Positive Deviant

Step five: Identify and analyze the deviants.

As you track how all people in the group go about their tasks, and as you begin to list the behaviors that they all have in common, the positive deviants will naturally emerge. At the same time, it will become clear that the deviants have found a better way; their results will prove it. If you've defined your community effectively (in such a way that everyone has the exact same set of resources), then the people who need to change can see how to do it -- if you help them identify the positive deviants. Just as important, they won't feel that an outside solution has been imposed on them. They will have discovered a new way of doing things themselves, making it their discovery, not yours. Analyze and list the set of behaviors that the deviants have in common. Single out exactly what makes them successful.

Certain practices became apparent among the positive deviants. These mothers used alternative sources of food, and their children thrived. In addition, they broke from conventional wisdom in a number of other areas: feeding children even while the children had diarrhea; feeding children more frequently; and making sure that the children actually ate, rather than hoping that the children would take it upon themselves to eat.

"The positive deviants were going to rice paddies and collecting tiny shrimps and crabs to mix with the rice," says Sternin. "They also collected sweet-potato greens -- which conventional wisdom considered low-class food -- and mixed them with the rice. They were supplementing the carbohydrates with protein and vitamins. And positive deviants displayed all kinds of caring behaviors: frequency of feeding, active feeding. They fed children who had diarrhea, for example, even though conventional wisdom said no to this."

Step six: Let the deviants adopt deviations on their own.

"The next step is critical," Sternin says. "Once you find deviant behaviors, don't tell people about them. It's not a transfer of knowledge. It's not about importing best practices from somewhere else. It's about changing behavior. You design an intervention that requires and enables people to access and to act on these new premises. You enable people to practice a new behavior, not to sit in a class learning about it."

Sternin makes a point of emphasizing the distinction: Don't teach new knowledge -- encourage new behavior. Let the people who have discovered the deviations spread the word in their group. Don't require adherence to the new practices, but do offer incentives for it.

In Vietnam, for example, a health volunteer would invite 8 to 10 mothers into her home for medicinal-food training. As a price of entry, the mothers were required to bring a contribution of shrimp, crabs, and sweet-potato greens. The volunteers and the mothers would then use those ingredients, along with rice, to cook a meal for the entire group. After two weeks of this, the session was over. Most of the group would continue to gather shrimp and greens, and their children would continue to recover. Those mothers whose children didn't rehabilitate could re-enroll and go through the two-week process again, over and over, until their children were rehabilitated and the behavior became habitual.

Step seven: Track results and publicize them.

Save the Children's next step: Post the results, show how they were achieved, and let other groups develop their own curiosity about them. Celebrate success when you achieve it. Go back on a periodic basis and observe how different groups have changed, and track the results quantitatively to show how positive deviance works. Chip away at conventional wisdom, and gradually alter low expectations by showing, in indisputable terms, the results that come with doing things differently.

"It was wildly successful," Sternin says. "We saw malnutrition drop 65% to 85% throughout the villages in a two-year period. But that's not all that's thrilling: The Harvard School of Public Health came to the four original villages and did an independent study. They found that children who hadn't even been born when we left the villages were at the exact same enhanced nutritional levels as the ones who benefited from the program when we were there. That means that the behavior sticks."

Step eight: Repeat steps one through seven.

Make the whole process cyclical. Once people discover effective ways to deviate from the norm, and once those methods have become common practice, it's time to do another study to find out how the best performers in the group are operating now. Chances are that they've discovered new deviations from the new norm. The bell curve of performance keeps moving up, as long as you disseminate the best deviations across the curve and continue to discover new examples of positive deviance among the next group of best performers.