Ketersediaan obat di Puskesmas sangat penting dalam menunjang kelancaran pelayanan kesehatan kepada masyarakat. Pengelolaan obat yang benar sesuai dengan Pedoman Pengelolaan obat di Puskesmas termasuk pencatatan dan pelaporan obat-obatan adalah suatu kegiatan yang harus dilakukan supaya obat tersedia dalam keadaan cukup baik jumlah maupun jenis. Laporan Pemakaian dan Lembar Permintaan Obat (LPLPO) adalah suatu format yang digunakan oleh Puskesmas untuk melaporkan keadaan obat dan pengajuan permintaan obat, selain itu LPLPO diharapkan dapat menyediakan data yang cukup dan benar yang diperlukan kapan saja oleh unit diatasnya untuk melaksanakan fungsi-fungsi pengelolaan obat dengan baik serta pengaturan dan pengendalian terhadap unit dibawahnya. Mengingat pentingnya fungsi LPLPO, maka studi ini akan melihat faktor-faktor yang berhubungan dengan kualitas LPLPO yang dihasilkan oleh petugas pengisi LPLPO di Puskesmas. Penelitian ini menggunakan data primer berupa kuesioner yang diperoleh dari wawancara untuk mendapatkan gambaran kualifikasi petugas pengisi LPLPO, faktor proses dan faktor lingkungannya (variabel independen) serta data sekunder berupa LPLPO Puskesmas untuk memperoleh sejauh mana kualitas LPLPO yang dinilai dari 3 aspek yaitu waktu penerimaan laporan, cara pengisian laporan, dan kesesuaian data laporan dengan stok obat. LPLPO yang diamati sebanyak 252 set yang diperoleh dgri 21 laporan dengan stok obat. LPLPO yang diamati sebanyak 252 set yang diperoleh dari 21 Puskesmas x 12 set LPLPO selama bulan september 1999 hingga agustus 2000 (variabel dependen). Hasil penelitian menunjukkan bahwa pada analisa bivariat diperoleh variabel independen yang berhubungan makna dengan kualitas LPLPO adalah Pendidikan, Pengetahuan, Motivasi, Lamanya waktu pengisian LPLPO serta Pengawasan dan bimbingan Pimpinan sedangkan pada analisa multivariat diperoleh bahwa Pengawasan dan bimbingan serta pendidikan berhubungan erat dengan Kualitas LPLPO dan Pengawasan dan bimbingan merupakan variabel yang paling dominan berhubungan dengan kualitas LPLPO. Saran yang diajukan berdasarkan hasil penelitian ditekankan kepada peningkatan Pengawasan dan bimbingan yang terarah dan terencana baik dari Pihak Dinas Kesehatan/Gudang Farmasi maupun Pimpinan Puskesmas terhadap petugas pengisi LPLPO (Pengelola gudang obat Puskesmas) serta penerapan sistem Reward and Punishment yang adil sebagai konsekuensi pengawasan yang dilaksanakan dan bentuk motivasi kepada petugas untuk meningkatkan kualitas kerja.

Factors that correlate with LPLPO quality of all Puskesmas in Kapuas Hulu District in 1999-2000The availability of medicines in Puskesmas (local community health center) is very important for sustaining excellent health service for the local community. Appropriate management of medicines that is in compliance with Medicines Management Guidelines in Puskesmas, including recording and reporting medicines status, is an activity that should be carried out to maintain the medicines availability in terms of their quantity and types. Laporan Pemakaian dan Lembar Permintaan Obat (LPLPO) or Medicines Use Report and Request Form is a format that is used by Puskesmas to report the medicines status and to request for medicines supply. In addition, LPLPO is meant for providing adequate and accurate data that are accessible in any time for any unit above Puskesmas to execute the medicines management functions well and for any unit under Puskesmas to regulate and control them. Considering the importance of LPLPO function, this study was focused on investigating factors that correlated with the quality of LPLPO completed by Puskesmas staffs that were in charge in completing the form. This study used primary data in the form of questionnaire obtained from interviews that were designed to get the description of the qualification of the staffs completing the LPLPO, the process factor and its environment factor (independent variable). This study also used secondary data in the form of Puskesmas LPLPOs collected for providing information regarding their quality in terms of 3 aspects, namely, the report acceptance time, the report mode of completion, and the report data compliance with the stock of medicines. The number of analyzed LPLPO was 252 sets that were obtained from 21 Puskesmas x 12 sets of LPLPO during September 1999 until August 2000 (dependent variable). The study results show that, on the basis of bivariate analysis, the independent variables that correlate with the quality of LPLPO are Education, Knowledge, Motivation, Length of time of LPLPO completion as well as Supervision and Guidance from the Executives, while on the basis of multivariate analysis, the results indicate that Supervision and Guidance as well as Education strongly correlate with the quality of LPLPO and that Supervision and Guidance are variables that most dominantly correlate with the quality of LPLPO. Recommendations based on the study emphasize on several issues such as the improvement of more well-directed and well-planned Supervision and Guidance from the local Health Department / Pharmacy Storehouse of Puskesmas Executives towards the staffs in charge of completing LPLPO (or Puskesmas Storehouse staff), and the implementation of fair Reward and Punishment system as a consequence of the applied supervision and a form of motivation for the staffs to improve their work quality.

Background: Diphtheria remains a public health problem in Garut District, with 100 reported cases and a case fatality rate (CFR) of 17.2%. This study aimed to determine the relationship between immunization status with the incidence of diphtheria in Garut District in 2023–2024. Methods: A mixed-method approach was used. The quantitative component employed a case-control design (1:2) with individual matching based on age and residence. A total of 141 children (47 cases and 94 controls) were selected using total sampling from outbreak data. Conditional logistic regression analysis was conducted to calculate odds ratios (OR) and 95% confidence intervals (CI). The qualitative approach was carried out through in-depth interviews with key informants using a phenomenological method. Result: Most children in the case group were not immunized (74.47%) and had a history of contact with diphtheria patients (76.6%). Children who were not immunized and had contact history were 9 times more likely to contract diphtheria compared to those who were fully immunized (95% CI: 2.67–31.79). A significant association was found between immunization status and diphtheria incidence (OR=5.82; 95% CI: 2.17–15.61; p=0.0001), and remained significant after controlling for covariates (OR=3.08; 95% CI: 1.40–23.79; p=0.008). The qualitative findings revealed that socio-cultural and religious factors, vaccine refusal, and a suboptimal surveillance system prior to the outbreak contributed to the cases. Conclusion: Strengthening immunization coverage, community education, and surveillance systems is needed to prevent diphtheria in high-risk areas.  

Pengobatan merupakan salah satu upaya terapi yang dilakukan oleh dokter atau paramedis terhadap pasien. Penggunaan obat untuk tujuan pengobatan harus didasarkan pada prinsip bahwa secara medis akan memberikan manfaat dan aman bagi pasien. Dalam praktek pengobatan sering ditemui kebiasaan-kebiasaan penggunaan obat yang tidak sesuai dengan prinsip diatas, hal ini disebut dengan penggunaan obat tidak rasional. Dampak penggunaan obat tidak rasional dapat menimbulkan rendahnya mutu pelayanan, meningkatnya biaya kesehatan, dan ketergantungan masyarakat terhadap obat-obat tertentu. Untuk mengurangi praktek penggunaan obat tidak rasional, Pemerintah telah melakukan berbagai upaya melalui proyek kesehatan IV di 5 propinsi termasuk Sumatera Barat dengan melaksanakan pelatihan penggunaan obat secara rasional untuk dokter dan paramedis serta pelatihan supervisi terpadu pengelolaan dan penggunaan obat secara rasional di Puskesmas. Penelitian ini bertujuan untuk mendapatkan informasi tentang penggunaan obat tidak rasional dan faktor-faktor yang berhubungan dengan penggunaan obat tidak rasional untuk penyakit ISPA non Pneumonia di Puskesmas se Kota Solok dengan metoda cross sectional yang diambil secara purpusif. Dari penelitian ini didapatkan proporsi penggunaan obat tidak rasional 26,9%, dimana 64,4% resep ditulis oleh tenaga perawat/bidan dan 35,6% ditulis oleh dokter. Hasil analisis bivariat menunjukkan beberapa variabel yang secara statistik bermakna (p<0,05) yang berhubungan dengan penggunaan obat tidak rasional yaitu; jenis tenaga, mesa kerja, penetapan diagnosis, sikap terhadap penggunaan obat secara rasional, sikap terhadap pedoman pengobatan, tingkat kecukupan obat dan tingkat pengetahuan pasien/pengantar tentang penggunaan obat. Selanjutnya dari basil analisis multivariate diketahui bahwa faktor sikap tenaga kesehatan terhadap Pedoman Pengobatan dan Penetapan Diagnosis merupakan faktor risiko yang paling dominan. Berdasarkan hasil penelitian ini disarankan agar Kepala Dinas Kesehatan Kota Solok agar membangun komitmen bersama dengan jajaran yang terlibat langsung pada pelayanan pengobatan di Puskesmas dengari membuat Surat Keputusan sebagai petunjuk pelak,anaan program penggunaan obat secara rasional, melaksanakan sosialisasi berupa penyuluhan yang tepat sasaran dan mengadakan pelatihan yang terprogram tentang pedoman pengobatan dan penggunaan obat secara rasional serta meningkatkan kegiatan monitoring, evaluasi dan suvervisi ke Puskesmas.

Factors which have Relationship with Irrational Use of Medicine for Non-Pneumonia ISPA Diseases in Public Health Centers of Solok, West Sumatra, 2001Healing diseases is one therapeutic effort conducted by a doctor or a paramedic towards patients. The use of medicine for healing diseases must be based on the principle that such effort will be useful and safe for patients. In healing diseases, practices of using medicine are often found not going along with such mentioned above principle, of which it is called as irrational use of medicine. The impact of such irrational use of medicine is that it can cause decrease in service quality, rise in health costs, and public dependence on certain kinds of medicine. To lessen such practice of irrational use of medicine, the Government has made various efforts through health projects W in five provinces including West Sumatra by way of conducting training of rational use of medicine for doctors and paramedics, and integrated supervision training in administration and rational use of medicine in Public Health Centers. This research has the objective to obtain information about irrational use of medicine and factors which have relationship with irrational use of medicine for ISPA Non-Pneumonia Diseases in Public Health Centers of Solok by applying cross-sectional methods which is taken as purposively. From this research the proportion of irrational use of medicine indicate 26.9 % in which 64.4 % of the prescriptions are written by nurses and 35.6 % by doctors. The outcomes of bivariat analysis shows that some variables are statistically significant (p<0.05) which has relationship with irrational use of medicine, i.e. types of labors, period of work, diagnosis determination, attitudes to rational use of medicine, attitudes to healing procedure, rates of medicine adequacy and knowledge levels of patients / introduction to use of medicine. Furthermore, from the outcomes of multivariate analysis, it is learnt that the factor of paramedics' attitudes towards Healing Procedure and Diagnosis Determination constitute factor of risk which is the most dominant. Based on this research it is suggested that Head of Health Institution of Solok establish common commitment with the line-ups who involve directly in healing services in Public Health Center by issuing a decree as the manual of conducting program of rational use of medicine, carry out socialization in the form of effective counseling, provide programmed trainings regarding healing procedure and rational use of medicine, and increase such activities as monitoring, making evaluations and supervising in Public Health Centers.