A Quest for Quality Health Care Workers a Nurses: The Case of Donggala Health Center Regency, Central Sulawesi, Indonesia

Abstract

Introduction: Indonesia continues to face high maternal and infant mortality rates, ranking third in ASEAN. Challenges persist in providing equitable and quality maternal and child health (MCH) services, particularly in rural areas. While national programs like BPJS Health Insurance aim to improve access and affordability, disparities in patient satisfaction between insured and non-insured users remain understudied.

Methods: This descriptive-analytical study surveyed 100 respondents using a Likert scale-based questionnaire to assess service satisfaction across nine indicators from the MENPAN 2024 standard. Respondents included BPJS-insured and non-insured patients at community health centers in Donggala, Central Sulawesi. The analysis employed a mean difference t-test to examine differences in satisfaction levels between the two groups.

Results: The study found that overall service quality was rated as "Good" with a Community Satisfaction Index (IKM) score of 76.01. Seven indicators met reasonable performance thresholds, particularly in cost and service procedures. However, competencies of health workers (score = 2.63) and infrastructure quality (score = 2.70) were rated poorly. Statistical testing revealed no significant difference in satisfaction between BPJS and non-BPJS users (mean difference = 1.0), supporting Hypothesis H1.

Conclusions: There is no significant perceived difference in the quality of MCH services based on insurance status. However, targeted workforce competency and infrastructure improvements are urgently needed to enhance primary healthcare service quality in rural Indonesia.