Positive deviance approach in the improvement of child health nutrition practices in Lukulu of Zambia

High rates of unacceptable deaths occur in children under five years mainly due to preventable conditions such as malnutrition. Lukulu a district in Western province of Zambia, records high levels of malnutrition as much as 25%.

The Positive Deviance/Hearth Developmental Approach is an approach which identifies solutions to problems within the environment in which such problems are occurring. This is done by learning unique behaviors of those who are not affected, but are exposed to the same conditions as the others and transferring them to others who are affected by the problem. The approach was employed in Lishuwa community of Lukulu in Zambia with the aim of rehabilitating malnourished children who had no complications or infections. The approach uses the “Behavior Change Theory” which states that there is need for at least twenty one days of practicing a new behavior in order for it to become a habit. In Zambia the introduction of the Positive Deviance/ Hearth approach has been used to identify those behaviors practiced by caretakers of well nourished children from poor communities. The positive practices are transferred to others in the communities with malnourished children. The results from Lukulu indicated improvements in nutritional status, knowledge, attitude/caring and feeding practices during the 12 months of the hearth sessions.

PD/hearth is a possible solution to the management of malnutrition at the community level. The challenge is to determine the extent to which caregivers internalize the positive practices. The ultimate goal is to sustain rehabilitation of malnourished children.