The Challenges and Constraint in Developing Pharmacy Practices
in Indonesia
MAURA LINDA SITANGGANG
Director General of Pharmacy and Medical Devices Ministry of Health, RI
OUTLINE
I. INTRODUCTION
MAP OF INDONESIA
Indonesia is the largest archipelago country with :
The population is 231,369,592 people
33 Provinces, including 7 archipelago provinces, total number of islands is 17,508
497 District/Municipality
9,005 Public Health Center
1,498 Public Hospital
463 Private Hospital
4
To improve people access to health services, including safe, effective and good quality of
medicines
IMPROVEMENT THE HEALTH DEGREE AND WELFARE
(Government Regulation number 7 of 2005 )
HEALTH DEVELOPMENT
NATIONAL MEDICINES POLICY
5
NATIONAL MEDICINES POLICY
Decree of Ministry of Health- Republic of Indonesia number
189/MENKES/SK/III/2006
PUBLIC PROTECTION
AVAILABILITY, FAIR DISTRIBUTION AND
AFFORDABILITY
SAFETY, EFFICACY AND QUALITY
RATIONAL USE OF MEDICINES
Improvement of Pharmaceutical
Services
Improvement of Production &
Distribution of Medical Devices and household med supplies
Improvement of Availability of Public Drugs and Medical Supplies
Improvement of Production and Distribution of Pharmaceutical Products
Management support and other technical implementation of pharmaceutical and med. devices program
PHARMACEUTICAL AND MEDICAL DEVICES
PROGRAM
MoH Program
II. REGULATION
INDONESIA REGULATION ON PHARMACY:
• Law Number 5 year 1997 regarding Psychotropics
• Law Number 35 year 2009 regarding Narcotics
• Law Number 36 year 2009 regarding Health
• Law Number 44 year 2009 regarding Hospital
• Government Regulation Number 72 year 1998 regarding Safety of Pharmaceutical and Medical Devices
• Government Regulation Number 51 year 2009 regarding Pharmaceutical Practice
• Decree of Ministry of Health RI Number 189/Menkes/SK/III/
2006 regarding National Medicines Policy
III. CHALLENGE AND CONSTRAINT
The expansion of pharmacy services paradigm is used only to product-oriented, is now more oriented to the patient. Pharmacists are no longer simply act as a
provider and manager of the medicines, but is now expected to be giving out the best service to patients so that quality health care will increase
PHARMACEUTICAL CARE
Role of Pharmacist in Public Health (1)
• Issuance of Government Regulation No. 51 of 2009 on Pharmaceutical Practices ; it is expected that an increase in the quality of pharmacy services to the community and other areas related to pharmacy practices
• Cost-efficient and cost effective medicines
Role of Pharmacist in Public Health (2)
PRODUCT
ORIENTED PATIENT
ORIENTED
PHARMACEUTICAL CARE
Community Pharmacy Practice
Most pharmacists viewed public health services as important and part of their role but secondary to medicine related roles. Some of the barriers in providing public health service including* :
• Pharmacists' confidence in providing public health services
• Time was consistently identified as a barrier to providing public health services.
• Lack of an adequate counselling space, lack of demand and expectation of a negative reaction from customers were also reported as barriers.
• A need for further training was identified in relation to a number of public health services.
* Claire E Eades, Jill S Fergusonand Ronan E O'Carroll, 2011
PHARMACEUTICAL CARE IN COMMUNITY
Pharmacists should have capability and responsibility in :
• Counseling
• Drug Information Services
• Drug Review
• Public Health Education (Promotive & Preventive)
Clinical Pharmacy Practices in Hospital
Pharmacists should have capability and responsibility in :
• Counseling
• Drug Information Services
• Drug Review
• Drug Use Study
• Terapeutic Drug Monitoring
• Aseptic Dispensing
• Handling Cytotoxic
• Public Health Education
REGULATION PROGRAMS
• Obligatory on generic prescribing (2010)
• Monitoring and evaluation on prescribing indicators (every year)
• Antibiotics use guidelines (2011 & 2012)
• Monitoring on Antibiotics Therapy Guideline (2011)
• National Essential Medicines List (the last revision in 2011)
• Certification of pharmacies as part of National Social Insurance
• Act No. 18 on Animal Husbandry and Health which bans the
use of antibiotics in animal feed 14
IV. GOVERNMENT’S EFFORTS
EDUCATIONAL PROGRAMS
• Workshops and training for health professionals
• Community empowerment
• Training and education tools : handbooks, posters, leaflets, stickers, etc
• Continuing professional development for health providers at hospitals and public health centers
• Univ. Curricula on Rational Use of Medicines (RUM) (Faculty of Medicine and Faculty of Pharmacy)
joint class, professional lecturers
31 faculties of medicines and 29 faculties of pharmacy have
already adopted the concept of RUM to their curriculum
15MANAGERIAL PROGRAMS
• Establishing Drug Formularies (National &
hospital).
• Networking among stakeholders, with MoH
related unit, provincial and district health offices, Ministry of Agriculture, etc.
• Supervision, auditing and feedback.
• Tiered reporting system for RUM indicators .
• Developing on line reporting system of
prescribing indicator.
16AUTHORITIES
MOH (NATIONAL PHARMACY COMMITTEE/ KFN)
PROVINCE
HO D/M HO PHARMACIST
ORGANIZATION (IAI)
FACULTY OF PHARMACY
ESTABLISHMENT GUIDELINE
ESTABLISHING / RECALL FOR
STRA
ESTABLISHMENT STRTTK
ESTABLISHMENT/
RECALL FOR SIPA, SIKA.SIKTTK
ESTABLISHMENT CERTIFICATE OF
COMPETENCY
PLACEMENT RECOMMEN-
DATION
DEVELOPING AND MONITORING
DEVELOPING AND MONITORING
MAPPING ON PHARMACISTS AND
HEALTH FACILITIES
ESTABLISHMENT CERTIFICATE OF PHARMACIST AND
TTK
PROCESSING CERTIFICATEOF COMPETENCY FOR
POST GRADUATE PHARMACIST
APPLY FOR STRA
& STRTTK TO KFN COLLECTIVELY
