1. The P o w e r of Positive Deviance Solutions before our very eyes 1 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

2. Positive Deviance (PD) Approach What enables some members of the community (the “Positive Deviants”) to find better solutions to pervasive problems than their neighbors who have access to the same resources? 2 Identifying Solutions to Community Problems Within the Community Today The Key Question?

3. The Positive Deviance Inquiry The PD Inquiry is the tool that enables the community to discover the uncommon PD behaviors/strategies enables the community to discover the uncommon PD behaviors/strategies 3 The community must discover what the PDs are doing that is different from their neighbors

4. PD Inquiry Establishes community behavioral norms related to the problem to be addressed Establishes community behavioral norms related to the problem to be addressed 4 uncommon behaviors/ strategies Uncovers successful uncommon behaviors/ strategies practiced by the Positive Deviants

5. Analyzing PD Findings PDI findings are passed through a conceptual “accessibility sieve” PDI findings are passed through a conceptual “accessibility sieve” 5 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 Behaviors strategies practices Accessible to All

6. Focus on PD Behavior We can’t (yet) clone people We can’t (yet) clone people 6 But we can adopt their successful behaviors/strategies

7. PD Focus on Practice Rather than Knowledge “It’s easier to ACT your way into a new way of THINKING, than to THINK your way into a new way of ACTING” 7

8. PD Enables us to Act TODAY The presence of Positive Deviants demonstrates that it is possible to find successful solutions TODAY before all the underlying causes are addressed! 8 Although most problems have complex, interlinked underlying causes...

9. PD Inquiry is an “Ends” as well as “Means” and MUST be repeated in each Community To discover successful, replicable PD behaviors 9 MEANS ENDS To empower community to discover and “own” their own solution, based on their own resources

10. The Six D s of Positive Deviance Approach D D D D D

11. Define Define the problem, its perceived causes and related current practices (situation analysis) Define the problem, its perceived causes and related current practices (situation analysis) Define what a successful solution/outcome would look like (described as a behavioral or status outcome) Define what a successful solution/outcome would look like (described as a behavioral or status outcome) 11 Stakeholders community

12. Define Define the problem: Children from poor families are malnourished Commercial sex workers (CSWs) are unable to get clients to use condoms Define the problem: Children from poor families are malnourished Commercial sex workers (CSWs) are unable to get clients to use condoms Define successful solution/outcome (behavior or status): Children from poor families are well nourished Commercial sex workers are able to get clients to always use condoms Define successful solution/outcome (behavior or status): Children from poor families are well nourished Commercial sex workers are able to get clients to always use condoms 12

13. Determine Determine if there are any individuals/entities in community who ALREADY exhibit desired behavior or status (PD identification) Determine if there are any individuals/entities in community who ALREADY exhibit desired behavior or status (PD identification) 13

14. Determine Determine if there are any individuals who already exhibit desired behavior (Identify PDs) : There are some children from poor families who are well nourished Some commercial sex workers are always able to negotiate condom use Determine if there are any individuals who already exhibit desired behavior (Identify PDs) : There are some children from poor families who are well nourished Some commercial sex workers are always able to negotiate condom use 14

15. Discover Discover uncommon practices/behaviors enabling the PDs to outperform/find better solutions to the problem than others in their “community” Discover uncommon practices/behaviors enabling the PDs to outperform/find better solutions to the problem than others in their “community” 15

16. Discover Discover PDs successful practices/strategies : PD families using active feeding and feeding children uncommon but nutritious foods, and feeding more frequently Commercial sex workers carry their own condoms, possess special negotiating strategies, including taking onus off client and relating risk to own status Discover PDs successful practices/strategies : PD families using active feeding and feeding children uncommon but nutritious foods, and feeding more frequently Commercial sex workers carry their own condoms, possess special negotiating strategies, including taking onus off client and relating risk to own status 16

17. esign Design and implement activities enabling others in “community” to access and PRACTICE new behaviors (focus on “doing” rather than transfer of knowledge) Design and implement activities enabling others in “community” to access and PRACTICE new behaviors (focus on “doing” rather than transfer of knowledge) 17 D

18. esign Design intervention enabling others to practice new behaviors : Create a Nutrition Program to which parents of malnourished children bring daily contributions of uncommon PD foods, practice active feeding Enlist willing commercial sex workers as peer educators, sharing and role playing successful condom use strategies with other CSWs Design intervention enabling others to practice new behaviors : Create a Nutrition Program to which parents of malnourished children bring daily contributions of uncommon PD foods, practice active feeding Enlist willing commercial sex workers as peer educators, sharing and role playing successful condom use strategies with other CSWs 18 D

19. Discern Discerns the effectiveness of activities or project through ongoing monitoring and evaluation Discerns the effectiveness of activities or project through ongoing monitoring and evaluation 19 community

20. Discern Discern effectiveness of intervention ( M/E ): Measure change in nutritional status of children in program and spillover effect on all children in community over time Measure CSW’s reported increase in exclusive condom use Discern effectiveness of intervention ( M/E ): Measure change in nutritional status of children in program and spillover effect on all children in community over time Measure CSW’s reported increase in exclusive condom use 20

21. Disseminate Disseminate successful process to appropriate “other” (scaling up) Disseminate successful process to appropriate “other” (scaling up) 21 Disseminate

22. Disseminate to Appropriate Others: Create a “Living University” (Social Laboratory) where others wishing to replicate the program come for hands-on participation in successful ongoing programs Create a “Living University” (Social Laboratory) where others wishing to replicate the program come for hands-on participation in successful ongoing programs Disseminate to Appropriate Others: Create a “Living University” (Social Laboratory) where others wishing to replicate the program come for hands-on participation in successful ongoing programs Create a “Living University” (Social Laboratory) where others wishing to replicate the program come for hands-on participation in successful ongoing programs 22

23. Positive Deviance Determine Discover Design Discern Disseminate Define

24. 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 Perceived Problem Parameters Traditional vs PD Problem Solving Approach

25. PD: Crossing The “Knowledge/Behavior Change Gap” Knowledge Behavior change Perceived advantage Opportunity for practice Social proof

26. TRADITIONAL VS POSITIVE DEVIANCE PROBLEM SOLVING APPROACH TRADITIONAL Externally Fueled (by “experts” or internal authority) Top-down, Outside-in Deficit Based “What’s wrong here?” Begins with analysis of underlying causes of PROBLEM Solution Space limited by perceived problem parameters Triggers Immune System “defense response” POSITIVE DEVIANCE Internally Fueled (by “people like us”, same culture and resources) Down-up, Inside-out Asset Based “What’s right here?” Begins with analysis of demonstrably successful SOLUTIONS Solution Space enlarged through discovery of actual parameters Bypasses Immune System (solution shares same “DNA” as host)

27. PD and Attributes Dictating “Speed of Adoption of Innovation” Diffusion Attributes relative advantage relative advantage compatibility compatibility complexity complexity triability triability observability observability Everett Rogers “Diffusion of Innovation” PD Behavior Innovation identified as “advantageous” identified as “advantageous” created within cultural context created within cultural context Requires no special resources Requires no special resources opportunity to practice opportunity to practice through PDI and personal experience through PDI and personal experience

28. 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

29. Current Applications of Positive Deviance Programmatic contextCountries Childhood development & Malnutrition (PD/Hearth) More than 40 countries throughout the world HIV/AIDS risk reductionMyanmar, Indonesia, Viet Nam Antenatal care, Maternal & Newborn Care, Breastfeeding Egypt, Pakistan Viet Nam Female Genital CuttingEgypt Girl TraffickingIndonesia, Nepal Education IssuesArgentina, US (NSDC) Quality of Health CareUS (Waterbury Hospital, Connecticut)

30. Illustrative Uses Of Positive Deviance 30