Five Project Management Performance Metrics key to Successful Project Execution – Operational Excellence

“If you don’t measure something, you can’t change it. The process of leadership is one of painting a vision, then saying how you’re going to get there, and then measuring whether you’re actually getting there. Otherwise, you risk only talking about great things but not accomplishing them.” Mitt Romney

Continual improvement is a prerequisite for any organization’s success. A continual improvement process, also often called a continuous improvement process (abbreviated as CIP or CI), is an ongoing effort to improve products, services, or processes. These efforts can seek “incremental” improvement over time or “breakthrough” improvement all at once. Delivery (customer valued) processes are constantly evaluated and improved in the light of their efficiency, effectiveness and flexibility (Wiki).

Gauging whether there is incremental improvement and setting up mechanisms to track and measure these improvements is the difficult part and this is where Metrics come in. I am passionate about metrics and have written about my favourite performance management metrics in business, sales and human resources earlier. In this guest post, Kavita Verma draws upon her PMO experiences to list the most effective metrics that can be used by project managers to determine the success of their projects.

‘Metric’ is defined as “Standard of measurement by which efficiency, progress, performance, productivity, quality of a deliverable, process, project or product can be assessed”.  Metrics help in building predictability, improving organization’s decision making ability, and lay out what is working and what is not working within the organization and help guide the management focus in the right directions.

Project management performance metrics enable Project managers to:

  • Assess status of ongoing project in terms of schedule, cost and profitability.
  • Foresee any potential risks.
  • Nail down the problems much before they become severe.
  • Keep a check on project profitability.
  • Assess productivity of team.
  • Assess quality of work products to be delivered.

There can be different project management metrics defined based on complexity and nature of project.  However, following five performance metric groups cover all the important aspects of a project to measure during execution:

Performance Metric #1: Schedule and Effort/Cost Variance

The goal of this metric is to measure the performance as well as progress of the project against signed baselines.  This metric is very important and is the base for profitability of project. The EVM (Earned Value Management) concept, as defined by PMI standard PMBOK, is the commonly used method to track this metric. It integrates project scope, cost and schedule measures to help the PM to assess and measure project performance and progress. The principles of EVM can be applied to all projects, in any industry. Under this method, at any given point in time, project performance to date is used to extrapolate the expected costs and duration at project completion. This technique uses past performance (i.e. actuals) to more accurately forecast future performance. EVM develops and monitors three key dimensions of each work package:

Planned Value (PV): How much you planned to spend for the work you planned to do i.e. it is the authorized budget assigned to the work to be accomplished for an activity or work breakdown structure component. Total PV is also known as Budget at Completion (BAC). PV at any stage = (Planned % Complete) X (BAC)

Earned Value (EV): Earned value is the value of work performed expressed in terms of the approved budget assigned to that work for an activity or work breakdown structure component. It is the authorized work that has been completed, against the authorized budget for such completed work i.e. EV is ‘how much you planned to spend for the work you actually did’. Earned Value is also known as the Budgeted Cost of Work Performed (BCWP).

Actual cost (AC): Actual cost is the total cost actually incurred and recorded in accomplishing work performed for an activity or work breakdown structure component. It is the total cost incurred in accomplishing the work that the EV measured. I.e. how much you spent for the work you actually did. Actual Cost is also known as the Actual Cost of Work Performed (ACWP).

Using these three variables project Schedule variance and Cost variance metrics can be derived which shows if the project is running over or under budget; project is running behind or ahead of schedule, as follows:


Schedule Variance (SV) is the measure of schedule performance of the project. It is the difference of Earned value and the planned value i.e.  SV = EV – PV

  • Positive result means that you are ahead of schedule.
  • Negative result means that you are behind schedule.

Cost Variance (CV) is the measure of cost performance on the project. It is equal to earned value (EV) minus actual costs (AC). Any negative CV is often non-recoverable to the project.

CV = EV – AC

  • Positive result means that you are under budget.
  • Negative result means that you are over budget.

Since EVM method allows PM to extrapolate the expected costs and duration at project completion based on project performance to date, PM can develop a forecast for the estimate at completion (EAC) which may differ from the budget at completion (BAC) based on project performance. Forecasting of EAC involves making estimates or prediction of conditions and events in the project’s future based on information and knowledge available at the time of forecasting. EAC is typically based on actual cost (AC) incurred for work completed, plus an estimate to complete (ETC) the remaining work. I.e. EAC = AC + ETC.

Based on this PM can also derive another metric, Variance at completion (VAC) = BAC – EAC


Performance Metric #2 – Productivity: Resource Utilization

The objective of this metric is to measure productivity of resources involved in project and let PM assess over or under-utilization cases.

Utilization% = Total Effort spent by resource/Total Budgeted Effort for the resource

Budgeted effort is the planned billable work of resource. Any over-utilization and under-utilization indicated by this metric has an impact on the project’s profitability. It is important for the PM to track this metric very closely and find out the reason for deviations and the action items to bring back resource utilization to optimal level. Delayed projects, increased ramp up activities, less work provided by customer, unplanned vacations, less competent resources can impact this metric. To get better control over this metric, robust time reporting systems should be available in the organization. Using this, PM can analyze effort distribution across different project phases/activities. For e.g. Effort distribution can tell PM that how much effort is being spent on defect resolution, customer support or design activities. PM can take corrective actions based on this, if required. For instance, if the resource is complaining that customer support is taking considerable time but the effort distribution shows it otherwise, PM can see where the corrections are needed on what resource is doing. Effort distribution from time reporting systems can also tell the areas of improvement for  better estimations/planning for the next project.


Performance Metric #3: Change requests to Scope of work

Signed Scope baseline with customer forms the baseline for the entire project planning and development. Any change to signed scope should happen in controlled manner. So here comes another important metric for PM to track i.e. the number of change requests coming from customer for the already signed scope of work. Each and every change request, once approved by internal change control board (CCB), requires update to Scope baseline which in turn has a cascade impact on cost baselines and schedule baselines and resource plans. Uncontrolled change requests often result in project scope creep and further impact negatively on the project cost/schedule, which is the worst thing to happen for any project. PM should never allow such scope creep. Based on the magnitude of the variance from original scope baseline, CCB should decide whether to accept or reject the change request and this decision should be communicated back to customer. In case of acceptance of change request, the impact on project cost and schedule should be clearly communicated in written form to customer and a written agreement from customer secured on those from customer before proceeding.


Performance Metric #4: Quality and Customer Satisfaction

Throughout the execution of project, Quality Assurance should always be on the radar of project manager. Quality here is defined as the number of severe, medium or low defects delivered through the lifetime of the project. It indicates the health of the deliverable to the end user and drives the Customer Satisfaction. PM needs to define, based on project type, what severe, low and medium means. Quality should be reported throughout the life of the project; the later defects are caught, the more impact they will have on the project. Under quality metrics, following are the key ones to track:

Defect density = Total number of defects found/ Measure of size.

For e.g. in case of software projects this can be: how many defects are found in 1KLOC (Kilo line of code). In general, size measure can be considered as planned effort like ‘person day total planned effort’.

Defect age

Number of days since the defect is open and not fixed. It can also be inferred as the time customer has been waiting for their issues to get resolved,

Defect resolution rate = Total number of defects resolved/ Total effort spent

Rate of closing the open defects over a period of time. If the rate of resolution is not in line with the defects being opened over a particular time, this indicates to the PM a situation of concern.



Number of defects reported by customer

PM should keep this as a separate metric to differentiate from the defects reported out of internal testing and the defects reported by end user i.e. Customer. Customer satisfaction depends a lot on the quality of deliverable provided and on how fast defects raised by customer are resolved.

As said above, the later defects are caught, the more impact they will have on the project, it is worth to mention here about Pareto’s principle i.e. 80/20 principle, which PM can use to categorize causes of defects and late time entry relationship. As per this law 80% of the problems are due to 20% of the causes. PM can concentrate on these 20% causes impacting the project most.

Performance Metric #5: Gross Margin

Gross Margin (as I wrote in my earlier post on key performance metrics) is the mother of all metrics and the quickest way to determine if your business in on track or not and acts as an early warning system to put in place margin improvement initiatives. Ultimate goal of project execution is to bring revenue to organization with the approved gross margin. Gross margin (GM) is basically the difference of total revenue and the total cost spent on project i.e. profit.

When a project is started, certain GM levels for the project are approved by project sponsor. This approved GM value is generally based on project scope definition, duration, a forecast of resources: onsite, offshore and organization’s investment analysis. Project PNL (Profit and Loss) statement gives a way to PM for tracking his/her projects GM metric at any point of time. For this, PNL statements and forecasts should be current documents i.e. changes in project parameters need to be reflected quickly in this statement to keep the PM informed about any potential risks to project profitability. All the above four project management performance metrics impact this metric, if not handled in controlled manner. A good organizational level PNL tool rather than manual excel sheets reduces the overhead on PM here.

While working with all of these metrics, following points should be very clear in the project manager’s mind:

In my view these five project management performance metrics are critical metrics to be tracked while taking charge and during execution of a project. The continued analysis of these metrics provides additional insights into what is working and what is not, allowing the PM to make appropriate improvements. These metrics also help in building up historical data for similar kind of projects so that in future, better project planning can be done. Success story of project can be then built up based on the effectiveness of defined metrics by showing the improved numbers “before” and “after”. This ensures that the effort spent by team in collection and measurement of data for these metrics is leading to continuous improvements and not just an overhead activity.

In summary, metrics improve decision making ability by providing the foundation and rationale for the decision by making explicit what is usually implicit in the decision-making process.

So what are your experiences when it comes to project management performance metrics and tracking? What are some of the other project management metrics you have been tracking?  We would love to hear and learn from you.

References: : PMBOK 4th Ed.

Today’s guest post is from Kavita Verma, PMP who is the Director – Global Program Office at a leading IT services company. She is a dynamic and outcome-oriented Program Manager with a fulfilling career spanning over 10 years of extensive industry experience in full software life cycle of requirements definition, architecture, design, prototyping, product implementation, integration and testing of Embedded Mobile Application and Platform Middleware.

Pic Courtesy :


The Salt Satyagraha

By Manjgu

The Salt Satyagraha, also known as the Dandi March, began on 12 March 1930 and was an important  part of the Indian independence movement. It was a direct action campaign of tax resistance and nonviolent protest against the British salt monopoly in colonial India, and triggered the wider Civil Disobedience Movement against the British colonialists.

Gandhi  set  out  from  his   ashram, or   religious   retreat,  at   Sabarmati near Ahmedabad ( Gujrat state) with several dozen Satyagrahis (activists of truth and resolution) on a trek of some 360 Kilometers  to the coastal town of Dandi on the Arabian Sea. There, Gandhi and his supporters were to defy British policy of Salt Tax by making salt from seawater. The Salt Tax essentially made it illegal to sell or produce salt, allowing a complete British monopoly.  Since salt is necessary in everyone’s daily diet, everyone in India was affected.  The Salt Tax made it illegal for workers to freely collect their own salt from the coasts of India, making them buy salt they couldn’t really afford.


Before embarking on the journey Gandhi sent a letter to the Viceroy himself, forewarning their plans of civil disobedience:

If my letter makes no appeal to your heart, on the eleventh day of this month I shall proceed with such co-workers of the Ashram as I can take, to disregard the provisions of the Salt Laws.  I regard this tax to be the most iniquitous of all from the poor man’s standpoint.  As the Independence movement is essentially for the poorest in the land, the beginning will be made with this evil.

Along the march, the satyagrahis listened to Gandhi’s favorite bhajan sung by Pandit Paluskar, a Hindustani vocalist; the roads were watered and softened, and fresh vegetation was thrown along the path.  Gandhi spoke to each village they passed, and more and more men joined the march.    On April 5, 1930 Gandhi and his satyagrahis reached the coast.  After prayers were offered, Gandhi spoke to the large crowd.  He picked up a tiny lump of salt, breaking the law.  Within moments, the satyagrahis followed Gandhi’s passive defiance, picking up salt everywhere along the coast.  A month later, Gandhi was arrested and thrown into prison, already full with fellow protestors.

The Salt March started a series of protests, closing many British shops and British mills.    The non-violent satyagrahis did not defend themselves against the clubs of policemen, and many were killed instantly.  The world embraced the satyagrahis and their non-violence, and eventually enabled India to gain their freedom from Britain.

Moving From MDGs to SDGs in Indonesia

By: Gordon B. Manuain*)

The year 2015 is undoubtedly a milestone year for all human development stakeholders across the globe. it marks a critical junction between the deadline of the Millennium Development Goals (MDGs) and the adoption of a new globally-agreed set of human development goals, officially known as the Sustainable Development Goals (SDGs). Last September, this United Nations-initiated set of 17 development goals was officially adopted globally to be achieved by 2030.

It has become increasingly clear that some of the MDG targets may be missed by their due date at the end of 2015. Yet, the 15-year span of the MDG implementation, since their universal adoption in 2000, offers a great deal of lessons learned, which, if harnessed effectively, may provide substantial leverage for meeting the SDG targets by 2030.


Learning from past efforts

From this perspective, governments, civil society groups, the private sector, academia and the philanthropic community — all key SDG stakeholders — are fortunate to have much-needed weapons in their arsenal to bring an end to the extreme poverty, which is the primary target in the SDGs.

In fact, putting the lessons learned from the MDGs to good use has been well reflected in the new development agenda itself. The SDGs aim, among others, to address what the MDGs had said little or nothing about, but which is nonetheless crucial to the successful implementation of a human development framework in the future. And, yet, at the same time, the new framework builds on the successful implementation of the MDG framework thus far.

However, the critical testing ground to testify that we have fully benefited from our experiences lies with how we plan to implement the newly-agreed development agenda.

Any entity, be it government, civil society or the private sector, working at the implementation level for a human development program, would realize that a heightened level of commitment on the part of development stakeholders plays a more crucial role than any prescriptive narrative spelled out in the goals and targets.

A well-conceived development program owes much of its successful implementation to the enduring commitment of development actors and its means of implementation.

The frequently cited problems encountered on the ground, such as a lack of coordination, a ‘silo’ way of thinking, incoherent policy patchworks, and mismanagement of resources usually go hand in hand with a business-as-usual approach by those responsible for achieving the agreed targets.

The SDG framework will not go far enough toward meeting all goals and targets if a robust mechanism of accountability is not put in place. The MDGs proved to have some important leverage in their implementation, and this, to some extent, has to do with how pressure has been put on governments to meet the targets they had committed to.

Yet, the MDGs would have fared much better if they have had a strong accountability mechanism in place to hold both state and non-state development actors to account.

Indonesia’s experiences

Indonesia’s experience with the MDG achievement offers plenty of material we can learn from. Even though some of the MDG targets related to maternal and infant mortality as well as HIV/AIDS in Indonesia will not be met, Indonesia has notched impressive gains in the MDGs.

Moreover, the commitment to meeting the MDG targets by 2015 has had the beneficial effect of providing a major boost for the country to meet its own national development goals as outlined in the national mid-term and long-term development plans.

Taking stock of what this country has performed over the past 15 years to meet the MDG targets would offer ample opportunity for the relevant development stakeholders to be better equipped to meet the SDG targets.

Mainstreaming of the MDGs into the national development plan has been a major driving force in helping the country realize these global development goals. The successful implementation of the MDGs could, to a great extent, be chalked up to the fact the MDGs are fully integrated across our own development goals.

Ultimately, the MDGs have been viewed as our own development goals, rather than an external entity superimposed on our own development plan.

Translating commitment into a legal framework to guide the MDG implementation has proved to be critically important. The presidential instruction on the Equitable Development Program, which necessitated the acceleration of the MDG achievement, issued by former president Susilo Bambang Yudhoyono in 2010, played a catalytic role in this endeavor. It brought together all development actors nationwide under an overarching legal framework to speed up the effort to meet the MDG targets by 2015.

Eventually, the future national campaign for the SDGs could be benchmarked against the MDGs in a number of areas.

The efforts by MDG stakeholders to make the framework workable at the community level across the country could serve as a point of reference for the SDG stakeholders in planning out their approaches.

Similarly, the unprecedented level of cross-sector partnerships between the government and a vast array of non-government stakeholders forged during the MDG period should be emulated and pushed even further by the new development stakeholders.

The agreed indicators of the SDGs, which complement their goals and targets, will be not finalized until March 2016 by the United Nations. But it is essential for national development actors to come up with a well-thought-out roadmap for achieving the SDGs as early as possible.

*) Gordon B. Manuain worked for the President’s Special Envoy on MDGs from 2010 to 2014.

Mengapa Harus Garam Beryodium?

BY BUNDA // 19 JUNE 2010 ; Edited by NanoDaru

Meskipun setiap hari para ibu berkutat dengan kesibukan memasak di dapur, ternyata tidak semua ibu mengerti pentingnya menggunakan garam beryodium. Yah, yang ada sajalah…toh semua sama saja asinnya, begitu pikir mereka.Padahal, penggunaan garam beryodium sangat penting bagi kesehatan keluarga.

Yodium bermanfaat untuk memicu pertumbuhan otak, menyehatkan kelenjar tiroid, menyehatkan proses tumbuh kembang janin, mencerdaskan otak, dsb.

Kekurangan yodium mengakibatkan penyakit gondok, keterbelakangan mental, bayi lahir cacat, anak kurang cerdas, keguguran pada ibu hamil, dsb.

Para pakar gizi menganjurkan untuk mengkonsumsi setidaknya 6 gram atau 1 sendok teh garam perhari. Atau, jika Anda termasuk orang yang memiliki keringat berlebih, dianjurkan untuk menambah 2 sendok teh perhari.

Bagaimana jika harus mengurangi makanan bergaram? Memang, tidak semua orang boleh mengkonsumsi banyak garam. Caranya, ganti dengan makanan yang berasal dari laut seperti ikan laut, udang, atau rumput laut.

Pastikan dapur Anda memiliki garam beryodium yang sesuai dengan standar. Saat membeli garam, pilihlah garam dengan label “beryodium” yang mengandung yodium minimal 30-80 ppm. Jangan lupa, belilah garam yang memiliki nomor MD atau SP dari BPOM.

Garam yang baik adalah garam yang bersih, berwarna putih, kering, dan tidak lembab. Untuk menyimpannya, simpanlah pada wadah khusus garam, dan setiap kali pemakaian ambillah dengan sendok yang kering dan segera tutup kembali.

Dan, tahukah Anda, bahwa merebus tanpa menutup akan mengakibatkan kadar yodium hilang sampai dengan 50%. Sedangkan menggoreng dan memanggang akan mengakibatkan yodium hilang 25-35%.

Note :

Pemahaman ini : “Agar kadar yodium tidak terlalu banyak hilang, saat memasak, tutuplah panci. Atau, bubuhkan garam setelah Anda mengangkat masakan dari tungku” telah dibuktikan tidak benar adanya. Titik didih dan titik bakar yodium dengan air tidak sama.

Selamat menjadi ibu cerdas!!

GAKI (Gangguan Akibat Kekurangan Yodium)


By; NanoDaru

Gaky merupakan salah satu gangguan dalam tubuh kita yang menyebabkan retardasi mental, namun sebenarnya hal ini bisa dicegah. Gangguan ini disebut pula dengan defisiensi yodium atau kekurangan yodium.

Saat ini diperkirakan 1.6 miliar penduduk dunia mempunyai risiko kekurangan yodium, dan 300 juta menderita gangguan mental akibat kekurangan yodium. Kira-kira 30.000 bayi lahir mati setiap tahun, dan lebih dari 120.000 bayi kretin, yakni retardasi mental, tubuh pendek, bisu tuli atau lumpuh.

Sebagian besar dari mereka mempunyai IQ sepuluh poin di bawah potensinya. Di antara mereka yang lahir normal, dengan konsumsi diet rendah yodium akan menjadi anak yang kurang intelegensinya, bodoh, lesu dan apatis dalam kehidupannya. Sehingga, kekurangan yodium akan menyebabkan masyarakat miskin dan tidak berkembang, sementara pada anak menyebabkan kesulitan belajar.

Risiko itu karena kekurangan yodium dalam dietnya, dan berpengaruh pada awal perkembangan otaknya. Yodium merupakan elemen yang sangat penting untuk pembentukan hormon tiroid.

Hormon itu sangat diperlukan untuk pertumbuhan normal, perkembangan mental dan fisik, baik pada manusia maupun hewan. Efek yang sangat dikenal orang akibat kekurangan yodium adalah gondok, yakni pembesaran kelenjar tiroid di daerah leher.

Di Indonesia telah diadakan penelitian pada anak sekolah dasar antara tahun 1980-1982 di 26 provinsi, didapatkan prevalensi goiter lebih dari 10% apda 68,3% dari 966 kecamatan yang diperiksa, dan di beberapa desa lebih dari 80% penduduknya dengan gondok.

Pada tahun 1998 dilakukan pemeriksaan terhadap 46.000 anak sekolah dari 878 kecamatan yang telah diseleksi pada tahun 1980-1982, dibandingkan data terdahulu prevalensi gondok yang terlihat (visible goiter prevalences) menurun sekitar 37,2 sampai 50%.

Tahun 1991, dilakukan survei di Indonesia bagian Timur (Maluku, Irian Jaya, NTT, Timor Timur) pada 29.202 anak sekolah dan 1749 ibu hamil, didapatkan gondok pada anak sekolah 12-13% dan ibu hamil 16-39%. Kemudian pada tahun 1996, dilakukan survei di 6 propinsi, didapatkan gondok 3,1-5%, di Maluku 33%.

Pada tahun 1998, mulai ada Thyro Mobile, yang memproses data ukuran kelenjar gondok dan kadar yodium dalam urin.

Berdasarkan data survei pada tahun 1980-1982, diperkirakan 75.000 menderita kretin, 3,5 juta orang dengan gangguan mental, bahkan di beberapa desa 10-15% menderita kretin.

Dari data hasil penelitian pada anak sekolah dasar. maka pengertian tentang kekurangan yodium sudah jauh dari hanya menyebabkan gondok saja. Yakni menyebabkan pada tumbuh kembang anak, termasuk perkembangan otaknya, sehingga istilahnya saat ini disebut sebagai ”Gangguan Akibat Kekurangan Yodium” atau disingkat GAKY.

Ekologi Kekurangan Yodium

Sebagian besar yodium berada di samudera / lautan, karena yodium (melalui pencairan salju dan hujan) pada permukaan tanah, kemudian dibawa oleh angin, aliran sungai, dan banjir ke laut. Kondisi ini, terutama di daerah yang bergunung-gunung di seluruh dunia, walau dapat juga terjadi di lembah sungai.

Yodium yang berada di tanah dan lautan dalam bentuk yodida. Ion yodida dioksidasi oleh sinar matahari menjadi elemen yodium yang sangat mudah menguap, sehingga setiap tahun kira-kira 400.000 ton yodium hilang dari permukaan laut. Kadar yodium dalam air laut kira-kira 50 mikrogram/liter, di udara kira-kira 0,7 mikrogram/meter kubik.

Yodium yang berada dalam atmosfer akan kembali ke tanah melalui hujan, dengan kadar dalam rentang 1,8 – 8,5 mikrogram/liter. Siklus yodium tersebut terus berlangsung selama ini.

Kembalinya yodium ke tanah sangat lambat dan dalam jumlah sedikit dibandingkan saat lepasnya. Proses ini akan berulang terus menerus sehingga tanah yang kekurangan yodium tersebut akan terus berkurang kadar yodiumnya.

Di sini tidak ada koreksi alamiah, dan defisiensi yodium akan menetap. Akibatnya, populasi manusia dan hewan di daerah tersebut yang sepenuhnya tergantung pada makanan yang tumbuh di daerah tersebut akan menjadi kekurangan yodium.

Melihat hal tersebut maka sangat banyak populasi di Asia yang menderita kekurangan yodium berat karena mereka hidup dalam sistem mencari nafkah dengan bertani di daerah gunung atau lembah.

Kekurangan yodium akan menimpa populasi di daerah tersebut yang dalam makanannya tidak ada suplemennya yodium atau tidak ada penganekaragaman dalam makanannya dengan makanan dari daerah lain yang tidak kekurangan yodium.

Akibat Kekurangan Yodium

Istilah GAKY menggambarkan dimensi baru dari pengertian spektrum kekurangan yodium. Berakibat sangat luas dan buruk pada janin bayi baru lahir, anak dan remaja serta orang dewasa dalam populasi yang kekurangan yodium tersebut. Akibat hal itu dapat dikoreksi dengan pemberian yodium.

Kebutuhan Yodium

Kebutuhan yodium setiap hari di dalam makanan yang dianjurkan saat ini adalah:

50 mikrogram untuk bayi (12 bulan pertama).
90 mikrogram untuk anak (usia 2-6 tahun).
120 mikrogram untuk anak usia sekolah (usia 7-12 tahun).
150 mikrogram untuk dewasa (diatas usia 12 tahun).
200 mikrogram untuk ibu hamil dan menyusui.
Ada beberapa pendapat yang salah dan kenyataan yang berbeda. Pendapat yang salah, misalnya, garam beryodium dapat mengobati GAKY seperti kretin, namun kenyataan GAKY tidak dapat diobati kecuali hanya dicegah. Juga pendapat yang salah, bahwa mengkonsumsi yodium sangat berbahaya, kenyataannya mengkonsumsi yodium, melalui garam beryodium dalam jangka lama tidak berbahaya.

Pemecahan Masalah



Pilihan pertama tentunya dengan garam beryodium karena biayanya sangat murah, dan teknologinya mudah. Untuk suplementasi minyak beryodium, keuntungannya praktis, sebaiknya hanya untuk intervensi pada populasi yang berisiko, walaupun masih terdapat banyak hambatan yang perlu dihadapi.

Advokasi masyarakat. Penyuluhan kesehatan secara berkala pada masyarakat perlu dilakukan, demikian juga perlu diberikan penjelasan pada pembuat keputusan, dan tentunya juga diberikan tambahan pengetahuan kepada tenaga kesehatan.

Gerakan Hukum dalam mengatasi produsen garam “nakal” yang dengan sengaja memproduksi garam dibawah standart juga perlu ditindak dengan tegas. Tindakan nyata tersebut sangat dibutuhkan dalam menghentikan peredaran garam dibawah standart di tingkat rumah tangga.

Selanjutnya yang penting juga adalah penelitian tentang GAKY dengan pendekatan multidisiplin, baik klinis, eksperimental maupun epidemiologi, untuk menemukan cara yang terjamin dan mudah penerapannya. GAKY yang terlihat di masyarakat atau populasi, hanya sebagai puncak gunung es.


Di daerah endemik, gondoklah yang terlihat dari bagian puncak gunung es tersebut, namun efek dari kekurangan yodium yang utama yaitu kerusakan otak merupakan komponen yang tersembunyi dan tidak terlihat dalam tragedi ini.

Sehingga problem dari GAKY ini sebenarnya adalah pada perkembangan otak, tidak hanya pembesaran kelenjar tiroid atau gondok. Dengan melihat besarnya populasi yang mempunyai risiko seperti diatas, pantas bila GAKY menjadi problem nasional maupun internasional.

Dengan diadakannya pertemuan ilmiah nasional GAKY 2001 yang tema ”Perkembangan Mutakhir tentang Masalah GAKY dalam rangka Indonesia Sehat 2010” harapan kita tentunya dapat mendapatkan konsep, pemikiran serta semangat baru dalam menanggulangi GAKY.

Kekurangan Yodium pada Janin

Kekurangan yodium pada janin akibat Ibunya kekurangan yodium. Keadaan ini akan menyebabkan besarnya angka kejadian lahir mati, abortus, dan cacat bawaan, yang semuanya dapat dikurangi dengan pemberian yodium. Akibat lain yang lebih berat pada janin yang kekurangan yodium adalah kretin endemik.

Kretin endemik ada dua tipe, yang banyak didapatkan adalah tipe nervosa, ditandai dengan retardasi mental, bisu tuli, dan kelumpuhan spastik pada kedua tungkai. Sebaliknya yang agak jarang terjadi adalah tipe hipotiroidisme yang ditandai dengan kekurangan hormon tiroid dan kerdil.

Penelitian terakhir menunjukkan, transfer T4 dari ibu ke janin pada awal kehamilan sangat penting untuk perkembangan otak janin. Bilamana ibu kekurangan yodium sejak awal kehamilannya maka transfer T4 ke janin akan berkurang sebelum kelenjar tiroid janin berfungsi.

Jadi perkembangan otak janin sangat tergantung pada hormon tiroid ibu pada trimester pertama kehamilan, bilamana ibu kekurangan yodium maka akan berakibat pada rendahnya kadar hormon tiroid pada ibu dan janin. Dalam trimester kedua dan ketiga kehamilan, janin sudah dapat membuat hormon tiroid sendiri, namun karena kekurangan yodium dalam masa ini maka juga akan berakibat pada kurangnya pembentukan hormon tiroid, sehingga berakibat hipotiroidisme pada janin.

Kekurangan Yodium pada Saat Bayi Baru Lahir

YANG sangat penting diketahui pada saat ini, adalah fungsi tiroid pada bayi baru lahir berhubungan erat dengan keadaan otak pada saat bayi tersebut lahir. Pada bayi baru lahir, otak baru mencapai sepertiga, kemudian terus berkembang dengan cepat sampai usia dua tahun. Hormon tiroid pembentukannya sangat tergantung pada kecukupan yodium, dan hormon ini sangat penting untuk perkembangan otak normal.

Di negara sedang berkembang dengan kekurangan yodium berat, penemuan kasus ini dapat dilakukan dengan mengambil darah dari pembuluh darah balik talipusat segera setelah bayi lahir untuk pemeriksaan kadar hormon T4 dan TSH. Disebut hipotiroidisme neonatal, bila didapatkan kadar T4 kurang dari 3 mg/dl dan TSH lebih dari 50 mU/mL.

Pada daerah dengan kekurangan yodium yang sangat berat, lebih dari 50% penduduk mempunyai kadar yodium urin kurang dari 25 mg per gram kreatinin, kejadian hipotiroidisme neonatal sekitar 75-115 per 1000 kelahiran. Yang sangat mencolok, pada daerah yang kekurangan yodium ringan, kejadian gondok sangat rendah dan tidak ada kretin, angka kejadian hipotiroidisme neonatal turun menjadi 6 per 1000 kelahiran.

Dari pengamatan ini disimpulkan, bila kekurangan yodium tidak dikoreksi maka hipotiroidisme akan menetap sejak bayi sampai masa anak. Ini berakibat pada retardasi perkembangan fisik dan mental, serta risiko kelainan mental sangat tinggi. Pada populasi di daerah kekurangan yodium berat ditandai dengan adanya penderita kretin yang sangat mencolok.

Kekurangan Yodium pada Masa Anak

Penelitian pada anak sekolah yang tinggal di daerah kekurangan yodium menunjukkan prestasi sekolah dan IQ kurang dibandingkan dengan kelompok umur yang sama yang berasal dari daerah yang berkecukupan yodium. Dari sini dapat disimpulkan kekurangan yodium mengakibatkan keterampilan kognitif rendah. Semua penelitian yang dikerjakan di daerah kekurangan yodium memperkuat adanya bukti kekurangan yodium dapat menyebabkan kelainan otak yang berdimensi luas.

Dalam penelitian tersebut juga ditegaskan, dengan pemberian koreksi yodium akan memperbaiki prestasi belajar anak sekolah. Faktor penentu kadar T3 otak dan T3 kelenjar hipofisis adalah kadar T4 dalam serum, bukan kadar T3 serum, sebaliknya terjadi pada hati, ginjal dan otot. Kadar T3 otak yang rendah, yang dapat dibuktikan pada tikus yang kekurangan yodium, didapatkan kadar T4 serum yang rendah, akan menjadi normal kembali bila dilakukan koreksi terhadap kekurangan yodiumnya.

Keadaan ini disebut sebagai hipotiroidisme otak, yang akan menyebabkan bodoh dan lesu, hal ini merupakan tanda hipotiroidisme pada anak dan dewasa. Keadaan lesu ini dapat kembali normal bila diberikan koreksi yodium, namun lain halnya bila keadaan yang terjadi di otak. Ini terjadi pada janin dan bayi yang otaknya masih dalam masa perkembangan, walaupun diberikan koreksi yodium otak tetap tidak dapat kembali normal.

Kekurangan Yodium pada Dewasa

Pada orang dewasa, dapat terjadi gondok dengan segala komplikasinya, yang sering terjadi adalah hipotiroidisme, bodoh, dan hipertiroidisme. Karena adanya benjolan/modul pada kelenjar tiroid yang berfungsi autonom. Disamping efek tersebut, peningkatan ambilan kelenjar tiroid yang disebabkan oleh kekurangan yodium meningkatkan risiko terjadinya kanker kelenjar tiroid bila terkena radiasi.

Community Development

What is it?

Community development is a process where community members come together to take collective action and generate solutions to common problems. Community wellbeing (economic, social, environmental and cultural) often evolves from this type of collective action being taken at a grassroots level. Community development ranges from small initiatives within a small group to large initiatives that involve the broader community.

Effective community development should be :

  • a long-term endeavour
  • well-planned
  • inclusive and equitable
  • holistic and integrated into the bigger picture
  • initiated and supported by community members
  • of benefit to the community
  • grounded in experience that leads to best practices

Community development is a grassroots process by which communities :

  • become more responsible
  • organize and plan together
  • develop healthy lifestyle options
  • empower themselves
  • reduce poverty and suffering
  • create employment and economic opportunities
  • achieve social, economic, cultural and environmental goals

Community development seeks to improve quality of life. Effective community development results in mutual benefit and shared responsibility among community members. Such development recognizes :

  • the connection between social, cultural, environmental and economic matters
  • the diversity of interests within a community
  • its relationship to building capacity

Community development helps to build community capacity in order to address issues and take advantage of opportunities, find common ground and balance competing interests. It doesn’t just happen – capacity building requires both a conscious and a conscientious effort to do something (or many things) to improve the community.


Often when we think of community, we think in geographic terms. Our community is the city, town or village where we live. When community is defined through physical location, it has precise boundaries that are readily understood and accepted by others. Defining communities in terms of geography, however, is only one way of looking at them. Communities can also be defined by common cultural heritage, language, and beliefs or shared interests. These are sometimes called communities of interest. Even when community does refer to a geographic location, it doesn’t always include everyone within the area. For example, many Aboriginal communities are part of a larger non-Aboriginal geography. In larger urban centres, communities are often defined in terms of particular neighbourhoods.

Most of us belong to more than one community, whether we’re aware of it or not. For example, an individual can be part of a neighbourhood community, a religious community and a community of shared interests all at the same time. Relationships, whether with people or the land, define a community for each individual.


The term “development” often carries an assumption of growth and expansion. During the industrial era, development was strongly connected to increased speed, volume and size. However, many people are currently questioning the concept of growth for numerous reasons – a realization that more isn’t always better, or an increasing respect for reducing outside dependencies and lowering levels of consumerism. So while the term “development” may not always mean growth, it always imply change.

The community development process takes charge of the conditions and factors that influence a community and changes the quality of life of its members. Community development is a tool for managing change but it is not :

  • a quick fix or a short-term response to a specific issue within a community;
  • a process that seeks to exclude community members from participating; or
  • an initiative that occurs in isolation from other related community activities.

Community development is about community building as such, where the process is as important as the results. One of the primary challenges of community development is to balance the need for long-term solutions with the day-to-day realities that require immediate decision-making and short-term action.

Source : The Micronutrient Initiative USI IDD Project in Central Java Province;