Analysis of Ability and Motivation of Health Officers on Services in Arjasa Public Health Center, Sumenep Regency

Health services are a form of professional service and become an integral part of the overall health service effort. The purpose of this study is to analyzethe influence of the ability and work motivation of health workers on services at the Arjasa Public Health Center, Sumenep Regency. The design of this research is an observational quantitative research with a cross sectional approach with the focus of the research being directed analyzing the influence of the ability and work motivation of health workers on services at the Arjasa Public Health Center, Sumenep Regency. The total population is 134 respondents and a sample of 100 respondents is taken using the Simple Random Sampling technique. In the study, it was found that most of the respondents had the ability in the good category as many as 57 respondents (57%). Most of the respondents have work motivation in the medium category of 52 respondents (52%). Most of the respondents have service quality in the good category as many as 54 respondents (54%). Based on the results of Multiple Linear Regression analysis shows that with a p-value of 0.000 < 0, 05, then H1 is accepted, so it can be concluded that simultaneously there is an influence of the ability and work motivation of health workers on services at the Arjasa Public Health Center, Sumenep Regency with a magnitude of 79.1%. It is hoped that health workers will be able to provide good service


INTRODUCTION
In order to maintain and improve the quality of service, the performance of all human resources is always encouraged to be continuously improved. Health workers are one of the health service teams who are required to improve the quality of services in hospitals. When viewed from the nursing side, the quality of service in hospitals includes aspects of the number and ability of professionals, work motivation, funds, supporting facilities and equipment, hospital management which needs to be perfected and adapted to the development of science and technology (Suryono, 2018).
Health services are a form of professional service and become an integral part of overall health service efforts (Depkes RI, 2015). Health services are the main services that must be carried out to achieve the recovery of patients treated in hospitals or at the public health center. To support the recovery of patients treated in hospitals or health centers, health workers have a very important role through the provision of health services in the form of care.
Based on the Community Satisfaction Index data at the Arjasa Community Health Center, Sumenep Regency, which was taken by the Quality Assurance Team of the Sumenep Regency Health Office in 2019, from in-depth results on 130 respondents, it was found that patients usually have unpleasant, even scary experiences when they come to the public health center, because the services provided are not good. The results obtained are not optimal and tend to harm the patient and this can lead to dissatisfaction. The patient's statement, which was summarized, said that the doctor seemed rushed and intimidated by the patient's illness, the nurse was indifferent and uninformative. (Sumenep Health Office, 2019).
Based on preliminary data collection conducted by researchers on February 26, 2021 to 10 health workers at the Arjasa Public Health Center, Sumenep Regency, it was found that a total of 7 (70%) of them said that the services at the Arjasa Health Center were not well organized as well as many officers who often came late, some Also the officers go home before the service hours are over. While 3 (30%) of them said that the service at the Arjasa Health Center was good, this was influenced because the health workers at the public health center had the ability or skill to be clever, intelligent, diligent and diligent.
The problems mentioned above are influenced by several factors, two of which are the ability and work motivation of health workers. First, ability. Several research results show a relationship between abilities and skills with the performance of implementing health workers (Mustofa, 2018). Another study investigated the relationship between growth opportunities and health worker performance. The opportunity to develop to acquire abilities or skills is a dominant factor related to the performance of health workers (Wibowo, 2015). Second, motivation. Motivation is an important factor to improve performance (Handoko, 2018). Several studies related to motivation have shown a significant influence in shaping the performance of health workers (Fitri, 2017).
Performance is a set of results achieved and refers to the act of achieving and carrying out the requested work. Performance means the comparison of the results achieved with the participation of the workforce per unit of time (Mangkunegara, 2017). Employee performance is influenced by various factors, including: their abilities, motivation, support received, the existence of the work they do, and their relationship with the organization (Mathis & Jackson, 2017). To assess performance, indicators that can be used are: quantity of work results, quality of work results, efficiency in carrying out tasks, discipline, initiative, thoroughness, honesty and creativity, including work reliability and work attitude (Mangkunegara, 2017).
Ability is one of the things that affect the quality of health services. Ability refers to an individual's capacity to perform various tasks in a job. The employee's ability to work can be measured from the following parameters: intellectual ability, physical ability and emotional ability (Robbins, 2019). More specific parameters of ability are: work results, timeliness of work, expertise and skills, mastery of work methods, work responsibilities, utilization of work infrastructure, reducing work errors, ability to manage costs, and ability to cooperate (Mangkunegara, 2017).
Motivation is one of the things that affect human behavior. A more complete goal of motivation is to improve employee morale and job satisfaction, increase employee productivity, maintain company employee stability, improve employee leadership, streamline employee procurement; create a good working atmosphere and relationship; increase employee loyalty, creativity, and participation; increase the level of employee welfare; enhance employees' sense of responsibility towards their duties; and improve the efficiency of the use of raw material tools (Hasibuan, 2015).
With a qualified ability and also high motivation, it can improve the quality of services provided to patients in order to improve the performance that must be done (Yahya, 2017). Based on the above conditions, the authors are interested in researching the analysis of the ability and work motivation of health workers towards services at the Arjasa Public Health Center, Sumenep Regency.

METHODS
In this study, the researcher used an observational quantitative design with a cross sectional approach, which is a study to study the dynamics of the correlation between risk factors and effects, by approaching, observing or collecting data all at once (point time approach), that is, each subject The study was observed only once and measurements were made on the status of the character or variable of the subject at the time of examination. This does not mean that all research subjects are observed at the same time (Soekidjo, 2012). This research will analyzethe influence of the ability and work motivation of health workers on services at the Arjasa Public Health Center, Sumenep Regency. The total population is 134 respondents and a sample of 100 respondents is taken using the Simple Random Sampling technique. Data analysis using Linear Regression test. This research has gone through the ethical test phase with the number SK: 2324/KEPK/III/2021. Based on the results of Linear Regression analysis shows that the p-value is 0.003 < 0.05, then H0 is rejected and H1 is accepted, so it can be concluded that there is partially The influence of work motivation of health workers on services at the Arjasa Public Health Center, Sumenep Regency

Simultaneous
Based on the results of Multiple Linear Regression analysis shows that with a p-value of 0.000 <0.05 then H1 is accepted so it can be concluded that simultaneously there is the influence of the ability and work motivation of health workers on services at the Arjasa Public Health Center, Sumenep Regency with a magnitude of 79.1%.

A. Ability of Health Officers at Arjasa Health Center, Sumenep Regency
The results showed that most of the respondents had the ability in the good category as many as 57 respondents (57%). In addition, a number of 31 respondents (31%) have the ability in the sufficient category. While a number of 12 respondents (12%) have the ability in the less category.
Health workers are health human resources which on the one hand are the main supporting elements in health services, on the other hand it turns out that the current quality condition is still lacking. The ability of Health Human Resources (HR) in planning health services as well as behavioral attitudes in anticipating health problems that occur are not in line with community expectations. It can be seen that the level of performance of the public service apparatus in health services is still weak (Brista, 2015).
Performance is defined as the result of a person's efforts achieved by their abilities and actions in certain situations. So performance is the result of the relationship between effort, ability and perception of the task. Performance is the result of work that can be achieved by a person or group of people in an organization in accordance with their respective authorities and responsibilities. The performance of individuals and groups of employees is a contribution to improving the performance of an organization, because organizational performance is a collection of achievements given by all sections related to business activities (Waloni, 2016).
Quality performance will further improve through good cooperation to produce quality services and production. In order to be a winner in an increasingly competitive world, organizations must be able to combine all the potential knowledge, skills, experience, and vision of their members to work in teams (Hermanto, 2018). Personal performance if that person has a high level of mastery of rational process techniques and has applied basic thinking patterns to basic principles in management.
Mastery of tasks in any given job will be able to make a health worker more engaged in the task. Besides that, the high level of task mastery in a health worker can help accelerate the achievement of work targets, be able to complete tasks with high accuracy, be able to carry out tasks in any situation and be able to complete tasks effectively and efficiently.

B. Work Motivation of Health Workers at Arjasa Health Center, Sumenep Regency
The results showed that most of the respondents had work motivation in the moderate category of 52 respondents (52%). In addition, a number of 25 respondents (25%) have work motivation in the high category. While a number of 23 respondents (23%) have work motivation in the low category.
Motivation is what causes and supports a person. According to Mashlow (2010) in Sunaryo (2018), individuals will be motivated to fulfill what needs are strongest in themselves at a certain time. If it is said that the emergence of a person's behavior at any given moment is determined by a need that has high power then it is important for every manager to have knowledge of the needs that are felt to be most important to their subordinates.
According to Ngalim Purwanto (2015) motivation is everything that encourages someone to do something. Motivation is to provide a stimulus or impetus or an excitement to a person or group to want to work properly and enthusiastically. With its ability to achieve goals in an efficient and effective manner (Wijono D, 2017).
According to Sunarya in a psychology book for nursing (2018), motivation is the desire and need for an individual, to motivate the individual to fulfill his needs and direct behavior towards everything he is aiming for. According to Nancy Stevenson (2016) motivation is all verbal, physical, or psychological things that make someone do something in response. And according to Suwarno, (2015) motivation refers to the process of movement, including encouraging situations that arise from within the individual, behavior that caused by the situation and the ultimate goal of the movement or action.
Someone wants to work because of the encouragement of various needs. This need is tiered or tiered if one basic need has been met, it will increase to a higher need and so on. This need for everyone is not the same and the difference is very far, with these circumstances it will lead to a perception of a need and will affect changes in work behavior at work. So that a person's motivation to work will have a significant impact. If someone has motivation to work, he will be active in work even though the job is classified as a difficult job. On the other hand, someone who does not have the motivation to work will tend to underestimate his work and be less active at work.

C. Health Officer Services at Arjasa Public Health Center, Sumenep Regency
The results showed that most of the respondents had service quality in the good category of 54 respondents (54%). In addition, a number of 35 respondents (35%) have service quality in the sufficient category. Meanwhile, 11 respondents (11%) had service quality in the poor category.
Service is an activity or a series of tools that are invisible (cannot be touched), which occur due to interactions between consumers and employees or other things provided by service providers that are intended to solve consumer problems (Winarsih, 2015).
People as consumers certainly want quality services. Service quality is defined as the level of excellence expected and control over the level of excellence to meet customer desires. Service quality can be interpreted as an effort to fulfill consumer needs and desires as well as the accuracy of delivery in balancing consumer expectations (Oktafani, 2014).
One of the services that is widely used by the community is health services. Utilization of health services by using the service facilities provided either in the form of outpatient care, inpatient care, home visits by health workers or other forms of activity from the use of these services based on the availability and continuity of services, public acceptance and fairness, easily accessible by the community, affordable and quality (Anwar, 2014).
Good services are health services that are available in the community and are sustainable. This means that all types of health services needed by the community are found and their presence in the community is available at any time of need. Health services must be reasonable and acceptable to the community. This means that the health service can overcome the health problems faced, does not conflict with customs, culture, beliefs and beliefs of the community, and is unnatural, is not a condition of good health care.
The location angle is easily accessible by the community, so the distribution of health facilities is very important. Coverage of auxiliary facilities to determine effective demand. If the facility is easily accessible by using the available means of transportation, this facility will be widely used. Past user levels and trends are the best indicators of short and long term changes in future demand. The services provided are affordable by the community, where the cost of these services is sought in accordance with the economic capacity of the community. Expensive health services may only be enjoyed by some people.
According to researchers, health services must have various basic requirements, namely the basic requirements that influence the community in determining their choices regarding the use of health services. The services needed by the community in general are health services that are available in the community and sustainable, health services must be reasonable and acceptable to the community, locations are easily accessible by the community, the services provided are affordable and the perfection of health services provided. With good service, it will attract people to use health facilities properly and wisely.

D. The Influence of the Ability of Health Officers on Services at the Arjasa Public Health Center, Sumenep Regency
Based on the results of Linear Regression analysis shows that the p-value is 0.001 <0.05 then H1 is accepted so it is concluded that partially there is the influence of the work ability of health workers on services at the Arjasa Public Health Center, Sumenep Regency In order to maintain and improve the quality of service, the performance of all human resources is always encouraged to be continuously improved. Nurses are one of the health service teams who are required to improve the quality of services in hospitals. When viewed from the nursing side, the quality of service in hospitals includes aspects of the number and ability of professionals, work motivation, funds, supporting facilities and equipment, hospital management which needs to be perfected and adapted to the development of science and technology (Suryono, 2018).
Ability is one of the things that affect the quality of health services. Ability refers to an individual's capacity to perform various tasks in a job. The employee's ability to work can be measured from the following parameters: intellectual ability, physical ability and emotional ability (Robbins, 2019). More specific parameters of ability are: work results, timeliness of work, expertise and skills, mastery of work methods, work responsibilities, utilization of work infrastructure, reducing work errors, ability to manage costs, and ability to cooperate (Mangkunegara, 2017).
Through testing the hypothesis, this study has succeeded in explaining the significance of the effect of ability on the performance of health officers in this research location, in accordance with the theory proposed by Handoko (2013). In addition, this study strengthens the results of research which also results in the conclusion that there is an influence of ability on performance (Wibowo, 2015).
According to the researcher, the influence of ability on the service of health workers, the results of hypothesis testing proved that the ability had a significant effect on the service of health workers at the Arjasa Public Health Center, Sumenep Regency. This significant influence indicates that with a change or improvement in the work ability of health workers, the quality of service for health workers at the Arjasa Health Center, Sumenep Regency will also increase.

E. The Effect of Work Motivation of Health Workers on Services at the Arjasa Public Health
Center, Sumenep Regency Based on the results of Linear Regression analysis shows that the p-value is 0.003 < 0.05, then H0 is rejected and H1 is accepted, so it can be concluded that there is partially The influence of work motivation of health workers on services at the Arjasa Public Health Center, Sumenep Regency Health services are a form of professional service and become an integral part of overall health service efforts (Depkes RI, 2015). Health services are the main services that must be carried out to achieve the recovery of patients treated in hospitals or at the public health center. To support the recovery of patients treated in hospitals or health centers, health workers have a very important role through the provision of health services in the form of care.
The problems mentioned above are influenced by several factors, two of which are the ability and work motivation of health workers. First, ability. Several research results show a relationship between abilities and skills with the performance of implementing health workers (Mustofa, 2018). Another study investigated the relationship between growth opportunities and health worker performance. The opportunity to develop to acquire abilities or skills is a dominant factor related to the performance of health workers (Wibowo, 2015). Second, motivation. Motivation is an important factor to improve performance (Handoko, 2018). Several studies related to motivation have shown a significant influence in shaping the performance of health workers (Fitri, 2017).
Performance is a set of results achieved and refers to the act of achieving and carrying out the requested work. Performance means the comparison of the results achieved with the participation of the workforce per unit of time (Mangkunegara, 2017). Employee performance is influenced by various factors, including: their abilities, motivation, support received, the existence of the work they do, and their relationship with the organization (Mathis & Jackson, 2017). To assess performance, indicators that can be used are: quantity of work results, quality of work results, efficiency in carrying out tasks, discipline, initiative, thoroughness, honesty and creativity, including work reliability and work attitude (Mangkunegara, 2017).
Motivation is one of the things that affect human behavior. A more complete goal of motivation is to improve employee morale and job satisfaction, increase employee productivity, maintain company employee stability, improve employee leadership, streamline employee procurement; create a good working atmosphere and relationship; increase employee loyalty, creativity, and participation; increase the level of employee welfare; enhance employees' sense of responsibility towards their duties; and improve the efficiency of the use of raw material tools (Hasibuan, 2015). With a qualified ability and also high motivation, it can improve the quality of services provided to patients in order to improve the performance that must be done (Yahya, 2017).

F. The Effect of Ability and Work Motivation of Health Officers on Services at the Arjasa Public Health Center, Sumenep Regency
Based on the results of Multiple Linear Regression analysis shows that with a p-value of 0.000 <0.05 then H1 is accepted so it can be concluded that simultaneously there is the influence of the ability and work motivation of health workers on services at the Arjasa Public Health Center, Sumenep Regency with a magnitude of 79.1%. The national health system is essentially an order that reflects the efforts of the Indonesian nation to improve its health status which emphasizes that the goal of national development is to improve the quality of human resources. (Ramadhania and Winarti 2018).
In the current era of technological development, especially health workers, human resources have a very important role. The need for output is felt to be increasing in the current era of reform development, which will demand a lot of resource participation as implementers of development, especially in the health sector (Faisal 2016).
Employee performance is a person's ability to do something with certain expertise in an organization that is expected to be able to carry out responsibilities for the achievement of a goal, the ability can be sourced from education, experience, training, and development that is followed. Performance is also influenced by work motivation, work motivation is a will or desire that arises in the officer who creates enthusiasm or encouragement to work optimally in order to achieve goals, with motivation the officers will feel they have a special urge to complete a job to achieve the effectiveness of the public health center. When officers have the motivation to excel, someone will do their job as well as possible.
Motivation is a human psychological characteristic that contributes to a person's level of commitment. Motivation as a process that causes the intensity, direction, and continuous effort of individuals towards the achievement of goals. In simple terms, motivation creates enthusiasm and enthusiasm for work so that work productivity increases. Motivation is something that inspires or encourages someone to create someone's enthusiasm to want to work hard by generating, directing and behaving work and expending a level of effort to contribute as much as possible to the success of the organization to achieve goals. Motivation to work is very important for the high and low productivity of the organization. Without the work motivation of employees to work together for the benefit of the organization, the stated goal will not be achieved. Conversely, if there is high motivation from employees, this will be a guarantee for the success of the organization in achieving its goals (Sutrisno, 2014).
According to Mangkunegara (2014) motivation is a condition that moves the condition of employees who are directed to achieve organizational goals (organizational goals), the motivation is formed from a person's attitude towards work situations. This motivation is related to mental attitude as a mental condition that encourages employees to try to achieve maximum work performance, and understand the main goals and work targets achieved.