The maternal mortality rate (MMR) is an important indicator of the quality of health services, with obstetric deaths that could be prevented if health services were in accordance with standards. Early detection and readiness of health workers, especially midwives, are essential for quality pregnancy, delivery, and postpartum care. One of the efforts to reduce MMR is to integrate ANC examination services at the Puskesmas. This study aims to determine the factors associated with the performance of midwives in the implementation of ANC at the Denpasar City Health Center. Analytical observational research with a cross-sectional design was conducted at all Puskesmas in Denpasar City from December 2024 to February 2025. The study sample consisted of 108 midwife respondents selected by simple random sampling. The results showed that more than half of the midwives (58.3%) at the Denpasar City Health Center had poor performance in ANC services. Age, education, tenure, employment status, knowledge, skills, and attitudes were not significantly related to midwife performance. However, motivation was shown to be significantly related to midwife performance, where midwives with high motivation had a 2.647 times greater chance of showing good performance in ANC services. This study concluded that motivation is related to the performance of midwives in ANC services at the Denpasar City Health Center. The implication of this study is the need for supervision, periodic education and training, awards, incentives, and increased communication between coworkers to create a work environment that supports quality ANC services.
Diantari et al. (Tue,) studied this question.
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