Unleashing the power of positive deviance

By Catherine Cheney on 20 July 2016 for Devex.com.

Bill Heisel, director of global engagement at the Institute for Health Metrics and Evaluation in Seattle, Washington, found hope in data on diarrhea. What stood out to him in data from the Global Burden of Diseases on the top five killers in West Africa? Ghana, which had reduced its diarrheal death rate by 80 percent between 1990 and 2010.

“If you are trying to make decisions and set priorities in your community, and you are focused only on things that aren’t working, then you can quickly end up in this cycle of always chasing the most obstinate problems instead of looking to areas where there’s a possibility of progress and trying to mirror that progress,” Heisel told Devex. “The data show there are success stories happening all the time, so it’s about putting a narrative around that and finding out what worked and whether it is replicable.”

The growing emphasis on data driven development presents an opportunity for global development professionals to learn from and perhaps even replicate the successes of the best performers within a data set. But that can only happen once they learn how to take a positive deviance approach, identifying the people or policies that defy the norm and achieve better outcomes as result, as a starting point to determine what is working.

Photo by: Anders Sandberg

Learning from the best performers in data sets

The experts who spoke with Devex emphasized that finding systematic data that can be trusted is easier said than done. Groups such as the Institute for Health Metrics and Evaluation work with researchers, journalists, and policymakers to find solutions oriented outcomes in data sets. Other data sets filled with data outcomes that are better than expected, if you know where to look, include the World Development Indicators from the World Bank and the UNESCO Institute for Statistics database.

“Assuming you have real data, with a distribution of scores that is reasonably ‘normal’ (i.e., at least vaguely resembles a bell curve), and that distribution represents meaningful scores on some outcome of interest (e.g., lives saved, dollars saved, carbon emissions mitigated, etc.), you would of course start by looking at those on the high end of the distribution,” Jack Glaser, a professor at the Goldman School of Public Policy at the University of California, Berkeley, wrote to Devex by email. But to identify those data points that are performing categorically differently, you have to direct your attention to discontinuities or gaps in an otherwise fairly continuous distribution.

Regardless of how the data is presented, identifying the outlier is the easier step, before the more challenging step of figuring out how or why that country or person or intervention did better than its counterparts. But that is where real insights emerge.

For example, Vietnam was the subject of an April 2016 paper from the World Bank Group exploring what is working in education. Crossnational data from the Program for International Student Assessment test demonstrated Vietnam not as a top performer but as a clear outlier among other lower-middle-income countries. But the authors dove into a number of details not present in the data to determine the factors such as school infrastructure and parental involvement that resulted in this performance.

“Often, the practitioner on the ground wants to know not just that intervention X worked in context Z, but wants to understand the underlying reasons as to why the intervention worked and the specific steps taken to implement changes,” said Pallavi Nuka, associate director of Innovations for Successful Societies at Princeton University.

During the selection phase, ISS reviews news reports, policy documents, and academic research to determine whether what the data suggested might be a best performer would in fact make for a good case study that others can learn from.

Scaling best practices within a community

In 1990, Jerry and Monique Sternin arrived in Hanoi, Vietnam, where two-thirds of children between the ages of 1 and 4 were malnourished, to open an office for the NGO Save the Children. The couple wondered if “positive deviance,” a term coined by Tufts University nutrition expert Marian Zeitlin several years prior, might offer a way forward. Rather than focusing on what was wrong within a community then fixing it from the outside, they would work with community members to identify what was already working then figure out how to amplify it from within.

When health volunteers weighed children across four villages selected for a nutrition baseline survey, they found that some children from very poor households were well nourished. Through interviews with community members, they learned about best practices such as adding greens from sweet potato plants or shrimp and crab from the rice paddies to meals, feeding children more than twice a day, or washing their hands before eating. After a two-year pilot project where these community members adopted the practices of those parents, malnutrition decreased by 85 percent, and the Positive Deviance approach scaled nationwide.

“We operationalized the concept of positive deviance that had been used in research and made it a tool that can be used in development,” said Monique Sternin, who co-authored “The Power of Positive Deviance: How Unlikely Innovators Solve the World’s Toughest Problems.” Now, she is an adviser to the Positive Deviance Initiative, which aims to amplify this approach through workshops, trainings, and other convenings, including an upcoming conference celebrating 25 years of the Positive Deviance approach in Copenhagen, Denmark.

The four stages of the Positive Deviance approach are defining the problem, discovering the norm, determining the behavior of the best performers, figuring out the what and the how, then spreading the results, said Lars Thuesen, founder of the Welfare Improvement Network. He has applied the Positive Deviance process to transform the prison system as head of strategy and innovation for the Danish Ministry of Justice and is now in talks with the International Federation of Red Cross and Red Crescent Societies and the United Nations Development Program about applying the approach to the question of how refugees can successfully adapt to their host countries.

“My experience is that sometimes in the positive deviance process the narrative comes before the hard data but building data along the way is crucial,” he told Devex. “We ask the communities what their most pressing challenges are and what they are doing about them and we gather the data to build a baseline.”

Driving attention toward what works in development

Development Progress, a project of the Overseas Development Institute, released a report earlier this year called “10 things to know about progress in international development.” The publication provides a picture of what progress was made and how it happened in case studies ranging from agriculture and Burkina Faso to maternal health in Nepal.

“The project was borne from a realization that while much of the research and analysis that emerged from the Overseas Development Institute suggested highly positive and encouraging trends, these were often buried in research reports that focused more extensively on the ongoing challenges and problems,” Katy Harris, who leads communications at Development Progress, told Devex.

The global development community was failing to connect the dots between signs of progress, let alone have those stories about what is working reflected in the public discourse, she said. But that is starting to change.

Another example of an initiative that is bringing an evidence based and rigorous approach to analyzing progress in global development is the Global Delivery Initiative, a collaboration across the international development community, led by the World Bank.  The initiative draws in part on research from the Science of Delivery at the World Bank Group, which is developing hundreds of case studies to help partners learn what has made success stories possible in one context and what elements of their approach might be translated to other contexts.

There are growing examples of content platforms such as Impatient Optimists, the blog of the Bill & Melinda Gates Foundation, using anecdotal or data driven examples of positive deviance to drive their coverage. And World’s Best News, a collaboration between the United Nations, the Danish development agency DANIDA, and 100 Danish development organizations and 90 corporate partners, is devoted to publishing news about progress in development.

“We’re so caught up with those places or those contexts where the need is the greatest that sometimes it’s hard to shift our focus our attention to those contexts where the need is less because they’ve managed to resolve those problems,” Nuka said.

But by learning how to identify the outliers that succeed against the odds, global development professionals can transition from seeing only the worst or weakest to finding the best or strongest and letting those effective responses drive their insights and decisions.

“I see it all as part of this larger push to create policies and development policies that are actually based on solid evidence on what works and what doesn’t work in development,” Nuka said.

With potential to change the trajectory of crises, such as famines or the spread of diseases, the innovative use of data will drive a new era for global development. Throughout this monthlong Data Driven discussion, Devex and partners will explore how the data revolution is changing our approach to achieving development outcomes and reshaping the future of our industry. Help us drive the conversation forward by tagging #DataDriven and @devex.

About the author

Catherine cheney devex

Catherine Cheney

Catherine Cheney covers the West Coast global development community for Devex. Since graduating from Yale University, where she earned bachelor’s and master’s degrees in political science, Catherine has worked as a reporter and editor for a range of publications including World Politics Review, POLITICO, and NationSwell, a media company and membership network she helped to build. She is also an ambassador for the Solutions Journalism Network and the Franklin Project at the Aspen Institute.