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Fasilitas pelayanan kesehatan dasar pemerintah dan swasta memiliki peran penting dalam menjaga mutu vaksin sebelum diberikan kepada sasaran imunisasi. Vaksin yang berkualitas menentukan keberhasilan program imunisasi. Dalam penelitian ini evaluasi dilakukan terhadap faktor-faktor yang mempengaruhi kualitas vaksin di Puskesmas dan Praktik Mandiri Bidan (PMB) di Kabupaten Lampung Timur. Desain penelitian adalah potong lintang dengan populasi berupa instansi atau fasilitas pengelola vaksin imunisasi dasar, sedangkan sampel meliputi 10 Puskesmas dan 30 PMB yang dipilih secara purposif. Pengumpulan data dilakukan melalui pengisian kuesioner mandiri, wawancara mendalam dan observasi. Wawancara mendalam dilakukan terhadap 16 orang pengelola vaksin puskesmas dan PMB yang dipilih secara purposif berdasarkan kesediaan mereka menjadi informan. Analisis data kuantitatif dilakukan secara deskriptif sedangkan data kualitatif diolah dengan metode konten analisis. Kegiatan diakhiri dengan focus group discussion (FGD) terhadap 20 orang informan secara purposif. Penelitian dilakukan pada bulan Agustus sampai Desember 2020 di 10 kecamatan di Kabupaten Lampung Timur. Berdasarkan hasil observasi, seluruh vaksin memiliki mutu yang baik di 10 puskesmas dan 20 Praktik Mandiri Bidan (PMB). Akan tetapi tingkat pengetahuan, sarana prasarana penyimpanan dan distribusi vaksin, SOP, proses pelatihan, sosialisasi, supervisi dan bimbingan teknis belum optimal khususnya di PMB. Secara umum kualitas vaksin masih memenuhi syarat namun pengetahuan pengelola vaksin, penyediaan dan kepatuhan SOP perlu ditingkatkan baik di puskesmas maupun di PMB. Selain itu, perlu peningkatan ketersediaan sarana parasarana penyimpanan dan distribusi vaksin terutama di PMB. Peningkatan kapasitas pengelolaan vaksin perlu dilakukan melalui proses pelatihan, supervisi dan bimbingan teknis bekerjasama dengan organisasi profesi. Kata Kunci: Mutu Vaksin, Puskesmas, PMB, Lampung Timur Abstract Both public and private basic health care facilities play an important role in maintaining the quality of vaccines which determines the success of the immunization program. In this study, an evaluation was carried out on the factors influencing the quality of vaccines at the community health center (CHC) and the Independent Midwife Practice (IMP) in the East Lampung Regency. The research design was cross-sectional using the population of institutions or facilities managing basic immunization vaccines and purposively selected samples of 10 Puskesmas and 30 IMPs. Data were collected through self-administered questionnaires, in-depth interviews, and observations. Depth, interviews were conducted with 16 vaccine managers at the Puskesmas and IMPs who were also selected purposively. Quantitative data was processed descriptively while qualitative data were analyzed using the content analysis method and finalized by a focus group discussion (FGD) for 20 purposively chosen informants. The study was conducted from August to December 2020 in 10 sub-districts in East Lampung Regency. Based on the observations, all vaccines had good quality in 10 Puskesmas and 20 IMPs. However, the level of knowledge, facilities for storing and distributing vaccines, SOPs, training processes, socialization, supervision, and technical guidance have not been optimal, especially in IMPs. The quality of vaccines is generally still as the requirements, yet the knowledge of vaccine managers as well as the provision and compliance with SOPs needs to be improved in both CHCs and IMPs. The availability of vaccine storage and distribution facilities at PMB and strengthening SOPs related to vaccine management are necessary. Capacity building needs to be done through training, supervision, and technical guidance in collaboration with professional organizations. Keywords: vaccine quality, Community Health Center, Independent Midwife Practice, East Lampung Regency

Peraturan Menteri Kesehatan Nomor 73 tahun 2016 tentang Standar Pelayanan Kefarmasian di Apotek antara lain menyatakan bahwa apoteker dalam menjalankan pekerjaan kefarmasian di apotek harus menerapkan standar pelayanan kefarmasian. Penelitian ini bertujuan untuk mengetahui pelaksanaan standar pelayanan kefarmasian di apotek. Desain penelitian yang digunakan adalah potong lintang (cross sectional) dilakukan pada Februari-November 2017. Lokasi penelitian dipilih secara purposif berdasarkan sistem regionalisasi Badan Pengelola Jaminan Sosial (BPJS) bidang kesehatan, yaitu ibukota Provinsi Jawa Barat, Jawa Timur, Sumatera Selatan. Nusa Tenggara Barat, Aceh, Sulawesi Utara, Sulawesi Selatan, Kalimantan Selatan, Kalimantan Tengah, Maluku Utara dan Papua. Sampel meliputi 21 apotek yang bekerjasama dengan BPJS Kesehatan di 11 ibu kota provinsi penelitian. Alat pengumpul data berupa daftar tilik standar pelayanan kefarmasian di apotek. Analisis data dilakukan secara deskriptif. Hasil penelitian menunjukkan bahwa rasio jumlah apoteker per apotek 1,8 dan kecukupan apoteker untuk pelayanan resep pasien per hari tanpa bantuan tenaga teknis kefarmasian sebesar 66,7%. Standar Pelayanan Kefarmasian di Apotek belum dilaksanakan secara lengkap, rerata pelaksanaan standar pengelolaan sediaan farmasi (98,4%) lebih tinggi daripada pelaksanaan standar pelayanan farmasi klinik (73,8%). Dalam upaya meningkatkan pelaksanaan SPKA disarankan agar apoteker meningkatkan kompetensi pelayanan kefarmasian di apotek, organisasi profesi melakukan pendidikan berkelanjutan terhadap apoteker dan Dinas Kesehatan Kabupaten/Kota membuat kebijakan, melakukan pembinaan dan monitoring/evaluasi secara berkala. Kata kunci: apotek, farmasi klinik, pengelolaan sediaan farmasi, tenaga kefarmasian Abstract Minister of Health Regulation No. 73 of 2016 on the Pharmaceutical Service Standards in Pharmacy, states that pharmacists should comply and apply the standards. This study aims to identify the implementation of pharmaceutical service standards in pharmacies. The research was cross-sectional and conducted in February-November 2017. The selection of research locations was conducted purposively based on the regionalization system of the BPJS Kesehatan. They were 11 capital cities of provinces, namely West Java, East Java, South Sumatra, West Nusa Tenggara, Special regional of Aceh, North Sulawesi, South Sulawesi, South Kalimantan, Central Kalimantan, North Maluku, and Papua. The sample included 21 pharmacies in collaboration with BPJS Kesehatan (Social Security Administrator for Health) in 11 capital cities of the provinces. Data were collected by using a checklist of pharmacy service standards. Data analysis was performed descriptively. The results showed that the ratio of the number of pharmacists per pharmacy was 1.8 and the adequacy of pharmacists for prescription services for patients per day without the help of pharmaceutical technical personnel was 66.7%. Pharmaceutical Service Standards in Pharmacy have not been fully implemented. The average implementation of pharmaceutical preparation management standards (98.4%) is higher than the implementation of clinical pharmaceutical service standards (73.8%). In order to improve the implementation of Pharmaceutical Service Standards, it is recommended that pharmacists increase the competency of services in pharmacies, professional organizations conduct continuing education of pharmacists and the District Health Office should develop policies, conducts training, and periodically strengthen the monitoring and evaluation on the compliance to this standard. Keywords: pharmacy, clinical pharmacy, pharmaceutical management, pharmaceutical personnel

Dana Alokasi Khusus (DAK) subbidang pelayanan kefarmasian diberikan pada provinsi dan kabupaten/kota tertentu di Indonesia yang bertujuan untuk penyediaan obat dan perbekalan kesehatan serta pengadaan atau rehabilitasi instalasi farmasi. Tujuan dari kajian ini yaitu untuk menelaah kebijakan, efektivitas dan efisiensi serta permasalahan yang terkait dengan DAK subbidang pelayanan kefarmasian. Kajian dilakukan melalui telaah kebijakan, pengolahan data sekunder dan pertemuan dengan pemangku kepentingan terkait. Hasil kajian menunjukkan bahwa berbagai kebijakan terkait DAK telah dibuat dan diperbarui setiap tahun untuk memudahkan teknis pelaksanaannya, namun masih ada masalah-masalah terkait dengan alokasi dan perencanaan, penggunaan, pelaporan serta ketersediaan sumber daya untuk pengelolaan DAK subbidang pelayanan kefarmasian. Efektivitas DAK subbidang pelayanan kefarmasian pada tahun 2014 yaitu yaitu 51,25% di tingkat Kabupaten/Kota dan 50% di tingkat Provinsi. Efisiensi hanya dapat dilihat dari realisasi penggunaan dana yaitu 87% di tingkat kabupaten/kota dan 84% di tingkat provinsi. Peraturan dan inovasi khusus diperlukan agar petugas daerah dapat mengerjakan laporan tepat waktu dengan prosedur yang lebih mudah. Dengan adanya perubahan kebijakan perencanaan dan pengalokasian DAK tahun 2016 maka perlu pertimbangan dalam penetapan faktor-faktor penentuan alokasi DAK. Kata kunci: DAK, subbidang pelayanan kefarmasian, pengadaan obat, instalasi farmasi Abstract The pharmaceutical services specific allocated fund has been given to selected provinces and districts in Indonesia, which is aimed to provide drugs and health equipment and build or renovate pharmaceutical installation. The study aimed to review the regulations, the effectiveness and efficiency, and problems related with pharmaceutical services specfic allocated fund. Study was conducted by reviewing the regulations, analyzing secondary data, and discussion with related stakeholders. The result showed that although several regulations were made and renewed every year to simplify the technical implementation, some problems were still exist in term of allocation and planning, utilization, reporting, and the availability of necessary resources for managing the fund. The effectiveness of pharmaceutical services specific allocated fund in 2014 was 51.25% in district level and 50% provincial level. The efficiency could only be analyzed through the realization of the fund that reached 87% in district level and 84% in provincial level. It is necessary to stipulate special regulation and innovation in order to encourage the local staff to report on time with an easier procedure. It is necessary to have consideration regarding the determination of allocating factors of the specific allocated fund, due to changes in the planning and allocating regulation since 2016 onward. Keywords: Specific allocation fund, pharmaceutical services, drug procurement, pharmaceutical installation