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Positive Deviance Initiative!

Published: Jul 9th, 2020 09:51 amBy Rajiv Krishnan

Published by Rajiv Krishnan Pisharoti

In the year 1997, Jerry Sternins and his wife, Monique started working on a unique project in Egypt. A project aiming to stop an age old practice of Female Genital Mutilation (FGM)

The World Health Organization has listed below facts around this subject, on its website.

Female genital mutilation (FGM) involves the partial or total removal of external female genitalia or other injury to the female genital organs for non-medical reasons.

The practice has no health benefits for girls and women. It only causes harm.

FGM can cause severe bleeding and problems urinating, and later cysts, infections, as well as complications in childbirth and increased risk of newborn deaths.

More than 200 million girls and women alive today have been cut in 30 countries in Africa, the Middle East and Asia where FGM is concentrated (1).

FGM is mostly carried out on young girls between infancy and age 15.

FGM is a violation of the human rights of girls and women.

WHO is opposed to all forms of FGM, and is opposed to health care providers performing FGM (medicalization of FGM).

Treatment of health complications of FGM in 27 high prevalence countries costs 1.4 billion USD per year


In Egypt, this procedure is called Il Rattan. A practice woven in the fabric of Egyptian life and culture. Highly resistant to change. So much so that even educated parents found ensuring their girl child subjected to Il Rattan. The only difference being, with modernization, this procedure carried out after administering anaesthesia. However long term health hazards still remain.

There have been international efforts since the 1970s to persuade practitioners to abandon FGM. Some countries have even outlawed same but the laws are poorly enforced. It was widely believed it is impossible to stop.

The couple were rank outsiders. Not from Egypt and different culture. They pioneered a method called Positive Deviance Initiative (PD) and could succeed in averting thousands of FGM

With active participation of Egyptians NGOs dedicated to eradicate this practice, “Positive Deviance” as a method started identifying, mothers or grandmothers who refused to circumcise their daughters & granddaughters.

Also priests and sheiks who advocated against the practice and many others who said “NO” to excision.

They were made to share their stories.

 “Rather than focuss on 97% of women in Egypt, then in who are circumcised, this practice focussed on the 3% minority who were not”.

The key message which went out was we did not allow our girl child to circumcise and every thing is good and fine. Since this message was going out from someone who has actually done it and from their own community, it was found to be having very powerful effects on other members of same communities. More and more members became curious to adopt and actually adopted.

Result: Thousands of FGM averted in Egypt . A four percent drop in FGM during period 1997-2000. Not bad considering that Sternins were rank outsiders in Egypt.

What is Positive Deviance?

Positive Deviance is based on the observation that in every community there are certain individuals or groups whose uncommon behaviors and strategies enable them to find better solutions to problems than their peers, while having access to the same resources and facing similar or worse challenges.

The Positive Deviance approach is an asset-based, problem-solving, and community-driven approach that enables the community to discover these successful behaviors and strategies and develop a plan of action to promote their adoption by all concerned

Key aspects in this approach is

a) Are there some people in this community who are not following this bad practice?

b) Who are they? (identify them)

b) What is their experience? (Understand from them)

c) Can we make them speak to other members of their community? (Make community members talk to each other, rather than an outsider coming and telling what to do?)

With their input into developing an advocacy program, they became the frontline community based advocates who worked side by side with the local NGOs’ staff, resulting in thousands of girls’ circumcision being adverted.

This pilot project was scaled up in 2002 to be included as a behaviour change communication strategy, in a government initiative called “the Abandonment of Female Genital Mutilation” (FGMAP) run by the National Council for Motherhood and Childhood (NCCM) supported by UNICEF.

In 2001 with a grant from the Ford Foundation, the Positive Deviance Initiative was established at Tufts University Friedman School of Nutrition with the mandate to expend the use of the PD approach to different sectors.

In December 2008 the New York Times celebrated ‘Positive Deviance’ as one of its annual “Year In Ideas” selection devoting a full page and half to this topic

The benefit in this approach is:

1. The solutions are seen as local. Not from someone who has come from outside and imposed.

2. The solutions are adapted. Simply because it is theirs.

3. They see a proof that this has worked.

When faced with problems in organizations, this approach can be adopted for problem solving.

Some key questions which Business Managers can ask are:

Are there some teams/individuals who have solved this problem within our organization?

How de we identify & reach out to them?

How do we make them share their problem solving experiences with others in organization, facing similar challenges?

The shift here for Business Managers is to play role of a facilitator and not problem solver.

Disclaimer: Though the above method could look simple, in reality it may not be. This calls for some practice.

However its worth the effort!

Rajiv Krishnan Pisharoti is an HR professional of more than two decades. He can be contacted at [email protected] or [email protected] or [email protected]

*More about Positive Deviance Initiative (PD) approach:

The PD approach was first operationalized and applied in programming in the field by Jerry and Monique Sternin through their work with Save the Children in Vietnam in the 1990s (Tuhus-Dubrow, Sternin, Sternin & Pascale).

At the start of the pilot, 64% of children who were part of the pilot villages selected, were malnourished. Through a PD inquiry, the villagers found poor peers in the community that through their uncommon but successful strategies, had well-nourished children. These families collected foods typically considered inappropriate for children (sweet potato greens, shrimp, and crabs), washed their children’s hands before meals, and actively fed them three to four times a day instead of the typical two meals a day provided to children.

Without knowing it, PDs had incorporated foods already found in their community that provided important nutrients: protein, iron, and calcium. A nutrition program based on these insights was created. Instead of simply telling participants what to do differently, they designed the program to help them act their way into a new way of thinking. To attend a feeding session, parents were required to bring one of the newly identified foods. They brought their children and while sharing nutritious meals, learned to cook the new foods.

At the end of the two year pilot, malnutrition fell by 85%.Results were sustained, and transferred to the younger siblings of participants.

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