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"Angka kematian ibu (AKI) sebagai salah satu indikator kesehatan ibu, dewasa ini masih tinggi di Indonesia bila dibandingkan dengan AKI di negara ASEAN lainnya. Menurut Survey Demografi dan Kesehatan Indonesia (SDKI 2007), Angka kematian Ibu adalah 228 per 100.000 kelahiran hidup dan Angka Kematian Bayi 34 per 1.000 kelahiran hidup. penyebab AKI di Indonesia dikelompokan ke dalam penyebab langsung, penyebab tak langsung, dan penyebab mendasar.Penelitian ini bertujuan untuk mengetahui pelaksanaan 11T dalam pelayanan antenatal oleh bidan dengan menggunakan penelitian kualitatif. Komponen yang di evaluasi meliputi: komponen input (kompetensi bidan, sarana dan prasarana), proses (pelaksanaan 11T oleh bidan, masalah yang dihadapi dalam pelaksanaan 11T dalam pelayanan antenatal ) serta komponen output (meningkatnya kepatuhan dan cakupan kunjungan ibu hamil ke pelayanan kesehatan).Lokasi penelitian di wilayah kerja Puskesmas Singkawang Tengah Kota Singkawang, Kalimantan Barat pada tahun 2012. Sebagai informan penelitian adalah bidan yang memberikan pelayanan antenatal.Pengumpulan data dilakukan dengan cara wawancara mendalam, Diskusi Group Terarah dan Observasi.

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Maternal mortality is one of health indicator,that still high if it be compared with maternal mortality in ASEAN countries. According to Demography and Indonesian Health Survey 2007, maternal mortality rate is 228/100.000 live births and infant mortality rate 34/1000 live births, The cause of maternal mortality in Indonesia consist of direct causes and indirect causes.This research aims is to know the implementation of 11-T in antenatal care by midwives that use qualitative research. The component that will be evaluated are input components (Midwives competency, infrastructure), Process components (Implementation of 11-T of midwives, problem encountered in 11-T implementation) and output components (increased compliance and coveraged the pregnant women visit in health care service).The location of this research in working area of Middle Singkawang Public Health Center Singkawang city West Kalimantan in year 2012. The informant of this research are midwives that give antenatal care.The Data aggregation are by depth interviews, Focus group discussion and observation."

"Lebih dari separuh dari seluruh obat di dunia diresepkan, diberikan dan dijual secara tidak tepat dan separuh dari pasien menggunakan obat secara tidak tepat. Penggunaan obatobatan yang berlebihan, kurang atau bahkan disalahgunakan dapat mengakibatkan pemborosan dan meluasnya bahaya kesehatan. Dalam memastikan penggunaan obat yang rasional diperlukan Evaluasi Penggunaan Obat (EPO) untuk menilai apakah obat tersebut digunakan secara rasional. EPO merupakan program evaluasi penggunaan obat yang terstruktur dan berkesinambungan secara kualitatif demham melakukan evaluasi POR, dan secara kuantitatif dnegan metode ATC-DDD serta DU90%. Tugas khusus ini bertujuan untuk mengetahui profil penggunaan obat di Puskesmas Kecamatan Kalideres pada periode Juli – Desember Tahun 2020 secara kuantitatif dan kualitatif. Penelitian dilakukan dalam dua tahap, yaitu penilaian secara kuantitatif dan penilaian secara kualitatif. Hasil penelitian secara kuantitatif menunjukkan dengan eksklusi berdasarkan nilai DDD, didapatkan sebanyak 79 jenis obat dan diperoleh nilai DDD sebesar 1.4999.903,6 dengan jumlah DDD terbesar yaitu amlodipin sebesar 488.910. Selain itu, terdapat 20 jenis obat yang berada dalams segmen DU90%. Sedangkan, secara kualitatif menggunakan beberapa indikator peresepean untuk tiga diagnosis penyakit, yaitu ISPA Non-Pneumonia, Diare Non-Spesifik dan Myalgia, serta rerata obat yang diresepkan untuk tiga penyakit tersebut penggunaan obat dikatakan sudah rasional, , didapatkan nilai rata-rata Capaian Kinerja POR sebesar 102,41%.

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More than half of all drugs worldwide are inappropriately prescribed, administered and sold and half of patients misuse drugs. Overuse, underuse, or even misuse of drugs can result in waste and widespread health hazards. A Drug Use Evaluation (DUE) is required to assess whether the drug is used rationally to ensure the rational use of drugs. EPO is a structured and qualitatively continuous drug use evaluation program that evaluates RDU and quantitatively with the ATC-DDD and DU90% methods. This special task aims to quantitatively determine the profile of drug use in the Kalideres District Health Center in July – December 2020 quantitatively and qualitatively. The research was conducted in two stages: quantitative and qualitative. The study's results quantitatively showed that with exclusion based on DDD values, 79 types of drugs were obtained, and DDD values were obtained of 1,4999,903.6 with the largest amount of DDD, namely amlodipine of 488,910. In addition, there are 20 types of drugs in the DU90% segment. Meanwhile, qualitatively using several prescribing indicators for three disease diagnoses, namely Non-Pneumonia ARI, Non-Specific Diarrhea, and Myalgia, as well as the average drug prescribed for the three diseases, the use of drugs is said to be rational, the average value of POR Performance Achievement is 102.41%."

"Puskesmas sebagai fasilitas kesehatan tingkat pertama, bertanggung jawab dalam kegiatan pelayanan kesehatan secara menyeluruh, terpadu, dan berkesinambungan. Dalam rangka melaksanakan program JKN dan memenuhi himbauan dari Kepala Dinas Kesehatan DKI Jakarta terkait akreditasi, Puskesmas Kecamatan Ciracas telah menyusun pedoman berupa Formularium Puskesmas. Pemilihan obat untuk Formularium Puskesmas mengacu pada daftar Obat Esensial Nasional (DOEN) dan Formularium Nasional (Fornas). Formularium tersebut digunakan sebagai acuan oleh Puskesmas Kecamatan Ciracas dalam menjamin ketersediaan obat yang berkhasiat, bermutu, aman, dan terjangkau. Tujuan dari laporan PKPA ini adalah untuk memahami alur penyusunan formularium puskesmas serta mengevaluasi kesesuaian daftar obat di formularium puskesmas dengan formularium nasional. Laporan ini didasarkan dari penelusuran literatur dan observasi data formularium puskesmas serta wawancara dengan apoteker yang terlibat dalam penyusunan formularium puskesmas. Berdasarkan analisis, alur penyusunan formularium telah sesuai dengan prosedur yang berlaku dan dilakukan evaluasi satu tahun sekali. Daftar obat di formularium puskesmas secara keseluruhan telah sesuai dengan formularium nasional yang berlaku. Namun, terdapat beberapa obat kategori fasilitas kesehatan tingkat 2 dan/atau 3 yang tetap dimasukkan ke Formularium Puskesmas Kecamatan Ciracas Tahun 2023 didasarkan atas hasil rapat dan disertai kajian/justifikasi dari dokter yang mengusulkan.

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Puskesmas, as the first-level health facility, is responsible for comprehensive, integrated, and sustainable health service activities. In order to implement the JKN program and comply with the appeal from the Head of the DKI Jakarta Health Office regarding accreditation, the ciracas subdistrict health center has developed guidelines in the form of a Puskesmas Formulary. The selection of drugs for the Puskesmas Formulary refers to the National Essential Medicines List and the National Formulary. The formulary is used as a reference by the ciracas subdistrict health center to ensure the availability of efficacious, quality, safe, and affordable medicines. The purpose of this PKPA report is to understand the flow of the formulation of the puskesmas formulary and to evaluate the conformity of the drug lists in the puskesmas formulary with the national formulary. This report is based on a literature search and observation of puskesmas formulary data, as well as interviews with pharmacists who were involved in preparing the puskesmas formulary. Based on the analysis, the flow of the formulation of the formulary is in accordance with the applicable procedures and is evaluated once a year. The list of medicines in the Pukkesmas formulary as a whole is in accordance with the applicable national formulary. However, there are several level 2 and/or 3 health facility category drugs that are still included in the ciracas subdistrict health center formulary based on the results of the meeting and accompanied by a review or justification from the doctor who proposed it."

"Puskesmas atau Pusat Kesehatan Masyarakat didefinisikan sebagai suatu fasilitas pelayanan kesehatan yang menyelenggarakan upaya kesehatan masyarakat (UKM) dan upaya kesehatan perseorang (UKP) tingkat pertama yang mengutamakan upaya promotif dan preventif di wilayah kerjanya. Pelayanan farmasi klinik di puskesmas terdiri dari pengkajian dan pelayanan resep, pelayanan informasi obat (PIO), konseling, visite pasien (khusus Puskesmas dengan ruang rawat inap), pemantauan terapi obat (PTO), pemantauan dan pelaporan efek samping obat, dan evaluasi penggunaan obat. Proses pencatatan dan pelaporan salah satu proses yang diperlukan dalam penatalaksanaan obat baik yang ketika obat diterima, disimpan, didistribusikan, serta yang digunakan di Puskesmas. Proses pencatatan dan pelaporan di Puskesmas dilakukan dengan membuat Laporan Pemakaian dan Lembar Permintaan Obat (LPLPO). Pencatatan dan pelaporan LPLPO di puskesmas dapat digunakan untuk memonitor jumlah pemakaian obat-obat yang memerlukan perhatian khusus seperti obat golongan antibiotik. Berdasarkan hasil monitoring penggunaan antibiotik di Puskesmas Kramat Jati tahun 2022 dengan menggunakan LPLPO, penggunaan tertinggi di Puskesmas Kramat Jati di tahun 2022 adalah amoksisilin sebesar 106.450 obat (39%) diikuti sefiksim dengan penggunaan sebesar 37.250 obat (14%) dan sefadroksil sebesar 28.160 obat (10%). Jenis antibiotik dengan penggunaan terendah di Puskesmas Kramat Jati di tahun 2022 adalah doksisiklin sebesar 1.100 obat (0,4%) yang diikuti oleh thiampenikol sebesar 5.100 obat (1,9%) dan azitromisin sebesar 6.195 obat (2,3%). Tren penggunaan antibiotik secara keseluruhan di Puskesmas Kecamatan Kramat Jati di tahun 2022 secara umum mengalami fluktuasi.

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Puskesmas is defined as a health service facility that organizes public health efforts (UKM) and first-level individual health efforts (UKP) that prioritize promotive and preventive efforts in their working areas. Clinical pharmacy services at the puskesmas consist of assessment and prescription services, drug information services (PIO), counselling, patient visits (especially Puskesmas with inpatient rooms), drug therapy monitoring (PTO), monitoring and reporting of drug side effects, and evaluation of drug use. . The process of recording and reporting is one of the processes needed in drug management, both when drugs are received, stored, distributed, and used at the Puskesmas. The process of recording and reporting at the Puskesmas is carried out by making a Usage Report and a Drug Request Sheet (LPLPO). Recording and reporting of LPLPO at the puskesmas can be used to monitor the amount of use of drugs that require special attention such as antibiotics. Based on the results of monitoring the use of antibiotics at the Puskesmas Kecamatan Kramat Jati in 2022 using LPLPO, the highest use at the Kramat Jati Health Center in 2022 was amoxicillin of 106,450 drugs (39%) followed by cefixime with use of 37,250 drugs (14%) and cefadroxil of 28,160 drugs ( 10%). The type of antibiotic with the lowest use at the Puskesmas Kecamatan Kramat Jati in 2022 is doxycycline with 1,100 drugs (0.4%) followed by thiampenicol with 5,100 drugs (1.9%) and azithromycin with 6,195 drugs (2.3%). The overall trend of antibiotic use at the Puskesmas Kecamatan Kramat Jati in 2022 will generally fluctuate."

"Praktik kerja Profesi di Apotek dilaksanakan di Puskesmas Kecamatan Gambir Jakarta Pusat pada tanggal 1 – 24 Agustus 2015. Pelaksanaan praktik ini bertujuan untuk memahami peranan, tugas dan tanggung jawab apoteker dalam praktek pelayanan kefarmasian di Puskesmas sesuai dengan ketentuan perundangan dan etika farmasi yang berlaku, dan dalam bidang kesehatan masyarakat; membangun kemampuan berkomunikasi dan berinteraksi dengan tenaga kesehatan lain yang bertugas di Puskesmas; Memiliki pengetahuan, keterampilan, sikap perilaku serta wawasan dan pengalaman nyata untuk melakukan praktik profesi dan pekerjaan kefarmasian di Puskesmas; Melihat dan mempelajari strategi dan pengembangan praktik profesi Apoteker di Puskesmas; Memiliki gambaran nyata tentang permasalahan praktik dan pekerjaan kefarmasian di Puskesmas.

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Profession internship in puskesmas is held at Puskesmas Kecamatan Gambir Jakarta Pusat on August 1st – 24th 2015. This internship is aimed to make student understand the duty and obligation of Pharmacist in puskesmas based on the existing regulation and ethics; Building a horison, knowledges, skills, and practical experiences to conduct pharmaceutical practice in puskesmas; Establishing a capability to communicate and interract with other healt practitioners wothon puskemas; and also to get a real picture of about pharmaceutical practice problems, and most importantly to study about the strategies and activites that can be done in order to achieve Pharmaceutical Care development in puskesmas."

"Pada tahun 2015 WHO melaporakan didapatkan 64% negara Asia Tenggara antibiotik dibeli tanpa resep. Dampak buruk bagi kesehatan apabila penggunaan antibiotik secara tidak rasional adalah resistensi antibiotik, meningkatnya biaya perawatan, dan peningkatan angka kematian. Tujuan penelitian ini adalah untuk menganalisis pola dan kerasionalan peresepan antibiotik di dua puskesmas terakreditasi dasar Kota Depok Januari-Maret 2020. Desain penelitian yang digunakan adalah cross sectional. Sampel yang digunakan adalah seluruh resep antibiotik yang memenuhi kriteria inklusi pada Januari-Maret 2020. Hasil penelitian menunjukkan pola peresepan antibiotik berdasarkan jenisnya yang paling banyak digunakan adalah kotrimoksazol (37%) di Puskesmas Limo dan amoksisilin (90.3%) di Puskemas Pancoran Mas. Berdasarkan jenis penyakitnya, antibiotik banyak diresepkan pada penyakit faringitis akut (34.4%) di Puskesmas Limo dan infeksi saluran pernapasan akut atas non-spesifik (38%) di Puskesmas Pancoran Mas. Ketidakrasionalan peresepan antibiotik pada Puskesmas Limo yaitu tidak tepat pemilihan antibiotik sebanyak 94 resep (24.5%), tidak tepat dosis sebanyak 65 resep (16.9%), tidak tepat frekuensi pemberian sebanyak 84 resep (21.9%), dan tidak tepat duasi pemberian sebanyak 265 resep (69%). Sedangkan ketidakrasionalan peresepan antibiotik pada Puskesmas Pancoran Mas yaitu tidak tepat pemilihan antibiotik sebanyak 49 resep (12.8%), tidak tepat dosis sebanyak 26 resep (6.8%), tidak tepat frekuensi pemberian sebanyak 27 resep (7%), dan tidak tepat durasi pemberian sebanyak 316 resep (82.3%). Diperoleh nilai signifikansi ketidakrasionalan peresepan antibiotik berdasarkan 4 kriteria penilaian yaitu 0.000, sehingga dapat disimpulkan terdapat perbedaan kualitas peresepan antibiotik pada dua puskesmas terakreditasi dasar Kota Depok periode Januari-Maret Tahun 2020.

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In 2015, WHO reported that in 64% of Southeast Asia countries antibiotic were available without prescription. The adverse effects on irrational use of antibiotics on health was antibiotic resistance, increased of treatment costs, and increased of mortality. The purpose of this research was to analyze the pattern and the rationality of antibiotic prescribing in two basic accredited Public Health Center in Depok City January-March 2020. The design used in this research was cross-sectional. The sample used was all antibiotic prescriptions that met the inclusion criteria in January-March 2020. Results of the study showed the most antibiotic used were cotrimoxazole (37%) at Limo Public Health Center and amoxicillin (90.3%) at Pancoran Mas Public Health Center. Based on the type of disease, antibiotics were often prescribed in acute pharyngitis (34.4%) at Limo Public Health Center and acute upper respiratory infections non-specific (38%) at Pancoran Mas Public Health Center. Irrational prescription at the Limo Public Health Center found were 94 prescriptions (24.5%) in the selection of antibiotics, 65 prescriptions (16.9%) in the correct dosage, 84 prescriptions (21.9%) in frequency of antibiotic administration, and 265 prescriptions (69%) in the duration of antibiotic administration. Irrational prescription at Pancoran Mas Public Public Health Center found were 49 prescriptions (12,8%) in the antibiotic selection, 26 prescriptions (6.8%) in the correct dosage, 27 prescriptions (7%) in the frequency of antibiotic administration, and 316 prescriptions (82.3%) in the duration of antibiotic administration. The significant value of the irrational prescription of antibiotics was obtained based on 4 assessment criteria is 0.000, so it can be concluded that there are differences in the quality of antibiotic prescribing in two basic accredited public health center in the City of Depok January-March 2020."

"Public health center reform as decentralization step in health sector had poured into SK Menkes No. 128/MENKES/SK/2004 about public health center basic policies. The aims of this research are to identified policy and strategy of district health office on health center reform included health human resources reform, health effort reform, health financing reform, and health management reform. The research done in 6 provinces, by purposive sampling that is DIY, Bengkulu, South Kalimantan, South Sulawesi, East Kalimantan and papua province. Each province chosen 1 regency and 1 municipality. Health Center which performing reform chose, amount of sample health center around 52 units. Data collecting done by indepth interview, secondary data and focus group discussion (FGD), and y descriptive analysis. The result of research indicating that policy and strategy District Health Office in supporting health center reform, (a) in HRD reform performed through flattening health personnel with job contract, (b) in health center effort reform through improving health services access ad revitalization, (c) in health financing reform performed with health center services with Certification ISO 9001 and Community Based Health Effort (UKBM) revitalization. Therefore necessary done institutional established in regional and relation manner, as well as allocating health budget suitable with determined health development objectives"