The Beginnings

The term “Positive Deviance” initially appeared in the nutrition research literature in the 1960s.  The concept of Positive Deviance in nutrition was further refined in the book ”Positive Deviance in Child Nutrition” by Tufts University professor, Marian Zeitlin, Hossein Ghassemi and Mohamed Mansour, published by the United Nations University Press in 1990. Based on solid research, the book documented the existence of healthy children or “Positive Deviant” children in very poor families living in communities with high level of childhood malnutrition. In this book, Zeitlin and her colleagues advocated for the use of this concept to address childhood malnutrition issues at the community level by identifying what was going right in the community in order to amplify it, as opposed to focusing on what was going wrong in the community and fixing it.

In the early 1990’s in Vietnam, Jerry Sternin, , and his wife, Monique, working for the US NGO Save the Children, supported by Save the Children Health Advisor Dr. Gretchen Berggren, experimented with Zeitlin’s PD concept and operationalized it  to eradicate childhood malnutrition  in a sustainable way as mandated by the Vietnamese government. Thanks to the dedicated work of the local organizations working together for the first time (Women’s Union, People’s committee and health services) the community based and owned pilot project was successful in rehabilitating 93% of children and was subsequently scaled up to reach 5 million families in Vietnam. 

Developing the PD Approach: 1997-2001

Based on these early successes, the approach was scaled-up both locally and internationally with the development of a community-based nutrition rehabilitation model called PD/Hearth which was promoted by USAID and other international organizations such as UNICEF.

In 1997, the Sternins moved to Egypt where the PD approach was first applied to another seemingly intractable problem: Female Genital Mutilation (FGM). During the next two years the PD approach methodology was developed to address the failure of local NGOs to advocate against this practice. With the active participation of Egyptians NGOs dedicated to eradicate this practice, “Positive Deviant” individuals such as mothers or grandmothers who refused to circumcise their daughters & granddaughters, priests and sheiks who advocated against the practice and many others who said “NO” to excision,  were identified and interviewed and shared their stories. They became the frontline community based advocates who tirelessly worked side by side with the local NGOs’ staff, resulting in thousands of girls’ circumcision being adverted. The PD methodology became the behavior change strategy in the government program for the abandonment of FGM in 2002 and was scaled up to most governorates in Egypt.

Concurrently the use of the PD approach was applied to Maternal & Newborn health in Northern Pakistan with SCF US with resounding success, not only reducing by more than half the newborn mortality and morbidity in the pilot villages but also promoting better collaboration between men and women in these communities and new breaches in the century old gender segregation.  

Expansion: 2002-2014

Sternins worked at Tufts University Friedman School of Nutrition to establish the Positive Deviance Initiative (PDI) with the mandate to expend the use of the PD approach to different sectors.  With a trained group of PD facilitators, PDI expanded the PD approach to new sectors such as health care, education and child protection and with many organizations over the next decade.  Further funding from the Rockefeller Foundation provided an opportunity to consolidate and disseminate the PD approach through the Positive Deviance website:  For example, in 2010 there were 50 events worldwide where PD was the main topic, 4 books published that featured positive deviance, 1,400 tweets about PD, and 41,000 visitors to the PDI website.

PDI has collaborated with a variety of partners to expand the use of the PD approach. Such collaborators include ministries of health in different countries, foundations and INGOs, UNICEF, Peace Corps, USAID, and the World Bank.

Within the US, PDI collaborated with the CDC, the Veterans’ Administration Heath Services (VAHS), the Plexus Institute and Delmarva Foundation, to apply successfully the use of the PD approach for the eradication and prevention of MRSA. Speared by the high visibility of this project, new PD research in public health and healthcare has flourished. 

During the same period the PD approach was applied in New York City of Public Housing, Children’s Aid Society, by the National Alliance on Mental Illness (NAMI) in Pittsburgh, and the California Department of Education, and teachers’ unions in Merced to address minorities’ failure to graduate from high school.

PDI also benefitted from the active support and collaboration with University of Texas-El Paso which undertook to document and disseminate some of the PD informed projects with the Wisdom Series. During this period dozens of articles about the PD approach and dozens of research articles using the PD concept were published (Link to a bibliography)

Internationally new applications of the PD approach took place in Denmark in the penal system, in the UK in social services, and in the following sectors:  child protection, business and governance. In the field of global health, the PD approach as a behavior and social change approach has been used in malaria prevention and eradication in South East Asia, polio eradication in Pakistan, HIV/Aids in Eastern Africa, and maternal health, to name a few.

The first book, dedicated to the Positive Deviance Approach was published in 2010: The Power of Positive Deviance; How unlikely Innovators Solve the World’s Toughest Problems by Richard Pascale, Jerry Sternin and Monique Sternin.  Jerry Sternin passed away in December 2008 and was given authored the book posthumously.

That same year, in 2010 the first international PD Forum took place in Bali, Indonesia with 145 participants from the South East Asia region. Emergence of new PD networks, either sectorial or regional were identified and supported.

The PD approach is being disseminated in an organic way with the help of sectorial or regional networks. To find the network closest to you or your interests, please check out our full list of Positive Deviance Networks

2014 - Present

In mid-2014, the Positive Deviance Initiative was dissolved. A new international PD Collaborative with an interactive Internet platform, will be officially launched towards the end of 2016. This platform will provide a common place for many different PD networks, a data base of PD facilitation and training resources for each sector and in different region of the world.

A new streamlined PD website directs easily the visitors to training resources, PD bibliography or project descriptions. Any questions pertaining to the website or related to positive deviance can be directed to



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