EKSISTENSI UNIT PENGELOLA OBAT DI BEBERAPA KABUPATEN/KOTA SUATU ANALISIS PASKA DESENTRALISASI

Abstract

Background: Accessibility to essential drugs is a public right,
therefore it’s the government responsibility to make them
available. Previously before the era of regional autonomy, public
drug management in all districts/cities was performed by the
so-called District Pharmaceutical Warehouses (GFK). However,
nowadays the situation has changed because of the difference
in vision and perception of each regional government on the
former warehouses. Some public drug management units in
certain districts/cities are not functioning optimally. Inefficient
drug procurement regarding the number and kind of drugs as
well as timeliness results in gap between drug need and
procurement. Furthermore, loosening in drug supply procedure
makes essential drugs more unavailable to public.
On the other hand, decentralization policy in drug
management also undeniably brings advantages to the 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 so
as to attain minimal health care standards in districts/cities,
baseline data in drug management and financing in several
districts/cities should make a valuable contribution.
Methods: A cross sectional descriptive study had been carried
out during July-December 2006 in 26 districts/cities out of 11
provinces. Samples were 26 district health offices (Dinas
Kesehatan Kabupaten/Kota) and 26 District Pharmaceutical
Warehouses (GFK) where as respondents were head of drug
section and head of warehousing respectively. Data were
collected by means of structured questionnaires and in-depth
interviews as well as the collection of secondary data of drug
logistics. Qualitative and quantitative analysis was performed.
Results: The study shows that: 1) although health budget in
general had risen, the average percentage of drug budget
allocation from 21 district health authorities was only 12.06%,
reflecting the low drug priority in district health policy because
drug expenditures may amount up to 40% of the total health
budget. 2) Public drug management was mostly performed by
the so-called regional technical provider unit (UPTD) with some
limitations concerning human resources and material in
achieving an effective and efficient drug management, and 3)
there was still lack of pharmacist assistants to manage drugs
in primary health care (Puskesmas) up to 20% and even more
piteously the lack of pharmacist in district drug management
unit (GF/UPOP Kabupaten/Kota, 12,5%).
Conclusions: Apart from the achievement of predetermined
indicators stated in minimal health care standards in districts/
cities, especially regarding essential and generic drugs, drug
management in general has been well performed concerning
planning and drug availability. More support and commitment
from the district government is a must considering that regional
development can not be separated from the health development
of the subject themselves.
Keywords: decentralization, District Pharmaceutical
Warehouse, public drugs, drug management