In March 2024 the World Health Organization (WHO) supported Indonesia’s Ministry of Health to launch new technical guidelines on medicine procurement planning (RKO), or Rencana Kebutuhan Obat (RKO), with the aim of ensuring access for all Indonesians to quality, safe and effective essential medicines.
Effective medicine supply planning is crucial to health system strengthening and achieving universal health coverage (UHC). It requires effective system-wide management of essential medicines supplies, ensuring that at all levels of care, health facilities maintain a reliable inventory of stock and can meet patient needs and prevent essential medicines stock-outs.
The new guidelines respond to a range of Indonesia-specific challenges detailed in a 2021 study, including errors in formulation and verification due to insufficiently trained personnel, non-standard processes and budget uncertainties. The study showed that across Indonesia, realization rates in e-purchasing transactions for 40 essential medicines were significantly low, often falling below 50% of the submitted RKO.
“The new technical guidelines discuss the importance of medicine procurement planning to ensure the availability of medicines that support the quality, efficiency and accessibility of healthcare services as part of the health transformation agenda and to support in achieving UHC,” said Dr Dra. Agusdini Banun Saptaningsih, MARS., Apt., Director of Pharmaceutical Management and Services, Ministry of Health, Government of Indonesia. “It serves as a reference for healthcare professionals involved in medicine planning, outlining the concept of RKO from facility level to national level, as well as monitoring and evaluation. The implementation of this guideline is expected to improve drug availability, distribution, accessibility and quality of drug management.”
The guidelines were the outcome of a series of WHO-supported workshops conducted in June, July, August and September 2023. At each of the workshops, an array of key stakeholders – including representatives from district health offices, primary health care facilities (puskesmas), tertiary care facilities and disease programme managers – identified challenges, developed calculation and forecasting methodologies, and agreed on how best to integrate the guidelines into existing health information systems.
“To be effective, medicine supply planning must account for all factors that can create a deviation between planning and procurement,” said Dr N. Paranietharan, WHO Representative to Indonesia. “Given the range of stakeholders involved, we are confident that the new guidelines will achieve much greater synchronicity, empowering health facility administrators and accelerating Indonesia’s quest to achieve UHC and its health transformation agenda.”
The guidelines have since been disseminated to key stakeholders from hospitals, provincial and district health offices, puskesmas and disease programme units within the Ministry of Health. The Ministry is set to conduct routine monitoring of implementation, alongside regular sensitization and feedback-gathering activities.