills in implant insertion.
Correlation Between Knowledge and MidwivesAo Skills Table 4.
Correlation Between Knowledge and MidwivesAo Skills Good
Skill Level Good
Adequate Amount
Knowledge Level Adequate p-value* Amount
0,002
Table 4 presents the results of the chi-square test of the relationship between midwives' knowledge and skills.
The results from 49 midwives showed that 14 .
2%) midwives who had good knowledge also had good skills.
A total of 20 .
8%) midwives with adequate knowledge also had good skills.
Meanwhile, all 15 midwives .
%) with adequate knowledge also had good skills.
The appropriate Fisher's exact test yielded a significant p-value of 0.
002 (<0.
, indicating a statistically significant relationship between midwives' knowledge and their skills in providing implant contraception services.
Skills refer to an individualAos ability to perform an activity or task effectively, acquired through learning, practical training, and experience12.
Proficiency reflects a personAos competence in addressing tasks or challenges efficiently, accurately, and with agility 13.
Such abilities develop over time via repeated training and hands-on experience.
Skills encompass both technical mastery of specific tools or procedures and non-technical competencies, such as effective communication and decision-making.
Strong skills enable individuals to perform tasks optimally and deliver satisfactory outcomes 14.
As shown in Table 4, following training on contraceptive implant insertion, most midwives demonstrated strong proficiency, with 34 respondents .
4%) rated as skilled.
In contrast, 15 respondents .
6%) exhibited moderate skills but had not yet achieved optimal performance.
Key factors influencing midwivesAo competence in implant insertion include knowledge level and work Among the 34 skilled respondents .
4%), 20 .
8%) possessed adequate knowledge, while 14 .
6%) had high knowledge.
Conversely, all 15 respondents .
6%) with moderate skills Open Access: http://ejournal.
poltekkes-denpasar.
id/index.
php/JIK ORIGINAL ARTICLE Jurnal Ilmiah Kebidanan (The Journal of Midwifer.
Volume 13.
Number 2 : 132-138 DOI: https://doi.
org/10.
33992/jik.
e-ISSN: 2721-8864 p-ISSN: 2338-669X had only adequate knowledge.
This suggests that comprehensive knowledge of contraceptive implants significantly enhances midwivesAo ability to perform the procedure effectively 16.
In summary, this study highlights that midwivesAo competency in implantable contraceptive procedures is shaped by knowledge, work experience, and training exposure.
To optimize skills, midwives must receive ongoing training and frequent opportunities for practical reinforcement.
CONCLUSION
There was a significant correlation between Work Duration and Midwives' Knowledge of Contraceptive Implants with Their Implant Insertion Proficiency.
These findings indicate that improvements through continuous training, formal education, and strengthened practice are still needed.
ACKNOWLEDGMENTS
Thanks are expressed to the respondents and the research institution who provided support during the research process.
REFERENCES