Background and purpose: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis (MTB). The high incidence of TB acquires the active role of TB cadres in TB case finding. Motivation is an important factor that support the performance of TB cadres. This study aims to explore factors that affect the motivation of TB cadres case detection rate of TB.

Methods: This was an observational analytic study with cross sectional study design, conducted in Kediri City. A total sampling technique was applied with a total of 59 TB cadres in the working area of Sukorame Public Health Center, in Kediri City. TB cadres filled in a questionnaire containing questions about sociodemographic, attitudes, knowledge, and motivation with a total of 39 questions. Data were analyzed with univariate descriptive statistics, bivariate test by Fisher and Chi Square tests and followed by multivariate analysis using logistic regression.

Results: Of the 59 cadres, 37 (67.2%) have a good motivation on TB case findings. The results of multivariate analysis showed that there were four independent variables which have a significant association with the motivation of TB cadres, including age, education, jobs and incentive. Cadres who are 41-60 years have better motivation compared to 25-40 years (OR=31.49; 95%CI: 2.373-417.907; p=0.009), cadres who have higher education (university/college) have better motivation (OR=36.957; 95%CI: 2.389-571.805; p=0.010). While those who not getting incentives (OR=0.100; 95%CI: 0.013-0.758; p=0.026) and having a job (OR=0.120; 95%CI: 0.021-0.670; p=0.016) were less likely to have a good motivation.

Conclusion: Motivation of TB cadres in Kediri City is influenced by intrinsic factors (age, education and employment) and extrinsic factor (incentive). Providing appropriate incentive will significantly boost cadre motivation and relevant stakeholders should consider making this strategy sustainable.

Rohana IGAPD, Jauhar M, Rachmawati U, Kusumawardani LH, Rasdiyanah. Empowering Community Health Volunteer on Community Based Tuberculosis Case Management Programs in Lower Income Countries: A systematic Review. Journal of Community Empowerment for Health. 2019;2(2):172-180.

World Health Organization. Global Tuberculosis Report. Geneva; 2014

Ministry of Health of Indonesia. Pedoman Nasional Pengendalian Tuberculosis [National Guidelines for Tuberculosis Control]. Jakarta; 2016.

Kediri District Health Office. Profil Kesehatan Kabupaten Kediri [Kediri District Health Profile]. Kediri District Health Office. Kediri; 2018.

Khazaei S, Mansournia MA, Nematollahi S, Ayubi E, Zahiri A, Mohamadian-Hafshejani A, et al. Determinants of delay in tuberculosis diagnosis in Hamadan Province, 2006—2014. Egyptian Journal of Chest Diseases and Tuberculosis. 2016;65(4):811–815.

Ratnasari NY, Marni, Husna PH. Knowledge, Behavior, and Role of Health Cadres in The Early Detection of New Tuberculosis Case in Wonogiri. Jurnal Kesehatan Masyarakat. 2019;15(2):235-240.

Okeyo ILA, Dowse R. An Illustrated Booklet for Reinforcing Community Health Worker Knowledge of Tuberculosis and Facilitating Patient Counselling. African Journal of Primary Health Care & Family Medicine. 2018;10(1):1-7.

Aduo K, Emmanuel O, Forster OM. The Impact of Motivation on the Work Performance of Health Workers (Korle Bu Teaching Hospital): Evidence from Ghana. Hospital Practices and Research. 2016;1(2):47-52.

Yanti, Hasballah. Mulyadi. Studi Komparatif Kinerja Kader Posyandu [A Comparative Study of The Work Performance of Integrated Health Services’ Cadres]. Jurnal Keperawatan. 2016;4(2):1-11.

Aryani L, Handayani S. Self Efficacy dan Self Motivation Kader dalam Melakukan Active Case Finding untuk Menurunkan Epidemi Tuberculosis dalam Mewujudkan Target SDGs 2030 [Cadres’ Self Efficacy and Self Motivation in Active Case Finding to Reduce Tuberculosis Epidemic and Achieve the Target of 2030 SDGs]. VisiKes Jurnal Kesehatan Masyarakat. 2017;16(1):30-37.

Sumartini. Penguatan Peran Kader Kesehatan dalam Penemuan Kasus Tuberkulosis (TB) BTA Positif melalui Edukasi dengan Pendekatan Theory of Planned Behaviour (TPB) [Strengthening the Role of Health Cadres in Finding Positive Tuberculosis (TB) Cases through Education using Theory of Planned Behavior (TPB) Approach]. Jurnal Kesehatan Prima. 2014;8(1):1246-1263.

Simamora RH. A Strengthening of Role of Health Cadres in BTA Positive Tuberculosos Case Invention through Education with Module Development and Video Approaches in Medan Padang Community Health Center. International Journal of Applied Engineering Research. 2017;12(20):10026-10035.

Daneshkohan A, Zarei E, Mansouri T, MaajaniK, Ghasemi MS, Rezaeian M. Factors Affecting Job Motivation among Health Workers. Global Journal of Health Science. 2015;7(3):153-160.

Veseli N, Aziri B, Veseli T. Motivation of Health Care Employees in The Republic of Macedonia. International Conference. Slovenia; 2014.

Kawakatsu Y, Sugishita T, Kioko J, Ishimura A, Honda S. Factors Influencing The Performance of Community Health Workers in Kisumu West, Kenya. Primary Health Care Research & Development. 2012;13(4):294–300.

Salame FM, Ferreira MD, Belo MT, Teixeira EG, Cordeiro-Santos M, Ximenes RA, et al. Knowledge about Tuberculosis Transmission and Prevention and Perceptions of Health Service Utilization among Index Cases and Contacts in Brazil: Understanding Losses in The Latent Tuberculosis Cascade of Care. PLoS ONE. 2017;12(9).

Ratih W. Insentif dan Kinerja Kader Posyandu [Incentive and Performance of Integrated Health Services’ Cadres]. Jurnal Kesehatan Masyarakat. 2013;9(1):58-65.

Kawakatsu Y, Sugishita T, Tsutsui J, Oruenjo K, Wakhule S, Kibosia K, et al. Individual and Contextual Factors Associated with Community Health Workers’ Performance in Nyanza Province, Kenya: a Multilevel Analysis. BioMed Central Health Services Research. 2015;15:442.

Berdud M, Cabases JM, Nieto J. Incentives and Intrinsic Motivation in Healthcare. Gac Sanit. 2016;30(6):408-414.

Nisa SM, Dyah Y. Hubungan antara Karakteristik Kader Kesehatan dengan Praktik Penemuan Tersangka Kasus Tuberkulosis Paru [Relationship between Characteristics of Health Cadres and the Practice of Finding Suspects of Lung Tuberculosis Cases]. Jurnal of Health Education. 2017;2(1):93-100.

Huang W, Long H, Li J, Tao S, Zheng P, Tang S, et al. Delivery of Public Health Services by Community Health Workers (CHWs) in Primary Health Care Settings in China: A Systematic Review (1996–2016). Global Health Research and Policy. 2018;3:18.

Lindquist LA, Tam K, Friesema E, Martin GJ. Paid Caregiver Motivation, Work Conditions, and Falls among Senior Clients. Archives of Gerontology and Geriatrics. 2012;55(2):442–445.

Ochola GO. Employee Motivation, An Organizational Performance Improvement Strategy (A Review on Influence of Employee Motivation on Organizational Performance). JOJ Sciences. 2018;1(5):120-125.

Sharma R, Webster P, Bhattacharyya S. Factors Affecting The Performance of Community Health Workers in India: a Multi-Stakeholder Perspective. Global Health Action. 2014;7(1).

Gardan DA, Craciunas D, Gardan IP, Militaru M. Healthcare Staff Motivation Effects on Healthcare Services Consumers Behaviour. International Conference on Economic Sciences Business Admnistration. 2015. Bucharest.

Anisah IA, Kusumawati Y, Kirwono B. Faktor-Faktor yang Berhubungan dengan Keaktifan Kader Communty TB Care ‘Aisyiyah Surakarta [Factors Related to Activity of TB Care Community Cadres of ‘Aisyiyah Surakarta]. Jurnal Kesehatan. 2017;10(2):47-57.

Amare Y. Non-Financial Incentives for Voluntary Community Health Workers: A Qualitative Study. 2009. JSI Research & Training Institute. Addis Ababa.

Kok MC, Muula AS. Motivation and Job Satisfaction of Health Surveillance Assistants in Mwanza, Malawi: an Explorative Study. Malawi Medical Journal. 2013;25(1).