Malaria Consortium has recently published a paper in Malaria Journal which describes our experiences carrying out an innovative approach to malaria control in Cambodia. Originally used to improve nutrition outcomes in the 1970s, ‘positive deviance’ is a problem-solving and community-driven approach to behaviour change that identifies and promotes positive, preventive and health-seeking actions that exist within communities. Once identified, ‘positive deviant’ role model behaviours are then shared by the actual role models or volunteers with the rest of the community in an attempt to improve overall health and reduce cases of illness.
Malaria Consortium is the first organisation to apply this method to malaria control in an elimination context. The results have been promising. Following the end of external support, we conducted focus group discussions and in-depth interviews with community members to assess the effectiveness and sustainability of the approach in reducing malaria. Overall, the approach was well received and created a strong sense of community empowerment. Positive behaviour changes were linked to the intervention, including greater use of nets by forest-goers as well as use of public health facilities for malaria diagnosis and treatment. Volunteers who had been involved in the positive deviance intervention had even continued to conduct activities following the end of the project.
These results suggest that positive deviance is a promising approach that has the potential to engage the community and reduce malaria in elimination settings. Governments and other stakeholders should be encouraged to consider the strategy for inclusion in national strategies.