All posts by ferry efendi

Concept analysis of nurse retention

Ferry Efendi RN, MSc, PhDAnna Kurniati SKM, MA, PhDAngeline Bushy RN, PhD, FAANJoko Gunawan RN


Nurse retention is widely acknowledged as a crucial international workforce issue, yet the concept remains ambiguous. This study focuses on a concept analysis in an effort to clarify the attributes of nurse retention, including its antecedents and consequences. The Walker and Avant approach was applied to analyze the concept of nurse retention. Four key attributes of nurse retention were identified in the analysis, specifically motivation, intention, and individual decision; strategy and intervention; geographic context; and attachment to work. Antecedents of nurse retention included the healthcare system at the macro level, the health care facility, health personnel, and living conditions. Retention has consequences for individual nurses, the healthcare organization, and the overall health system. Our concept analysis provides clarification to better understand nurse retention along with its implications for the healthcare workforce. The analysis further emphasizes the importance of retention as a comprehensive priority issue for human resources when recruiting and maintaining the nursing workforce internationally.

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Determinants of Facility-Based Childbirth in Indonesia

Ferry Efendi,1Ani Rihlatun Ni’mah,1Setho Hadisuyatmana,1Heri Kuswanto,2Linlin Lindayani,3 and Sarni Maniar Berliana4

1Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
2Department of Statistics, Institut Teknologi Sepuluh Nopember, Indonesia
3Sekolah Tinggi Ilmu Keperawatan PPNI Jawa Barat, Bandung, Indonesia
4Politeknik Statistika STIS, BPS, Jakarta, Indonesia

Correspondence should be addressed to Ferry

Received 9 January 2019; Revised 9 April 2019; Accepted 3 June 2019; Published 20 June 2019

Academic Editor: Hind A. Beydoun

Copyright © 2019 Ferry Efendi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Reducing maternal mortality remains a significant challenge in Indonesia, especially for achieving the country’s Sustainable Development Goals (SDGs) by 2030. One of the challenges is increasing delivery at healthcare facilities to ensure safe and healthy births. In Indonesia, research on factors affecting women’s use of facility-based childbirth services is scarce. Objective. This study was conducted to identify the determinants of facility-based deliveries in Indonesia. Methods. This study used data from the Indonesia Demographic and Health Survey of 2012, with a cross-sectional design. An odds ratio with 95% confidence intervals (CI) was employed to outline the independent variables for the determinants, including maternal age and education, place of residence, involvement in decision-making, employment status, economic status, and number of antenatal care visits. The dependent variable in this study was the place of delivery: whether it took place in healthcare or nonhealthcare facilities. The statistical significance was set at p<0.05 using bivariate analysis and binary logistic regression. Results. This study showed that a high level of education (OR: 3.035, 95% CI: 2.310–3.987), high economic status (OR: 6.691, 95% CI: 5.768–7.761), urban residence (OR: 2.947, 95% CI: 2.730–3.181), working status (OR: 0.853, 95% CI: 0.793–0.918), involvement in decision-making (OR: 0.887, 95% CI: 0.804–0.910), and having more than four visits to antenatal care centers (OR: 1.917, 95% CI: 1.783–2.061) were significant determinants of delivery at healthcare facilities. Conclusion. Efforts to improve facility-based childbirth in Indonesia must strengthen initiatives that promote women’s education, women’s autonomy, opportunities for wealth creation, and increased uptake of antenatal care, among others. Any barriers related to maternal healthcare services and cultural factors on the use of health facilities for childbirth in Indonesia require further monitoring and evaluation.