Health Education and Health Promotion

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.