Keywords

Entrepreneur leadership, Learning organization, Commitment, Performance midwife

Introduction

Public awareness about the importance of health is increasing. Health is very influential on a person's activities. Humans can carry out activities optimally without any disturbance if their condition is healthy both physically and spiritually. Efforts to improve the degree of public health can be carried out by routine maintenance and health checks, prevention of disease, and prompt cure of disease. Efforts to improve the degree of public health require optimal health services from medical doctors, midwives and nurses to improve the quality of life of patients.

Midwife Association of East Java (2015) released the UNICEF data of women in Indonesia who gave birth with the help of labor helper namely midwife amounted to 62%, around 21% gave birth with the help of doctor, while the rest gave birth with the help of health workers and traditional healer, it shows the percentage of labor helper of more than fifty percent being helped by the midwife, showing how important and noble the role of midwife as the needed profession. A midwife who opens independent practice or becomes a business actor is seen as a noble profession also useful for the surroundings because it can open new employment for other people.

Ciputra & Waluya (2013)stated that entrepreneur is the competent/capable person who can turn trash to useful stuff and dirt into gold, there should be dramatic and creative changes, creative people will be able to change risk into income, the difficulty becomes opportunity and changes becomes chance. Midwives should be have the ability to manage management starting from offering ideas up to services and having entrepreneur spirit (Suswati & Budianto, 2013); Suswati et al., 2015); Suswati, 2020)). An entrepreneur is surely a leader with the entrepreneurship leadership as the entrepreneur leadership. The application of entrepreneur principle should be competent that will give the impact on the performance ( Suharsaputra, 2014).

Entrepreneur leadership is a leadership that has a clear goal, can create opportunity, empower people, conserve the relationship in the organization to improve the performance ( Cunningham & Lischeron, 1991). Entrepreneur leadership is a motivated leader with future-oriented vision, focus, and having the ability to influence and inspire other people, creativity, skilled, developing, and can catch the new business chance (Renko et al., 2013; Thornberry, 2006). Russell and Murphy (2004) stated that in order to achieve success in this globalization era, it requires an entrepreneur leadership. Due to technology advancement, economic crisis, and environment that are full of uncertainty, a leader with entrepreneur orientation is expected to be able to bring the organization to a better direction.

These midwives should commit to being delima midwife, which means being the midwife with high-quality service in accordance with the standard and code of ethics of the profession ( Nurjasmi, 2014 ). Midwife Education is currently growing in Indonesia, but the rapid development of the midwife program has not been able to answer the challenge of high-quality and competent midwife needs. Midwives have to improve the performance. Without having good performance and professionalism, these midwives in Indonesia will not be able to compete in the globalization era (Okva, 2011). Hackett et al. (2001) stated that employees who have a higher commitment to their job are high performing employees. Learning organization is an organization that has developed the capacity to keep making changes and adjustment to improve performance (Robbins & Judge, 2006).

The research on midwife entrepreneur leadership is very important to create a learning organization and commitment of qualified midwife to improve performance. Entrepreneur leadership is expected to give a direction in the decision making. Research on entrepreneur leadership is still very rare, in general, most of the researches only highlight the leadership in managing business (Swiercz & ; Lydon, 2002; Townsend et al., 2010), and there has not a single research on the entrepreneur leadership, learning organization, and commitment to improving the performance of delima midwife. Entrepreneur leadership that realizes the characteristic of the business actors and successful leaders occur as the new type of leadership in entrepreneurship (Fernald, et al., 2005; Sundararajan et al., 2012).

Aragon (2007) His research on leadership and the role of learning organizations on innovation and performance. The results obtained by the leadership style do not have a direct effect on innovation and performance and the learning organization has no direct effect on innovation and performance. In this study the authors included organizational commitment in seeing the influence of entrepreneurial leadership, and organizational learning, on performance. In this study the authors included organizational commitment in seeing the influence of entrepreneurial leadership, and organizational learning, on performance. The reason for including the organizational commitment variable as a mediating variable is because the researcher sees a partial impact of mediation / research gaps raised by previous researchers.

Based on the background, entrepreneur leadership, commitment, and learning organization, the midwife performance is an important part to be analyzed with the aim to examine the direct influence of entrepreneur leadership, learning organization, commitment, and midwife performance, the second purpose is to examine the commitment mediation effect in its relationship with the entrepreneur leadership, learning organization, and performance of midwife.

Literature Review

Entrepreneurship is a dynamic process in creating vision, mission, change, and creation, where the application of an entrepreneurial attitude also requires enthusiasm during the process of creating and implementing new ideas and solutions to problems (Kuratko & Hodgetts, 2004 Kuratko; Thornberry, 2006; Renko et al., 2013). The application of an entrepreneurial attitude requires organizational commitment. Organizational commitment itself is a multi-concept consisting of three main components, namely affective commitment, continuance commitment, and normative commitment (Meyer & Allen, 1991). The existence of organizational commitment through employee commitment will form entrepreneurial leadership that can assist organizational members in understanding the organization's vision, mission, and goals (Cunningham and Lischeron 1991; Gupta, et al., 2004; Renko, et al., 2013).

The relationship between organizational commitment and performance has been proven both theoretically and empirically (Meyer & Allen, 1991; Yiing & Ahmad, 2009). Dirani's research (2009) says that organizational commitment has a significant effect on employee output which is one of the performance indicators. Other research explains that entrepreneurial leadership has a positive and significant effect on employee commitment (Greef de Annique, 2014; Yiing & Ahmad, 2009). The results of this study are in line with the type theory proposed by McGregor (1960) in Greef de Annique (2014) which says that the emergence of creative attitudes, motivation, responsibility, satisfaction with work results and happy to face challenges is formed because employees like their jobs and can work with them. Well in the organization. According to Senge (1990), learning organization as an organization is where people keep developing its capacity to achieve the desired results, using new thinking pattern and aspiration. Group is given the freedom to keep learning something jointly in order to improve their performance. The indicators of learning organization covering system thinking, mental models, personal mastery, team learning, shared vision.

Standard Performance and Commitment of Midwives In Indonesia

Performance is the result of work that has been achieved by employees who meet work quality standards within a certain period of time (Bernandin & Russel, 1993). According to the Decree of the Minister of Health of the Republic of Indonesia Number 900/MENKES/SK/VII/2002 concerning the Registration and Practice of Midwives as well as a description of the performance, the performance of midwives is the result of the achievement of midwives' work in completing tasks related to the quality of maternal and child health services which include antenatal care, childbirth, postpartum, and neonatal services (Menkes, 2002). In the context of the health sector, especially midwifery, the application of entrepreneurial leadership behavior is also carried out.

Achievement of entrepreneurial leadership can be done through empowerment which will have an impact on performance (Hmieleski & Ensley, 2007). Business development cannot be done without effective leadership behavior (Bryant, 2004 ; Coglycer & Brigham, 2004). The results of previous studies showed that entrepreneurial midwives had a significant positive effect on performance ((Suswati et al., 2015)). The results of this study show that when the entrepreneurial orientation with an entrepreneurial spirit is getting better, the performance will be better (Suswati et al., 2015). The results of research from Suswati and Budianto (2013) show that organizational commitment has a significant positive effect on employee performance, where this shows that the more committed employees are, the better the resulting performance.

Learning Organizational and Performance

Organizational Learning is closely related to organizational performance. In other words, the decline in organizational performance can be influenced by organizational learning, and this has an impact on the loss of organizational efficiency and effectiveness ((Usefi et al., 2013). Learning Organizational is the best recommendation for improving organizational performance (Bates & Khasawneh, 2005). The lack of emphasis on organizational learning will reduce organizational performance (Usefi et al., 2013).

The main characteristics of the learning organization are the use of information to increase knowledge for the organization. Ahmad and Marinah (2013) stated that becoming a learning organization by improving training programs is a number of important factors to develop learning, improve individual performance and organizational performance. A number of studies understand the factors that influence the organizational performance, among others are commitment and leadership that have emerged to be one of the most significant factors that contribute to performance ( Cascio et al., 2010 ).

Methodological Approach

Population and Sample

The population of this study is Midwives who open independent practice in the Banyuwangi Regency of Indonesia. According to 2016 statistics and information from the chairman of the Indonesian Midwife Association (IBI) of Banyuwangi Regency, the number of midwives in the Banyuwangi Regency Health Office amounted to hundred and fifty midwives. The method of sampling is a simple random sampling. In determining the sample, the researcher used Slovin formula justification with alpha (α) value of 5%, the number of samples in this study amounted to 110 (one hundred and ten) midwives. One hundred and ten questionnaires were distributed to respondents, while only one hundred and two (102) questionnaires could be used for this study; this number had fulfilled the requirements used in the analysis of Structural Equation Modeling (Hair et al., 2010).

Variable Measurement

The questionnaire used in this study was first about the description of the demographics of the respondents; the second part tested the hypothesis about the variables of entrepreneurial leadership, learning organization, commitment and performance of midwives. In measuring variables with questionnaires as research instruments, the researcher used a Likert scale with five attitude scales from (1) strongly disagree to (5) scale strongly agree.

The unit of analysis surveyed in this study was business owners as midwives who open independent practice. Measurement was sourced from previous researchers, the entrepreneur leadership variable: is leadership that applies an entrepreneurial spirit with future orientation, creative thinking, innovation, critical thinking, risk taking, and motivation. Learning organization variable: Organizations in which all members continuously learn together on an ongoing basis to improve their abilities, where new thinking is always valued and developed by (1) systems thinking, (2) personal mastery, (3) mental models, (4) building a shared vision, and (5) team learning as an organizational foundation. The commitment variable: where employees believe and want to accept the goals of the organization and will remain loyal and will not leave the organization, consists of three components are Affective Commitment, Continuance Commitment, and Normative Commitment. Midwife performance variable was derived from the Decree of the Minister of Health of the Republic of Indonesia No. 900/MENKES/SK/VII/2002, Performance of midwives: work results achieved by midwives in carrying out tasks related to the quality of maternal and child health services consisting of coverage of antenatal services, coverage of delivery services, coverage of postnatal and neonatal services (after birth).

All hypotheses illustrated on Figure 1 below (Source: Own model):

Conducting Research and Results

Structural Equation Modeling (SEM) is used for testing data in this research. SEM is a series of separate but simultaneously interdependent multiple regression equations (Hair et al., 2010), is intended to analyze the interrelationship between the proposed criteria or variables.

General Characteristics of Respondents

The general characteristic of the respondents is an overview of the 102 respondents which were observed based on age, education, practice status, and number of patients can be seen in the Table 1 below (Source: own compilation):

Table 1 Characteristics Of Respondents
No	Characteristic		Number (%)
1	Age (years old)	< 30	11	10.78
		31-40	46	45.1
		41-50	34	33.33
		51-60	11	10.78
2	Education	D3	74	72.55
		D4/S1	25	24.51
		S2	3	2.94
3	Practice status	Privately owned	100	98
		Contract/rent	2	2
4	Number of patients	< 10 patients	69	67.6
		10-20 patients	28	27.5
		> 20 patients	5	4.9

Based on the characteristics of respondents, most of them were at the productive age amounting 45.10%, most of respondents were D3 amounting to 72.55%, because midwife profession usually needs skills more. Based on the status of practice, 98% of were independently owned. It means they are more independent, the number of patients per day was 67.60% less than ten patients.

Validity Test

Result of validity test of research instrument shown on Table 2 below:

Table 2 Validity Testing Of Research Instrument
Variable	Item
		Validity
		Validity Coefficient	Critical Point	Conclusion
Entrepreneur Leadership (X1)	X1.1.1	0.633	0.300	Valid
	X1.1.2	0.473	0.300	Valid
	X1.2.1	0.682	0.300	Valid
	X1.2.2	0.608	0.300	Valid
	X1.3.1	0.701	0.300	Valid
	X1.3.2	0.701	0.300	Valid
	X1.4.1	0.565	0.300	Valid
	X1.4.2	0.680	0.300	Valid
	X1.5.1	0.692	0.300	Valid
	X1.5.2	0.696	0.300	Valid
	X1.6.1	0.662	0.300	Valid
	X1.6.2	0.701	0.300	Valid
	X1.7.1	0.672	0.300	Valid
	X1.7.2	0.580	0.300	Valid
	X1.7.3	0.619	0.300	Valid
Learning Organization (X2).	X2.1.1	0.683	0.300	Valid
	X2.1.2	0.664	0.300	Valid
	X2.2.1	0.748	0.300	Valid
	X2.2.2	0.731	0.300	Valid
	X2.2.3	0.715	0.300	Valid
	X2.3.1	0.719	0.300	Valid
	X2.3.2	0.733	0.300	Valid
	X2.3.3	0.746	0.300	Valid
	X2.4.1	0.694	0.300	Valid
	X2.4.2	0.671	0.300	Valid
	X2.5.1	0.864	0.300	Valid
	X2.5.2	0.813	0.300	Valid
	X2.5.3	0.801	0.300	Valid
Commitment (Y1)	Y1.1.1	0.802	0.300	Valid
	Y1.1.2	0.747	0.300	Valid
	Y1.1.3	0.762	0.300	Valid
	Y1.2.1	0.703	0.300	Valid
	Y1.2.2	0.748	0.300	Valid
	Y1.3.1	0.708	0.300	Valid
	Y1.3.2	0.735	0.300	Valid
	Y1.3.3	0.759	0.300	Valid
Midwife Performance (Y2)	Y2.1.1	0.686	0.300	Valid
	Y2.1.2	0.489	0.300	Valid
	Y2.1.3	0.656	0.300	Valid
	Y2.1.4	0.572	0.300	Valid
	Y2.1.5	0.716	0.300	Valid
	Y2.1.6	0.692	0.300	Valid
	Y2.1.7	0.760	0.300	Valid
	Y2.2.1	0.880	0.300	Valid
	Y2.2.2	0.886	0.300	Valid
	Y2.2.3	0.912	0.300	Valid
	Y2.2.4	0.860	0.300	Valid
	Y2.2.5	0.806	0.300	Valid
	Y2.3.1	0.779	0.300	Valid
	Y2.3.2	0.816	0.300	Valid
	Y2.3.3	0.851	0.300	Valid
	Y2.3.4	0.686	0.300	Valid
	Y2.3.5	0.874	0.300	Valid
	Y2.3.6	0.847	0.300	Valid

Based on Table 2 (Source: own data), it appears that all the question items in the Entrepreneurial Leadership, Learning Organization, Commitment and Performance variables of midwives have validity coefficients greater than 0.30. This shows that all questions are declared valid.

Reliability Test

Result of reliability test shown on Table 3

Table 3 Reliability Test
Variable	Reliability Index	Critical Value	Description
Entrepreneur Leadership (X1)	0.855	0.6	Reliable
Learning Organization (X2).	0.894	0.6	Reliable
Commitment (Y1)	0.899	0.6	Reliable
Midwife Performance (Y2)	0.896	0.6	Reliable

Based on Table 3 (Source: own data), it can be seen that the reliability coefficient for Entrepreneurship Leadership variable (X1) of 0.855; Learning Organization Variable (X2) of 0.894; Commitment (Y1) of 0.899 and Midwife Performance (Y2) of 0.896, reliability coefficient value is greater than critical value (0.600). Hence, all research variables are declared reliable.

Table 4 Evaluation Of Structural Model Compatibility
Goodness of fit Index	Cut of value		Results	Description
Chi-Square / CMIN	< ChiTable	Good fit	232.962	Model Poor Fit
	> ChiTable	Poor fit
P-value CMIN	> 0.050	Good fit	0	Model Poor Fit
	< 0.050	Poor fit
CMIN/DF	< 2.000	Good Fit	1.806	Model Good fit
	< 3.000	Marginal Fit
	> 3.000	Poor Fit
RMSEA	< 0.080	Good fit	0.089	Model Marginal fit
	< 0.100	Marginal Fit
	> 0.100	Poor fit
GFI	> 0.900	Good fit	0.808	Model Marginal fit
AGFI	> 0.800	Marginal fit	0.746	Model Poor fit
TLI	< 0.800	Poor fit	0.876	Model Marginal fit
CFI			0.896	Model Marginal fit

Structural Equation Modeling (SEM)

Structural equation model (SEM) consists of 2 elements, namely the measurement model (outer model) and the structural model (inner model). Where in SEM, three analysis activities were carried out at once in one analysis, namely 1) CFA validity (Confirmatory factor Analysis); 2) Path Analysis; 3) Goodness of fit test.

Test the accuracy of the Goodness of Fit (GOF) model

The Evaluation of Structural Model Compatibility shown on Table 4 below (Source: own data):

According to Hair (2010), there was not even one from the GOF or GOFI measurements that could exclusively use as the fitness evaluation of the overall model. The best guidance for assessing the fitness of a model is strong substantive theory. It means that there is unfulfilled criteria, it does means that the model is not accepted completely, if there is only one indicator of GOF being fulfilled, the indicator can represent the indicators of accuracy test for other models. Table 5 below show estimation results and hypothesis testing (Source: own data).

Table 5  Estimation Results And Hypothesis Testing
Variable			Path coefficient	Hypothesis Test Results		Conclusion
Exogenous	-	Endogenous		CR	p-value
	-
	>
Entrepreneur Leadership (X1)	-	Commitment (Y1)	0.785	3.525	0	Significant
	-
	>
Learning organization (X2).	-	Commitment (Y1)	0.107	0.555	0.579	Not Significant
	-
	>
Entrepreneur Leadership (X1)	-	Midwife Performance (Y2)	0.146	0.508	0.612	Not Significant
	-
	>
Learning organization (X2).	-	Midwife Performance (Y2)	0.075	0.442	0.658	Not Significant
	-
	>
Commitment (Y1)	-	Midwife Performance (Y2)	0.679	2.474	0.013	Significant
	-
	>

Based on Table 5, the estimation results and hypothesis testing. Entrepreneurship Leadership variable (X1) has an influence (Path coefficient) on Commitment (Y1) of 0.785 with a CR value of 3.525 and p-value of 0, p-value < 0.05, then the statistical hypothesis shows that Ho is rejected. It means that Entrepreneurship Leadership (X1) has a significant effect on Commitment (Y1).

Learning Organization variable (X2) has an influence (Path coefficient) on Commitment (Y1) of 0.107 with a CR value of 0.555 and p-value of 0.579, p-value > 0.05, the statistical hypothesis states that Ho is accepted. It means that the Learning Organization (X2) does not have a significant effect on Commitment (Y1).

Entrepreneurship Leadership variable (X1) has an influence (Path coefficient) on Midwife Performance (Y2) of 0.146 with a CR value of 0.508 and p-value of 0.612. P-value > 0.05, the statistical hypothesis states that Ho is accepted. It means Entrepreneurship Leadership (X1) has no significant effect on Midwife Performance (Y2).

Learning Organization variable (X2) has an influence (Path coefficient) on Midwife Performance (Y2) of 0.075 with a CR value of 0.442 and p-value of 0.658. P-value > 0.05, then the statistical hypothesis states that Ho is accepted. It means that the Learning Organization (X2) has no significant effect on Midwife Performance (Y2).

Commitment variable (Y1) has influence (Path coefficient) on Midwife Performance (Y2) of 0.679 with a CR value of 2.474 and p-value of 0.013. a p-value < 0.05, then the statistical hypothesis states Ho is rejected. It means that Commitment (Y1) has a significant effect on Midwife Performance (Y2).

In order to facilitate the evaluation of outer model which is also integrated with the path analysis), the measurement model of the path diagram (outer model) and the structural model (structural model) are presented below on Figure 2 (Source: own data).

The path diagram of the above Structural equation model can be converted in the form of the following equation:

• Commitment (Y1) = 0.79 Entrepreneurship Leadership (X1) + 0.11
Learning Organization (X2) + Z1

•Midwife Performance (Y2) = 0.68 Commitment (Y1) + 0.15 Entrepreneurship Leadership (X1) + 0.08
Learning Organizations (X2) + Z2

Discussion

The first purpose of the research is developed in this research, there are five hypotheses to examine the direct effect and the second purpose is to examine the indirect effect of the two hypotheses. The findings of the research are:

Hypothesis 1, The Influence of Entrepreneurial Leadership on The Commitment of Midwife

Analysis of the influence of entrepreneur leadership on midwife’s commitment is positive and significant. This shows that the better or effective the entrepreneur leadership, the more committed the midwives are. Entrepreneurial leadership, the leader has the vision or future orientation, has the ability to be able to think creatively, act in an innovative way, take the risk, ready to face the challenge, capable to inspire and influence, as the driver in improving the commitment of midwives.

This study strengthens the results of the study Greef de Annique (2014): dan Yiing and Ahmad (2009) that entrepreneurial leadership has a positive and significant effect on employee commitment. This result is appropriate with the theory of type by McGregor (1960) in Greef de Annique (2014) that employees can work in the organization, employees who like their job, who are creative, motivated, proud of their work, full of responsibility, and happy to accept challenges. These findings strengthen several previous types of research ( Blau, 1985; Williams & Hazer, 1986) giving credibility to the idea that leadership plays an important role in influencing organizational commitment.

Hypothesis 2, The Effect of Learning Organization on Midwife Commitment

The results of the analysis of the influence of the Learning Organization on midwife’s commitment are positive and insignificant. It means that the higher role of learning organization has an effect on increasing commitment. However, it has not been able to give a real influence on the commitment of midwives. The results of other studies showed similar positive results with previous studies showing that organizational learning has a significant and positive effect on organizational commitment.

The support from several studies found that organizational learning is one of the factors affecting organizational commitment (Hsu, 2009; Rose et al., 2011; Salarian et al., 2015; Usefi et al., 2013). Based on the research results by Ahmad and Marinah (2013), organizational learning and organizational commitment were highly correlated.

Hypothesis 3, The Effect of Entrepreneurship Leadership on Midwife’s Performance

The results of this analysis are positive and insignificant. It means the higher the role of entrepreneur leadership, the higher the performance. However, it has not given real influence on the improvement of midwife’s performance. The results of the study from Hmieleski and Ensley (2007) stated that entrepreneurial leadership behavior can be achieved by directing and empowering subordinates to achieve good performance. ( Bryant, 2004 ; Cogliser & Brigham, 2004 ) Entrepreneurial leadership can influence social performance or performance in the organization. The better social performance will not only lead to higher profit, but it also plays a role in the company’s competitive advantage (Porter & Kramer, 2006 in Chung-Wen, 2008), Chung-Wen (2008) , the results of his research have proven a positive relationship between leadership with organizational performance.

Hypothesis 4, The Effect of Learning Organizations on the Performance of Midwife

These positive and insignificant results of analysis show that higher role of learning organizations will improve performance. However, it has not been able to give a real influence on the performance of midwife. Organizational learning is the best recommendation for improving organizational performance (Bates & Khasawneh, 2005). The lack of emphasis on organizational learning will reduce organizational performance (Usefi et al., 2013).

The main characteristic of a learning organization is the use of information to increase knowledge for the organization (Nonaka & Takeuchi, 1995 in Hanaysha, 2016). Ahmad and Marinah (2013) stated that becoming a learning organization by improving training programs is a number of important factors to develop learning, improve individual and organizational performance as well as maintaining the competitive advantage.

Hypothesis 5, The Effect of Organizational Commitment to Midwife’s Performance

Positive and significant analysis results show that a higher commitment of the midwife in the organization can give a positive influence on the improvement of the midwife’s performance. Having a commitment will be able to improve her performance. These findings strengthen the findings by Abdullah and Ramay (2012) , in which they concluded that organizational commitment has a direct effect on organizational performance, profitability, and competitiveness. Several experts have also strengthened this direct effect (Jaramillo et al., 2005; Peterson et al., 2003). Entrepreneurship leadership is often associated with visionary leadership (Gupta et al., 2004). It means that entrepreneurial leader must create an inspiring vision to get support from participants or subordinates. Table 6 below show the indirect effect between variables (Source: own data).

Table 6 Indirect Effect Between
Indirect Effect	Calculation	Results	%	t-test (Sobel)	p-value	Description
Entrepreneurship Leadership (X1) on Midwife Performance (Y2) through Commitment (Y1)	0.785 × 0.679	0.533	53.3%	2.025	0.043	Significant
Learning Organization (X2) on Midwife Performance (Y2) through Commitment (Y1)	0.107 × 0.679	0.073	7.3%	0.107	0.915	Not Significant

Hypothesis 6, The Effect of Entrepreneurship Leadership on Performance Through Commitment

Entrepreneur leadership on the midwife performance mediated by commitment is significant, indirect influence between entrepreneur leadership on the midwife performance mediated by commitment show positive and significant results. The better the entrepreneur leadership of the midwife mediated by commitment, the higher the midwife performance, these results shows that there is an important role of the midwife’s commitment in establishing the midwife’s performance (Henton et al., 1997; Dees, 2009). A number of studies understand the factors that influence the organizational performance, among others are commitment and leadership that have emerged to be one of the most significant factors that contribute to performance ( Cascio et al., 2010 ). According to them, the commitment of employees is directly influenced by entrepreneurial leadership and it can also indirectly influence the social performance of the organization.

Hypothesis 7, The Effect of Learning Organizations on Midwife Performance through Commitment is not significant

The results of direct and indirect influence with commitment as mediation, learning organization on performance are not significant. Based on some of the results of the tabulation of open questionnaires, Learning Organization is still required in midwife organizations to develop science and stay committed. In addition, the spirit of high commitment will improve the performance of midwife. The results of the study of Ahmad and Marinah (2013) stated that organizational learning and organizational commitment are highly correlated. Furthermore, Wang (2007) ( Hanaysha, 2016) mentioned that learning organization can increase employee commitment in the organization and can produce a positive performance.

Conclusion

After hypothesis testing is carried and the research purposes have been solved, there are several contributions that can be given through this research. First, the theoretical contribution is building a comprehensive theoretical model to explain the relationship between entrepreneur leadership, learning organization, commitment, and midwife performance. This study is considered to be comprehensive because this study has combined the ideas of entrepreneur leadership, learning organization, commitment and midwife performance as a single conceptual study. Second, entrepreneurial leadership variable is used in predicting the commitment and performance of midwife about the direct effect. Theoretically, this research shows that leadership has a direct influence on commitment as well as commitment to performance. Third, there is a commitment mediation role between entrepreneur leadership with midwife performance. Based on the results of this research, there is an important role in forming the midwife performance theoretically. Some of the practical contributions are the fact that this research is important for the entrepreneur delima midwives in opening independent practice to improve their business performance. Fourth, this research also gives insight for business actors to improve the performance of delima midwives. Practitioners of delima midwives must be committed to becoming leaders who have an entrepreneurial spirit as entrepreneurial leaders.

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