What is it about?
Positive deviance is an approach wherein learnings from persons who fare better than their peers under similar circumstances are used to enable behavioral and social change. Such behaviors and solutions are likely affordable, acceptable, sustainable, and fit into the socio-cultural milieu. Despite the wide use of positive deviance in many public health programs and research, it has yet to be used to study frontline workers in the context of COVID-19. This study aimed to explore the experiences of frontline workers during the early days of the pandemic and identify the key examples of positive deviance with a specific focus on the earlier days of the pandemic during the first wave in Nepal.
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Why is it important?
This study provides insights into how the positive deviance approach can help identify the solution amid the most challenging circumstances, such as the COVID-19 pandemic in low-resource settings. This study serves as a reminder to policymakers, implementers, and practitioners to be better prepared to avoid a similar crisis and also encourage positive deviance practices in the future. The study also reflected better coordination with the local and provincial government, particularly in remote districts, indicating opportunities for better public health management in Nepal. The findings based on the positive lessons in this study could encourage future positive deviance interventions for frontline health workers in low resource settings.
Perspectives
In any setting, there are people whose uncommon but successful behaviors or strategies enable them to find better solutions to a problem than their peers, despite facing similar challenges and resource constraints. Such behaviors are likely affordable, acceptable, sustainable, and most socially and culturally contextual. Such positive deviances could also have helped identify sustainable solutions to tackle the COVID-19 pandemic amid resource constraints. The positive traits identified in this study included overcoming challenges, finding innovative solutions, learning positive lessons from the crisis, and motivation behind their actions. The key learnings from this study include self-sustainability and timely actions, which can be incorporated in future planning of pandemics and other disasters. Other learnings include efficient management of local resources, which could be incorporated into regular healthcare management practices. The findings also highlighted the policy and implementation gaps in the readiness for the pandemic and the risks the frontline health workers had to go through in resource constraint settings.
Rolina Dhital
Health Action and Research, Kathmandu, Nepal
Read the Original
This page is a summary of: How positive deviants helped in fighting the early phase of COVID-19 pandemic? A qualitative study exploring the roles of frontline health workers in Nepal, PLOS Global Public Health, March 2023, PLOS,
DOI: 10.1371/journal.pgph.0000671.
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