Kesenjangan Transformasi Pengetahuan Menjadi Kompetensi Administratif: Evaluasi Pemberdayaan Kader dalam Integrasi Layanan Primer di Puskesmas Wara Barat Kota Palopo

Abstract

Indonesia’s Primary Health Care transformation through the Integrated Primary Care Service (ILP) scheme requires community health workers (kaders) to master technical-clinical and administrative-integrative competencies. However, empowerment programs often evaluate success through aggregate knowledge scores without examining whether knowledge gains are equally transferred into different types of practical competencies. This study evaluates an ILP kader empowerment program at Wara Barat Health Center, Palopo City, by comparing knowledge and practical skill outcomes across four material domains and four skill-test types. A quasi-experimental one-group pretest-posttest design involved 20 kaders in the knowledge test and 50 kaders in the practical skill checklist. Data were analyzed descriptively and through pretest-posttest difference testing. The results showed significant knowledge gains across all domains (p < 0.001), with the highest relative increases in non-communicable disease screening for productive-age and elderly groups (+105.0%) and PWS recording and educational communication (+91.1%). However, practical skill outcomes showed a different pattern. Technical-clinical skills achieved pass rates above 90%, while PWS worksheet recording, the only administrative-integrative skill tested, had the lowest pass rate (84%). These findings indicate that knowledge gains do not automatically translate into practical competence. Administrative-integrative competencies require extended mentoring and pedagogical strategies that differ from those used for single technical skills.