10 Positive Deviance Examples

Positive deviance refers to the phenomenon by which some individuals of a community are able to achieve exceptional results through their unique non-normative (or ‘deviant‘) behavior.

Despite being in the same context and facing similar challenges as their peers, these individuals perform better and are known as positive deviants. By studying the behavior of these positive deviants, we can learn how to solve problems in a better way.

This can then be shared across the entire community. So, positive deviance is essentially a problem-solving approach based on behavioral & social change. Today, the concept is applied in various fields, such as public health, education, business management, and criminology.

Positive Deviance Definition

Pascale and Sternins define positive deviance as:

“…an approach that involves identifying and amplifying solutions already existing in the community, especially among those who are marginalized or poor, by encouraging them to adopt exceptional practices that have led to success in their situations.” (2010).

It involves “identifying” individuals who have successfully overcome a challenge, studying their behavior to determine “exceptional practices”, and then “amplifying” these practices to the entire community.

The concept was originally developed in nutrition research. During the 1990s, Jerry and Monique Sternin were working with Save the Children in Vietnam (Pascale and Sternins, 2010). In the villages, they found out that 64% of the children were malnourished. 

However, some families in these villages had well-nourished children because of their uncommon strategies. These families brought food that was typically considered inappropriate for children, such as sweet potato greens, crabs, shrimp, etc.

They washed their children’s hands before the meals and fed them three to four times a day (unlike others, who typically gave their children two meals). Unknowingly, these families had given their children food that was rich in nutrients like protein, iron, and calcium. 

The Sternins then created a nutrition program based on these insights. In order to amplify this strategy, they did not simply tell others in the community to follow the positive deviants. Instead, they designed a program to help them “act” their way into the new thinking. 

A feeding session was organized where parents were asked to bring one of the newly identified foods. While sharing nutritious meals with their children, they learned how to cook new foods. By the end of the two-year program, malnutrition fell by 85%.

The strategies were then applied to the participants’ younger siblings. Later, the positive deviant approach was adopted to improve nutrition programs in over 40 countries with the help of organizations like Mercy Corps, CARE, Plan International, etc.

Positive Deviance Examples

1. Public Health: In public health, positive deviance helps to identify and learn from those who have achieved exceptional health results. PD projects in Guatemala, Ivory Coast, and Rwanda have helped improve reproductive health in adolescents. Similar projects in India, Pakistan, and Myanmar have given women greater access to prenatal care, delivery preparation, and antenatal care (both for themselves and the babies). In Indonesia & Vietnam, PD projects have helped restrain the spread of STDs.
2. Businesses: Through positive deviance, businesses can benefit from significant performance improvements. In every business, there are positive deviants with attitudes and behaviors that lead to better results in key metrics like the speed of service, profitability, etc. Seidman and McCauley argue that, in private sectors, we can gather knowledge from positive deviants and scale it to the entire organization (2002). Such an approach, says Hamel, can set examples for “management innovation” (2007).
3. Primary Care: The positive-deviant approach to primary care first began in rural New Hampshire and has been termed “Bright Spotting” (Selby, 2015). The outpatient clinic studied a complex patient population and identified “Bright Spots” (those facing high risks and still being healthy). They performed qualitative research to identify their patterns of behavior and then promoted these through community meetings.
4. Education: In education, positive deviance can help improve students’ performance and well-being. PD projects in California and New Jersey have reduced dropout rates and helped girls continue their education in schools. Even in disadvantaged areas, some teachers can achieve excellent results with their students through innovative teaching methods (project-based learning, student-centric approaches, etc.). Through PD, education can become more effective and equitable.
5. Environmental Movement: Positive deviance can help us identify and learn from individuals/groups who have taken innovative steps for addressing environmental issues. The “Zero Waste” movement is one example, which encourages people to reduce the amount of waste they generate through practices like composting, recycling, and reusing. Some individuals have also adopted renewable energy sources, despite significant cost & infrastructure barriers.
6. Hospitals: The PD approach has helped to restrain the spread of hospital-acquired infections such as Clostridioides difficile and Methicillin-resistant Staphylococcus aureus (MRSA). This has been successfully done in various countries like the United States, Brazil, Mexico, etc. As per the CDC, the PD approach led to a reduction of 30-70% in infections in the United States (Awad, 2009). Such programs have also led to better care for patients who have recently suffered a heart attack.
7. Social Services: Positive-deviant approaches can help address social problems and bring positive social change. For example, positive deviants in social work can develop a program to solve homelessness in their country. They may begin by identifying the root cause of homelessness (lack of affordable housing, no job opportunities, etc.). Then they can work together with the community to find solutions to the root cause.

8. Child Protection: Positive deviance helps to promote strategies that protect children from neglect, exploitation, and abuse. In Indonesia, Save the Children and local NGOs started a five-year PD project in 2003 to prevent child trafficking; they helped them find economically viable options to stay in their communities. The CEDPA, along with other organizations, has been working to prevent FGM in Egypt since 1998, and the practice has been significantly reduced.
9. Agriculture: Farmers often use innovative techniques of agriculture that can be adopted by others for improved performance. Children’s malnutrition had been a major problem in rural India due to the lack of access to protein-rich food. However, some villages had better nutrition status than others, because the milkmaids added a few drops of curd to the milk, increasing its protein content. This simple technique was shared across the community and helped improve the nutrition status.
10. Technology: Positive deviance in technology can lead to significant improvements in various fields. During the Covid-19 pandemic, the Singapore government developed a contact tracing app. It used Bluetooth to detect nearby devices, and users were alerted if they had been close to someone who later tested positive. The app helped control the spread of the coronavirus in Singapore and was later replicated in many other countries.

Principles of Positive Deviance

Positive deviance is an approach that provides solutions from within the community—as against outside experts—and, so, is an effective tool for bringing change. 

It is based on the following principles:

• Specific Cultural Context: Positive deviance caters to a specific cultural context. This can be a village, a school, a business, etc. Since it functions within the assets of the context, it is tailor-made for a particular community.
• Communities are the Best Experts: It is based on the belief that communities are the best experts in their fields. They have the potential to solve their own problems and have the ability to organize their resources in an effective way. Since the solutions stem from the community, it avoids the “immune response” that can occur when outside experts provide their (contextless) solutions.
• Collective Intelligence: Positive deviance believes in collective intelligence. This is not merely present in the leaders or the experts of the community; instead, it is spread throughout the group. Positive deviance tries to employ this collective intelligence to solve problems.
• Sustainable and Effective: The PD approach is sustainable and effective. It allows a community to find sustainable solutions within the constraints of the context. Moreover, since the unusual behavior is already practiced within the community, others are more likely to adopt it—the positive deviants serve as “social proof” that such behavior is socially acceptable and useful.
• Change Occurs through Practice: It believes that bringing behavioral change is easier through practice than through knowledge. Pascale described this perfectly in his adage: “It is easier to act your way into a new way of thinking than think your way into a new way of acting” (2010).

Conclusion

Positive deviance is just one type of deviance. It is a way of solving problems by identifying and amplifying the unusual behavior of certain individuals.

These individuals, despite facing similar obstacles as their peers, are able to achieve better results due to their unique practices. Through a PD approach, these practices can be identified and shared with others, helping the entire community.

The concept of positive deviance originated in nutrition research. Today, it is used in various fields, such as public health, education, business management, etc.

References

Awad S., Palacio C., Subramanian A., et al. (2009). “Implementation of a methicillin-resistant Staphylococcus aureus (MRSA) prevention bundle results in decreased MRSA surgical site infections”. The American Journal of Surgery. New York: Elsevier. 

Hamel, Gary. (2007). The Future of Management. Harvard: Harvard Business School Press.

Pascale, R., Sternin, J., & Sternin, M. (2010). The power of positive deviance: How unlikely innovators solve the world’s toughest problems. Harvard: Harvard Business Press.

Seidman, William & McCauley, Michael. (2002). Performance Improvement in a Far-flung Enterprise. Los Angeles: Wiley.

Selby, Laura (2015). “Public health project taps into superstar patients’ expertise”. The DO. https://thedo.osteopathic.org/