Eksistensi Unit Pengelola Obat di Beberapa Kabupaten/kota suatu Analisis Paska Desentralisasi

Background: Accessibility to essential drugs is a public right,therefore its the government responsibility to make themavailable. Previously before the era of regional autonomy, publicdrug management in all districts/cities was performed by theso-called District Pharmaceutical Warehouses (GFK). However,nowadays the situation has changed because of the differencein vision and perception of each regional government on theformer warehouses. Some public drug management units incertain districts/cities are not functioning optimally. Inefficientdrug procurement regarding the number and kind of drugs aswell as timeliness results in gap between drug need andprocurement. Furthermore, loosening in drug supply proceduremakes essential drugs more unavailable to public.On the other hand, decentralization policy in drugmanagement also undeniably brings advantages to the districts,for example capacity building in drug procurement, increasingcapability in budget management and negotiation with districtdecision makers as well as enhancing regional economicactivity. In revitalizing district pharmaceutical warehouses soas to attain minimal health care standards in districts/cities,baseline data in drug management and financing in severaldistricts/cities should make a valuable contribution.Methods: A cross sectional descriptive study had been carriedout during July-December 2006 in 26 districts/cities out of 11provinces. Samples were 26 district health offices (DinasKesehatan Kabupaten/Kota) and 26 District PharmaceuticalWarehouses (GFK) where as respondents were head of drugsection and head of warehousing respectively. Data werecollected by means of structured questionnaires and in-depthinterviews as well as the collection of secondary data of druglogistics. Qualitative and quantitative analysis was performed.Results: The study shows that: 1) although health budget ingeneral had risen, the average percentage of drug budgetallocation from 21 district health authorities was only 12.06%,reflecting the low drug priority in district health policy becausedrug expenditures may amount up to 40% of the total healthbudget. 2) Public drug management was mostly performed bythe so-called regional technical provider unit (UPTD) with somelimitations concerning human resources and material inachieving an effective and efficient drug management, and 3)there was still lack of pharmacist assistants to manage drugsin primary health care (Puskesmas) up to 20% and even morepiteously the lack of pharmacist in district drug managementunit (GF/UPOP Kabupaten/Kota, 12,5%).Conclusions: Apart from the achievement of predeterminedindicators stated in minimal health care standards in districts/cities, especially regarding essential and generic drugs, drugmanagement in general has been well performed concerningplanning and drug availability. More support and commitmentfrom the district government is a must considering that regionaldevelopment can not be separated from the health developmentof the subject themselves.Keywords: decentralization, District PharmaceuticalWarehouse, public drugs, drug managemen

Drug Management Reviews in District Drug Management Unit and General Hospital

Drug is one of the essential elements in healthcare that should be effectively and efficiently managed. Following the decentralization in 2001 in Indonesia, drug management has changed in district drug management units and also in District General Hospitals. Certainly this condition influences the sustainability of drug access in primary health care such as in Community Health Center and District General Hospital, especially in drug financing policy. A cross sectional descriptive study to obtain information on drug management in public healthcare in district had been carried out between July and December 2006 in 10 District Public Drug Management Units from 10 district health offices and 9 district general hospitals as samples. Data were collected by interviewing heads of Drug Section in District Health Offices and heads of Hospital Pharmacies using structured questionnaires and observing drug storage in District Drug Management Units, Community Health Centers, and Hospital Pharmacies. Results of the study show that drug planning in District Health Offices and General Hospitals did not meet the basic real need in some districts nor District Hospitals. The minimum health service standards had not been achieved yet. Furthermore, drug procurement, storage and recording as well as reporting was not good enough either, such as shown by the existence of expired drugs. Lead time for drug delivery to community health centers in some districts was longer than the average of lead time in the past 3 years

Sarana Dan Prasarana Rumah Sakit Pemerintah Dalam Upaya Pencegahan Dan Pengendalian Infeksi Di Indonesia

Nosocomial infections is an important issue around the world. Hospitals are required to provide qualified, efficient and effective service to ensure patient safety. The Ministry of Health has revitalized prevention and control of infection program (PPI) in hospitals which is one of the cornerstones towards patient Safety. The purpose of this study is to identify the preparedness of hospitals to implement the PPI program. The data source is Health Facility Research of 2011 which was done by National Institute of Health Research and Development. The aspects examined include facility, infrastructure, human resource, organization, guidelines, compliance in prescribing, the availability of clean water and hospital sewage treatment. The results show that many hospitals are not yet ready to conduct PPI, especially in terms of infrastructure, clean water sterilization and processing waste, mostly hospitals of classes C and D. Sewage treatment is important in the control or prevention of spread of antimicrobial resistance. This program gives many benefits especially in preventing the occurrence of total resistance or back to the era before antibiotics. The PPI program does require a large fee such that hospital management often disapproves, although the result of available cost analysis indicates that PPI is highly cost-effective

An Analysis Of Pharmacy Services By Pharmacist In Community Pharmacy

Background: Up to now there are more than 60 schools of pharmacy with a variety of accreditation level in lndonesia. Previous study found that the standard of pharmaceutical services at various service facilities (hospitals, primary health care and community pharmacy) can not be fully implemented because of the limited competency of pharmacist. This study was conducted to identify the qualification of pharmacist who delivers services in community pharmacy in compliance with the Indonesian Health Law No. 36 of 2009. As mandated in the Health Law No. 36 of 2009, the government is obliged to establish minimum requirements that must be possessed. Methods: This cross sectional study was conducted in 2010 at 2 community pharmacies in each of 3 cities, i.e. Bandung, DI Yogyakarta and Surabaya. Other than ten pharmacists delivering services in community pharmacies, there were pharmacists as informants from 4 institutions in each city selected, i.e. six pharmacists from two Schools of Pharmacy, three pharmacists from three Regional Indonesian Pharmacists Association,six pharmacists from three District Health Offices and three Provincial Health Offices. Primary data collection through in-depth interviews and observation as well as secondary data collection concerning standard operating procedures, monitoring documentation and academic curricula has been used. Descriptive data were analysed qualitatively Results: The findings indicate that pharmacists' qualification to deliver services in a community pharmacy in accordance with the Government Regulation No. 51 of 2009, Standards of Pharmacy Services in Community Pharmacy and Good Pharmaceutical Practices (GPP) was varied. Most pharmacists have already understood their roles in pharmacy service, but to practice it in accordance with the standards or guidelines they are still having problems. It is also acknowledged by pharmacists in other institutions, including School of Pharmacy, Regional Indonesian Pharmacists Association, Provincial and District Health Offices. To practise such as stated by the Indonesian Health Law No. 36 of 2009, the Government Regulation No. 51 of 2009. Conclusion: The Standards of Pharmaceutical Services and GPP requires prevailing role of pharmacists in community pharmacy in terms of time and capability Training or continuing development is also needed through upgrading, seminars, socialization and supervision in the community pharmacy practices which may involve cooperation with professional organizations needs to be improved

Improving Access to Drugs

Although essentially not all therapies need drug intervention, drugs is still an important components in health sector, either in preventive, curative, rehabilitative or promotion efforts. Hence the access to drugs is a main problem, either in International or national scale even to the smallest unit. The problem on access to drugs is very complicated and cannot be separated especially from pharmacy management problems; moreover in general from the overall lack of policy development and effective of health policy, and also the implementation process. With the policy development and effective health policy, rational drug uses, sufficient health service budget so a country can overcome the health problems. Besides infrastructures, regulations, distribution and cultural influences; the main obstacles for drug access is drugs affordability if the price of drugs is an important part and determined by many factors, especially the drug status whether is still patent orgenerics that significantly decrease cost of health cares and enhance the drugs affordability. The determination of essential drug prices in developing countries should based on equity principal so that poor people pay cheaper and could afford the essential drugs. WHO predicts two third of world population can not afford the essential drugs in which in developing countries, some are because of in efficient budget allocation in consequence of drug distribution management, including incorrect selection and allocation and also irrational uses. In part these could be overcome by enhancing performances on the allocation pharmacy needs, including the management of information system, inventory management, stock management and the distribution

Penggunaan Jamu Buatan Sendiri di Indonesia (Analisis Data Riset Kesehatan Dasar Tahun 2010)

Background: A study to analyze data of Basic Health Research 2010 (Riskesdas 2010) was done to describe the profile of household using self-made herbal medicines and to identify the characteristics of household members that related to use of self-made herbal medicines. Methods: The sampel was individuals aged fifteen years old or more and who use self-made herbal medicine i.e. 177,927 people from selected household in 33 Indonesian provinces. Data was collected by interviewing the respondent that use structured questionnaire, including age, sex, marital status, education, job, household monthly expenditure, residence, province and self-made herbal medicines USAge. The data were analyzed by proportion and Chi square test and multiple logistic regression method. Results: Results of data analysis shows that nearly ten percents of household that ever used herbal medicines are those using self-made herbal medicines. A greater proportion of them used either Kaemferia sp. and or Zingiber sp. as raw material in liquid formulation and got the benefit of using it as well as living in North Maluku, Bali and East Nusa Tenggara. About seventeen percents of household members who ever used herbal medicines are those using self-made herbal medicines. Conclusion: Factors related to self-made herbal medicines are married/divorce (OR= 1.76; CI = 1.63-1.90), urban residence (OR= 1.45; CI = 1.38-1.53), female (OR= 1.43; CI = 1.363-1.50) dan higher economic group (OR= 1.34; CI = 1.27-1.40)

Pola Pembiayaan Obat di 10 Kabupaten/kota di Indonesia (Pattern Of Drug Financing In Ten Districts In Indonesia)

Background: Since decentralization era the health budgets including drug budget has been allocated into the development regional budget through formula-based DAU, based on regional revenues and fiscal needs. Health budget is included in DAU, though not explicitly stated. Therefore the health sector practically has to strive for their own budget in every province or every district. This is a new kind of phenomenon for regional governments especially related to the health sector. They should have strategic plan in financing while competing with other sectors to obtain it. Drug consumption in Indonesia is lower than in other ASEAN countries. To ensure access to drugs in primary heath care, the government (Ditjen Bina Farmasi dan Alkes) in the mid-year of 2003 in collaboration with WHO has facilitated a meeting among districts. This meeting leads to an agreement that the regional government should allocate Rp5.000,00 per capita annually for drug budget. Methods: A cross sectional descriptive study was done in ten districts in Indonesia in the year of 2006 on how far the realization of the district agreement of drug budget allocation, particularly in relation with improving drug access issues. District Health Office and Drug Management Unit were taken as samples and data were collected by structured interviews. Results: 1) Drug budget for most districts/cities is still less than Rp5.000,00 per capita per annum so that it can be assumed a shortage in terms of kind of, as well as, quantity of drugs. 2) Some districts showed an increase in drug budget, while the other ones showed just the opposite. 3) Not all districts had all essential and/or generic drug procurement. Conclusion: We suggest more intensive socializations for drug financing to districts in order to improve the commitment to the agreement on the allocation of drug budget and, secondly, a better technical training with topics: planning, advocacy and negotiation with relevant stakeholders