Positive deviance (PD) is a fascinating approach, a decade and a half old, and the focus of growing interest in health, education and numerous other sectors in domestic public policy. Interestingly, given PD saw first widespread application in an aid programme, it is still less well known than it should be across the international community.
This post compiles information from a variety of sources into Q&A form to explore the ideas and assumptions of positive deviance. Rather randomly, it is posted on the same day as another PD-related post, by Duncan Green.
What is Positive Deviance?
According to Richard Pascale, co-author of The Power of Positive Deviance:
It’s an oxymoronic term, in a way, but it’s a very simple observation that in many situations—both in companies and in societies—there are problems that seem absolutely intractable, where you tried everything and you can’t get anything to work, and you just end up accepting things by saying, “that’s just the way it is.” Yet in almost every one of those situations there usually are a few people with the same resources as everyone else, who, against all odds, are succeeding when everyone else is not. So the simple idea is to look at those people who are deviant in a positive direction, and who are prevailing when the conventional wisdom says you can’t.
Where did Positive Deviance come from?
From the PD website:
In 1991, the Jerry and Monica Sternin faced what seemed like an insurmountable challenge in Vietnam. As new Director of Save the Children in Vietnam, Jerry was asked by government officials to create an effective, large-scale program to combat child malnutrition and to show results within six months. More than 65 percent of all children living in Vietnamese villages were malnourished at the time. The Vietnamese government realized that the results achieved by traditional supplemental feeding programs were rarely maintained after the programs ended. The Sternins were mandated by the government to come up with an approach that would enable the community to improve and sustain their young children’s health status…and quickly!
Building on Marian Zeitlin’s ideas of positive deviance, working with four communities and a population of 2,000 children under the age of three, the Sternins invited the community to identify poor families who had managed to avoid malnutrition despite all odds, facing the same challenges and obstacles as their neighbors and without access to any special resources. These families were the positive deviants. They were “positive” because they were doing things right, and “deviants” because they engaged in behaviors that most others did not. The Sternins and the community discovered together that caregivers in the PD families collected tiny shrimps and crabs from paddy fields, and added those, along with sweet potato greens, to their children’s meals. These foods were accessible to everyone, but most community members believed they were inappropriate for young children. The PD families were also feeding their children three to four times a day, rather than twice a day, which was customary.
The communities developed an activity which enabled all of the families with malnourished children to rehabilitate their children and to learn how to sustain their children at home on their own, by inviting them to practice the demonstrably successful but uncommon behaviors which they had discovered in their communities. The pilot project resulted in the sustained rehabilitation of several hundred malnourished children and the promotion of social change in their communities. (PD website)
So it’s basically a way of identifying best practices? Great, just what we need!
Steady on there, not so fast.
Of course the initial reaction of any hierarchical organization is, “this is a best practice, let’s do it everywhere.” The strong counsel of both the villagers and Jerry and Monique Sternin was, “Absolutely not. Every community has to be curious about the question. They have to accept the invitation, if you will, to do something about a problem they regard as really essential. They’ve got to be at the front end to figure out what’s going on, what’s working.
Then they’ve got to find the other positive deviants and learn what they’re doing. Then they have to figure out to disperse this information within their community. But if you go out and say to people in another village, ‘Gather and eat shrimps, crabs, and greens,’ they’re going to say something like, ‘You know, we’re different. Those guys eat weird things.’ You’ve got to get the community to own it.”
So what differentiates this from best practices in most applications is that there is always this invitation, an authentic invitation, that has to be accepted by the target group. (Richard Pascale in interview)
So what are the principles behind Positive Deviance?
It’s pretty simple:
…The standard model… is this hierarchical principle of experts and people in authority having the answers to our problems. That notion seems to be baked into the human psyche. It’s just generally true throughout the world. You always begin, and not wrongly, with looking for a technical solution. So [vaccines are] a great answer, and you don’t really need a lot of community mobilization if you’ve come up with a silver bullet and can prove that it works—that’s not a particularly hard sell.
But really hard problems—what we call adaptive problems—are imbedded in a complex social system. They require behavioral change, and they’re rife with unintended consequences. These kinds of problems, like the ones that we’re facing all around the world: developed societies with governments that can no longer afford the social safety net, the healthcare problems in the United States, and any number of issues like that, are not just technical problems. They’re really adaptive problems.
You try the technical solutions. For reasons that are imbedded in the complex social system and behavior, they don’t work. When you impose them in a top-down fashion, you don’t get closer to anticipating all the unintended consequences. So they don’t work.
Learn from the people
Plan with the people
Begin with what they have
Build on what they know
Of the best leaders
When the task is accomplished
The people all remark
We have done it ourselves.”~Lao-Tzu Tao Te Ching
That all sounds very good. But what impact has it actually had on the ground?
Here’s the great bit. The successful application of the PD approach has been documented in more than 41 countries in nutrition and a variety of other sectors from public health to education to business. The following is an illustrative sample of PD-informed program impacts over the 15 years:
- Sustained 65 to 80% reduction in childhood malnutrition in Vietnamese communities, reaching a population of 2.2 million people.
- Significant reduction in childhood malnutrition in communities in over 40 countries around the world.
- Reduction in neo-natal mortality & morbidity in Pashtun communities in Pakistan and minority communities in Vietnam with near universal adoption of protective behaviors and social change.
- Estimated 50% increase in primary school student retention in 10 participating schools in Missiones, Argentina.
- Documented reduction in girl trafficking in impoverished communities in East Java, Indonesia.
- Thousands of documented female circumcisions averted in Egypt and the formation of 12 “FGM free” communities.
- In the Spring of 2005 Merck Mexico began a project to address the issue that only 13 out of 21 districts at Merck Mexico had a sales coverage of 100% or greater. Within 8 months all districts (100%) were covering their sales target.
Wow. So how exactly does PD relate to traditional approaches to innovation?
According to the classic diffusion-based approach, innovation is based on the following principles:
- it comes from the ‘outside’
- it is pushed and promoted by a change agency anf through expert and knowledgeable change agents
- these agents use persuasive communication strategies to plug existing knowledge-attitude -practice (KAP)
gaps among the client / user audience
- they harnessing the influence of charismatic opinion-leaders, who serve as visible role models of adoption for the non-adopters.
PD turns this model on its head. As one account puts it:
We are not suggesting the PD approach substitute for the classical diffusion of innovations paradigm. Rather, we argue that the PD approach provides additional options. We believe that often the wisdom to solve intractable social problems lies within the community. Diffusion in the PD approach is an “inside-out” process, in contrast to the classical dominant framework of “outside-in” diffusion.
As Pascale and Sternin put in a 2005 HBR article:
When identification of a superior method is imposed, not self-discovered, cries of “We’re not them” or “It just won’t work here” predictably limit acceptance. By contrast, a design that allows a community to learn from its own hidden wisdom is, among other things, respectful. Innovator and adopter share the same DNA. Community members invest sweat, and, in the process, they become partners to change.
Where has it been applied so far?
Hundreds of places. Here is a list of applications by organisation. Don’t be surprised if you see your own organisation on the list.
Can PD be applied to every problem?
Of course not. When there are proven remedies to technical problems—the Salk vaccine to polio, supply chain management practices, hardware and software solutions—companies can use them to work harder, faster, or smarter. And problems that rely on brainpower but that don’t require major behavioural adjustments are unsuitable for the positive deviance approach.
The method works best when behavioral and attitudinal changes are called for—that is when there is no apparent off-the-shelf remedy and successful coping strategies remain isolated and concealed. In such cases, change from within, discovered, celebrated, and implemented by the people who need to do the work. People are much more likely to act their way into a new way of thinking than to think their way into a new way of acting.
Sounds a bit familiar. So what’s the connection to complexity and evolutionary sciences?
The Power of Positive Deviance, the 2010 book, suggests that complexity science is a key part of the rationale for Postive Deviance. Specifically:
the [PD] process excels over most alternatives when addressing problems that (1) are enmeshed in a complex social system, (2) require social and behavioral change, and (3) entail solutions that are rife with unforeseeable or unintended consequences. It provides a fresh alternative when problems are viewed as intractable (i.e., other solutions haven’t worked).
And later on:
PD works like nature works… this isn’t an analogy; it is the way it is… nature tinkers with a different shaped bird beak or a slightly larger brian… natural selection does the rest, favouring variations that improve access to food and reproduction… In nature, this all plays out in evolutionary timescales of centuries or millennia. Emploring identical principles, the PD process achieves change within months or a few years…
How can I find out more?