Kontakt X:X | DOI: 10.32725/kont.2026.036

Quality of work life as a conditional mediator between organizational factors and job performance in a decentralized health systemSocial Sciences in Health - Original article

Muchti Yuda Pratama ORCID...1, *, Ida Yustina ORCID...1, Nurmaini Nurmaini ORCID...1, Zulkarnain Zulkarnain ORCID...2
1 Universitas Sumatera Utara, Faculty of Public Health, Medan, Indonesia
2 Universitas Sumatera Utara, Faculty of Psychology, Medan, Indonesia

Introduction: Quality of Work Life (QWL) is frequently conceptualized as a mediating mechanism linking organizational factors to employee job performance. However, empirical findings across health systems, particularly in decentralized settings, remain inconsistent.

Objectives: This study investigates whether QWL mediates the relationships between organizational commitment, healthy work environment, motivational climate, career development, and job performance among health workers in decentralized primary health care systems.

Methods: Data were collected from 320 health workers working in local government primary health care facilities in Aceh, Indonesia. Structural Equation Modeling using the Partial Least Squares approach (PLS-SEM) was applied to examine direct and indirect relationships among the study variables.

Results: The results indicate that QWL functions as a selective mediator. QWL significantly mediates the effects of motivational climate and career development on job performance but does not mediate the relationships involving organizational commitment and healthy work environment.

Conclusion: These findings suggest that QWL functions as a conditional rather than a universal mediator in decentralized health systems.

Keywords: Decentralized health systems; Health workers; Job performance; Quality of work life
Conflicts of interest:

The authors have no potential conflict of interest to declare with respect to the research, authorship, and/or publication of this article.

Received: January 12, 2026; Revised: April 29, 2026; Accepted: May 28, 2026; Prepublished online: June 2, 2026 

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