EVALUASI MANAJEMEN OBAT ANTI TUBERKULOSIS (OAT) DALAM PROGRAM DOTS DI RUMAH SAKIT UMUM DAERAH (RSUD) ENCIK MARIYAM

Tuberkulosis (TB) masih menjadi masalah kesehatan masyarakat yang serius di Indonesia, negara dengan beban TB tertinggi kedua di dunia. Keberhasilan program Directly Observed Treatment Short-course (DOTS) sangat bergantung pada manajemen Obat Anti Tuberkulosis (OAT) yang baik, sementara kondisi geografis kepulauan menciptakan tantangan distribusi tersendiri. Penelitian ini bertujuan mengevaluasi manajemen OAT dalam program DOTS di Rumah Sakit Umum Daerah (RSUD) Encik Mariyam, Kabupaten Lingga, serta mengidentifikasi hambatan yang dihadapi petugas farmasi dan pengelola program TB. Penelitian menggunakan desain kualitatif deskriptif dengan pendekatan observasional, melibatkan enam informan (kunci, utama, dan pendukung) melalui observasi, wawancara mendalam, dan telaah dokumentasi, dianalisis dengan model Miles, Huberman, dan Saldana. Hasil penelitian menunjukkan bahwa aspek teknis-fisik manajemen OAT, yaitu perencanaan, pengadaan, dan penyimpanan, telah berjalan sesuai pedoman nasional. Namun, ditemukan tiga kesenjangan pada aspek governance-dokumentatif: tidak adanya SOP tertulis untuk alur distribusi internal, keterlambatan pelaporan triwulanan TB.08, dan lemahnya monitoring kepatuhan minum obat secara real-time. Hambatan lain meliputi kekosongan stok obat pencegahan, kurangnya kedisiplinan pelaporan puskesmas, serta keterbatasan tenaga medis spesialistik. Kesimpulannya, kekuatan manajemen OAT terletak pada aspek teknis, sementara area prioritas perbaikan adalah penguatan dokumentasi formal dan sistem monitoring kepatuhan pasien di wilayah kepulauan.

Tuberculosis (TB) remains a serious public health issue in Indonesia, which ranks as the country with the second-highest TB burden in the world. The success of the Directly Observed Treatment Short-course (DOTS) program depends heavily on effective management of Anti-Tuberculosis Drugs (ATD), while the archipelagic geography of certain regions creates distinct distribution challenges. This study aimed to evaluate ATD management within the DOTS program at Encik Mariyam Regional General Hospital, Lingga Regency, and to identify the obstacles faced by pharmacy staff and TB program managers. A descriptive qualitative design with an observational approach was employed, involving six informants (key, main, and supporting) through direct observation, in-depth interviews, and document review, analyzed using the Miles, Huberman, and Saldana model. The findings indicate that the technical-physical aspects of ATD management, namely planning, procurement, and storage, were largely consistent with national guidelines. However, three gaps were identified in the governance-documentation domain: the absence of a written standard operating procedure for internal distribution flow, delays in quarterly TB.08 reporting, and weak real-time monitoring of medication adherence. Additional barriers included stockouts of preventive therapy drugs, inconsistent reporting discipline at the primary care level, and a shortage of specialist medical personnel. In conclusion, the strength of ATD management lies in its technical aspects, while priority areas for improvement include strengthening formal documentation and adherence-monitoring systems in archipelagic settings.