Overcoming Shortage of Pharmacists to Provide Pharmaceutical Services in Public Health Centers in Indonesia

Abstract

Indonesia is facing shortage of pharmacist in public health centers (PHCs), therefore the local government and PHCs have to cope with this problem. This paper aimed to describe the pharmaceutical manpower availability in PHCs, the problems occurred and potential applied solutions. Data was taken from National Health Facility Research 201. Quantitative data related to pharmaceutical manpower in PHCs was analyzed descriptively based on regions. Supporting qualitative data through in-depth interviews with the health office staffs in Bogor and Bekasi and pharmacists in four PHCs were conducted and being analyzed using thematic analysis. It was found that Sulawesi had the highest percentage of PHCs having pharmacist (29.1%) while Eastern Indonesia 51.5% of PHCs didn't have any staff with pharmacy related educational background. The highest percentages of staff composition were pharmacy technician followed by nurse. The main problem was due to high workload with limited manpower available. The proposed solutions are recruitment of new pharmacists, but in case it is not possible then placing pharmacist in certain type of PHCs with urgent needs is a priority. Empowering pharmacy technician, all available trained staff and other resources such as on job students are other feasible choices.Keywords: Pharmacist, pharmaceutical service, public health center Abstrak Indonesia masih menghadapi keterbatasan jumlah apoteker di puskesmas, sehingga pihak pemerintah daerah dan puskesmas harus berupaya mengatasi permasalahan tersebut. Penelitian ini bertujuan untuk menggambarkan ketersediaan dan distribusi tenaga pelayanan kefarmasian di puskesmas serta permasalahan dan alternatif pemecahannya. Data diambil dari hasil Riset Fasilitas Kesehatan (Rifaskes) tahun 2011I. Data kuantitatif tentang tenaga pelayanan kefarmasian di puskesmas dianalisis secara deskriptif berdasarkan regional. Data kualitatif sebagai pendukung diperoleh melalui wawancara mendalam dengan bagian kepegawaian dinas kesehatan dan apoteker empat puskesmas di Kota Bogor dan Bekasi, 3 kemudian dianalisis dengan metode analisis tema. Hasil analisis menunjukkan bahwa Sulawesi memiliki persentase puskesmas dengan tenaga apoteker tertinggi (29,1%) sedangkan Indonesia Timur memiliki persentase puskesmas tertinggi dengan tenaga pelayanan kefarmasian tanpa latar belakang pendidikan farmasi (51,5%). Persentase tenaga kefarmasian terbesar di puskesmas adalah tenaga teknis kefarmasian kemudian perawat. Permasalahan utama yang dihadapi puskesmas adalah beban kerja yang berat dengan kondisi tenaga yang terbatas. Alternatif pemecahan masalah yaitu pengangkatan apoteker baru, namun jika tidak memungkinkan maka penempatan apoteker pada puskesmas dengan kebutuhan mendesak merupakan prioritas utama. Pilihan lain yang memungkinkan adalah pemberdayaan tenaga teknis kefarmasian dan staf lain yang sudah dilatih atau memanfaatkan tenaga siswa magang.

A national analysis of the pharmacy workforce in Indonesia

“…This finding seems consistent with other research that found an uneven distribution of the mixed healthcare workforce between rural and urban areas in Indonesia [40][41][42]. A survey conducted in 2011 found variation across islands ranging from 23.2 to 51.5% of community health centres did not have pharmacists and pharmacy support staff to provide pharmaceutical care and medicines expertise, particularly in the Eastern Indonesia region [43]. The uneven distribution and unavailability of the pharmacy workforce illustrate that accessibility to medicines expertise, in the face of increasing use of medicines in an ageing co-morbid population, may have repercussions for universal health coverage and sub-optimal primary healthcare support.…”

The role of family caregivers in medication adherence of elderly in Asian setting: a scoping review

“…For example, in primary health services in Indonesia, the availability of pharmacists is still limited, and they are already overloaded with managerial activities. 36 The results of this review provide an overview and suggestions on the role of the family and the practical implications of increasing adherence. The current results suggest researchers, policy makers or health care personnel should provide more attention to medical adherence among elderly, especially in Asia.…”

Pengaruh Pelatihan Pelayanan Kefarmasian terhadap Pengetahuan Pengelola Obat di Puskesmas Kabupaten Ogan Komering Ilir

“…[12][13][14] Lain halnya di negara berkembang, pelayanan kefarmasian kurang diperhatikan, terutama pada peran tenaga kefarmasian yang bekerja di puskesmas. 15 Hal mendasar yang menyebabkan kondisi tersebut adalah kurangnya pendidikan dan pelatihan kefarmasian yang memadai. 16,17 Pengetahuan menjadi kunci utama dalam pemecahan masalah-masalah tersebut.…”