Ketersediaan obat esensial menjadi tantangan saat menghadapi Pandemi COVID-19 di Indonesia. Evaluasi JEE (Joint External Evaluation) 2023 menunjukkan koordinasi lintas sektor masih lemah dalam mencegah, mendeteksi dan menanggapi keadaan darurat kesehatan. Tahun 2021 sebanyak 30% kabupaten/kota belum memenuhi target 85% obat esensial tersedia. Tingkat ketersediaan ini dipengaruhi oleh implementasi kebijakan nya. Penelitian ini bertujuan menganalisis kesiapsiagaan pemerintah daerah dalam menjamin ketersediaan obat esensial pada masa pandemi dan membangun model konseptual resiliensinya.

Penelitian ini dilakukan dengan pendekatan kualitatif di Provinsi Jawa Barat, Kota Depok dan Kabupaten Bogor, serta di Provinsi Bali, Kota Denpasar dan Kabupaten Badung. Pengumpulan data wawancara mendalam, observasi dan data laporan dari instansi. Instrumen wawancara telah divalidasi dengan nilai I-CVI >0,83. Implementasi kebijakan dan penyusunan model resiliensi pemerintah daerah di analisis menggunakan model Van Meter Van Horn.

Kesiapsiagaan pemerintah daerah saat Pandemi COVID-19 pada awalnya belum siap namun dengan adaptasi dan peningkatan kapasitas telah lebih siap. Semua aktor telah menjalankan perannya sehingga tingkat ketersediaan obat esensial indikator selama pandemi COVID-19 memenuhi target capaian indikator di puskesmas maupun kabupaten/kota tahun 2020-2022. Faktor-faktor yang mendukung tingkat ketersediaan obat esensial indikator adalah adanya dukungan pemerintah daerah, dukungan kebijakan, kepemimpinan, ketersediaan anggaran BTT, kolaborasi lintas sektor dan ketepatan perencanaan obat. Faktor-faktor penghambat antara lain terbatas anggaran daerah, SDM, sarana prasarana, ketergantungan industri terhadap bahan baku impor, SIM belum terintegrasi dan ego-sektoral. Terdapat 37 indikator yang terbagi 22 indikator utama dan 15 pendukung pada dimensi ukuran dan tujuan kebijakan, sumber daya, komunikasi antar organisasi, karakteristik badan pelaksana, lingkungan sosial, ekonomi dan politik serta disposisi pelaksana yang dapat membangun resiliensi pemerintah daerah dalam mejamin ketersediaan obat esensial. Pemerintah daerah perlu meningkatkan kapabilitas SDM, penguatan surveillance obat, pemastian buffer stock, kolaborasi lintas sektor, SIM terintegrasi, serta penerapan kebijakan BLUD puskesmas dapat meningkatkan implementasi kebijakan pemerintah daerah dalam menjamin ketersediaan obat esensial.

The availability of essential medicines has been a challenge during the COVID-19 pandemic in Indonesia. The 2023 Joint External Evaluation (JEE) showed that inter-sectoral coordination remains weak in preventing, detecting, and responding to health emergencies. In 2021, 30% of districts/cities had not met the target of 85% availability of essential medicines. This availability rate is influenced by the implementation of policies. This study aims to analyze the preparedness of regional governments to ensure the availability of essential medicines during the pandemic and to develop a conceptual model of their resilience. This study used a qualitative approach in West Java Province, Depok City, Bogor District, Bali Province, Denpasar City, and Badung District. Data collection involved in-depth interviews, observations, and reports from relevant agencies. The interview instrument was validated with an I-CVI value >0.83. The Van Meter Van Horn model analyzed policy implementation and the development of regional government resilience models. Regional government preparedness during the COVID-19 pandemic was initially inadequate, but through adaptation and capacity building, it has improved. All actors have fulfilled their roles, ensuring that the availability of essential medicines during the COVID-19 pandemic met the target indicators at health centers and districts/cities from 2020 to 2022. Factors supporting the availability of essential medicines include regional government support, policy support, leadership, availability of Unexpected Costs Unexpected Costs budget, cross-sectoral collaboration, and accurate medicine planning. Hindering factors include limited local budgets, human resources, infrastructure, industry dependence on imported raw materials, unintegrated SIM, and sectoral egoism. There are 37 indicators divided into 22 main indicators and 15 supporting indicators in the dimensions of policy size and objectives, resources, inter-organizational communication, characteristics of implementing agencies, social, economic, and political environment, and the disposition of implementers that can build the resilience of regional governments in ensuring the availability of essential medicines. Regional governments need to enhance human resource capabilities, strengthen drug surveillance, ensure buffer stock, promote cross-sectoral collaboration, integrate SIM, and implement Regional Public Service Agency policies for community health centers to improve the implementation of regional government policies in ensuring the availability of essential medicines.