EKSISTENSI UNIT PENGELOLA OBAT DI BEBERAPA KABUPATEN/KOTA SUATU ANALISIS PASKA DESENTRALISASI
Background: Accessibility to essential drugs is a public right,therefore it's 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 management