Intrinsic and Extrinsic Factors of Cadre Performance in Non-Communicable Disease Integrated Development Post (Posbindu Ptm): Qualitative Study on Posbindu PTM Cadre in Gadingrejo Public Health Center, Pasuruan, East Java, Indonesia

Abstract

Background: Non-communicable Disease Integrated Development Post (Posbindu PTM) is the
manifestation of the public participation in the early detection and monitoring of main noncommunicable
disease in integrated, routine, and periodic manners. The activities of Posbindu PTM in Gadingrejo Public
Health Center Working Area are based on the Activity Performance Indicator (API) of Posbindu. Regardless
of the above-target Posbindu coverage amount (in API number 1), the performance of Posbindu (API number
2, 3, 4) is below the national target and average. This article is aimed at analyzing and revealing the factors
of the phenomenon occurred in Gadingrejo PHC Working Area comprehensively.
Material and Method: This article combines qualitative method with phenomenology approach. Thirtyeight
respondents participated in this study have met the inclusion criteria. The study is conducted in April–
May 2019 by in-depth interview to collect the research data. The collected data is analysed using content
analysis approach.
Result: The performance phenomenon in Gadingrejo PHC Working Area is influenced by intrinsic and
extrinsic factors. The intrinsic factors include: (a) individual factor (compulsion, skill and ability, ineffective
training, and concurrent position of the cadres), (b) Posbindu internal factor (ineffective schedule, lack of
infrastructure, active cadres, supporting investigation), and (c) psychological factor (shame, doubt, and lack
of confidence). Meanwhile, the extrinsic factors include: (a) social factors (less support from the family and
the society), (b) political factors (less support from the regional government apparatus, lack of assistance
from the Public Health Center), and (c) economics factor (low budget).
Conclusion: The optimization of synergy and intervention for the intrinsic and extrinsic factors is needed
to avoid the low performance of Posbindu PTM. Ottawa Charter can be used as a strategy for the promotion
of non-communicable disease treatment which include healthy public policy, optimizing personal skill, and
public movement.