Ketersediaan Sumber Daya Manusia Kesehatan pada Fasilitas Kesehatan Tingkat Pertama dalam Era Jaminan Kesehatan Nasional di Delapan Kabupaten-Kota di Indonesia

Implementation of the National Health Insurance program causes various effects, including an increased number of visits to primary health facilities, so it takes an adequate distribution of human resources.The aims of this study is to describe the availability of human resources for health in primary health centers in the era of National Health Insurance. Type of research is quantitative-qualitative method withcross sectional approach. Data collecting has done by interviews and round table discussion. Researchlocations were selected purposively in eight districts/cities, namely Bekasi City and Bogor District (WestJava), South Tangerang City and Serang District (Banten), Yogyakarta City and Bantul District (DIY),Surakarta City and Sragen District (Central Java). Informants are leaders/representatives of primaryhealth centers, clinics, physicians and the district/city health office. The quantitative data were analyzed descriptively and qualitative data using content analysis. Health centers in eight districts/cities do notall have the human resources for health in accordance of Permenkes RI No. 75/2014, but general practitioners, midwives and nurses have been available in all health centers though the amount isstill lacking. With the exception of Bogor, the number of medical personnel throughout the clinic is inconformity with Permenkes RI No. 9/2014, but other types of human resources for health is still a lot that has not been available. Meanwhile, throughout the medical practitioners, the most human resources widely available are general practitioners and nurses. There are changes in procurement planning ofhuman resources in the era of National Health Insurance, increased workload and working hours, sothat it is needed planning and procurement of human resources based on needs

Kepuasan Pasien Peserta Program Jaminan Kesehatan Nasional Terhadap Pelayanan Kefarmasian Di Apotek

Pharmacy is a place where a pharmacist provides pharmaceutical services. To improve services, it is necessary to carry out an evaluation of patients\u27s or consumers\u27 satisfaction on pharmaceutical services.This research aimed to assess the satisfaction of the patients covered by national health insurance programme (JKN) and to find out the relationship of patients\u27 characteristics and their satisfaction. This research used a cross sectional survey design, conducted for patients visiting pharmacy to redeem the prescribed drug in Tangerang Selatan city, Serang district, Bekasi city, Bogor district, Yogyakarta city, Bantul district, Solo city, and Sragen district. The sample was 152 adult JKN patients chosen by accidental sampling. Data were collected using self assessment questionnaire analyzed using chi square analysis. This study found that the highest level of dimension of pharmaceutical services satisfaction was empathy and the lowest one was assurance, in term of the availability of drugs and the number of drugs that was covered by JKN scheme. Among 5 characteristics (i.e: age, sex, marriage status, education, and occupation), only occupation variable that had significant correlation with satisfaction. The pharmacy management should communicate with the JKN provider regarding the kinds of drugs covered and concern with the drugs availability in the pharmac

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

Interpretasi Efikasi Obat Dalam Pengobatan Anak Dengan Infeksi Saluran Pernafasan Atas Di Depok, Indonesia

ISPA (Infeksi Saluran Pernafasan Akut) adalah (Acute Respiratory Infection) salah satu penyakit utama pada anak. Pada umumnya perilaku pencarian pengobatan untuk ISPA berakhir dengan penggunaan obat. Efikasi obat tidak hanya merupakan pengetahuan medis tetapi merupakan konstruksi budaya. Penelitian dilakukan untuk memahami bagaimana obat diinterpretasikan oleh orang awam di wilayah kumuh perkotaan. Penelitian dilakukan pada bulan Oktober 2009 di sebuah komunitas pemulung yang tinggal di kota Depok. Data dikumpulkan dengan melakukan wawancara mendalam terhadap 20 orang ibu yang memiliki Balita dengan gejala ISPA dalam waktu paling lama sebulan sebelum penelitian dilakukan. Informan diwawancarai mengenai pengalaman dalam menangani Balita dengan gejala ISPA, pengobatan yang dilakukan dan bagaimana mereka mengevaluasi obat yang digunakan. Hasil menunjukkan bahwa dalam menghadapi Balita ISPA, para ibu melakukan pengobatan sendiri, membawa anak ke Puskesmas atau praktek swasta yang semuanya berujung pada penggunaan obat. Istilah “cocok” merupakan kata kunci dalam mengevaluasi efikasi dan kompatibilitas obat

Studi Monitoring Efek Samping Obat Antituberkulosis Fdc Kategori 1 di Provinsi Banten dan Provinsi Jawa Barat

Hasil Riskesdas 2007 menunjukkan kasus Tuberkulosis (TB) Paru ditemukan merata di seluruh provinsi di Indonesia, sedangkan hasil Riskesdas 2010 menunjukkan prevalensi TB paru nasional adalah 725 per 100.000 penduduk. Salah satu penyebab putusnya terapi adalah efek samping obat. Hal ini menimbulkan resistensi kuman sehingga memperberat penyakit. Penelitian ini bertujuan untuk mendapatkan informasi efek samping akibat penggunaan obat antituberkulosis(OAT) dan kepatuhan pasien. Jenis penelitian adalah time series, dilakukan terhadap pasien baru penderita tuberkulosis di 10 puskesmas di Provinsi Banten dan Jawa Barat pada bulan Mei 2011. Pasien diikuti selama 6 bulan hingga periode penelitian berakhir. Pasien diwawancara mengenai efek samping obat yang dialaminya setiap bulan saat mengambil obat atau kunjungan ke rumah oleh petugas puskesmas. Pemantauan kepatuhan dilakukan dengan menghitung obatsisa yang disimpan oleh pasien. Jumlah sampel dalam penelitian ini adalah 92 pasien, semuanya masih patuh dalam menjalani terapi. Frekuensi kejadian efek samping yang paling sering timbul pada bulan pertama dan kelima yaitu mual; pada bulan kedua pusing; serta pada bulan ketiga, keempat dan keenam nyeri sendi. Efek samping lain yang sering timbul akibat penggunaan OAT yaitu mengantuk dan lemas pada bulan pertama, kedua dan ketiga. Berdasarkan hasil penelitian dapat disimpulkan bahwa dengan adanya pemantauan yang dilakukan petugas, efek samping yang terjadi dapat terdata dan tidak menyebabkan menurunnya kepatuhan pasien. Hal ini dapat terjadi karena adanya komunikasi yang baik antara pasien dengan petugas mengenai proses pengobatan TB. Disarankan agar pemantauan efek sampingdan kepatuhan dilakukan dengan menekankan pada komunikasi pasien dengan petugas. Selain itu perlu dilakukan pemantauan laboratorium secara rutin.Kata Kunci: Efek Samping, Obat Antituberkulosis (OAT), Tuberkulosis (TB) paruAbstractThe result of Basic Health Research in 2007 shown that lung tuberculosis cases spread out all over Indonesia. Meanwhile, the 2010 Basic Health Research shown the prevalence of lung TB was 725 per 100,000 populations. Side effects are among the causes of therapy drop out thus resulted in bacterial resistance which further caused the severityof TB. This research aimed to explore the information of side effects experiences caused by TB drugs therapy as well as to monitor adherence. The research was a time series research, conducted to new patients diagnosed as having lung TB in 10 public health centers (PHCs) in Banten and West Java provinces on May 2011. Those patients were followed up to6 months until the research was terminated. Patients experiences of side effects were collected by monthly interview, when they came to the PHCs to take drugs or during patients home visit by the PHC staff. Monitoring of adherence was conducted by counting the tablet at patients home. The sample was 92 patients, whom all were counted as adhering thetherapy. The most frequent side effect in the first and fifth months was nausea; in the second month was dizziness; and in the third, fourth and sixth month was neuromyalgia. Other side effects reported were drowsiness and weakness in the first three months. Based on the result, it is concluded that by health provider monitoring, the side effects can beidentified and had not caused low adherence. This can be the result of good communication between patients and health provider about TB therapy. It is recommended that side effects and adherence monitoring should be conducted by emphasizing on patients and provider communication. In addition, laboratory monitoring should be conductedperiodically.Keywords : side effects, antituberculosis drugs, lung tuberculosi

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)

Logistic Management of Antiretrovirals in Indonesia

Background: The escalation of HIV-AIDS epidemic needs a comprehensive control efforts including the treatmentstage. ARV is inevitably needed to control the development of HIV-AIDS infection. The availability and accessibility of ARVis crucial to reach the successful treatment. Objective: To identify the implementation of logistic management process inthe central level. Methods: Conducting in depth interviews with informants from AIDS and Infectious Disease sub divisionof the Directorate General of Disease Prevention and Control-MoH, Directorate General Pharmacy and Medical Devices,GF-ATM, and PT. Kimia Farma as the manufacturer of ARV in Indonesia. Data was collected in Jakarta during May-August2011. Result: Source of fund procurement of ARV drugs in Indonesia comes from the national budget and Global Fund.Kimia Farma is the only national manufacture of 5-drugs firts line of ARV, while second line ARV is import include rawmaterials of ARVs. Logistics management consists of planning, procurement and storage, and distribution. Conclusion:Logistic management of ARV in the central level has run in accordance to drug logistic cycle. Unfortunately, most rawactive materials and final second line of ARVs product were still being imported. The government has planned an exitstrategy to reduce the dependency on the donor funding. The report and coordination process among the government,PT. Kimia Farma and end user (hospitals) has not worked well and synchronized. Recommendation: The governmenthave to encourage the local pharmaceutical industries to be able to produce ARV, especially the second line. All relatedstakeholders should enhance good coordination through periodic monitoring and evaluation in ARV distribution processand human resources capability in reporting mechanism