Analysis of the Effect of Leadership Style and Motivation on the Performance of Health Workers at UPT PKM Dlanggu, Mojokerto Regency in 2021

An organization must have good performance to be able to exist and excel in the competition. Performance is an indicator of good or bad management decisions in decision making. Performance is influenced by leadership style and employee motivation. Good or high performance can help the organization make a profit, and vice versa if the performance decreases it can harm the organization. The purpose of the study was to analyze the influence of leadership style and motivation on the performance of the employees of the Technical Service Unit of the Dlanggu Public Health Center, Mojokerto Regency in 2021. This research was carried out for 1 month. The population in this study were all employees of the Technical Service Unit of the Dlanggu Public Health Center, Mojokerto Regency. The sample in this study was 67 people. The results obtained show that Based on the results of the Logistics Regression test, shows that for the leadership style variable on the performance variable p value = 0.003 which means that there is an influence of leadership style on the performance variable and on the motivation variable on performance, p value of = 0,035 which means that there is an influence of motivation on performance. The Omnibus law sig value of 0.000 is smaller than 0.05 which indicates that there is a significant influence of Leadership Style and Motivation simultaneously on the Performance variable. It can be concluded that there is an influence of leadership style and motivation on employee performance.


INTRODUCTION
The era of modernization has changed the order and behavior of human relations, namely the shift in values of human needs and desires. Organizations that provide goods and services to meet these human needs have sprung up in society so that the competition between them becomes very tight. The organization must be sensitive and responsive to various changes and developments that exist. People's lives are undergoing a process of development from a traditional society that relies on the agrarian sector to a service and information industry society. The process of changing people's lives in this era of globalization is triggered by the rapid development of science, information and communication technology. These various developments have given rise to the global economy, global competition, global business, global company or global organization (Tewal et al., 2017).
An organization must have good performance to exist and excel in the competition. Performance is an indicator of good or bad management decisions in decision making. Good or high performance can help the organization make a profit, and vice versa if performance drops it can harm the organization. Performance is a set of financial and non-financial indicators that offer information on the level of achievement of goals and outcomes (NB, 2014). The results of performance are usually related to efficiency and effectiveness. The definition of efficiency and effectiveness according to Stoner and Freeman as follows: Efficient is the ability to minimize the use of resources in achieving organizational goals means doing the right thing, while effectiveness is the ability to set adequate goals means doing the right thing. According to (Langton et al., 2013) said efficiency shows the achievement of the most output (output) with the least amount of input (input), while effectiveness shows the completion of activities so that organizational goals are achieved.
A public health center is a health service organization that organizes public health efforts and first-level individual health efforts by prioritizing promotive and preventive efforts to achieve the highest degree of public health in its working area. (RI, 2014). The success of the public health center in achieving the National Health Goals cannot be separated from the existence of quality human resources, namely health workers. The performance of health workers is a very important issue to be studied in order to maintain and improve health development. The study of performance provides clarity on the factors that influence individual performance. Seeing the importance of the role of health workers in carrying out their duties, health workers are required to further improve their abilities and performance. To improve this performance, it is necessary to have good work motivation, work attitude, leadership and supervision (Rahmanita, 2014). Performance in an organization is carried out by all existing human resources, both leaders and workers. There are several factors that can affect human resources in carrying out their performance. Whether it's a factor that comes from within human resources and from outside him. Every worker has the ability based on knowledge and skills, competence in accordance with his job, work motivation and job satisfaction. However, workers also have personalities, attitudes and behaviors that can affect their performance (Larasati, 2018).
Gibson stated that the performance of health workers is influenced by 3 variables, namely individual variables, organizational variables and psychological variables. Individual variables, consisting of abilities, skills, experience, demographics and family background. Psychological variables consist of perception, attitude, motivation, personality and learning. Organizational variables consist of resources, rewards, workload, structure, supervision and leadership. Nurses' clinical performance is influenced by internal and external factors, internal factors are skills and motivation, while external factors are supervision, leadership and monitoring (Mandagi et al., 2015).
The ratio of the number of health workers in Indonesia according to the Minister of Health in 2017 is 1 compared to 4000 residents. In East Java alone, the number of health workers includes 19,144 doctors, 51,276 nurses, 24,375 midwives, 7,589 pharmacists, and 2,386 nutritionists. (Statistics, 2020), while health workers in Mojokerto district are divided into 435 doctors, 1622 nurses, 695 midwives, pharmacists. 165, and 56 nutritionists. Specifically, Technical Service Unit of the Dlanggu Public Health Center has a total of 32 health workers. The number of health workers at the UPT Puskesmas Dlanggu is very less when compared to the number of outpatient visits, namely 886 patients in August 2020 alone. When added with additional workloads such as preparation for accreditation and others, the performance of health workers will automatically decrease. Preliminary surveys show that some health workers show less than optimal work, their motivation and discipline are still lacking, this can be seen from their late arrival and leaving the place during working hours. From the leadership aspect, there were also some health workers who stated that the leadership was less able to provide direction to health workers, although there were also those who stated that the leadership at Technical Service Unit of the Dlanggu Public Health Center was good.
In this study, the research wanted to analyze the relationship between leadership style and motivation with the performance of health workers at Technical Service Unit of the Dlanggu Public Health Center, Mojokerto Regency. This research is important to do considering that there is no research with that title, so when the hypothesis can be proven, this research can be a reference in order to improve the performance of health workers as an effort to improve health services for the realization of national health goals.

MATERIALS AND METHODS
This type of research uses a quantitative descriptive method, with a simple correlation analysis approach and logistic regression to measure the relationship between variables. This research was conducted at the Technical Implementation Unit of the Dlanggu Community Health Center, Mojokerto Regency in 2021. The sample used was some of the employees in the Technical Implementation Unit of the Dlanggu Community Health Center with a total of 67 people. This research has been conducted an ethical test by the Health Research Ethics Commission of IIK Strada Indonesia with the number 2568/KEPK/VIII/2021. The flow of this research is conducting a preliminary study, then compiling a research instrument in the form of a questionnaire, giving informed consent to respondents and collecting data by means of interviews. The variables in this study are independent variables, namely leadership style and motivation and the dependent variable is performance. This research has passed the ethical test and obtained ethical clearance information from the Health Research Ethics Commission of IIK Strada Indonesia. The statistical test in this study used the Chi Square test for bivariate and logistic regression for multivariate.

Characteristics of Respondents Based on Age and Last Education of employees at Technical
Implementation Unit of the Dlanggu Community Health Center, Mojokerto Regency in 2021. Based on Table 5, it was found that out of 67 respondents, most of them, namely 25 people (37.3%) thought that the leadership style was democratic and had a positive performance at the Technical Implementation Unit of the Dlanggu Community Health Center, Mojokerto Regency.
6. The effect of motivation on employee performance at Technical Implementation Unit of the Dlanggu Community Health Center, Mojokerto Regency in 2021. Based on Table 6, it was found that out of 67 respondents, most of them were 40 people (59.7%) with positive motivation and performance. at the Technical Implementation Unit of the Dlanggu Community Health Center, Mojokerto Regency.

The influence of leadership style and motivation on employee performance at Technical
Implementation Unit of the Dlanggu Community Health Center, Mojokerto Regency in 2021. Based on Table 7, it can be seen that the value of Exp (B) X1 to Y is 3,185, which means that the value of leadership style is more positive, the employee's performance will be 3,185 times more positive. The value of Exp (B) X2 to Y 4,577 means that the motivation value is more positive, the employee's performance will be 4,577 times more positive. In Table 8 above, it can be seen that the Omnibus law sig value is 0.000 less than 0.05. This indicates that there is a significant influence of X1 Leadership Style and X2 Motivation, the independent variable simultaneously affects the dependent variable Y Performance.
The coefficient of determination R2 is used to determine the percentage of Variation in Dependent Variables that can be explained by variations in the independent variables. This R2 value lies between 0 and 1. A small R2 value means that there is very little variation in the dependent variable explained by the independent variable. If the value of R2 moves closer to 1, it means the greater the variation in the dependent variable that can be explained by the Independent variable (Alhamda, 2018).
Based on the results of the coefficient of determination (Appendix) the value of Adjusted R square is 0.452. This result indicates that 45.2% of the work performance variable (Y) can be explained by the leadership style variable (X1) and motivation (X2), the remaining 50.8% is influenced by the variable others that were not investigated in this study.

The influence of leadership style on employee performance at Technical Implementation Unit of the Dlanggu Community Health Center, Mojokerto Regency in 2021.
According to Table 7, it has been proven that there is an influence between leadership style on the performance of Technical Implementation Unit of the Dlanggu Community Health Center employees, Mojokerto Regency. Through the results of the calculations that have been carried out, the p value of 0.003 is smaller than 0.005, thereby proving that leadership style has a positive effect on employee performance. It can also be seen that the value of Exp (B) X1 to Y is 3.185, which means that the value of leadership style is more positive, the employee's performance will be 3.185 times more positive.
The results of this study indicate that leadership style has a positive influence on employee performance. This means that leadership is an effort to influence many people through the communication process to achieve organizational goals, which is expected to cause positive changes in the form of dynamic forces that can coordinate organizations in order to achieve organizational goals (J Winardi, 2015). Leadership is a process of moving people in an organization because they have the power, authority and ability, so that they work in an atmosphere of high morality and can enthusiastically complete their respective jobs according to the expected results. This shows that the leadership at Technical Implementation Unit of the Dlanggu Community Health Center, Mojokerto Regency tends to be able to mobilize existing employees, in accordance with what is expected by the leadership, namely the running of existing Health programs at Technical Implementation Unit of the Dlanggu Community Health Center. On average, the head of the Technical Implementation Unit of the Dlanggu Community Health Center will act as management, they have good knowledge of how the Health program will be implemented. So that his ability in terms of telling, selling, participating and delegating tends to be good. The ability of management and of course will tend to have a positive impact on employee performance (Wijono, 2018).
The results of this study are consistent with the research findings of Sri Wahyuni (2013) which concludes that the level of relationship or correlation coefficient R between the variables of Work Motivation, Employee Ability, Work Environment, Work Discipline, Leadership, and Personality with the employee performance variable is 0.780 or belongs to the category strong relationship level. While the level of influence between these types of variables is 60.9% and shows that there are still 39.1% of other independent variables that also affect performance, where leadership has a positive effect on employee performance (Wahyuni et al., 2017). 2. The effect of motivation on employee performance at Technical Implementation Unit of the Dlanggu Community Health Center, Mojokerto Regency in 2021.
Based on Table 7, it can be concluded that there is an influence between motivation on the performance of Technical Implementation Unit of the Dlanggu employees, Mojokerto Regency. Through the results of the calculations that have been carried out, the p value of 0.035 is smaller than 0.005, thus proving that motivation has a positive effect on employee performance. In Table 7 it can also be seen that the Exp (B) X2 to Y is 4,577, meaning that the motivation value is more positive, the employee's performance will be 4,577 times more positive.
According to Maslow in the book of Imam Mohtar (2019), one of the basic human needs is self-actualization, where the need that is never satisfied is the need for self-actualization, which is always continuously fulfilled incessantly, so that unsatisfied needs will encourage or motivate actions. /behavior (Mohtar, 2019). Given this, if someone is always motivated at work, then he will always try to improve his actions/performance.
These results have relevance to the results of an empirical study conducted by Tampi (2014), where the work motivation factor is one of the factors that has a significant effect on the performance of employees in both government organizations. This is in line with the opinion expressed by Robin in Mulyadi (2011) where work motivation is one component that has a significant effect on employee performance.

The influence of leadership style and motivation on employee performance at Technical
Implementation Unit of the Dlanggu Community Health Center, Mojokerto Regency in 2021.
In Table 8 above, it can be seen that the Omnibus law sig value is 0.000 less than 0.05. This indicates that there is a significant influence of X1 Leadership Style and X2 Motivation, the independent variable simultaneously affects the dependent variable Y Performance.
Based on Table 5, it was found that out of 67 respondents, most of them, namely 25 people (37.3%) thought that the leadership style was democratic and had a positive performance at the Technical Implementation Unit of the Dlanggu, Mojokerto Regency. Perception of leadership style can affect a person's performance. Positive perceptions about the leadership style of the leading manager, will form motivation in a person to behave positively as well, which can form positive performance/behavior. (Wijono, 2018).
Based on Table 6, it was found that out of 67 respondents, most of them were 40 people (59.7%) with positive motivation and performance. at the Technical Implementation Unit of the Dlanggu, Mojokerto Regency. Motivation arises in a person because of the encouragement of one of the goals. Motivation is needed because of human nature that requires some kind of inducement, encouragement or incentive to get better performance (Andjarwati, 2015). The results of this study are in line with the research of Tampi (2013) which concluded that based on hypothesis testing using the T test, leadership style and motivation have a positive and significant effect on employee performance.

ACKNOWLEDGMENTS
The author is thankful for respondents for their valuable information and its awareness to participate in this research.

CONFLICTS OF INTEREST
The author declares that they have no conflict of interest