PD Practitioner: Ms. Borton (Infection Disease Control Nurse)
Location: Pittsburgh, PA
“If you asked staff two years ago who is in charge of infection control, they would say it’s the infection control professionals. If you ask now, they’ll say they are, and they are comfortable making suggestions and asking how to fix things. They have truly taken ownership of this effort.”
Sector: MRSA
Organization: Virginia Health Services
PD Practitioner: Jon Lloyd (MRSA Prevention Coordinator)
Location: Pittsburgh PA, USA
“PD has contributed two additions* to the old adage: "What I hear, I forget. What I see, I remember. What I do, I understand." (PD additions) *What I do, I own and I use it and improve on it. *What WE co-create, WE own and the process builds trustful relationships that foster learning together and self-sustaining improvements because WE own them”.
Sector: Girl’s access to Education in Ethiopia
Location: Ethiopia
PD Parents’ Success Messages:
“I want to send both my boys and my girls because they are equally my children.”
“Flying an airplane or driving an automobile is not through inheritance, but through education.”
“An educated person is always gaining, but an uneducated person is always losing.”
“Girls are more costly than boys. Girls do not just wake up in the morning and go to school like boys, they want to wash their face, put some lotion, and wear some decent clothes which is most of the time difficult.”
PD Girl Students’ Messages:
“I deal with the challenge [feeling shame for being poor] by not seeing those students of wealthy families and living according to the standard of my family”
“I will tell the child to be strong and bear all the problems that he or she faces and finish schooling to get a job.”
“I want to be a teacher. My teacher used to be a student just like me and now that he is grown he can support himself by being a teacher and I want to do just like that.”
“I will advise parents to go to Erre town and see all the doctors and teachers, etc, and ask them if you want your children to be just like these people they need to be educated and for that they need to sacrifice.”
Author: Cole Zanetti, DO, MPH
Family Medicine & Preventive Medicine Physician
I am from a small town called Otisville, New York made up of about 800 people. My mother was a deli manager, my father a linemen that fixed electric poles. Neither went to college. My grandmother who was a music teacher in a local school helped raise me and my younger sister. I went to an osteopathic medical school in Texas and during my last year my grandmother became ill. It was the first time that I was able to see the healthcare system through the eyes of a family member, a loved one, not a physician. Due to a key medication mistakenly not given my family and I had to see my grandmother so confused she could barely recognize us. Her wishes and our families’ wishes were not considered as the same weight as the "experts."
From that point on, a new understanding of what expert meant began to grow. I decided to go to Dartmouth for family medicine and preventive medicine residency because it offered an opportunity to test real change in our healthcare system. During this time I had the honor to dive deeper into positive deviance where I discovered a new world of untapped, impassioned, brilliant leaders that not only could change our healthcare but our community and our hearts. I am now working in Denver as a Clinical Innovator with Iora Health applying these same principles for Denver's geriatric population. Making sure that everyone's grandparents and families are listened to, cared for, and respected the way they deserve to be. I have so much to learn from them.
Linkedin: linkedin.com/in/colezanetti Twitter: @ColeZanettiDO
Author: Michèle Dabaghian
M. Dabaghian Advisory,
International Marketing & Communications, Change Management & Business Development
Michele is a multicultural and versatile senior advisor in international business development, sales & marketing and change management with a proven track record of successful achievements across the Middle East, India, the Gulf Cooperation Council, European and African countries.
I first came across the concept of Positive Deviance (PD) in the context of the thesis that I wrote as part of the CCC Consulting and Coaching for Change course 1.
I had decided to explore how Saudi Arabian women become leaders in their country. My interest in this topic emerged in light of the ongoing reforms which have been revolutionising the Kingdom of Saudi Arabia since 2017, when the arrival of the 32 year old Crown Prince Mohamed Bin Salman instigated numerous decrees that would allow Saudi Arabia to diversify its oil-driven economy. A series of social reforms has begun to ease women’s condition in this religious state that is underpinned by Wahabism – a radical form of Sunni Islam.
These newly-promulgated decrees cover civil and social aspects of life, such as lifting the ban on women’s driving, allowing them to attend sporting events in the national stadium, etc.
In addition, it’s important to note that as part of the 2030 Vision of the Kingdom2, the female workforce is envisaged to increase to 30% by 2030. (vs. 17% in 2017)
When I started exploring existing literature around women’s leadership in Saudi Arabia, I was struck by the fact that despite the stringency of the Saudi regime and its cultural constraints, some women had been successful over the last few decades in becoming business leaders in one way or another. I realised I could not ignore these exceptions, the ‘silver lining’, those few outliers who had somehow managed to manoeuvre within or alongside the system to become successful leaders and entrepreneurs – and yet remain in tune with their society, proudly claiming their culture and their national values. This intriguing question led me to consider the potential existence of an underlying PD behaviour within the system. In order to find an answer, I focused my research question on how a minority of Saudi women leaders build and preserve their identity in the context of the prevailing socio-cultural constraints.
Although I had not approached this subject from an interventional perspective, I believed that using the PD methodology of investigation would help me explore how the journey of some Saudi women enabled them to overcome resignation and fatalism - despite the fact that their life experiences remain enmeshed in a complex social system that could prevent such achievement.
I knew that the key to unlocking these ideas would be found at the heart of women’s life stories. To explore these, I spent 15 days in Saudi Arabia and I chose the ‘life narrative’ interview process to talk to 19 women leaders of different ages (28 to 58) in Jeddah, Khobar and Riyadh. The ‘life narrative’3 interview process invites participants to consider their lives as a book, enabling the emergence of key moments, people, influences etc, through their story-telling.
I speak Arabic, the language of their heart, which gave me privileged entry to their confidence and access to their innermost stories. I used the PD investigation method of open listening, remaining flexible and respectful of the sensitivity of the information that they were sharing with me. At times I allowed myself to admit my own vulnerability and share my own stories, which created a safe space for them to express their own emotions. As a result, I was able to collect extensive data about the women’s childhood, their families, their education, their lifestyle, their hopes and fears and also their successes as leaders in the patriarchal society of Saudi Arabia.
I had embarked on my research with the assumption that each Saudi woman leader would be a ‘warrior’, fighting for her dream against the constraints of her society. What I discovered was that each of the 19 women demonstrated agency and determination to become leaders through their resourcefulness, diplomacy and ability to manoeuvre around the cultural limitations.
I also discovered that behind each woman stood a strong ‘pillar’, in the form of her father or a fatherly figure, which was another surprising finding. I had assumed that Saudi fathers would be obstacles to their daughters’ fulfilment, whereas I found that they shielded them from the constraints of their society and encouraged their education, allowing them to travel and obtain international degrees, and work in gender-mixed environments.
I found myself wondering: who actually is the Positive Deviant? The daughter? Or the father? I am tempted to speculate that the father demonstrates equal PD behaviour, fuelled by a strong desire for his daughter to become a female leader in Saudi Arabia and a willingness to support her self-realisation.
The PD methodology provided a helpful framework to explore, design and carry out my research. Furthermore, it gave me guidance on how to conduct myself in the interview process, for example refraining from using leading questions, jumping to conclusions, interrupting and giving advice, or allowing my personal biases to contaminate the integrity of the narratives.
Finally, the Saudi Vision 2030 places great importance on growing, educating, developing and enabling a new generation of women leaders. My research took place over 3 months in 2018, reflecting a moment in time at the genesis of this nationwide initiative. These preliminary findings show that beyond the Saudi culture and its societal paradigms, the importance of the family culture is at the heart of the solution.
I believe a PD intervention involving other participants, including women and their fathers, mothers, family members and their support systems, would provide an interesting opportunity to expand the solution space.
1 Consulting and Coaching for Change is a Mastère Spécialisé degree which is run jointly by the Said Business School (Oxford University) and the HEC in Paris
2 http://vision2030.gov.sa/en
3 (McAdams, 2001)
McAdams, D. P. (2001). The psychology of life stories. Review of General Psychology Review of General Psychology, 5(2), 100–122.
Michele Dabaghian
+33783618349
Author: Lars Thuesen
Founder and Change Leader
Welfare Improvement Network
Lars Thuesen is a change leader with over 20 years of experience as a leader and senior civil servant, facilitator and consultant in the public sector. In his work the focus is on what already works well to create sustainable solutions in the communities. He leads and facilitates change processes combining different co-creation and community based approaches to obtain the best possible impact.
My team and I have been fortunate to help facilitate solving complex social problems using the positive deviance approach for the last 12 years, firstly with the Danish Prison Service, later with UN agencies, international and local NGO’s in the Balkans and Palestine. Here are 3 key things we have learned over the years:
Let go of control – from managers to leaders and facilitators of social change
Enlarge solution spaces by distributing ownership at multiple levels
Community involvement in all phases of the innovation processes: communities define problems, discover PD solutions, and develop monitoring tools to keep track of progress
1. Let go of control – from managers to leaders and facilitators of social change
In 2007, as newly-appointed head of strategy and organizational development in the Danish Prison Service, my team and I faced numerous challenges. The reputation and image of the prison service was at a low point. We were being criticized by politicians, the media, the trade unions, and even, internally, by our leaders and staff. Our CEO wanted my team to present a solid plan for change. We had tried several change initiatives previously, but nothing had worked effectively and could be sustained.
During the summer of 2007, I met PD co-founder Jerry Sternin and change leadership scholar and author, Richard Pascale, while participating in an executive masters’ program at Oxford University in the UK. Jerry introduced us to Positive Deviance (PD). I came away truly inspired and also puzzled, because I knew that if my team were going to test and implement this approach, we needed to unlearn or at least let go of a lot of our normal ways of working and be open to new mind-sets tools and innovation processes. I called Jerry and we decided to bring PD to Denmark and initiate a pilot project in the prison service. My colleagues were highly skeptical, but I managed to persuade them to give PD a try.
Though facing a rough beginning, the process and results were amazing. The Innovation team and I gradually learned to become experts in being non-experts, meaning being able to facilitate processes where communities (guards, social workers and inmates) in the prisons were asked how they saw problems that kept them awake at night. We helped to flip problems to discover what behaviours were already practiced successfully by community members. We ‘gave work back to the people’, which at the time was highly unusual. Communities in the prisons identified and upscaled PD behaviors themselves. Something we had never tried before. The results speak for themselves: e.g. reduction of threats and violence among inmates and against staff, improved relationships between inmate and staff, improved employee satisfaction. See this link for more information about the prison case: https://docs.google.com/viewerng/viewer?url=http://win-org.eu/onewebmedia/ComplexityUnravelled.pdf
A prisoner’s heavily-tattooed hand on the guard’s shoulder at Nyborg maximum security prison, showing the high degree of trust and relationship building. Source: Personal files of the author used with permission.
2. Enlarge solution spaces by distributing ownership at multiple levels
After 15 years of serving as a senior manager, I decided to leave the prison service in 2014. I wanted to explore more ways to help people in vulnerable communities to solve complex social problems using asset-based social change approaches to disseminate and upscale solutions of ‘what already works well’.
In Moldova, we have been helping UN Women and partners to accomplish their goal of reducing violence against women, which in Moldova is a serious problem rooted in cultural norms with almost 7 out of 10 women experiencing some kind of violence. The PD team has since 2015 managed helping communities discover positive champion behaviours among survivors of violence, police officers, social workers and even former aggressors and upscaled them with impressive results.
A key principle has been a ‘if it is about me – not without me’ philosophy. Because violence is a very complex and relational behavioural problem, it has been very important to involve all relevant stakeholders at different levels. Therefore, a key driver of progress has been the ability to enlarge solution and innovation spaces by engaging relevant partners and community members at multiple levels. And even politicians in the parliament. It has been possible to psychically bring people together from different sectors and levels to have conversations about change. But also, in terms of changing perspectives and mind-sets.
We have experienced that a combination of internal and external change facilitators is a powerful driver for positive change.
Women positive champions: survivors of violence and supporters demonstrating in Moldova. Source: UN Women used with permission.
Read more about the ending violence against women case here: Eliminating Violence Against Women in Moldova with PD
3. Community involvement in all phases of the innovation processes: communities define problems, discover PD solutions, and develop monitoring tools to keep track of progress
Once successful PD behaviours have been discovered and unraveled, it is crucial to help communities to disseminate and upscale. Thinking of effectively tools of keeping track of success evidently comes to mind. As professionals we usually define indicators for success and impact. It is in our DNA. A positive deviance innovation process involves community stakeholders deeply in defining criteria for success and performance indicators. That is different from traditional change approaches. This can be done by helping communities develop scorecards that can be used as supporting structures for dialogues among community members as they monitor the progress of change.
For example, during workshops in Gaza and the West Bank in 2018, local NGO’s and we helped community members develop quantitative and qualitative indicators – so-called community scorecards and tools – so they can keep track of upscaling of positive champion behaviours to reduce early and relative marriages, improve women’s heritage rights, and improve sharing household work. Community members also agreed to meet monthly or bi-monthly with updated scorecards to discuss progress.
Draft scorecard developed and presented by community members in Gaza, Palestine – not measuring and evaluation experts. Men and women for gender and equality project spearheaded by UN Women and NDC (local NGO). Source: personal files of the author used with permission.
Read more about the UN Palestine Innovation Labs here: A UN Innovation Lab for Palestine
A major event during these years has been organizing the International Positive Deviance Conference: Past, Present and Future in 2016 with the help of many, many good people. 120 PD enthusiast from more than 20 countries met for a week in Copenhagen, Denmark to share experiences and discuss the future of the PD approach. Take a look at conference website to learn more, watch videos and presentations: http://pdcph16.com
For more information, please contact Lars Thuesen: [email protected] or http://win-org.eu/english/index.html
Author: Mohammad Shafique
PD Facilitator, Behavior Change Communication Specialist
Before entering into a community, try to understand its social, political and cultural context and understand the dynamics of the community very well
Working with community is fun, it’s a great learning opportunity, therefore, take it as a privilege and enjoy this interaction
Always go as learner and learn about their culture, traditions, behaviours and the overall context
Respect culture and values of the community and try to build on these cultural events to disseminate the positive behaviours of the community
Always consider that the community is the expert; they know about their issues, problems, areas and what constitute these issues. Therefore, always engage them as ‘active’ partner to address the problems together
Be inclusive and engage all the segments of the community in the PD process. Avoid any discrimination on the basis of social class, ethnicity, gender or geographical distance. Provide everyone equal opportunities to be part of the project to ensure their ownership
Positive Deviance approach builds the capacity and self-efficacy of the community members so that they could gradually take the lead to solve their issues. Therefore, build their confidence, capacity and skills so that they could take charge and solve their issues without any external help
The PD process takes few weeks to understand the context of the community, therefore, go along-with local leaders, work in the community in a non-threatening way, for example, do not walk through community holding cameras or note books, it makes the community suspicious. Always conduct transact walk empty hand and make the mental notes and when you complete the walk, then sit and take notes.
Respect community’s time and routines and always plan your work when community is available. If you plan your work based on their convenience, they will give you a quality time and you will come up with rich information. But if you go with your convenience, they may want to finish it early or do not give your quality responses.
When you have identified positive deviant individual, make sure, that there is no cultural sensitivity to share their stories using their identify. In case of sensitive topic, always ask their permission to use their identity or names to share their positive behaviours with other community members
Always keep community’s expectation low, do not make false promises or give incentives, it will raise their expectations and they will expect such favours in the future or without incentive they might cease participating
Always wear culturally appropriate dresses and avoid wearing expensive dresses or ornaments as it creates social distance
Use story telling approaches during the PD process and training of facilitators as it helps the communities better understand
Use lots of local games to explain the PD concepts, games help the participants open up and create a very conducive environment for learning
Muhammad Shafique is a specialist in communication and behaviour change with areas of expertise in malaria and dengue prevention and control, maternal and newborn health, and polio eradication. He has worked with Malaria Consortium, Save the Children, and Merlin organzations and in many countries, including Thailand, Myanmar, Cambodia, and Pakistan.
To learn about other individuals with experience working with PD, visit our Facilitators page.