Analisis Situasi Pengelolaan Obat Publik Dl Beberapa Kabupaten/kota

Drugs as an essential element in health care must be available at the time they are needed. Accessibility to essential drugs is a public right, therefore it is the government responsibility to make them available. Before the era of regional autonomy, public drug management in all districts/cities was performed by the so-called District Pharmaceutical Warehouses (Gudang Farmasi Kesehatan). However. at present the situation has changed because of differences in vision and perception of each regional government on the past warehouses. Some public drug management units in certain districts/cities are not functioning optimally. Inefficient drug procurement on numbers and kinds of drugs as well as timeliness result in gap between drug needs and procurement. Furthermore, loosening in drug supply procedure makes essential drugs more inavailable to public. On the other hand, decentralization policy in drug management also undeniably provides advantages to districts, for example capacity building in drug procurement, increasing capability in budget management and negotiation with district decision makers as well as enhancing regional economic activity. In revitalizing district pharmaceutical warehouses as to attain minimal health care standards in districts/cities (Keputusan MenKes No.1457 tahun 2003), baseline data in drug management and financing in several districts/cities should therefore give a valuable contribution. A cross sectional descriptive study had been carried out during July to December 2006 in 26 districts/cities out of 11 provinces. Samples were 26 district health offices (Dinas Kesehatan Kabupaten/Kota), 26 district pharmaceutical warehouses (GFK) and 52 primary health cares (Puskesmas), i.e. two PHCs from each district, where as respondents were heads of drug section, heads of warehouse and drug provider, respectively. Data were collected by structured questionnaires and analysis of effectiveness and efficiency of district drug management were using the evaluation guidelines issued by Directorate General of Pharmaceutical Care And Medical Devices. Results showed 1) Almost all districts drug procurement was conducted by open tender (90.5%); 2) Timely reporting from primary health cares was 68.7%; 3) The average percentage of drug budget allocation from 21 district health offices was only 12.06%; 4) The average drug budget per capita was Rp2,670,- whereas average drug expenditure per capita was slightly higher, Rp2,817,-;5) All district warehouses use price guidelines of PHC and Programme drugs; 6) The average percentage of drugs included in essential and/or generic drug list and in appropriateness with morbidity pattern were 87.47%, 85.22%, and 147%, respectively; 7) The average drug availability in 24 district warehouses was slightly higher than 18 months and the average percentage of safely stock drug was 79.0%; 8) The average time out of stock drug in a year was 24 days, while the average percentage of expired drugs was 9.51% (average value Rp5,328,615,-) and the average of damaged drugs was 4.18% (average value Rp7,154,779,-). A part from the achievement of predetermined indicators stated in minimal health care standards in districts/cities, drug management in general has been performed well