Evaluasi praktek donasi obat untuk penanganan Gempa Yogyakarta dan sekitarnya, 27 Mei 2006
WARDANI, Susilo Ari, Dra. Siti Munawaroh, Spt.,M.Kes
2007 | Tesis | S2 Ilmu Kesehatan Masyarakat (Manaj. dan Kebij. ObLatar belakang: Gempa tektonik terjadi pada 27 Mei 2006 di Provinsi Daerah Istimewa Yogyakarta dan sebagian Jawa Tengah. Sebagian bantuan untuk bencana berupa donasi obat. Pedoman untuk melakukan praktek donasi obat telah diterbitkan oleh WHO yaitu Pedoman Obat Donasi revisi tahun 1999; dan oleh Departemen Kesehatan 2002 yaitu Pedoman Pengelolaan Obat dan Perbekalan Kesehatan di saat bencana. Dibutuhkan suatu infrastruktur dan ketrampilan sumber daya manusia untuk pengelolaan bantuan obat pada saat bencana meliputi seleksi, pengadaan, distribusi dan penggunaan obat donasi yang telah diterima. Tujuan penelitian ini adalah mengevaluasi praktek donasi obat dan mengevaluasi perencanan kebutuhan (selection), pengadaan (procurement), pendistribusian (distribution), penggunaan (use) obat donasi. Metode Penelitian: Penelitian kualitatif ini menggunakan desain studi kasus (case study). Pengumpulan data dengan cara purposif, dengan teknik sampel bola salju (snow ball sampling). Unit Analisis di Dinas Kesehatan Propinsi Daerah Istimewa Yogyakarta. Wawancara mendalam dilakukan kepada 4 orang petugas kesehatan Dinas Kesehatan Propinsi DIY, 5 orang petugas Dinas Kesehatan Kabupaten dan Kota, 4 orang petugas instalasi farmasi rumah sakit, satu orang petugas BPOM DIY, 3 Donatur, 2 orang Non Govermental Organization (NGO) dan 3 orang relawan. Observasi berupa pengamatan dan penelusuran dokumen yang berkaitan praktek donasi obat dan pengelolaan obat. Hasil Penelitian: Praktek donasi obat di wilayah Propinsi DIY pada masa emergensi maupun pemulihan masih belum memenuhi syarat pedoman WHO dan pedoman Depkes RI. Hampir semua donor belum memperhatikan permintaan kebutuhan obat untuk korban gempa di DIY, belum memahami pedoman donasi obat WHO 1999 dan pedoman Depkes 2002. Pada masa emergensi, pihak donor tidak dapat memenuhi persyaratan tentang persyaratan standar kualitas, tentang pengemasan, tentang nilai obat dan tentang persyaratan biaya. Donasi berupa Emergency Health Kit WHO 98 (EHK 98), kurang tepat untuk wilayah Propinsi DIY. Pengelolaan obat meliputi seleksi (perencanaan kebutuhan): bahwa wilayah DIY telah melakukan perencanaan kebutuhan obat dalam rangka kesiapsiagaan bencana yang sesuai dengan pedoman Depkes; Pengadaan: hasil donasi di wilayah Propinsi DIY belum sesuai dengan kebutuhan sehingga untuk memenuhi kebutuhan pola penyakit pada saat gempa masih dilakukan pengadaan dengan cara pembelian; Distribusi: pada saat bencana Dinas Kesehatan Propinsi DIY telah berhasil melakukan koordinasi dalam memobilisasi pendistribusian obat yang berasal dari semua unsur yang meliputi lintas program dan lintas sektor; Penggunaan: hanya sebagian kecil obat donasi yang dapat digunakan, sebagian besar obat donasi tidak sesuai dengan pola penyakit pada saat bencana. Kesimpulan: Praktek donasi di wilayah Propinsi DIY belum memenuhi syarat pedoman donasi WHO dan Depkes. Dinas Kesehatan Propinsi DIY telah melakukan pengelolaan obat donasi meliputi seleksi, pengadaan, distribusi dan penggunaan yang sesuai dengan kondisi bencana. Saran: Pedoman WHO yang terdiri dari 12 item agar disusun kembali untuk masa emergensi dan sesudah emergensi. Departemen Kesehatan RI agar menyiapkan daftar kebutuhan obat untuk bencana yang terjadi di Indonesia meliputi gempa, bom, banjir dan gunung berapi. Pihak donor khususnya dari industri farmasi agar melaksanakan pedoman donasi obat WHO dan Depkes. Dinas Kesehatan Propinsi DIY agar melakukan evaluasi pengelolaan obat pasca bencana sesuai dengan pedoman Depkes RI .
Background: tectonic earthquake occurred on the 27th of May 2006 in D.I. Yogyakarta Province and part of Central Java Province. One of the aids for the disaster was drug donation. Guidance for the drug donation practice, published by WHO, was The Guidance for Donation Drugs, year 1999 revised edition and; published by Ministry of Health, Guidance on Drugs Management and Health Provision During Disaster. During disaster, infrastructures and skills of human resources for drugs aid management including selection, procurement, distribution, and usage of received donation. The aims of this research were to evaluate the drug donation practice and also requirement planning (selection), procurement, distribution, and the usage of drug donation. Methods: This qualitative study design is a case study, while data are purposively collected, through snow ball sampling. The unit of analysis was DIY Provincial Health Office. In-depth interviews were conducted to 4 officials of the DIY Provincial Health, 5 officials of Sub Provincial Health Office, 4 officials of pharmaceutical installation of DIY, 3 donors, 2 of NGO’s persons and 3 volunteers. Observation and documents exploration related to drugs donation practice and management were conducted. Result: Donation practice at DIY Province in the emergency period and recovery did not yet fulfill the requirements of WHO Guidance and also the Guidance of The Ministry of Health 2002. Almost all donors had not take into account the demand and the need of drug for the DIY Province earthquake victims, did not understand the WHO Guidance 1999 and the Health Department Guidance2002. By the time of disaster, the donors were not able o fulfill the requirement of the standard of quality and packaging, about drug value and the cost requirement. Emergency Health Kit WHO 98 (EHK 98) donation was not suitable for the D.I.Y Province area. The management of drugs consisted of selection (requirement planning), i.e. DIY region had already conducted the drugs requirement planning for disaster preparedness according to The Ministry of Health Guidance. Procurement: the result of donation in DIY province did not match the need of illness types since in the earthquake condition the procurement was done by purchasing. Distribution: during the disaster, DIY Province Heath Office had been successfully conducting the coordination of the drug donation from all elements, including cross-programs and cross-sectors. Utilization: just small amount of the drugs could be used, almost all donation were not suitable for the illness types during the disaster. Conclusion: Donation practice in DIY Province had not fulfilled the donation requirement of WHO and Health Ministry. DIY Provincial Health Office had already conducted the donation drugs management consisting of: selection, procurement, distribution, and usage according to the state of the disaster Recommendation: It is recommended to the 12 items of WHO Guidance to redesign for emergency and post-emergency period. It is recommended to the Health Ministry of R.I. to prepare the drug list for disasters occurred in Indonesia, e.g. earthquake, bombs blasting, flood and volcanoes. It is recommended to donors especially from pharmaceutical to implement both drug donation guidance of WHO and the health ministry. It is recommended to DIY Health Office to evaluate the management of the drug after the disaster by using the Health Ministry Guidance.
Kata Kunci : Pengelolaan Obat,Donasi Obat,Gempa,Distribusi,Yogyakarta earthquake and surroundings, donation practice, drug
