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Tuberculosis is a contagious disease that causes high morbidity and mortality rates and have becoming 10 deadly diseases in the world in 2015. WHO have been estimating the total of 10,4 million new TB cases at the global level in 2017. There are 425.089 new TB cases have been found in Indonesia. The largest number of TB cases has been reported in Jawa Barat, Jawa Timur, and Jawa Tengah which has precentage 43% of all Province. The TB cases in Kabupaten Bogor is about 8.099 cases. In one year, the number of patients with pulmonary TB BTA (+) in the year of 2017 is 3861 people. At the same time, the number of recovery patients with pulmonary TB has decreased from 97% (2015) to 82% (the second quarter in 2018). This Research is intended to ascertain how to implement pulmonary Tuberculosis Disease Countermeasures Program in Puskesmas on Kabupaten Bogor during 2020. The research encompass in many aspect from input component until output component. It’s use qualitative study with data collection through indepth interview, observation and review of documentation. The research data is acquired from 6 puskesmas and Public Health Office in Kabupaten Bogor in range March – July 2020. The informant consist of 6 Heads of Puskesmas, 6 tuberculosis focal persons, 6 laboratory technicians, 6 promkes officer and 1 wasor TB in Public Health Office. The result form this research show that Puskesmas Sukarja and Cibaruyut have met the target at above 70% Suspected Case numbers. Puskesmas Ciawi, Puskesmas Cinagara and Puskesmas Karya Mekar have not reached the target for case founding. The target of successful rate has been fulfilled in Puskesmas Cimandala, Puskesmas Sukaraja and Puskesmas Karyamekar, but not yet in Puskesmas Ciburayut, Puskesmas Ciawi and Puskesmas Cinagara. Puskesmas Cimandala and Puskesmas Sukaraja are quite successful in the TB Programme due to the fulfillment of adequately trained human resources, adequate infrastructure, sufficient funding, integrated of system information, collaboration on sectoral program – cross sectoral and good management in Puskesmas. Puskesmas Karya Mekar and Puskesmas Cinagara have not reached the target due to insufficient of trained human resource, inadequate infrastructures, collaboration of cross sector are not optimally implemented and leak education about health information to the public. The recommendation from this research is that the success achieved through supporting factors can be applied to the other Puskesmas in Kabupaten Bogor.
ABSTRAK Nama : Yeti Nuryeti Program Studi : Ilmu Kesehatan Masyarakat Judul : Analisis Pengelolaan Obat Publik Di Dinas Kesehatan Kota Serang Tahun 2017 Pembimbing : Prof. Dr. drg. Yaslis Ilyas, MPH Obat Publik merupakan obat-obatan esensial yang sangat diperlukan untuk memenuhi kebutuhan perawatan mayoritas penduduk terutama di sektor publik atau pemerintah sehingga harus tersedia dan dapat diakses setiap saat dalam bentuk sediaan yang tepat dan juga dengan harga terjangkau. Untuk meningkatkan akses, ketersediaan dan memastikan obat digunakan dengan benar maka harus dilakukan pengelolaan obat yang baik, efektif, dan efisien secara berkesinambungan. Adanya masalah pada tingkat ketersediaan obat untuk pelayanan kesehatan dasar yaitu kekosongan obat (stockout), jumlah obat berlebih (overstock), serta besarnya nilai obat kedaluwarsa yang terjadi karena pengelolaan obat publik yang belum baik sehingga perlu dilakukan analisis pengelolaan obat publik yang dilakukan di Dinas Kesehatan Kota Serang. Penelitian ini menggunakan metode kualitatif dengan menggunakan wawancara mendalam (indepth interview), FGD, dan telaah dokumen. Perhitungan secara kuantitatif dilakukan untuk menghitung output pengelolaan obat berupa tingkat ketersediaan obat dan nilai rupiah obat kedaluwarsa. Informan penelitian terdiri dari Pengelola obat puskesmas, Kepala seksi dan pelaksana di seksi farmalkes, Kepala UPT dan pelaksana Gudang obat dan perbekalan kesehatan dan Kepala Dinas Kesehatan Kota Serang. Penelitian dilaksanakan pada bulan April – Mei tahun 2019. Hasil penelitian menunjukkan tingkat kekosongan dan kelebihan obat yang tinggi, dan besarnya obat kedaluwarsa di Dinas Kesehatan Kota Serang. Faktor input yang berpengaruh adalah kurangnya jumlah, pengetahuan dan keterampilan pengelola obat, dana yang tidak dikelola dengan efektif dan efisien, fasilitas yang belum memadai, organisasi dan manajemen yang tidak optimal serta sistem informasi yang tidak terintegrasi. Kendala pada proses pengelolaan obat yaitu perhitungan kebutuhan obat yang tidak akurat, penyesuaian rencana pengadaan obat yang tidak menggunakan metode sesuai pedoman, penyimpanan obat tidak melaksanakan sistem FEFO, tidak adanya manajemen pengendalian persediaan, dan belum terlaksananya proses pemusnahan obat. Kesimpulan didapatkan bahwa pengelolaan obat publik di Dinas Kesehatan Kota Serang belum berjalan dengan efektif dan efisien. Perlu dilakukan perbaikan pada faktor input dan proses pengelolaan obat sehingga output pengelolaan obat publik di Dinas Kesehatan Kota Serang menjadi efektif dan efisien. Kata kunci: Pengelolaan Obat Publik, Dinas Kesehatan Kota Serang, Input, Proses, Output
ABSTRACT Name : Yeti Nuryeti Study Program : Public Health Sciences Title : “Analysis Of Public Drugs Management At Serang Health District Office In 2017” Counsellor : Prof. Dr. drg. Yaslis Ilyas, MPH Public medicine is essential medicines that are very necessary to meet the care needs of the majority of the population, especially in the public or government sectors so that they must be available and can be accessed at any time in the right dosage forms and also at affordable prices. To improve access, availability and ensure that drugs are used properly, good, effective and efficient drug management must be carried out continuously. There are problems in the level of availability of medicines and the amount of expired drugs that occur due to poor public drug management, so an analysis of public drug management is needed at Serang District Health Office. This study uses qualitative methods using in- depth interviews (in-depth interviews), FGD, and document review. Quantitative calculations are carried out to calculate the drug management output in the form of drug availability and the value of the drug expires. The research informants consisted of primary health care medicine managers, section heads and staf in the pharmacy section, head of the Medical And Health Supplies Store Of Serang District Health Office and the head of the Serang District Health Office. The study was conducted in April - May of 2019. The results showed a high level of drugs stockout and overstock and the amount of drug expired at the Serang District Health Office. Influential input factors are lack of quantity, knowledge and skills of drug managers, funds that are not managed effectively and efficiently, inadequate facilities, non optimal organization and management and non integrated information systems. inaccurate drug quantification, adjusting the plan for procurement of drugs that do not use the method according to the guidelines, drug storage does not implement the FEFO system, the absence of inventory control management and drug destruction process is an obstacle to the drug management process. The conclusion was that the management of public drugs at the Serang District Health Office had not been effective and efficient. It is necessary to make improvements to the input and process drug management factors so that the output of public drug management at the Serang District Health Office becomes effective and efficient. Key words: Public Drugs Management, Serang District Health Office, Input, Process, Output
The Ministry of Health is implementing programs to improve the performance of healthresources through education and training, especially training of traditional health careworkers, through the training of acupressure services for Primary Health Care, butacupressure service has not been run in Primary Health Care. In South Jakarta, PrimaryHealth Care that have been providing acupressure service are only two (2). Thisresearch is a qualitative research, and aims to analyze the policy and implementation ofacupressure service in Primary Health Care and its obstacles. Informants in the studyamounted to 11 people, namely the Ministry of Health, Sudinkes South Jakarta, Head ofPrimary Health Care, Doctor, program implementer. Methods of data collection throughWM and document review. The result of research of input component have beenrunning, existence of support of Head of Puskesmas, service SOP, and SK ofassignment but not optimal rotation of staff become one of obstacle, component ofoutput and outcome not yet optimally. The communication aspect (clarity andconsistency) has not been effective about the existing policy regulation informationfrom the policy makers to the implementers, the financing aspect has not been supportedby local regulations, the bureaucratic aspects are still lacking coordination and thepolicy socialization from the Health Service to tribe of health service and PrimaryHealth Care.
Tujuan: Penelitian ini bertujuan untuk mengetahui pemanfaatan dana BOK dan capaian indikator gizi dan KIA Puskesmas di Kabupaten Bogor dan Ciamis tahun 2013-2014 serta mengetahui faktor pendorong & penghambatnya.
Metode Penelitian: Penelitian ini merupakan penelitian kualitatif. Data primer diperoleh dari hasil wawancara mendalam dengan informan dan data sekunder dari laporan tahunan BOK Puskesmas dan Dinas Kesehatan Kabupaten, serta dokumen terkait pelaksanaan BOK lainnya.
Hasil: Berdasarkan hasil penelitian yang dilakukan pada 4 (empat) Puskesmas di dua Kabupaten tersebut sesuai dengan teori sistem yaitu input, process dan output didapatkan hasil bahwa Input BOK yang terdiri dari 15 (lima belas) unsur sangat berperan dalam pemanfaatan dana BOK. Proses adalah fungsi manajemen yang dijalankan oleh Puskesmas dan Dinas Kesehatan Kabupaten untuk mengoptimalkan unsur-unsur input agar tercapai ouput yang optimal. Faktor pendukung pemanfaatan BOK salah satunya adalah Dana BOK merupakan satu- satunya sumber dana yang membiayai UKM melalaui kegiatan promotif dan preventif. Salah satu faktor Penghambatnya adalah pengurangan alokasi pembiayaan kesehatan dari dana APBD untuk pelaksanaan kegiatan promotif dan preventif berdampak pada capaian indikator SPM bidang kesehatan.
Kesimpulan: Dari pemanfaatan dana BOK Puskesmas di Kabupaten Bogor dan Kabupaten Ciamis dari sisi input, proses dan outputnya terdapat peningkatan capaian indikator Program Gizi dan KIA tahun 2013-2014. Peningkatan capaian indikator Gizi dan KIA tahun 2013-2014 di Kabupaten Bogor adalah D/S 3,2%, Pn 3,09%, KN1 1,55%, sedangkan di Ciamis yaitu D/S 8,87%, Pn 8,8% dan KN1 2,48%.
