Behavior Change

Tools and Approaches

Positive Deviance

This is a formative research tool to help understand what specific solutions are already being tried and are working (among a minority of people) in a community, with regard to difficult health and nutrition challenges. The concept of positive deviance (although not the term) has been applied in nutrition programs since the 1960s. The basic approach is to identify mothers who, while typically poor, are feeding, caring for, and/or seeking health care for their children in more effective ways than others in the community. Basic research questions are: who are these mothers, how are their practices different, and why? With the answer to such questions, a program can design more effective behavior-change activities (see First Households (Hearth Model) tool description.)

The concept grew out of efforts to reduce child malnutrition starting as early as the 1960s. More recently, it is being adapted to other areas of public health. (Some of these experiences are described more fully under First Households (Hearth Model).) In Egypt, the approach is being used to change norms and behavior regarding female circumcision. Research attempted to answer the question, "What are the factors that enable some families not to circumcise their daughters?" In the process of asking questions and getting answers, communities discovered what is inherently positive and "working" within families, and are able to plan their own actions based on this information. Because community members themselves are conducting the research, analysis, and program planning, the process builds the capacity of individuals and local organizations and fosters sustainability.