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Home / Healthcare & Medicine / Care / Capacity Building: Core Competencies for Health Promotion / Undernutrition Project in Vietnam

Undernutrition Project in Vietnam

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14.2
After inquiry, they found three uncommon practices. First, the positive deviant mothers fed their children with sweet potato greens, small shrimps, and crabs. We usually eat sweet potatoes, but we throw away the green’s leaves. But they feed it these leaves to children and small shrimps and crabs. They are freely available from rice fields. You don’t need to go to the sea. And they caught these shrimps and crabs and feed it to their babies. Usually these behaviors were not considered appropriate in the culture of Vietnam but they did it. Second, the mothers washed their children’s hands whenever these children touched something dirty and these mother’s did not aware that they were doing the right thing.
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And these behaviors were found interesting by observation. So sometimes, these behaviors were not recognized as good thing by those who are conducting. Finally, these positive deviant children ate four to five times a day. In Vietnam people eat food twice a day. It is common practice. Where one parent went to the fields, they asked siblings and grandparents to feed two to three times more. Somehow they knew the children’s stomach is small and they needed to eat more frequently. And they did it. These behaviors are all assets of the mothers and did not cost a lot. Well, we can say no cost. Because of this low cost behaviors, it is very sustainable.
164.8
And only after that focusing on 36% of well-nourished children, the NGO started to give care to the remaining 64% who were suffering from under-nutrition. It was a two-week training and they encouraged mothers to do these three behaviors. They didn’t teach a lot about the knowledge. They let mother’s to practice, practice, practice, these three behaviors. When two weeks was enough for them to become like habits. And after carrying out these two-week training, on the last day, the mothers measured the body weight of the children. Among 80% of all the children’s body weight were increased, mothers were very satisfied. They learned they did in the last two weeks was the right thing.
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And because of this evaluation by themselves, they could continue to do this behavior after coming back to their home. Moreover, when a new baby was born, they could continue this practice to improve the nutrition of these babies. Then it was scaled up to more than 250 villages and 15,000 children were saved in seven years. And it scaled up to national level too. This is a surprising success of Positive Deviance approach.

Continue on the previous step, Dr. Jimba is explaining the American NGO team with the undernutrition project. He first compares with the common and uncommon practices. As you can see in the chart. The team conducted their intervention later. The result is a huge success.

He first reveals why the positive deviants were able to remain well-nourished despite the same living conditions. Unorthodox food and hygiene practices were found to be the difference makers, even though the positive deviants themselves were unaware of it. The NGO then trained parents to mimic what the positive deviants did without much focus on the knowledge behind it. Since the methods were simple and had low to no cost, it was easy to scale up and very sustainable. Moreover, allowing parents to evaluate the success themselves, motivated them to continue these practices.

Compare the positive deviant approach and other asset-based approaches. What are its strengths? Despite its effectiveness, it can be difficult to identify positive deviants. Besides this, what are some other challenges one might face when employing this approach? If you would like to share your thoughts please leave a comment in the comments section.

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This content is taken from Taipei Medical University online course
Capacity Building: Core Competencies for Health Promotion
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