Suchergebnisse

"One of a series of investigations into various phases of banking history and policy undertaken by the faculty and graduates of Columbia university."--Pref

International audience ; Jusqu'à un passé récent en Afrique, les problèmes macro économiques (croissance, développement, employabilité, etc…) étaient l'apanage seul des gouvernements. Mais on assiste de plus en plus à l'irruption des entreprises dans les problèmes liés au développement durable. Dans l'abondante littérature sur la thématique du DD, la question de l'éduction et de la professionnalisation de la fonction demeure peu étudiée. Nous proposons dans le cadre de cet article, un essai de contribution à l'enrichissement des échanges entre enseignants et apprenants en vue de promouvoir l'éducation au développement durable. Une étude exploratoire menée auprès des enseignants de lycées d'enseignements techniques et professionnels au Cameroun permet d'aboutir à la conclusion selon laquelle les techniques d'enseignement promeuvent significativement l'éducation au développement durable au sein des établissements d'enseignement secondaire techniques prospectés. Il est donc primordial que des politiques destinées à promouvoir l'éducation au développement durable soient mises sur pied.

Background: Accessibility to essential drugs is a public right,therefore it's the government responsibility to make themavailable. Previously before the era of regional autonomy, publicdrug management in all districts/cities was performed by theso-called District Pharmaceutical Warehouses (GFK). However,nowadays the situation has changed because of the differencein vision and perception of each regional government on theformer warehouses. Some public drug management units incertain districts/cities are not functioning optimally. Inefficientdrug procurement regarding the number and kind of drugs aswell as timeliness results in gap between drug need andprocurement. Furthermore, loosening in drug supply proceduremakes essential drugs more unavailable to public.On the other hand, decentralization policy in drugmanagement also undeniably brings advantages to the districts,for example capacity building in drug procurement, increasingcapability in budget management and negotiation with districtdecision makers as well as enhancing regional economicactivity. In revitalizing district pharmaceutical warehouses soas to attain minimal health care standards in districts/cities,baseline data in drug management and financing in severaldistricts/cities should make a valuable contribution.Methods: A cross sectional descriptive study had been carriedout during July-December 2006 in 26 districts/cities out of 11provinces. Samples were 26 district health offices (DinasKesehatan Kabupaten/Kota) and 26 District PharmaceuticalWarehouses (GFK) where as respondents were head of drugsection and head of warehousing respectively. Data werecollected by means of structured questionnaires and in-depthinterviews as well as the collection of secondary data of druglogistics. Qualitative and quantitative analysis was performed.Results: The study shows that: 1) although health budget ingeneral had risen, the average percentage of drug budgetallocation from 21 district health authorities was only 12.06%,reflecting the low drug priority in district health policy becausedrug expenditures may amount up to 40% of the total healthbudget. 2) Public drug management was mostly performed bythe so-called regional technical provider unit (UPTD) with somelimitations concerning human resources and material inachieving an effective and efficient drug management, and 3)there was still lack of pharmacist assistants to manage drugsin primary health care (Puskesmas) up to 20% and even morepiteously the lack of pharmacist in district drug managementunit (GF/UPOP Kabupaten/Kota, 12,5%).Conclusions: Apart from the achievement of predeterminedindicators stated in minimal health care standards in districts/cities, especially regarding essential and generic drugs, drugmanagement in general has been well performed concerningplanning and drug availability. More support and commitmentfrom the district government is a must considering that regionaldevelopment can not be separated from the health developmentof the subject themselves.Keywords: decentralization, District PharmaceuticalWarehouse, public drugs, drug management

The implementation of the ASEAN Economic Community (AEC) as an Indonesian Government's strategic step has an impact on economic globalization. The study on pharmaceutical products and medical devices free trade was done using qualitative and quantitative methods. The data were collected from a round table discussion about "Free Trade in Health Goods and Services in ASEAN" which involved the Ministry of Health (MoH), Ministry of Trade (MoT), and National Agency for Drug and Food Control (NADFC). The discussion aimed to obtain information on the readiness to meet the AEC blueprint. Secondary data on export and import of pharmaceutical products and medical devices were obtained from the MoT. The results of the study show that between 2013 and 2017 there were 70-72 product items exported to 9 ASEAN countries with a value much greater than the import. The tariff measure (TM) requirements included the Most Favored Nation (MFN) assessment and regulation of the trade remedy procedure by MoH and MoT. The implementation of ASEAN Common Technical Dossier (ACTD) and Good Manufacturing Practice inspection agreements, Bioequivalence reporting agreements, agreements related to traditional medicines and health supplement have been done by NADFC and industry. The simplification of Certificate of Origin, operation certification procedures and realization of ASEAN self-certification have to be specified. MoH must coordinate with NADFC and MoT in deciding and implementing regulations

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.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.

The authors employ the techniques of oral history to penetrate the nether world of the drug user, giving us an engrossing portrait of life in the drug subculture during the ""classic"" era of strict narcotic control. Praise for the hardcover edition:""A momentous book which I feel is destined to become a classic in the category of scholarly narcotic books.""-Claude Brown, author of the bestseller, Manchild in the Promised Land.""The drug literature is filled with the stereotyped opinions of non-addicted, middle-class pundits who have had little direct contact with addicts. These stories are

Process and outcome evaluation results are reported for a unique in-jail methadone maintenance program in New York City with three thousand admissions annually. The main study examined inmates who were not enrolled in methadone at arrest. Eighty percent were drug injectors (usually both heroin and cocaine) who admitted committing an average of 117 property crimes and nineteen violent crimes in the six months before jail. Methadone program participants' post-release outcomes were compared with outcomes for similar addicts who received seven-day heroin detoxification in jail. Multivariate analyses indicated that program participants were more likely than controls to apply for methadone or other drug abuse treatment after release and to be in treatment at a 6.5-month follow-up. Moreover, being in treatment at follow-up was associated with lower drug use and crime, but rates of retention in community treatment after release were modest. KEEP participants have more chronic and severe social and personal deficits than other addicts applying for treatment. The in-jail program was most effective in maintaining post-release continuity of methadone treatment for inmates already enrolled in methadone at arrest. The process evaluation yielded several recommendations to help overcome client-centered, administrative, and systemic obstacles to improved outcomes for this difficult-to-treat population of criminally-involved addicts.

Undang-undang Republik Indonesia No. 36 tahun 2009 tentang kesehatan dan peraturan pemerintah No. 51 tahun 2009 menyatakan bahwa tenaga kesehatan harus mempunyai kualifikasi minimum yang ditetapkan oleh pemerintah. Studi kualitatif secara potong lintang pada tahun 2010 untuk mengidentifikasi kualifikasi apoteker rumah sakit dalam memenuhi persyaratan tersebut di Bandung, Yogyakarta dan Surabaya. Data dikumpulkan dengan wawancara mendalam terhadap 10 orang apoteker dari enam rumah sakit dan empat orang direktur/wakil direktur rumah sakit, masing-masing satu orang apoteker dari enam perguruan tinggi farmasi, tiga pengurus Ikatan Apoteker Indonesia, tiga dinas kesehatan provinsi dan kabupaten/kota. Observasi praktek kefarmasian dengan menggunakan daftar tilik dilakukan pada tiap rumah sakit dan data sekunder terkait dokumentasi pemantauan dan evaluasi obat, kepuasan pasien, standar operasional prosedur dan kurikulum perguruan tinggi farmasi juga dikumpulkan. Analisis dilakukan dengan metode triangulasi dan hasil menunjukkan bahwa pengelolaan obat dalam hal pengadaan, distribusi dan penyimpanan dilaksanakan dengan baik oleh apoteker rumah sakit. Praktek farmasi klinik dan keselamatan pasien masih sangat terbatas karena alasan sumber daya manusia dan dokumentasi yang memadai. Informasi obat dan konseling kadang dilakukan tanpa fasilitas yang cukup dan apoteker juga terlibat dalam berbagai tim di rumah sakit seperti penanggulangan infeksi nosokomial dan komite farmasi dan terapi.The Indonesian Health Law No. 36 in 2009 and the Government Regulation No. 51 in 2009 state that health-care providers, including pharmacist, shall have minimum qualification set by the government. A qualitative cross sectional was conducted to to identify hospital pharmacist qualification as health care professionals in meeting the requirements was done in 2010 in Bandung, Yogyakarta and Surabaya. Data were collected through indepth interviews with pharmacists involving ten hospital pharmacists and four hos- pital directors/vice directors, six pharmacy colleges, three regional pharmacist associations, three provincial health offices and district health offices and observation of pharmacy practices using check list in each hospital was also conducted. Secondary data concerning documentation of drug monitoring and evaluation, patient satisfaction, standard operating procedure and pharmacy college curricula were collected too. Qualitative analysis was done descriptively using triangulation method. The study shows that drug procurement, distribution and storage, was well-managed by pharmacist. Practice in clinical pharmacy and patient safety was still limited for the reason of human resources and appropriate documentation. Drug information and counseling was sometimes conducted without adequate facilities and pharmacist was involved in various hospital teams like nosocomial infection control and pharmacy and therapy committee.