PD Basics

What is Positive Deviance (PD)?

Positive deviance (PD) is an improvement and social change methodology that has been used to tackle some of the most intractable behavior-based problems around the world such as childhood malnutrition in developing countries. Of relevance to this project, PD has been shown to be an effective tool to engage healthcare staff and reduce MRSA rates in a recent project involving some US hospitals.

In many settings, one may find that a few at risk individuals follow uncommon,

beneficial practices and consequently experience better outcomes than their neighbors who share similar risks and who have the same resource constraints. These individuals that have unique and beneficial practices can be considered to be ‘positive deviants’1.


An uncommon practice that confers advantage to the people who practice it compared with the rest of their community, is considered to be positive deviant behaviour. Such behaviours tend to be affordable, acceptable, and sustainable because they are already practiced by at risk people, they do not conflict with local culture, and they work1.



1.       Marsh, D., Schroeder, D., Dearden, K., Sternin, J. and M. Sternin. (2004). The Power of Positive Deviance. British Medical Journal, 329: 1177-79.