The The P o w e rP o w e rof Positive of Positive DevianceDeviance

Solutions before our very eyesSolutions before our very eyes

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The Premise:

In every community there are certain individuals whose uncommon practices/behaviors enable them to find better solutions to problems than their neighbors who have access to the same resources

Positive Deviance (PD) Positive Deviance (PD) ApproachApproach

What enables some members of the communityWhat enables some members of the community(the “Positive Deviants”) to find better solutions(the “Positive Deviants”) to find better solutionsto pervasive problems than their neighbors who to pervasive problems than their neighbors who

have access to the same resources?have access to the same resources?

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• Identifying Solutions to Community Problems Within the Community Today

The Key Question?

The Positive Deviance The Positive Deviance InquiryInquiry

The The PD InquiryPD Inquiry is the tool is the tool thatthat

enables the community to enables the community to discover the uncommon PD discover the uncommon PD

behaviors/strategiesbehaviors/strategies

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• The community must discover what the PDs are doing that is different from their neighbors

PD InquiryPD Inquiry

Establishes community behavioral Establishes community behavioral normsnorms related to the problem to be related to the problem to beaddressedaddressed

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Uncovers successful uncommonuncommon behaviors/ strategiesbehaviors/ strategies practiced by the Positive Deviants

Analyzing PD Findings

Analyzing PD Findings

PDI findings are passed through a PDI findings are passed through a conceptual “accessibility sieve”conceptual “accessibility sieve”

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Only those behaviors/strategies accessible to all are kept

The rest are “TBU,” True but Useless (i.e. not accessible to all) and are discarded

PD

Behavio

rs

PD

Behavio

rsst

rate

gie

stra

tegi

ess

pract

ices

pract

ices

Accessible to

Accessible to

AllAll

Focus on PD Focus on PD

BehaviorBehaviorWe can’t (yet) clone peopleWe can’t (yet) clone people

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• But we can adopt their successful behaviors/strategies

PD Focus on PD Focus on PracticePractice Rather than KnowledgeRather than Knowledge

““It’s easier to It’s easier to ACTACT your way into a new way of your way into a new way of THINKING, than toTHINKING, than to

THINK your way into a new way of ACTING”THINK your way into a new way of ACTING”7

PD Enables us to Act PD Enables us to Act TODAYTODAY

The presence of Positive Deviants demonstrates that The presence of Positive Deviants demonstrates that it is possible to find successful solutions TODAY it is possible to find successful solutions TODAY beforebefore all the underlying causes are addressed! all the underlying causes are addressed!

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Although most problems have complex, interlinked underlying causes . . .

PD Inquiry PD Inquiry is an “Ends” as well as is an “Ends” as well as “Means” and “Means” and MUSTMUST be repeated in be repeated in

each Communityeach Community

To To discoverdiscover successful, successful, replicable replicable PD behaviorsPD behaviors

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MEANS

ENDS

To empower community to discover and “own” their own solution, based on their own resources

The SixThe Six DDs of Positive Deviance s of Positive Deviance ApproachApproach

D

DD

D

D

DDefineefine

Define the Define the problemproblem, its perceived causes and , its perceived causes and related current practices (situation analysis)related current practices (situation analysis)

Define what a successful Define what a successful solution/outcomesolution/outcome would look like (described as a behavioral or would look like (described as a behavioral or status outcome)status outcome)

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StakeholdersStakeholders

community

community

DDefineefine

Define the problem:Define the problem:

Children from poor families are malnourishedChildren from poor families are malnourished

Commercial sex workers (CSWs) are unable Commercial sex workers (CSWs) are unable to get to get clients to use condomsclients to use condoms

Define successful Define successful solution/outcomesolution/outcome (behavior or (behavior or status):status):

Children from poor families are well Children from poor families are well nourishednourished

Commercial sex workers are able to get Commercial sex workers are able to get clients to clients to always use condomsalways use condoms

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DDetermietermi

nene Determine if there are any individuals/entities Determine if there are any individuals/entities

in community who ALREADY exhibit desired in community who ALREADY exhibit desired behavior or status (PD identification)behavior or status (PD identification)

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DDetermineetermine

Determine if there are any individuals who Determine if there are any individuals who already exhibit desired behavior (Identify PDs) :already exhibit desired behavior (Identify PDs) :

There are some children from poor There are some children from poor families who are families who are well nourishedwell nourished

Some commercial sex workers are always Some commercial sex workers are always able to able to negotiate condom usenegotiate condom use

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DDiscoveriscover

Discover uncommon practices/behaviors Discover uncommon practices/behaviors enabling the PDs to outperform/find better enabling the PDs to outperform/find better solutions to the problem than others in their solutions to the problem than others in their “community”“community”

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DDiscoveriscover

Discover PDs successful practices/strategies :Discover PDs successful practices/strategies :

PD families using PD families using activeactive feedingfeeding and and feeding children feeding children uncommonuncommon but nutritious but nutritious foods, and feeding foods, and feeding more more frequentlyfrequently

Commercial sex workers carry their own Commercial sex workers carry their own condoms, condoms, possess possess special negotiating special negotiating strategiesstrategies, including taking , including taking onus off client onus off client and relating risk to own statusand relating risk to own status

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esignesign

Design and implement activities enabling Design and implement activities enabling others in “community” to access and others in “community” to access and PRACTICE new behaviors (focus on “doing” PRACTICE new behaviors (focus on “doing” rather than transfer of knowledge)rather than transfer of knowledge)

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D

esignesign

Design intervention enabling others to practice Design intervention enabling others to practice new behaviors :new behaviors :

Create a Nutrition Program to which parents Create a Nutrition Program to which parents of of malnourished children bring malnourished children bring daily daily contributionscontributions of of uncommon PD foods, uncommon PD foods, practice active feedingpractice active feeding

Enlist willing commercial sex workers as Enlist willing commercial sex workers as peer peer educators, sharing and educators, sharing and role playingrole playing successful successful condom use strategiescondom use strategies with other with other CSWsCSWs

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D

DDiscerniscern Discerns the effectiveness of activities or Discerns the effectiveness of activities or

project through ongoing monitoring and project through ongoing monitoring and evaluationevaluation

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community

DDiscerniscern

Discern effectiveness of intervention (Discern effectiveness of intervention (M/EM/E):):

Measure change in Measure change in nutritional statusnutritional status of of children in programchildren in program and spillover effect on and spillover effect on all all children in communitychildren in community over time over time

Measure CSW’s reported Measure CSW’s reported increaseincrease in in exclusive exclusive condom usecondom use

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DDisseminateisseminateDisseminate successful process to Disseminate successful process to

appropriate “other” (scaling up)appropriate “other” (scaling up)

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DisseminateDisseminate

DDisseminateisseminate

Disseminate to Appropriate Others:Disseminate to Appropriate Others:

Create a “Living University” (Social Create a “Living University” (Social Laboratory) Laboratory) where others wishing to where others wishing to replicate the program come replicate the program come for for hands-on hands-on participationparticipation in successful ongoing in successful ongoing programsprograms

Create a “Living University” (Social Create a “Living University” (Social Laboratory) Laboratory) where others wishing to where others wishing to replicate the program come replicate the program come for for hands-on hands-on participationparticipation in successful ongoing in successful ongoing programsprograms

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Positive Positive DDevianceeviance

DDetermineetermine

DDiscoveriscover

DDesignesign

DDiscerniscernDDisseminateisseminate

DDefineefine

Fixed Solution Space

Traditional

Flows from problem analysis towards solution

PD

Flows from identification and analysis of successful solution to problem solving

Expanded

Solution Space

Actual Problem

Parameters

Actual Problem

Parameters

Actual Problem

Parameters

Perc

eiv

ed

P

rob

lem

P

ara

mete

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Perceived Problem Parameters

Perc

eiv

ed

P

rob

lem

P

ara

mete

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Traditional vs PD Problem Solving Approach

PD: Crossing The PD: Crossing The “Knowledge/Behavior “Knowledge/Behavior

Change Gap”Change Gap”

Knowledge Behavior change

•Perceived advantage

•Opportunity for practice

•Social proof

TRADITIONAL VS POSITIVE DEVIANCE TRADITIONAL VS POSITIVE DEVIANCE PROBLEM SOLVING APPROACH PROBLEM SOLVING APPROACH

TRADITIONALTRADITIONAL

Externally Fueled (by Externally Fueled (by “experts” or internal “experts” or internal authority)authority)

Top-down, Outside-inTop-down, Outside-in

Deficit Based “What’s wrong Deficit Based “What’s wrong here?”here?”

Begins with analysis of Begins with analysis of underlying causes of underlying causes of PROBLEMPROBLEM

Solution Space Solution Space limitedlimited by by perceivedperceived problem problem parameters parameters

Triggers Immune System Triggers Immune System “defense response”“defense response”

POSITIVE DEVIANCEPOSITIVE DEVIANCE

Internally Fueled (by “people Internally Fueled (by “people like us”, same culture and like us”, same culture and resources)resources)

Down-up, Inside-outDown-up, Inside-out

Asset Based “What’s right Asset Based “What’s right here?”here?”

Begins with analysis of Begins with analysis of demonstrably successful demonstrably successful SOLUTIONSSOLUTIONS

Solution Space Solution Space enlargedenlarged through discovery of through discovery of actualactual parametersparameters

Bypasses Immune System Bypasses Immune System (solution shares same (solution shares same “DNA” as host)“DNA” as host)

PD and Attributes Dictating PD and Attributes Dictating “Speed of Adoption of Innovation”“Speed of Adoption of Innovation”

Diffusion AttributesDiffusion Attributes relative advantage relative advantage

compatibility compatibility

complexity complexity

triability triability

observability observability

Everett Rogers “Diffusion of Everett Rogers “Diffusion of Innovation”Innovation”

PD Behavior InnovationPD Behavior Innovation identifiedidentified as as

“advantageous”“advantageous”

created created withinwithin cultural cultural

contextcontext

Requires no special Requires no special

resources resources

opportunity to practice opportunity to practice

through PDI and personal through PDI and personal

experienceexperience

Geoffrey A Moore. Crossing the Chasm.

PD & The Diffusion of Innovation Life-Cycle

Community participates in discovery of innovation

Thereby jumping the “early adopters/early majority” chasm

Current Applications of Positive Current Applications of Positive DevianceDeviance

Programmatic context Countries

Childhood development & Malnutrition (PD/Hearth)

More than 40 countries throughout the world

HIV/AIDS risk reduction Myanmar, Indonesia, Viet Nam

Antenatal care, Maternal & Newborn Care, Breastfeeding

Egypt, Pakistan

Viet Nam

Female Genital Cutting Egypt

Girl Trafficking Indonesia, Nepal

Education Issues Argentina, US (NSDC)

Quality of Health Care US

(Waterbury Hospital, Connecticut)

Illustrative Uses Of Positive Illustrative Uses Of Positive DevianceDeviance

ISSUE

HIV/AIDS GOOD NUTRITION STATUS ETHNIC CONFLICT TRAFFICKING OF GIRLS EXCLUSIVE BF HEALTHY PREGNANCY ACCESS GIRLS EDUCATION ERRADICATION FGC

“COMMUNITY” Brothel Clients Commercial Sex Worker Drug Users Adolescents Law Enforcement Agents Widows of AIDS victims Residents w/ high obesity Poor Villages with high

incidence of malnutrition Communities with high

incidence of conflict Communities with high

incidence of trafficking Mothers of infants <6mos. Pregnant women Husbands of Pregnant

women School age girls Girls 8-13 years old Parents/ grandparents Husbands Religious leaders

PD BEHAVIOR/STATUS Exclusive condom use Exclusive condom use Use of clean needles Exc. condom use/ Abstinence No punishment condom

poss. Able support children Well nourished/ non-obese Poor well nourished child Community w/ no conflict Families with no girls

trafficked Mothers exclusively BF Resting last mo. pregnancy Doing work for wives Girls attending school Not circumcised Against FGM Married uncircumcised

women Openly opposed to practice

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