District Health Services Research Articles

Description of Complementary Feeding Practice to Underweight Children Under Two Years Old in The Working Area of Puskesmas Kanor, Bojonegoro District

Children under two years of age, are in a very important developmental period often referred to as the Golden Age. Child classified as Underweight based on anthropometry, measurements if their body weight for Age (BB/U) is between -3 SD <-2 SD. According to data from the Bojonegoro District Health Service. This study aims to describe complementary feeding practice to underweight children aged 6-24 months with in the working area of the kanor community health center. Research used an interview method with a questionnare for data collectin, A total of 41 children were selected through random sampling. The result showed that the age at first complementary feeding was correct in 68.4% of cases however, frequency 75.6%, amount 63.4%, texture 75.6%, variation 53, 6%, responsiveness 58.5% and hygiene 58.5%. While most children had a story of exclusive breastfeeding, aspect such as children had a history of exclusive breasfeeding aspect such as frequency, quantity, texture, variety, and responsivenness of complementary feeding were incorrect even though cleanliness was satisfactory. Educational interventions are needed to improve knowledge and practices related to proper complementary feeding for children.

Analisis Manajemen Logistik Obat di Dinas Kesehatan Kabupaten Kolaka Tahun 2023

Good logistics management of medicines is one of the factors so that medicines can be managed well. The pharmacy unit of the Kolaka District Health Service has problems with inadequate storage or storage of medicines and delays in the arrival of medicines. The aim of this research is to determine the Analysis of Drug Logistics Management at the Kolaka District Health Service. The research uses qualitative methods through in-depth interviews, observations and observation guides. The results of the research show that at the drug planning stage using the consumption method, drug procurement using an e-catalog system, drug storage is still not good because the warehouse is not large enough for drug storage. Suggestions for the Kolaka District Health Service.

Implementation Machine Learning of K-Means Clustering Method and Linear Regression for Detecting the Risk of Tuberculosis Spread in Bangka Regency

The number of tuberculosis (TB) sufferers in Bangka Regency tends to increase and is becoming a very serious public health problem. In 2023, there will be around 331,581 residents of Bangka Regency, with around 1,489 of them suffering from TB. The high number of TB cases in Bangka Regency requires comprehensive monitoring. Surveillance can be carried out by grouping TB cases by region. One clustering method is K-Means which groups data based on similar criteria. Researchers also used the Linear Regression method to predict the effect of population density on increasing TB prevalence. This research was conducted to cluster the distribution pattern of TB by region and identify the influence of population density variables on the increase in TB. Based on the results of the K-Means method analysis by looking at the Performance Davies Bouldin-Index (Dbi) test, researchers obtained a pattern of TB distribution which was categorized into: Areas with High Prevalence (Sungailiat), Medium Prevalence (Belinyu and West Mendo) and Low Prevalence (Bakam, Merawang, Pemali, Pudding Besar, and Riau Silip). Meanwhile, the prediction results show that there is a positive influence of 81% of the population density variable on increasing the number of TB spreads and 19% is influenced by other variables. The results of this research can be used as a reference for the Bangka District Health Service to assist decision-making in preventing an increase in TB cases.

Efektifitas Komsumsi Tablet Fe dengan Air Jeruk Nipis terhadap Peningkatan Kadar HB Ibu Hamil Anemia Ringan Trimester III

Background: Anemia is a body condition where the hemoglobin level in red blood cells is lower than the normal standard. Pregnant women are said to be anemic if their Hb content is <11gr/dL. According to WHO, the prevalence of pregnant women throughout the world who experience anemia is 41.8%. The percentage of anemia in pregnant women in Indonesia is 37.1%. For the Special Region of Yogyakarta, the prevalence in pregnant women is 19.01%, and the highest incidence of anemia is in Bantul Regency (27.67%). Data from the Bantul District Health Service, from 27 Community Health Centers, there are 5 Community Health Centers with the highest number of anemia, namely at Sewon II Community Health Center. From this data, Sewon II Community Health Center is in second place. Objective: To determine the effectiveness of consuming fe tablets with lime juice on increasing Hb levels in mildly anemic pregnant women at the Sewon II Bantul Community Health Center, Yogyakarta. Method: This quasi-experiment research uses a one group pretest-posttest design. The sample in the study consisted of 30 pregnant women. The sampling technique uses total sampling. The research instrument gave lime to pregnant women with mild anemia for 2 weeks. Then the hemoglobin level was checked before and after drinking lime using a hemoglobin meter checking device in collaboration with the Puskesmas lab section. Results: The results of this research are based on univariate analysis of the characteristics of respondents aged 20-35 years as many as 26 (86.3%) respondents, the majority have a high school education as many as 26 (86.7%) respondents, the occupation of respondents is housewives 28 (93.3%) ) respondents. The results of the bivariate analysis showed that there was a significant effect on the average value of increasing hemoglobin levels before (10.21) and after drinking lime (11.23) with an average of (1.02). Conclusion: Based on the research results, it can be concluded that there is an effect of giving lime juice on hemoglobin levels in pregnant women in the second trimester at the Sewon II Bantul Community Health Center.

Study on Environmental and Health History Risk Factors for Pneumonia Cases in Toddlers at Motui Health Center

Introduction: Pneumonia case data in North Konawe Regency / 1000 Toddlers in 2017 found 121 cases, in 2018 found 175 cases, in 2019 increased found 162 cases for 2020 decreased by 158 cases and in 2021 found increased with a total of 240 cases from 888 toddlers handled by health workers. The purpose of this study was to analyze the Risk Factors of Toddler Health History and Environment on Pneumonia Cases in Toddlers in the Motui Health Center Work Area. Method: The study used a quantitative method with an observational approach using a Case Control Study design. This study was conducted from March 1 to May 1, 2023. The sample size for each group was at least 46 samples. The comparison of case and control samples is 1: 1. The total sample is 92 respondents with a simple random sampling technique, using the SPSS 26 statistical test. Result: The health history of toddlers has a risk of 8.67 times for the occurrence of pneumonia, environmental conditions have a risk of 8.91 times for the occurrence of pneumonia in toddlers in the Motui Health Center Work Area. Conclusion: The need for a North Konawe District Health Service specifically for handling infectious disease programs.

PENGARUH EDUKASI DENGAN MEDIA E-BOOKLET TERHADAP PENGETAHUANiIBU TENTANG STUNTING DI DESA PANGAUBAN WILAYAH KERJA PUSKESMAS BATUJAJAR TAHUN 2024

Stunting is one of the problems faced in the world, especially in developing countries which have middle to lower average incomes. Based on data obtained from the West Bandung District Health Service, the prevalence of stunted toddlers reached 5.16% August (2023), this is due to several factors causing stunting, one of which is a lack of maternal knowledge which influences the incidence of stunting. The efforts to minimize the number of stunting incidents include providing education using e-booklet media. The aim of the study was to determine the influence of education using e-booklets on mothers' knowledge about stunting. This study method is pre-experimental with a one group pretest-posttest design. The population of this study was all mothers with toddlers in Pangauban Village, namely 1,520 mothers, and the sample size was 20 mothers of toddlers using a non-probability sampling technique. Data analysis uses the Dependent T-Test (Paired Samples Test). The results of this study showed that the average knowledge value of mothers before being given education using e-booklets was 68.45 and after being given education using e-booklets was 76.60, with ?-Value = 0.006, which means there was an influence of education using e-booklet media on mother’s knowledge about stunting. It is hoped that the E-Booklet can be used as a media for providing health education in order to minimize the occurrence of stunting.

An evaluation of support to the second victims in Tshwane District Health Services, South Africa.

Initiatives to reduce patient safety incidents (PSI) and support healthcare professionals who may experience psychological trauma as a result are becoming increasingly common. However, little is known about the quality of the support provided by Tshwane District Health Services. Therefore, it is necessary to assess their assistance for the second victims in order to evaluate their effectiveness. A cross-sectional study was conducted, and 319 healthcare professionals from six primary health care institutions were invited to participate in the study. The sociodemographic information, work experience, emotional support, familiarity with the concept of the 'second victim' and involvement with PSIs were collected. The mean age was 39.8 years, ranging from 22 years to 66 years. The majority of participants were females (n= 249; 78.1%), nurses (n= 153; 49.2%), and those with 5-9 years of experience (n= 82; 25.8%). Most participants (n= 168; 52.7%) were aware of the possibilities of emotional support, while less than half (n= 142; 44.5%) were familiar with the term 'second victim'. The cumulative incidence of adverse events in the institutions was 19.4%, and the majority of second victims (n= 39; 62.9%) emotionally felt the need to speak with someone about it, preferably outside of the workplace. Less than 5% of individuals received support that was initiated by existing structures at their workplace. Frameworks exist to assist second victims, although they are only known to some healthcare professionals. However, their current use in Tshwane health facilities is ineffective. After experiencing PSIs, second victims often rely on psychological assistance outside of the workplace.Contribution:Authorities need to determine the causes behind some healthcare professionals' lack of awareness regarding the support framework for second victims, as well as their growing tendency to rely on psychologists outside of the workplace, and corrective measures should be implemented.

Faculty development for supervisors of medical student rural attachments in Zimbabwe.

Reflective writing and keeping portfolios during rural hospital attachments has been shown to give medical students more confidence, better communication skills and clinical competence, thereby making them stronger adult learners. The role of supervisors as facilitators of learning during Community-based Education rural site visits is critical. The University of Zimbabwe Faculty of Medicine and Health Sciences established faculty development workshops to train supervisors to be better able to support students in becoming active learners and critical thinkers, giving them constructive feedback, and encouraging them to look for positive outcomes during their rural attachments. These educational skills were new to most supervisors, requiring a culture change from the usual didactic approaches. Educators had to learn about adult learning theories, the constructivist approach to knowledge creation, role-modelling and methods of assessment that were empowering for students. They were encouraged to form communities of practice through the faculty development process of training and assessment and to consider how to develop research and scholarship in documenting their experiences as facilitators and learning partners with their students and colleagues. These activities enhanced their professional identity formation as scholars, educators and facilitators. Their exposure to the functioning of rural hospitals, partly through narratives of the students' reflective writing, enabled them to develop a greater appreciation of the potential of primary care and the district health services as the foundation of the Zimbabwe health system. Future benefits could include application of this training to other health professional programmes, as part of interprofessional education.

Peran Mahasiswa dalam Kuliah Kerja Nyata di Kampung Mandopi Rimom Kabupaten Manokwari Provinsi Papua Barat

Community Service Program (CSP) is a form of manifestation of community service that is in line with the demands and realization of the Tridharma of Higher Education. It is hoped that through CSP, students will be able to utilize knowledge, analyze community conditions, and provide solutions to various problems (social, economic, health, and education) in villages especially. The CSP implementation method consists of 4 stages, namely the initial stage (literature study, location survey, and interviews), the planning stage, the implementation stage, and the monitoring and evaluation stage. The CSP activity which took place in Mandopi Rimom Village, Manokwari Regency was carried out for 36 days (24 June - 8 August 2022) involving 1 field supervisor and 9 students from different study programs. A total of 35 work/activity programs (wp) have been successfully implemented involving participation and cooperation from village residents, school officials, posyandu officers, district health services, and the LPPM of Papua University. The work programs cover 8 areas of activity, namely village administration (7 wp), education (5 wp), health (5 wp), environment (10 wp), religion (2 wp), agriculture (2 wp), animal husbandry (2 wp) and socio-cultural economics (2 wp). The KKN seminar was held on the 35th day to present the results of the activities as well as get appreciation and suggestions as recommendations for implementing KKN in the next period. The results of the work program, activity documentation, obstacles, and suggestions/recommendations are then prepared in the form of a report to be submitted to the university's LLPM.

The Role of E-Kinerja, Additional Employee Income (TPP) and Work Ability towards Job Performance Mediate by Job Satisfaction in Public Health Office, Malang Regencyh

E-Kinerja is a tool for calculating employee performance allowances by implementing an e-performance system, providing employee performance allowances more evenly for the same work. Additional Employee Income (TPP) is an incentive given to civil servants (PNS) in the form of additional income in order to improve performance, and it is given to employees as a bonus for the performance achieved. Work ability is the skills individuals possess in carrying out tasks given to individuals concerned. Therefore, apart from being driven by a person's outstanding abilities and sufficient motivation, peak performance is also supported by a conducive environment. The research aims to determine and analyze the description of E-Kinerja, Employee Income Allowance (TPP), Work Ability, Employee Job Satisfaction and Employee Performance at the Malang District Health Service. This research uses an explanatory research approach. Explanatory research. E-Kinerja system, Employee Income Allowance (TPP), work ability on performance through job satisfaction. Analysis techniques used: classical assumption test, validity test, reliability test, path analysis test. The research results show an influence of E-Kinerja, TPP (Employee Income Allowance), and Work Ability on Employee Job Satisfaction at the Malang District Health Service. The research results show an influence of E-Kinerja, Employee Income Allowance, and Work Ability on Employee Performance at the Malang District Health Service. The research results show job satisfaction influences employee performance at the Malang District Health Service. The research results show that the influence of E-Kinerja, Employee Income Allowance (TPP), and Work Ability on Performance is mediated by Employee Job Satisfaction at the Malang District Health Service.

PREVENTIVE BEHAVIORS FOR DENGUE HEMORRHAGIC FEVER

Dengue fever is a viral infection caused by the dengue virus which is transmitted to humans through the bite of an infected mosquito. About half of the world's population is now at risk of dengue fever with an estimated 100–400 million infections occurring annually. This study aims to determine factors related to dengue prevention behavior in the East Ogan Komering Ulu District Health Service in 2024. The design of this research is quantitative with a cross-sectional approach. The population of this study was visits to the Gumawang Health Center in 2024. The sample in this study consisted of 93 respondents. The sampling method used purposive sampling. This research was carried out on 15-26 February 2024. Data was collected using a questionnaire. Bivariate data analysis used the Chi-Square test and multivariate logistic regression. Data collection using questionnaires. Results of statistical test analysis using the Chi-Square statistical test. The results of the study knowledge (p value 0.022), draining the landfill (p value 0.047), preventive measures (p value 0.005) and ventilation (p value (0.017). Age (p value 0.35), mosquito wire installation (p value 0.47) with dengue hemorrhagic fever (DHF) prevention behaviour at the East Ogan Komering Ulu District Health Office in 2024. The most dominant factor with dengue hemorrhagic fever (DHF) prevention behaviour is DHF prevention measures (p Value = 0.003) (OR 0.252). Conclusion There is a relationship between knowledge, landfill draining, preventive measures and ventilation. For the Health Office to carry out dengue prevention activities, carried out routinely and scheduled integrated in basic health services.

District health service delivery and the contribution of family physicians

District health service delivery and the contribution of family physicians

The Relationship between Mother's Knowledge and the Incident of Stunting in Toddlers at the Mundar Village Polindes, South Labuan Amas District, Hulu Sungai Tengah Regency in 2024

Stunting is stunted growth caused by a lack of nutritional intake due to a diet that does not meet long-term needs. South Kalimantan Province is in the top 3 provinces with the highest reduction in stunting (-5.4%) in 2022 based on the SSGI results released by the Indonesian Ministry of Health. Initially in 2021 stunting in South Kalimantan reached 30.0% and in 2022 it decreased by 24.6%. With a figure of 24.6%, reducing stunting is still a priority for South Kalimantan to achieve the target of 14% in 2024. Based on data from the Hulu Sungai Tengah district health service in 2020, the figure was 10%, experiencing a decrease in 2021 with a figure of 9.44%, and in in 2022 there will be an increase of 31.10%. This research is analytical research. With a Cross Sectional approach. The research results showed that the majority of mothers had sufficient knowledge and 21 children were not stunted (33.9%), 9 children were stunted (14.5%), and there was insufficient knowledge with the incidence of stunted children being 13 people (21.0%). and there were 2 children (3.2%) who were not stunted, while there were 0 people (0%) with good knowledge and stunted babies, and 17 people (27.4%) who were not stunted. Based on the results of the chi square test, it was found that there was a relationship between maternal knowledge and the incidence of stunting at the Mundar Village Polindes with a P value = 0.000. It is recommended that the Mundar Village Polindes, South Labuan Amas District, Hulu Sungai Tengah Regency further increase health education activities related to health and education for mothers with babies and toddlers about preventing stunting through improving child nutrition.

Implementation of Path Analysis for Modeling the Influence of Organizational Culture on Work Productivity

This research aims to determine the significant factors of organizational culture that influence employee performance productivity using a path analysis model by looking at the total direct and indirect influence of sub-variables. Path analysis can describe the magnitude of the influence and significant variables using direct and indirect influences. By adapting to this case, direct and indirect modeling is needed to see the magnitude of the influence of these sub-indicators. Research related to organizational culture has been carried out to see how much influence organizational culture and motivation have on employee performance. The result is that the greater the organizational culture and achievement motivation, the higher the influence on employee performance. This type of research uses a qualitative and quantitative approach. This research uses a questionnaire to collect data, which has been tested for validity and reliability. This research was conducted at the Gorontalo District Health Service in 2022. Respondents used in this research were 57 Gorontalo District Health Service employees. Data analysis using software R. Results of the research show that organizational culture variables and sub-variables, namely artifacts (X1), values ​​(X2), and basic assumptions (X3), significantly influence employee performance productivity (Y). The total effect is calculated using the path coefficient calculation of the significant variables. The total influence of organizational culture in the form of artifacts (X1) on employee work productivity (Y) is 72%, and the total influence of organizational culture in the form of values ​​(X2) on employee work productivity (Y) is 65%. The total influence of organizational culture is in the form of basic assumptions (X3 ) on employee work productivity (Y) of 78%. This shows that the organizational culture variable influences the most significant influence, namely basic assumptions (X3). The Gorontalo district health office can consider the results of this analysis to make further policies regarding which organizational culture priorities will be implemented to increase employee productivity to the maximum.

Gambaran Sanitasi Lingkungan Pasar dan Tingkat Kepadatan Lalat di Pasar Inpres Larantuka, Kecamatan Larantuka, Kabupaten Flores Timur

Market environment sanitation is an effort to monitor, prevent, control and control everything in the market environment such as flies. The density of flies can increase if the environment is dirty, for example markets that do not meet market environmental sanitation requirements such as rubbish dumps, waste water drainage channels and adequate water supplies. The aim of this research is to determine the description of environmental sanitation conditions and the density of flies at the Larantuka Inpres Market, Larantuka District, East Flores Regency. The type of research used is descriptive observation. The samples used in this research were all market sanitation facilities or facilities. The data obtained was then analyzed descriptively. The results of the research show that the results of the environmental sanitation conditions of the Larantuka Inpres Market based on the results of calculating the assessment variables on the external supervision observation sheet for environmental health inspections are categorized as not meeting the requirements for a healthy market (57.5%). The level of fly density at the Larantuka Inpres Market based on the results of measurements and calculations was obtained. 7 birds/blockgrill with a high density category of flies, it is necessary to secure the fly breeding places and if possible plan control measures. Therefore, it is necessary to collaborate between the government and local communities, including traders, market managers and district health services, to pay attention to the cleanliness of the market environment.

EVALUASI PROGRAM PENINGKATAN KINERJA APARATUR SIPIL NEGARA (ASN) DINAS KESEHATAN KABUPATEN MOJOKERTO

The ASN professionalism index (IP) is a statistical measure that describes the quality of ASN based on the educational qualifications, competence, performance and discipline of ASN employees in carrying out their job duties. The aim of this service activity is to evaluate the Performance Improvement Program for State Civil Apparatus (ASN) within the Mojokerto District Health Service in 2023. This activity was carried out in March 2023. The activity was carried out in the stages of analyzing the situation, identifying problems, determining problem priorities, determining alternative solutions. problems, determining activity plans, implementing activities and evaluating activities. The results of the activities obtained are that the performance of the ASN Health Service has increased in 2023. The performance of the ASN Mojokerto District Health Service has changed for the better with the SUHITA Application. The majority of employees have passed the set target points. The Personnel Section of the Mojokerto District Health Service should publish the results of the performance assessment within the Mojokerto District Health Service at every meeting so that it can be a motivation for ASN.

Village as Contextual Factors and Other Risk Factors Related with the Incidence of Clinical Tuberculosis in Children in Wonogiri, Central Java: A Multilevel Analysis

Background: Indonesia is in the second rank with the highest burden of tuberculosis (TB) in the world. Childhood is a period of rapid growth, the body still has a low immune system so it is susceptible to disease including tuberculosis in children which requires control efforts. This study aims to analyze the influence of risk factors and village contextual factors on the incidence of TB in children.Subjects and Method: Case-control study research was conducted in 82 villages in Wonogiri Regency, from November to December 2023. A sample of 200 children aged 0 to 4 years old was selected through fixed disease sampling. The dependent variable of this study was the incidence of TB in children. The independent variables in this study were stunting, contact history, exposure to cigarette smoke, home sanitation, gender, parental education, child age, parental income, BCG immunization status, and village contextual influences. Data on TB disease was obtained from the Tuberculosis Information System Application (SITB) at the Wonogiri District Health Service in 2023. Other data was collected through questionnaires. The data analysis was done through multilevel multiplelogistic regression.Results: The factors that increased the incidence of TB in children were stunting (OR= 10.94; CI 95%= 2.50 to 47.90; p= 0.001), contact history to TB (OR= 8.37; CI 95%= 1.60 to 43.83; p= 0.012), and exposure to cigarette smoke (OR= 7.36; CI 95%= 1.99 to 27.14; p= 0.003). The reducing factors were healthy sanitation (OR= 0.24; CI 95%= 0.08 to 0.78; p= 0.017), female children (OR= 0.40; CI 95%= 0.15 to 1.05; p= 0.062), and parents with ≥high school education (OR= 0.40; CI 95%= 0.15 to 1.05; p= 0.062). There was no relationship between age (OR= 0.93; CI 95%= 0.13 to 6.23; p= 0.940), parental income (OR= 1.14; CI 95%= 0.40 to 3.25; p= 0.807), and BCG immunization status (OR= 0.12; CI 95%= 0.00 to 105.98; p= 0.550). Village has a contextual influence on the incidence of clinical TB in children (ICC= 52.95%).Conclusion: The risk of clinical TB in children increased with stunting, a history of TB contact and exposure to cigarette smoke, it decreased with healthy home sanitation, female gender, parents with ≥high school education. There was no relationship between age, parental income, and BCG immunization status. The village has a contextual effect on the incidence of clinical TB in children.

Demonstration of Cough Etiquette As an Effort to Reduce Pulmonary Tuberculosis Cases in Sindang Jaya Using a Community Diagnosis Approach

ABSTRACT Pulmonary Tuberculosis is currently still a serious health problem and is very easily transmitted. Indonesia is the country with the second-highest number of new pulmonary TB cases in the world. The Tangerang District Health Service at the end of 2022 found the number of pulmonary TB cases was 8,941 cases. There was an increase of 60% in new cases of pulmonary TB in Sindang Jaya District within 3 months in 2023. It was necessary to determine which villages had the main problem of pulmonary TB. This study aims to know the causes and carry out interventions to reduce new cases of pulmonary TB. Activities are carried out with a community diagnosis approach. A situation analysis is carried out to determine the problem. Identify the cause of the problem using the Blum Paradigm. Prioritization of problems using the Delphi non-scoring technique. Fishbone diagram to determine the root cause of the problem. Intervention plan with log frame goals and plan of action. Intervention is carried out through a demonstration of cough etiquette. There has been an increase in the ability to practice cough etiquette to help reduce the number of new cases of pulmonary TB. It was proven that 50% of the counseling participants could understand and practice cough etiquette well. After taking a community diagnosis approach, the cause of the problem was found and intervention was carried out, so it is hoped that new cases of tuberculosis in the Sindang Jaya Health Center working area will decrease. Keywords: Tuberculosis, Community Diagnosis, Blum Paradigm, Fishbone Diagram

Cross-site scripting (xss) vulnerability in the cirebon district health service web system

Cross-site scripting (xss) vulnerability in the cirebon district health service web system

PENGARUH KEPEMIMPINAN TRANSFORMASIONAL DAN LINGKUNGAN KERJA TERHADAP KINERJA PEGAWAI DENGAN MOTIVASI KERJA DAN DISIPLIN KERJA SEBAGAI VARIABEL MEDIASI DI DINAS KESEHATAN KABUPATEN PASER

The aim of the research is to determine the influence of transformational leadership, discipline, motivation and work environment on employee performance at the Paser District Health Service. tUsing path analysis with the help of the PLS tsoftware program. The results of the analysis show that transformational leadership has a significant influence on the work motivation of employees at the Paser District Health Service. The work environment has a significant influence on the work discipline of employees at the Paser District Health Service. Work motivation has a significant influence on the performance of employees at the Paser District Health Service. Work discipline has a significant influence on the performance of employees at the Paser District Health Service. Transformational leadership has a significant effect on employee performance at the Paser District Health Service. The work environment has a significant influence on the performance of employees at the Paser District Health Service. Transformational leadership has a significant influence on employee performance at the Paser District Health Service with work motivation as mediation by television. The work environment has a significant influence on the performance of employees at the Paser District Health Service with work motivation as the mediating variable