Abstract

Indonesia masih menghadapi keterbatasan jumlah apoteker di puskesmas, sehingga pihak pemerintah daerah dan puskesmas harus berupaya mengatasi permasalahan tersebut. Penelitian ini bertujuan untuk menggambarkan ketersediaan dan distribusi tenaga pelayanan kefarmasian di puskesmas serta permasalahan dan alternatif pemecahannya. Data diambil dari hasil Riset Fasilitas Kesehatan (Rifaskes) tahun 2011I. Data kuantitatif tentang tenaga pelayanan kefarmasian di puskesmas dianalisis secara deskriptif berdasarkan regional. Data kualitatif sebagai pendukung diperoleh melalui wawancara mendalam dengan bagian kepegawaian dinas kesehatan dan apoteker empat puskesmas di Kota Bogor dan Bekasi, 3 kemudian dianalisis dengan metode analisis tema. Hasil analisis menunjukkan bahwa Sulawesi memiliki persentase puskesmas dengan tenaga apoteker tertinggi (29,1%) sedangkan Indonesia Timur memiliki persentase puskesmas tertinggi dengan tenaga pelayanan kefarmasian tanpa latar belakang pendidikan farmasi (51,5%). Persentase tenaga kefarmasian terbesar di puskesmas adalah tenaga teknis kefarmasian kemudian perawat. Permasalahan utama yang dihadapi puskesmas adalah beban kerja yang berat dengan kondisi tenaga yang terbatas. Alternatif pemecahan masalah yaitu pengangkatan apoteker baru, namun jika tidak memungkinkan maka penempatan apoteker pada puskesmas dengan kebutuhan mendesak merupakan prioritas utama. Pilihan lain yang memungkinkan adalah pemberdayaan tenaga teknis kefarmasian dan staf lain yang sudah dilatih atau memanfaatkan tenaga siswa magang. Indonesia is facing shortage of pharmacist in public health centers (PHCs), therefore the local government and PHCs have to cope with this problem. This paper aimed to describe the pharmaceutical manpower availability in PHCs, the problems occurred and potential applied solutions. Data was taken from National Health Facility Research 201. Quantitative data related to pharmaceutical manpower in PHCs was analyzed descriptively based on regions. Supporting qualitative data through in-depth interviews with the health office staffs in Bogor and Bekasi and pharmacists in four PHCs were conducted and being analyzed using thematic analysis. It was found that Sulawesi had the highest percentage of PHCs having pharmacist (29.1%) while Eastern Indonesia 51.5% of PHCs didn’t have any staff with pharmacy related educational background. The highest percentages of staff composition were pharmacy technician followed by nurse. The main problem was due to high workload with limited manpower available. The proposed solutions are recruitment of new pharmacists, but in case it is not possible then placing pharmacist in certain type of PHCs with urgent needs is a priority. Empowering pharmacy technician, all available trained staff and other resources such as on job students are other feasible choices.

References

1. Foster N, McIntyre D. Economic evaluation of task-shifting approaches to the dispensing of anti-retroviral therapy. Foster and McIntyre Human Resources for Health. 2012;10(32).

2. Malaysia Health Statistic. Number of pharmacist and ratio [database on the Internet]. 2008 [cited February 11th 2013]. Available from: http://micpohling.wordpress.com/2008/03/08/malaysia-health-statistic-number-of-pharmacist-and-ratio.

3. World Bank. Indonesia’s doctors, midwives and nurses: current stock, increasing needs, future challenges and options. Jakarta: World Bank Indonesia; 2009.

4. Handayani L, Ma’ruf NA, Sopacua E. Peran tenaga kesehatan sebagai pelaksana pelayanan kesehatan Puskesmas. Buletin Penelitian Sistem Kesehatan. 2010; 13(1): 12-20.

5. Badan Litbang Kesehatan Kemenkes RI. Laporan akhir riset fasilitas kesehatan Puskesmas 2011. Jakarta: Badan Litbang Kesehatan; 2012.

6. Gidman W. Increasing community pharmacy workloads in England: causes and consequences. International Journal of Clinical Pharmacy. 2011; 33: 512–20.

7. Walton SM. The pharmacist shortage and medication errors: issues and evidence. Journal of Medical Systems. 2004; 28(1): 63-9.

8. Rothschild JM, Churchill W, Erickson A, Munz K, Schuur JD, Salzberg CA, et al. Medication errors recovered by Emergency Department Pharmacists. Annals of Emergency Medicine. 2010; 55(6): 513-21.

9. Hattingh HL, King MA, Smith NA. An evaluation of the integration of standards and guidelines in community pharmacy practices. Pharmacy World & Science: PWS. 2009; 31: 542–9.

10. Departemen Kesehatan Republik Indonesia. Keputusan Menteri Kesehatan Republik Indonesia Nomor 128/Menkes/ SK/II/2004 tentang kebijakan dasar pusat kesehatan masyarakat. Jakarta: Departemen Kesehatan Republik Indonesia; 2004.

11. Resosudarmo BP, Yusuf AA, Hartono D, Nurdianto DA. Regional economic modelling for Indonesia: implementation of IRSA-Indonesia. Journal of Indonesian Economy and Business. 2011; 26(3): 287 – 309.

12. Rustia HN. Kontroversi legalitas praktek kefarmasian oleh tenaga keperawatan. Aspirasi. 2010; 1(1): 51-74.

13. Bell HM, McElnay JC, Hughes CM. A self-reported work sampling study in community pharmacy practice Pharmacy World & Science. 1999; 21(5): 210-6.

14. Direktorat Jenderal Bina Kefarmasian dan Alat Kesehatan. Keputusan Direktur Jenderal Kefarmasian dan Alat Kesehatan Nomor. HK.00.DJ.II.924 Tahun 2004 tentang pembentukan tim penyusun pedoman pelayanan kefarmasian di Puskesmas. Jakarta: 2004.

15. Kementerian Kesehatan Republik Indonesia. Undang-undang Republik Indonesia Nomor 36 tahun 2009 tentang kesehatan. Jakarta: Kementerian Kesehatan Republik Indonesia; 2009.

16. Presiden Republik Indonesia. Peraturan Pemerintah Republik Indonesia Nomor 51 tahun 2009 tentang pekerjaan kefarmasian. Jakarta: Kementerian Sekretariat Negara Republik Indonesia; 2009.

17. Myers CE. Opportunities and challenges related to pharmacy technicians in supporting optimal pharmacy practice models in health systems. American Journal of Health-System Pharmacy. 2011; 68(12): 1128-36.

18. Dambisya YM, Matinhure S. Policy and programmatic implications of task shifting in Uganda: a case study. BMC health services research. 2012; 12(61). Available from: http://www.biomedcentral.com/1472-6963/12/61.

19. Barber SL, Gertler PJ, Harimurti P. The contribution of human resources for health to the quality of care in Indonesia. Health Affairs. 2007; 26(3): w367-79.

20. Dennis S, May J, Perkins D, Zwar N, Sibbald B, Hasan I. What evidence is there to support skill mix changes between GPs, pharmacists and practice nurses in the care of elderly people living in the community? Australia and New Zealand health policy. 2009; 6(1): 23.

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