Positive Deviance


The classic model of the diffusion of social change is one where the change comes from outside. Experts try to persuade people to adopt new ways and often look for charismatic locals to lead the change.

A newer model, Positive Deviance, tries to approach the idea of change from a different angle.

In the struggle to achieve participation and not simply persuasion, it has been found that local wisdom will usually be better than outside expertise.  This model also proposes that if people can be brought along as participants, even the most intractable problems can be solved.

In 1990, Jerry and Monique Sternin arrived in Hanoi to open a branch of the U.S. NGO, Save the Children.  At that time two-thirds of Vietnamese children under five were suffering from malnutrition. The Sternins hoped to find ways to help with this as supplemental feeding had already failed.

They initially travelled to the Quong Xuong District. There they weighed 2,000 children under the age of three and discovered that 64% of them were malnourished.  The Sternins weren’t the first people to discover this but they were the first to ask a very important question.

Were any of the well-nourished children they had encountered from very poor families?

The answer was ‘yes.’  Some of the children were well nourished even though their families were just as poor as those of the malnourished children.  These families were exhibiting positive deviant behaviour.

So the Sternins studied them.  What were they doing that was so different?

It turned out that the mothers in these families were all doing a number of things –

  • Collecting tiny shrimp and crabs from the paddy fields and adding them to the children’s meals.
  • Adding sweet potato greens to the meals.
  • Feeding the children three or four times a day instead of the customary twice.
  • Actively feeding the children, making sure they ate and that no food was wasted.
  • Washing their children’s hands before and after they ate.

Now they knew the key to the nourishment of the local children but how would they convince the villagers? They struggled to come up with ideas until a village elder reminded them of a local saying – “A thousand hearings isn’t worth one seeing, and a thousand seeing isn’t worth one doing.”

The Sternins designed a pilot project where local mothers agreed to work for two weeks with the ‘positive deviant’ mothers, harvesting the shrimps and greens, encouraging the children to eat, feeding them more often and washing their hands.

They were at all times encouraged to ‘do.’  They weighed their children every day and plotted the data on their own charts.  Within two weeks they could see the changes in their children for themselves.

This pilot project continued for two years after which malnutrition had decreased by 85% where the Positive Deviance approach was implemented.  Over the next several years this approach was used all over Vietnam and helped more than 2.2 million people improve their nutritional status.

The interview below is with Monique Sternin and demonstrates not only the success of this project but also beautifully shows how much the way we interact with others – all others – impacts on the outcome.