Nursing competency readiness for integrated primary health care implementation: a multi-province cross-sectional...

Integrated Primary Health Care (IPHC) reform in Indonesia requires a competent nursing workforce capable of delivering coordinated, life-course-oriented, and community-linked primary care. However, evidence on factors associated with nurses' competency readiness for IPHC implementation remains limited. This study aimed to assess nursing competency readiness for IPHC implementation and examine its associations with knowledge, perceived IPHC implementation, stakeholder support, and professional development needs.

A facility-based analytical cross-sectional study was conducted among 687 nurses recruited through non-probability consecutive sampling from selected public primary health care centres in 15 Indonesian provinces. Data were collected using a structured self-administered questionnaire assessing demographic and professional characteristics, IPHC knowledge, perceived IPHC implementation, stakeholder support, professional development needs, and nursing competency readiness. Reliability testing, descriptive statistics, Mann-Whitney U and Kruskal-Wallis tests, Spearman correlation, multiple linear regression, and supplementary logistic regression were performed.

The mean nursing competency readiness score was 102.32 (SD 15.48). Using the sample median score of 108 as a supplementary analytical cut-off, 53.4% of nurses were classified as having higher competency readiness. Competency readiness was positively correlated with stakeholder support (rho = 0.577), perceived IPHC implementation (rho = 0.496), and professional development needs (rho = 0.474) (all p < 0.001). In multivariable analysis, stakeholder support showed the largest standardized association with competency readiness (β = 0.400), followed by perceived IPHC implementation (β = 0.243) and professional development needs (β = 0.231). The model explained 50.6% of the variance in competency readiness. Supplementary logistic regression using the median-based readiness category showed a similar pattern of associations.

Nursing competency readiness for IPHC implementation was more strongly associated with implementation-related and stakeholder-support factors than with demographic, educational, or knowledge-related characteristics. These findings suggest that implementation environment, stakeholder engagement, and professional development may be relevant areas for workforce planning, but their effects on nursing competency readiness should be tested in longitudinal, mixed-methods, or intervention studies using stronger competency measures.